Defects in resting metabolic rates and mitochondrial respiration in Kwashiorkor and dietary obese rats

Summary Resting metabolic rates have been measured and compared with hepatic mitochondrial respiration in Kwashiorkor and diet-induced obese weaned rats. In Kwashiorkor, resting metabolic rate was 21% lower than the value of controls, while that of the obese rats was 14% higher than in control animals. The resting metabolic rate for Kwashiorkor animals was 50% of the predicted basal metabolic rate (BMR), whereas that of the obese rats was 23% higher than the predicted BMR. The mitochondrial oxygen consumption patterns, using malate plus glutamate or succinate as respiratory substrates, revealed that the resting respiration (state 4) was 23.9% higher in Kwashiorkor and 29.1% higher in obese animals, while the active (state 3) respiration was 34.8% lower in Kwashiorkor and 43.3% lower in obese rats compared to controls. The respiratory control ratios (RCR) were 51.1% and 43.8% in Kwashiorkor and obese rats, respectively, relative to the values in control rats. It is concluded from these studies that Kwashiorkor disease and diet-induced obesity appear to interfere with oxygen utilization at the level of state 3 mitochondrial respiration, which is markedly decreased when compared to the values for control animals.Abbreviations BMR basal metabolic rate - CPD commercially produced diet - KWD low protein, high carbohydrate diet - OBD high fat diet - PEM protein-energy malnutrition - RCR respiratory control ratios Present address: Department of Biochemistry, University of Nairobi, P.O. Box 30197, Nairobi, Kenya     

Skeletal development of non-institutionalized children with low Intelligence Quotients

Children of both sexes with mild mental retardation show delays in skeletal maturation and cortical bone growth, but boys in general are more affected than girls. Skeletal age for both sexes is below normal in the younger age groups, but approaches normality at adolescence. None of the measures of IQ is significantly correlated with any of the regional measures of skeletal age in the hand-wrist. The approach toward normality of skeletal development in this population at adolescence is reflected in their normal time of first appearance of the adductor sesamoid. Anomalies of the hand-wrist reflect irregularities in comparing normal and low-IQ children. Only brachymesophalangy V displays significantly higher frequencies in the low-IQ groups. Due to the cross-sectional nature of the study and the different methods of classifying anomalies, little can be said about the other comparisons. Growth in cortical bone reflects a consistent trend for both the humerus and second metacarpal. While measures of total diameter and total cross-sectional area do appear to be below normal standards, the measures of the marrow do not. This finding accounts for a decreased cortical bone thickness and cross-sectional area in the low-IQ sample. All measures of the humerus correlate significantly with two IQ scores in the boys and all three scores in the girls. Measures of the total metacarpal and marrow area show significant correlations with the three IQ scores among low-IQ boys, while only measures of total metacarpal area show significant correlations with verbal IQ in low-IQ girls. The degree of mental deficiency, then, is only irregularly associated with deficits of bone size for age.     

Serum IGF-1, IGFBP-3 and growth hormone levels in children with congenital heart disease: relationship with nutritional status, cyanosis and left ventricular functions

