Nonendocrine influences on growth

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This review covers recent data concerning normal patterns of linear and head circumference growth, changes in body composition and shape, and bone mineral accretion in normal infants, children, and adolescents. The importance of the normal pubertal process on bone mineralization is emphasized. The roles of growth-determining genes, exercise, and nutrition are discussed. The long-term adverse consequences of very low (but gestationally appropriate) birth weight and of intrauterine growth retardation on adult height are described. The growth-inhibiting effects of chronic renal insufficiency and inflammatory bowel disease present important therapeutic challenges. On the other hand, asthma that is treatabte by inhaled glucocorticoids does not appear to significantly impair attainment of genetic height potential. Poverty, homelessness. neglect, abuse, and lead exposure result in slow linear growth during childhood.

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