ABSTRACT
This chapter examines the importance of both nutritional deficiencies and infectious-inflammatory insults in the context of what might be described as a first principles model of growth regulation. Although it has long been accepted that growth failure can result from multiple environmental influences of which poor nutrition and infection are important, the complexity of the interactions between environmental adverse influences has been recently reviewed by Prendergast AJ and Humphrey JH in terms of a "stunting syndrome". Poor growth in children is currently defined as inadequate height, weight, and weight in proportion to height, based on growth standards. In an Institute of Nutrition of Central America and Panama (INCAP) longitudinal study of infants and preschool children in Guatemala provided with a good-quality protein or energy alone, energy intake was the strongest predictor of both linear growth and weight increase. The chapter discusses the role of nutrition and inflammation on the regulation of endochondral ossification.
