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Growth Plate Modulation Through Nutrition Supports Catch-Up Growth

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Growth Plate Modulation Through Nutrition Supports Catch-Up Growth H ILD OO H D Growth Plate Modulation C ROSS PETERSON, PHD Through Nutrition Supports Regulatory Science & Innovation GROWTH & Abbott Nutrition NUTRITION E Catch-up growth X S P E RT SCIENTIFIC OVERVIEW The height a child achieves in adulthood is the result of dynamic processes that THE GROWTH PLATE OF A LONG BONE IS WHERE Figure 1 CHONDROGENESIS OCCURS occur at the growth plate of long bones.1 Each long bone has at least two growth plates that determine the future length and shape of the mature bone through a process called chondrogenesis (Figure 1).2 Genetic factors like parental height are an important determinant of a child’s height, but environmental factors such as nutrition during childhood also affect bone growth. Nutrition provides the required “building blocks” for optimal growth, including energy, proteins and micronutrients.1 Without adequate nutrition, children will be at high risk of Growth Linear becoming underweight and not achieving their growth potential.3 In times of nutrient deficiencies, the growth plates of long bones conserve growth capacity by delaying senescence. When nutrition improves, growth factors reactivate the growth plates, and growth takes place at a faster-than-usual rate: Figure 2 INTERVENE EARLY TO MAXIMIZE HEIGHT POTENTIAL this type of growth is known as catch-up growth (Figure 2).4 Ultimately, a child’s bone growth velocity decreases to zero (i.e., growth stops) after growth plate senescence in late puberty. SIZE Nutritional Intervention Point About 60% of adult height is achieved within the first 5 years of life, and growth Normal growth Impaired growth continues until late puberty.5 For a child to reach his or her full-growth potential, it Type A catch-up growth is crucial to identify those who fall behind during the active growth interval. Once Bone age at the onset of recovery TIME identified, intervene promptly with complete nutrition to promote catch-up growth. From Roselló-Díez & Joyner. Endocr Rev. 2015;36(6):646-80. APPLYING TO YOUR PRACTICE KEY TAKEAWAYS • Anthropometric measures and comparison with height-for-age • Normally, 60% of adult height is achieved by age 5 years. standards should be done routinely to identify children at risk of • Adverse environmental conditions such as undernutrition may faltering growth. slow growth or even stop it temporarily. • Consider the height of both parents when assessing a child’s • Growth plates close in late puberty, marking an end to the height potential; some children are short due to genetics. opportunity for a child to gain height and achieve genetic • With evidence of faltering growth, intervene promptly with oral growth potential. nutritional supplements and dietary counseling. References: 1. Gat-Yablonski G, et al. Nutrients. 2015;7:517-551. 2. Baron J, et al. Nat Rev Endocrinol. 2015;11:735-746. 3. UN Standing Committee on Nutrition. 6th report on the world nutrition situation. Geneva. 2010. 4. Lui JC, et al. Endocr Dev. 2011;21:23-29. 5. CDC. 2 to 20 years: boys stature-for-age and weight-for-age percentiles. 2000; https://www.cdc.gov/growthcharts/ JP-18452.
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