Pediatric Nutrition in Practice

1 Specific Aspects of Childhood Nutrition

Key Words

Weight · Height · Body mass index · Obesity ·

Stunting · Wasting · Growth monitoring ·

Insulin-like growth factor 1

Key Messages

• Growth is a sensitive marker of health and nutrition-
  al status throughout childhood


• Growth monitoring is important both for children
  with disease conditions and for healthy children


• Early growth is associated with long-term develop-
  ment, health and well-being


• Breastfed infants have a slower growth velocity
  during infancy, which is likely to have beneficial
  long-term effects © 2015 S. Karger AG, Basel

Introduction

Growth is a typical characteristic of childhood; it is
also a sensitive indicator of a child’s nutritional sta-
tus. Deviations in growth, especially growth re-
striction, but also excess fat accumulation typical of
obesity, are associated with greater risk of disease
both in the short and the long run. Monitoring
growth is therefore an important tool for assessing
the health and well-being of children, especially in

countries with limited access to other diagnostic

tools. It is also important in more advanced clinical

settings, but is often neglected, favouring more ex-

pensive, sophisticated examinations.

Growth of the Healthy Child

Growth during early life can be divided into peri-

ods: intrauterine, infancy, childhood and adoles-

cence. Each period has a characteristic pattern

and specific mechanisms that regulate growth

( fig. 1 ) [1]. Nutrition, both in terms of energy and

specific essential nutrients, exerts a strong regula-

tory effect during early life, growth hormone se-

cretion plays a critical role throughout childhood

and, finally, growth is modified by sex hormones

during puberty.

Insulin-like growth factor 1 mediates the ef-

fect of growth hormone on growth, but insulin-

like growth factor 1 release can also be inf lu-

enced directly by nutrients. Insulin, which has a

potent anabolic effect on fat and lean tissue gain,

is also positively associated with childhood

growth. Length and weight gain velocity is very

high during the first 2 months after birth, with

median monthly increments of about 4 cm and

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 1–
DOI: 10.1159/

1.1 Child Growth

Kim F. Michaelsen

1