Aschauhof, 24340, Altenhof, Germany.
Human Biology, University of Potsdam, 14469, Potsdam, Germany.
Eur J Clin Nutr. 2018 Dec;72(12):1603-1619. doi: 10.1038/s41430-018-0274-z. Epub 2018 Aug 30.
In view of the ongoing debate on "chronic malnutrition" and the concept of "stunting" as "a better measure than underweight of the cumulative effects of undernutrition and infection (WHO)", we translate, briefly comment and re-publish three seminal historic papers on catch-up growth following re-feeding after severe food restriction of German children during and after World War I. The observations were published in 1920 and 1922, and appear to be of particular interest to the modern nutritionist.
The papers of Abderhalden (1920) and Bloch (1920) describe German children of all social strata who were born shortly before World War I, and raised in apparently "normal" families. After severe long-standing undernutrition, they participated in an international charity program. They experienced exceptional catch-up growth in height of 3-5 cm within 6-8 weeks. Goldstein (1922) observed 512 orphans and children from underprivileged families. Goldstein described very different growth patterns. These children were much shorter (mean height between -2.0 and -2.8 SDS, modern WHO reference). They mostly failed to catch-up in height, but tended to excessively increase in weight particularly during adolescence.
Whereas Abderhalden and Bloch illustrate rapid height catch-up in children from intact social background, Goldstein's observations in orphans and children from poor social background parallel the growth patterns observed in children of modern middle and low-income countries. The historic observations question the current concept of stunting as prima facie evidence of malnutrition and chronic infection, and support the view that "the child's longitudinal growth is largely independent of the extent and nature of the diet".
鉴于目前关于“慢性营养不良”和“发育迟缓”（“比体重不足更好地衡量营养不足和感染的累积效应（世卫组织）”）的概念的争论，我们翻译、简要评论并重新发表了三篇关于德国儿童在第一次世界大战期间和之后严重食物限制后重新喂养时追赶生长的重要历史论文。这些观察结果发表于 1920 年和 1922 年，似乎对现代营养学家特别感兴趣。
阿伯达伦（1920 年）和布洛赫（1920 年）的论文描述了在第一次世界大战前出生并在显然“正常”家庭中长大的所有社会阶层的德国儿童。在长期严重营养不良后，他们参加了一个国际慈善计划。他们在 6-8 周内身高显著增加了 3-5 厘米。戈德斯坦（1922 年）观察了 512 名孤儿和贫困家庭的儿童。戈德斯坦描述了非常不同的生长模式。这些孩子矮得多（平均身高在-2.0 和-2.8 SDS 之间，现代世卫组织参考值）。他们的身高几乎没有赶上，而是倾向于在青春期过度增加体重。
虽然阿伯达伦和布洛赫说明了来自完整社会背景的儿童快速身高追赶，但戈德斯坦在孤儿和贫困家庭儿童中的观察结果与现代中低收入国家儿童的生长模式相似。这些历史观察结果对目前将发育迟缓作为营养不良和慢性感染的第一手证据的概念提出了质疑，并支持了“儿童的纵向生长在很大程度上独立于饮食的程度和性质”的观点。
