International standard growth charts overestimate stunting prevalence in Nabire and Jakarta, Indonesia, compared to the Indonesian national growth chart

Abstract

Children’s height in Indonesia is increasing slowly and unevenly across the country, with urban areas growing faster than rural areas. Thus, international growth charts may be ineffective for monitoring the development of Indonesian children. We conducted an analytical cross-sectional study on 1,829 children aged 6 to 12 in Nabire and 1,283 children in Jakarta. Anthropometric measurements were obtained and plotted on the Centers for Disease Control and Prevention (CDC) growth charts and Indonesian National Growth Charts to determine which chart is more suitable for monitoring children’s growth in Indonesia. Nabire children were shorter and had lower body mass index (BMI) than Jakarta children, with a mean height difference of 7.03 cm in boys and 6.89 cm in girls (p = 0.001) and a mean BMI difference of 1.66 in boys and 1.39 in girls (p = 0.001). Despite their short stature, more Nabire children had a normal BMI, indicating a healthy nutritional status. Using the Indonesian National Growth Charts, fewer children were classified as stunted or wasted. Most of the short stature observed in Nabire children was not due to stunting; the children showed no signs of malnutrition. The Indonesian National Growth Charts represent the growth of Indonesian children more accurately than the CDC growth charts.