In this study we aimed to evaluate serum insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3) and growth hormone (GH) levels in children with congenital heart disease (CHD) and to determine if these parameters have any relationship to the cyanosis, nutritional status and the left ventricular systolic function. This study is prospective-randomized study which conducted in 94 CHD patients (36 girls and 58 boys, aged between one 1-192 months, 19 cyanotic CHD and 75 acyanotic CHD) and age-sex matched 54 children (26 girls and 28 boys) with no CHD. In the study group, 37 out of the 94 CHD patients (39.4%) and 16 out of the 54 controls (29.6%) had malnutrition. The difference between the cyanotic and acyanotic patients in respect to malnutrition was significant (57.9% and 34.6%, p<0.05). Serum IGF-1 levels were lower (41.8+/-3.9 microg/L, 106.9+/-17.9 microg/L respectively, p<0.001) and GH levels were higher (6.43+/-0.9 ng/ml, 3.87+/-0.5 respectively, p<0.05) in CHD patient group than the controls. Serum IGF-1 levels were significantly lower in cyanotic CHD patients than the acyanotic patients (17.2+/-3.2 microg/L, 48.7.0+/-4.6 microg/L respectively, p<0.001) and serum IGF-1 levels were both lower in acyanotic and cyanotic CHD patients than the controls (p<0.001 for both). Serum IGF-1 and GH levels were similar between the well-nourished CHD patients and CHD patients with malnutrition (p>0.05). In total study group, the most effective factors on serum IGF-1 levels was presence of CHD (p<0.001), in CHD patients, the presence of cyanosis is the most effective factor on serum IGF-1 level, the presence of malnutrition is the most effective factor on serum IGFBP-3 levels (p<0.01). In the acyanotic, cyanotic, and the entire CHD patient groups, we find no correlations between the serum IGF-1, IGFBP-3 levels and left ventricular systolic function measurements. But serum GH levels were negatively correlated with diastolic left ventricular interseptum diameter, diastolic left ventricular mass and left ventricular end-diastolic volume measurements in CHD patients. In conclusion, we determined that the most important factor on serum IGF-1 levels is cyanosis. Reduced IGF1 levels and decreased left ventricular mass with an elevated GH levels in CHD patients and these findings are prominent in the cases with cyanosis and malnutrition. For this reason we believe that chronic hypoxia plays a significant role in the pathogenesis of malnutrition and also we believe that IGF-1 deficiency seen in CHD patients may be responsible in the etiology of the decrease in left ventricular mass independently from GH.     

Obesity and Malnutrition in a Shantytown Population in the City of São Paulo,Brazil

To investigate the prevalence of obesity and malnutrition in the poor Brazilian population we conducted a survey on the socioeconomic and nutritional status of 535 families (comprising 2 411 individuals) living in shanty towns in the city of São Paulo. There was a 30% prevalence of malnutrition in the children, with chronic malnutrition as the most predominant problem. The prevalence of obesity was 6.4% in boys and 8.7% in girls. Overweight and obesity associated with stunting was found in 5.8% of boys and 6.8% girls. Adolescents showed a higher prevalence of malnutrition when weight-for-age distribution was used (boys 46.4%, girls 40.2%), but a right deviation in the distribution was observed with an increase in obesity and a decrease of malnutrition was observed (obesity was 21% in girls and 8.8% in boys; malnutrition was 15.5% in boys and 12.6% in girls) when the weight-for-height adjustment was made. Stunting was the most predominant type of malnutrition in both sexes. Obesity associated with stunting was more common than obesity without stunting, both in younger children and adolescents. Adults had a higher prevalence of obesity than malnutrition according to both the Metropolitan Life Insurance tables (1.7% of undernutrition, 16.7% of overweight, and 14.1% of obesity) and Body Mass Index (8.5% of undernutrition, 21.9% of overweight, and 14.6% of obesity). There was an increase in the percentage of obese children when at least one adult in the family was obese and an increased percentage of malnourished children when undernourished adults were present in the family. Obesity among the adults of the family decreased the occurrence of malnutrition among the children. In 9% of families there was a coexistence of obesity in the adults and malnutrition in the children. These results demonstrate a coexistence of malnutrition and obesity in poor urban Brazilian communities.     

Bone maturation reflects the secular trend in growth

The aim of this study was to compare a series of X-rays from the mid-1990s with another taken in the mid-1980s in order to test the possibility that environmental causes affect the skeletal maturation. The first group of subjects included a total of 1,057 girls and 1, 055 boys participating in a project for Japan and China health research in 1986. The second group of subjects included a total of 382 girls and 629 boys participating in a project for bone mineral density research in 1996. The skeletal maturity score using the Tanner-Whitehouse 2-RUS method was used as the fundamental datum. This score was used to represent each group. The Wilcoxon's rank sum test was applied to examine the significance of the difference between the 1986 and the 1996 groups. The 1996 children had not matured more than the 1986 children; children in both groups reached the given scores at almost the same ages. In girls, there was little difference between the groups at 7 years of age, but it declined from 8 years of age onward. Some apparent differences arose at ages 14 and 15, but ceased by age 16 in girls. In boys, no differences were found in those aged from 7 to 17 years, except for 12-year-olds. We did not detect much of a difference in bone maturation between the 1986 and 1996 groups of children, and no differences in height during the same period. Our findings suggest that bone maturation reflects the secular trend in growth.     

