Do children on macrobiotic diets show catch-up growth? A population-based cross-sectional study in children aged 0-8 years.

Children who are fed alternative and especially macrobiotic diets have been reported to be smaller and weigh less than their peers fed omnivorous diets. To answer the questions: at what age does growth in children on macrobiotic diets slow down, and is there any return to standards later in childhood, a cross-sectional anthropometric study was performed in the Dutch macrobiotic child population aged 0-8 years (n = 243). Addresses were obtained from macrobiotic organizations and from families already participating in the study. Food habits were checked by a structured food frequency questionnaire. Anthropometric measurements included weight, height, mid-upper arm circumference and triceps and subscapular skinfolds. For each sex, age curves were constructed in comparison to standards. For selected age intervals, standard deviation scores (SDS) were tested for differences from the reference after accounting for confounding variables in a multiple regression model. Reported birth weight was 150 g lower than the Dutch reference; birth weight was positively associated with the consumption frequency of dairy products and fish. During the first 6-8 months of life, SDS were not different from the standard except for arm circumference and skinfolds. From 6-8 months onwards, growth stagnation occurred in both sexes, but was most marked in girls. A minimum level of 1 to 1.5 SD below the P50 of the reference was reached by the age of 18 months. Between 2 and 4 years a partial return towards the P50 occurred for arm circumference and, in boys only, for weight and skinfolds, but not for height. SDS of weight, height and arm circumference were higher in children from families with regular consumption of dairy products than in children from families avoiding dairy products.