ESPEYB19 13. Global Health for the Paediatric Endocrinologist Endocrinology (5 abstracts)
SAMRC Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
shane.norris@wits.ac.za Lancet 2022; 399: 17284. doi: 10.1016/S0140-6736(21)01590-7
Brief Summary: This review found that the role of nutrition on adolescent growth and development has been poorly studied. Adolescence is a nutrition-sensitive phase for growth, in which the benefits of good nutrition extend to many other physiological systems.
This article is the first of a Lancet Series on Adolescent Nutrition. Referrals to pediatric endocrinologists very commonly include short/tall stature, early/delayed pubertal development and under/overweight. While pediatric endocrinologists are trained to identify hormonal issues, they are often not trained on the relationships between nutrition and the epigenetic/hormonal factors underlying these conditions during adolescence. One of the reasons is that the information on this topic is scarce. The authors emphasize that the pubertal transition offers a nutrition sensitive window to promote healthy growth (including body composition, cardiorespiratory fitness, neurodevelopment and immune system development).
They provide several examples of studies performed in low- and middle-income countries on the interaction between nutrition and growth. One interesting example was the negative effect of calcium supplementation on linear growth of boys in Gambia, without benefits on bone mineral content. Overall, they suggest that growth and nutrition should move towards integrated system wide approaches over the life course and that research should lead to a better understanding of the relationships between pubertal development and nutrition, physical activity, and metabolic state. This could lead to novel strategies that optimise growth and prevent non communicable diseases (such as type 2 diabetes, osteoporosis and cardiovascular disease) in later life.