Treatment of central precocious puberty with an LHRH agonist (Buserelin): effect on growth and bone maturation after three years of treatment

The LHRH analog Buserelin was used to treat 27 children (21 girls, 6 boys) with central precocious puberty. Nineteen patients had idiopathic precocious puberty and 8 had organic lesions (hamartoma, hydrocephalus or suprasellar arachnoid cyst). All patients received 20 or 30 micrograms/kg/day s.c. of Buserelin, and we obtained plasma E2 less than 20 pg/ml, vaginal maturation index less than 30 in girls or plasma testosterone less than 0.3 ng/ml in boys. The mean growth rate decreased from 9.3 +/- 0.5 to 4.6 +/- 1.3 cm/year after 3 years. The velocity of skeletal maturation decreased so that the final height prediction improved by a mean value of 1.6 SD. As the follow-up increases, this study confirms that LHRHa therapy is effective and potentially improves the final height of children presenting active and severe central precocious puberty.     

Predicting the timing of maturational spurts in skeletal age

Measures of maturity provide windows into the timing and tempo of childhood growth and maturation. Delayed maturation in a single child, or systemically in a population, can result from either genetic or environmental factors. In terms of the skeleton, delayed maturation may result in short stature or indicate another underlying issue. Thus, prediction of the timing of a maturational spurt is often desirable in order to determine the likelihood that a child will catch up to their chronological age peers. Serial data from the Fels Longitudinal Study were used to predict future skeletal age conditional on current skeletal age and to predict the timing of maturational spurts. For children who were delayed relative to their chronological age peers, the likelihood of catch‐up maturation increased through the average age of onset of puberty and decreased prior to the average age of peak height velocity. For boys, the probability of an imminent maturational spurt was higher for those who were less mature. For girls aged 11 to 13 years, however, this probability was higher for those who were more mature, potentially indicating the presence of a skeletal maturation plateau between multiple spurts. The prediction model, available on the web, is most relevant to children of European ancestry living in the Midwestern US. Our model may also provide insight into the tempo of maturation for children in other populations, but must be applied with caution if those populations are known to have high burdens of environmental stressors not typical of the Midwestern US. Am J Phys Anthropol, 2013. © 2012 Wiley Periodicals, Inc.     

Ethnic and secular influences on the size and maturity of seven year old children living in Guatemala City

Three groups of children, those of European parentage, those of Guatemalan parentage, and those of mixed European-Guatemalan parentage were measured for height, weight, and skeletal maturity. The children were born between 1945 and 1965, they were all of high socioeconomic status, and they all attended the same private school in Guatemala City. At 7 years, the boys of the European group were significantly taller than boys of the Guatemalan group. European and mixed European-Guatemalan girls were significantly taller than Guatemalan girls. These results are maturity independent. The influence of skeletal age was removed statistically by analysis of covariance. Girls of the mixed group were significantly heavier than girls of European and Guatemalan groups. Mixed group girls also had more significantly advanced skeletal ages than European girls. When the patterns of size and maturity status are analyzed by sex, there is evidence for a relatively greater environmental influence on the boys and a relatively greater genetic influence on the girls. Dividing the data into two birth year cohorts, 1945 to 1955, and 1956 to 1965, does not provide evidence for secular trends in growth or maturation. These results are similar to those from studies in developed nations that report an end to the secular trend for the “well off” population of those countries.     

The Stature of Boys Is Inversely Correlated to the Levels of Their Sertoli Cell Hormones: Do the Testes Restrain the Maturation of Boys?

