Which of the following is the reference standard on which classification of protein-energy malnutrition is based –
For national and international comparisons and for monitoring, "reference or standard values" of growth are essential.
The well known reference standards are -

1. Harvard (or Boston) standards

Not in common used
Have been replaced by WHO reference values

2. WHO reference values

Most commonly used reference values for international use.
These values are based on the data assembled by the United States National Centre for health statistics (NCHS).
Classification of PEM is based on these standards.

3. Indian standards

 Are used for Indian children
Values are based on the data assembled by the Indian Council of Medical Research (ICMR)

Note -


The normal, expected value is 50th percentile of the reference value.
When weight for age is <80% of expected (expected = 50th percentile of reference) → wasting.
When height for age is <90% of expected (expected = 50th percentile of reference) → stunting.
Gomez classification
10th percentile of weight for age of ICMR
80% of the 50th percentile of weight of ICMR
80% of the 50th percentile of weight for age of American standard