The variation in stature among the people of the world is evident to us all.
Throughout the years, numerous hypotheses have been advanced to explain differences
in stature among populations.
The reason for organizing this workshop is very simple. If we use a low weight
for age as the basis for the anthropometric diagnosis of malnutrition, then in many
countries some four-fifths of the children considered to be malnourished are simply
small in size, with normal weight for height (Table 1).
The process of growth inhibition in children (stunting) leads to "stunted
growth." Stunted growth implies the existence of inhibiting factors without which
growth would have continued unabated according to the genetically determined
growth potential of the individual.
We consider how length measurements taken every 4 or every 8 weeks in infancy
may be used to detect slowing down of growth as a result of nutritional or
other causes. Mixed longitudinal data from 427 children from the Sudan are presented.
The growth of long bones and vertebrae, on which body stature largely depends,
takes place through activities within the growth plate, a zone of dividing cartilage
cells separating the primary from secondary ossification center that deposits substances
containing mineral salts to form the bone matrix.
In a logical approach to the subject of determinants of growth in utero, genetic
influences should be considered separately, since they are fixed at the time of conception
It is generally accepted that adequate nutrition is a prerequisite for normal postnatal
growth. Hormones such as growth hormone (GH), insulin, thyroxine, and
sex steroids play a pivotal role in controlling musculoskeletal growth, as proven
in a number of well-described clinical conditions (Fig. 1).
A universal observation in vertebrate biology is that a low plane of nutrition in
early life slows the rate of growth and, if it persists may result in small stature at
When a wheat plant is grown in soil low in selenium, the result is a normally
sized plant that has a low selenium concentration in its tissues. When a wheat
plant is grown on a soil low in zinc, the result is a stunted plant that has a normal
concentration of zinc in its tissues.
In this chapter, we examine patterns of children's linear growth in Nepal and in
Bangladesh. We then present an analysis of different variables associated with
slowed linear growth; these include the child's sex, the place where the child lives,
the season, the economic status of the household, the ethnic group to which the
child belongs, and illnesses to which the child is exposed.
The general relationships between malnutrition and infection have been recognized
for centuries, but the details of the links have been defined considerably only
during the last few decades. Many of the studies examining the effect of malnutrition
on the response to infection have been reviewed (1,2).
Mental development is a product of the interaction between hereditary and environmental
factors. If one assumes that the brain is the organ for intellectual functioning,
it is important to point out that its development extends over a very long
period of time, the longest of all organs in the body, and is therefore susceptible
to the influence of a great variety of events that might interfere with its normal
evolution: traumas, infections, deprivations, nutritional deficits, etc.
The relationship in poorer, developing nations of the world between small body
size of the adult population and nutritional deprivation during the period of growth
has been discussed at length in previous chapters. Some of the functional consequences
have also been discussed.
When discussing the relationship between stunting and mortality in developing
countries, one has to distinguish two separate issues, (a) Does being stunted, i.e.,
presenting with retarded linear growth, carry an additional risk of dying? (b) Does
stunting, i.e., presenting with deceleration of linear growth, carry an additional
risk of dying? Very little is known on either subject.
Available anthropometric data on different communities around the world
broadly indicate a close relationship between the heights of children (and, for that
matter, of adults) in a community and the level of its socioeconomic development.
The greater the socioeconomic deprivation in a community, the greater, generally,
are the extent and degree of stunting in it.
Adipocyte lipid, 92
Adolescent growth spurt, 123
Adrenal androgen, 116
Adult size, 58
Age group, 35