Pediatric Nutrition in Practice

Child Growth 3

1

Regulation of Growth

Many factors influence growth. Genetic influenc-
es are strong, but these can be modified by mul-
tiple environmental factors. Ethnic differences
are likely to be caused more by the environment
than by genetic factors. The new WHO growth
standards obtained for 0- to 5-year-old children
from different parts of the world show a similar
growth potential. Basically, under optimal nutri-
tional and socioeconomic conditions, the growth
pattern was the same, independent of geographic
and ethnic diversity (see Chapter 4.1). Other
studies show that with children of families mov-
ing to a country with very different dietary and
socioeconomic conditions, the growth pattern
can change over time (secular trend); within one
generation the growth pattern becomes more like

that in the adopted country. Adult height has in-

creased over the last decades in many popula-

tions. This secular change came to a halt in North-

ern Europe around the mid-1980s, while it con-

tinues to increase in other countries [4]. The age

of puberty differs considerably between popula-

tions, with later onset of puberty in populations

with poor nutritional status.

Nutrition has a central inf luence on growth,

especially during the first years of life. Breastfed

infants grow faster in their first months and are

slightly shorter at 12 months of age, they weigh

less and are leaner than formula-fed infants [5].

Breastfeeding also influences body composition.

Breastfed infants gain more fat during the first 6

months and gain more lean mass from 6 to 12

months of age than formula-fed infants [6]. The

growth pattern of breastfed infants is likely to

Age (years) Age (years)

30

97

90

75

50

25

10

3

90

75

50

25

10

3

3

4

5

6

7

8

9

12

14

15

20

25

Subscapular skinfold – boys (mm)

1357911131517

27

9

8

11

13

15

17

19

21

23

25

BMI – boys

Percentiles

Percentiles

1357911131517

97

ab

Fig. 4. Reference charts (percentiles) for subscapular skinfold (boy) and BMI. Modified after Tanner and Whitehouse
[14] and Nysom et al. [15].

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