This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- Wednesday Marie A. Sevilla, MD, MPH, CNSC*
- *Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
AUTHOR DISCLOSURE
Dr Sevilla has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Abbreviations
- BMI:
- body mass index
- CF:
- cystic fibrosis
- CHD:
- congenital heart disease
- CKD:
- chronic kidney disease
- DRI:
- daily required intake
- ESLD:
- end-stage liver disease
- GH:
- growth hormone
- GI:
- gastrointestinal
- IBD:
- inflammatory bowel disease
- MCT:
- medium-chain triglycerides
Practice Gaps
Clinicians should be knowledgeable of the multiple factors that affect nutritional status and cause growth failure in children with chronic disease.
Clinicians should be knowledgeable of the basic elements of nutritional assessment in children who need nutritional support for growth failure.
Clinicians should be aware of the effects of limited dietary intake on nutritional status and growth.
Objectives
After completing the article, readers should be able to:
Determine the pathophysiological factors in childhood chronic disease that lead to growth failure.
Describe components of clinical evaluation and basic anthropometric measurements that are used to monitor nutritional status in children with chronic disease.
Recognize the effects of a restricted diet on nutritional intake adequacy.
Introduction
Growth failure, defined as the inability to reach expected growth potential based on standard anthropometric measurements for age regarding weight and height, is common in chronic childhood disease. Growth failure in chronic childhood disease is multifactorial. Nutritional outcome is affected by baseline nutritional status, disease state, and, rarely, an inherent genetic abnormality. (1) A sign of growth failure is stunting, defined as length or stature below the minimum cutoff for age, usually the fifth percentile. (2) It represents systemic dysfunction during an important phase of physical development and is the hallmark of chronic malnutrition. Related to this is the definition of short stature—a height measurement 2 standard deviations (SD) scores below the mean for age and sex. Wasting, on the other hand, is an indicator of acute malnutrition and is defined as weight-for-height or -length 2 SD scores or more below the mean for age and sex. It usually signals more recent weight loss. (2)
The measurement of height and …
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.
Log in through your institution
Pay Per Article - You may access this article (from the computer you are currently using) for 2 days for US$25.00
Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.