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The National Center for Health Statistics reference and the growth of Indian adolescent boys²

¹ From the Department of Nutrition for Health and Development, World Health Organization, Geneva; the Anthropology and Human Genetics Unit, Indian Statistical Institute, Calcutta; and the Applied Statistics Unit, Indian Statistical Institute, Calcutta.

Background: Few studies describing the growth of adolescents exist because of the difficulties in interpreting anthropometric data in this age group.

Objective: We describe the growth of adolescent boys from West Bengal, India, and assess the adequacy of using the National Center for Health Statistics (NCHS) reference data.

Design: A cross-sectional anthropometric survey was conducted in 818 Bengali boys from middle-class families. Anthropometric measurements were taken on each subject's birthday (±3 d) by use of standard measuring techniques. The NCHS reference data on height and body mass index (BMI) were used to estimate age-specific prevalences of stunting, thinness, and overweight. BMI was also assessed by using British, Dutch, and French reference data. The biological parameters of the adolescent growth spurt were estimated by using the Preece-Baines growth model.

Results: With use of the 5th percentile of the NCHS reference data, the prevalence of thinness was 5 times (50.5%) that of stunting (11.2%). The median curves of the 3 European references lay between the Indian and NCHS samples and also yielded high prevalences of thinness when applied to the study sample. The prevalence of being at risk of overweight was low (4.2%). Mean age at peak height velocity was 13.0 y and peak height velocity was 7.0 cm/y.

Conclusions: The NCHS reference data seem inadequate for this sample. Consideration should be given to developing appropriate reference data based on healthy adolescent populations from different ethnic groups. Issues of maturation-related variation in assessing growth during adolescence should be given particular attention.

Key Words: Growth • anthropometry • adolescents • puberty • maturation • body mass index • India • boys • National Center for Health Statistics reference

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