2.1. Height

Following the introduction of systems for the classification of malnutrition which differentiate between stunting and wasting (WATERLOW, 1973), and the increased appreciation that stunting of itself may be associated with long-term functional impairment (GRANTHAM-McGREGOR, POWELL and WALKER, 1989), there has been increased interest in factors that determine and control the achievement of height potential (see WATERLOW, 1987). Attempts to explore the relationship on a community-wide basis have produced some insights, but have not provided us with the ability to focus intervention specifically (GOLDEN, 1985; KELLER, 1987; GRANTHAM-McGREGOR et al., 1989). Similarly, specific associations have not been identified in analyses of the extent to which children recovering from severe malnutrition are able to catch up in height (ASHWORTH, 1975; WALKER and GOLDEN, 1988). Therefore, there are important factors operating of which we have little understanding at the present. There are models of producing substantial height with consistency and reliability that might be worthy of exploration: following the use of human growth hormone in children of short stature; in children with sickle cell disease following splenectomy for hypersplenism (EMOND, 1987); and following the treatment of severe trichuriasis (COOPER and BUNDY, 1988). One important feature of each of these conditions is that not only may the children experience substantial gains in height, but the height gain appears to be of high priority, if necessary at the expense of depositing adipose or lean tissue.