|Causes and Mechanisms of Linear Growth Retardation (International Dietary Energy Consultative Group - IDECG, 1993, 216 pages)|
|Guidelines for the study of mechanisms involved in the prevention or reversal of linear growth retardation in developing countries|
The following measurements may detect or be related to a growth response to intervention, or explain the mechanism of stunting or its reversibility.
1. Size and growth velocity during the first 2 years of life measuring recumbent length, lower leg length, weight and head circumference. Length should be measured monthly for the first 5 months of life, every 2 months in later infancy, and every 3 months thereafter for detecting the age at the onset of the childhood growth phase (see paper by Karlberg et al. pp. 25-44).
2. Measurement of the tibial growth plate to explore its sensitivity to the independent variable and its usefulness as an index of linear growth velocity.
3. Changes in trace element status and haematological response to supplementation.
4. Pyridinoline (PYD) and deoxypyridinoline (DPD) in urine as indices of bone collagen turnover.
5. Growth hormone and IGF-I levels in plasma and growth hormone in urine as indices of the hormonal regulation of growth.
6. Incidence of infectious morbidity (gastrointestinal, respiratory, skin).
7. Cytokine response (TNF, IL-1 and IL-6).
8. Appetite and feeding behaviour.