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  • Title: A comparison of skeletal growth and maturation in undernourished and well-nourished girls before and after menarche.
    Author: Dreizen S, Spirakis CN, Stone RE.
    Journal: J Pediatr; 1967 Feb; 70(2):256-63. PubMed ID: 4289450.
    Abstract:
    A 25 year study comparing undernourished and well-nourished girls found that malnutrition delayed menarche and delayed, but did not stunt, skeletal growth. The Birmingham, Alabama study followed 30 undernourished and well-nourished local white girls from approximately 4 - 19 years of age. The well-nourished girls' diets met the US Daily Recommended Allowances but the other girls' diets were deficient in nutrients especially Vitamin A, ascorbic acid, iron, calcium and animal protein. The girls' height was measured every 3 months, serial sequential roentgenograms were taken of their left hands and wrists every 6 months and the age of menarche of noted. The undernourished group's rate of skeletal maturation was significantly slower premenstrually than the others and the occurrence of menarche was closely related to skeletal maturation. Menarche was over 24 months later in the malnourished group at which time their skeletal maturation was similar to the group at the time of their menarche. The postmenstrual rate of skeletal maturation of both groups was similar. Asymmetry of maturation (the range from the most to the least advanced bones in an individual's hand) was higher in the undernourished group at the earliest age but declined in both groups with age. The well-nourished group reached zero asymmetry at age 18; the malnourished group about two years later. The mean height at maturity of both groups was not significantly different but the undernourished groups' greatest growth spurt was again 18-24 months behind the other group.
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