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Long-term effects of early kwashiorkor compared with marasmus. I. Physical growth and sexual maturation
J R Galler1, F C Ramsey, P Salt
1Center for Behavioral Development, Boston University School of Medicine, MA 02118.
Insights
Children with a history of marasmus experienced delayed menarche but showed catch-up growth. Kwashiorkor did not impact sexual maturation or growth in Barbadian girls, while boys showed no differences regardless of early childhood malnutrition.
Area of Science:
- Pediatrics
- Human Growth and Development
- Nutritional Science
Background:
- Early childhood malnutrition, specifically kwashiorkor and marasmus, can have long-term effects on physical growth and sexual maturation.
- Follow-up studies are crucial to understand the recovery trajectories and lasting impacts of severe childhood undernutrition.
Purpose of the Study:
- To assess the long-term physical growth and sexual maturation in Barbadian adolescents with a history of kwashiorkor or marasmus.
- To compare the developmental outcomes of malnourished children with healthy, age-matched peers.
Main Methods:
- A longitudinal follow-up study involving adolescents aged 11-18 years.
- Participants included girls and boys with prior kwashiorkor or marasmus, compared to a control group of healthy children.
- Measurements included physical growth parameters and sexual maturation indicators (menarche, Tanner ratings).
Main Results:
- Girls with a history of marasmus showed delayed menarche but exhibited accelerated catch-up growth.
- Girls with a history of kwashiorkor did not differ significantly from controls in menarche, sexual maturation, or physical growth.
- Boys with histories of either kwashiorkor or marasmus showed no significant differences in physical growth or sexual maturation compared to controls.
Conclusions:
- Severe early childhood malnutrition, particularly marasmus, can lead to delayed sexual maturation in girls, though catch-up growth may mitigate size differences.
- Kwashiorkor appears to have less impact on long-term sexual maturation and physical growth in girls compared to marasmus.
- Adolescent boys with a history of severe malnutrition do not exhibit significant long-term deficits in physical growth or sexual maturation.
Abstract:
Physical growth and sexual maturation were measured in a follow-up study of Barbadian girls and boys aged 11-18 years with histories of kwashiorkor (n = 54) or marasmus (n = 56) in their first year of life. They were compared with healthy neighborhood children matched by sex and age who had normal patterns of growth in early childhood (n = 59). Girls with histories of marasmus had significant delays in the onset of menarche compared with healthy comparison girls. However, their rate of growth during the previous 2 years was accelerated, and the differences in size were smaller than at the earlier testing, confirming catch-up. This pattern was not evident for girls with histories of kwashiorkor, who did not differ from the healthy comparison girls on either onset of menarche, Tanner ratings of sexual maturation, or measures of physical growth. In contrast, boys with histories of kwashiorkor or marasmus did not differ from healthy comparison boys in physical growth or Tanner ratings at these ages.