The testes of preadolescent boys appear to be dormant, as they produce only trace levels of testosterone. However, they release supra-adult levels of Müllerian Inhibiting Substance (MIS, anti-Müllerian hormone) and lesser levels of inhibin B (InhB), for unknown reasons. Boys have a variable rate of maturation, which on average is slower than girls. The height of children relative to their parents is an index of their maturity. We report here that a boy's level of MIS and InhB is stable over time and negatively correlates with his height and his height relative to his parent's height. This suggests that boy's with high levels of MIS and InhB are short because they are immature, rather than because they are destined to be short men. The levels of MIS and InhB in the boys did not correlate with known hormonal modulators of growth, and were additive with age and the growth hormone/IGF1 axis as predictors of a boy's height. If MIS and InhB were causal regulators of maturity, then the inter-boy differences in the levels of these hormone produces variation in maturation equivalent to 18-months of development. MIS and InhB may thus account for most of the variation in the rate of male development. If boys lacked these hormones, then an average 5-year-old boy would be over 5 cm taller than age-matched girls, making boys almost as dimorphic as men, for height. This indicates that boys have a high growth potential that is initially suppressed by their testes. The concept of the childhood testes suppressing an adult male feature appears paradoxical. However, the growth of children requires intergenerational transfer of nutrients. Consequently, the MIS/InhB slowing of male growth may have been historically advantageous, as it would minimizes any sex bias in the maternal cost of early child rearing.     

Physical growth and nutritional status of Tsimane' Amerindian children of lowland Bolivia

This study examines patterns of growth and nutritional status of indigenous Tsimane' children under 9 years of age (n = 199 boys and 210 girls), based on a cross-sectional sample from 58 villages from the Beni Deparment of lowland Bolivia. Compared with US children, Tsimane' children are quite short, with linear growth tracking at or below the US 5th centile in both sexes. The prevalence of low height-for-age ("stunting;" HA Z-scores 相似文献   

Body height,weight, and skeletal maturation in Hottentot (Khoikhoi) children

Growth of body height and weight and skeletal maturation are discussed, based on 49 male and 61 female Hottentot children aged 3 to 17 years from Warmbad, Namibia (South West Africa) and 124 boys and 113 girls aged 1 to 21 years of related populations, the Rehoboth Basters of Namibia and Cape Coloreds from Cape Town, South Africa. The related populations are taller and heavier than the Hottentots, and have almost the same body height as American blacks and whites at least after the age of 18 years. In the Hottentots and Rehoboth Basters, the mean TW2 skeletal age is always less than the British standard by one or two years in both sexes. In general, the Rehoboth Basters have a skeletal age that is intermediate between Hottentot and British children. In both Hottentots and Rehoboth Basters, the increase in body height shows a linear relation to the skeletal age, and the regression curves are almost parallel in both sexes. The differences in body height and weight between the Hottentots and Rehoboth Basters become greater after the skeletal ages of 15 years for boys and 13 years for girls.     

Effect of protein malnutrition on the metabolism of dermal collagen in the rat

The effect of protein malnutrition on the metabolism of collagen was studied in young female albino rats after a single injection of 3H-proline by determining the specific as well as total activities of 3H-hydroxyproline in the skin collagen fractions and in the urine. a) Compared to controls, the total activity of 3H-hydroxyproline in the soluble collagen and in the urine was significantly lower in the deficient group at 12 hrs. after the administration of 3H-proline. b) The urinary excretion of hydroxyproline and the total activity of urinary 3H-hydroxyproline measured after four weeks of labelled proline injection were also considerably decreased in the protein-deficient animals. c) When the total radioactivities of both soluble and insoluble collagen are expressed as a percentage of the sum of both, the recorded activity was more in soluble and less in insoluble collagen at 12 and 120 hrs. after the administration of 3H-proline, due to the influence of protein malnutrition. The results of the present investigation therefore clearly indicate that the synthesis of collagen is decreased and accompanied by a retardation in the maturation of soluble to insoluble collagen in the protein-deficient animals compared to controls. In addition, protein deficiency is accompanied by decreased rates of catabolism of both soluble and insoluble collagen.     

Deferred costs of compensatory growth after autumnal food shortage in juvenile salmon

Growing animals are often able to offset the effects of periods of reduced food availability by subsequently undergoing a phase of elevated compensatory or 'catch-up' growth. This indicates that growth rates are not normally maximized even when food is not limiting, suggesting that fast growth may be costly. Here, we show experimental evidence of a long-term deferred cost of compensatory growth after a period of food shortage. Juvenile salmon subjected to a short-lived low-food regime in autumn subsequently entered a hyperphagic phase, leading to complete restoration of lipid reserves and partial recovery of lost skeletal growth relative to controls. However, several months later they entered a prolonged phase of poorer performance (despite food now being freely available), so that by the following spring they were substantially smaller than controls and had lower lipid reserves for their body size. The incidence of sexual maturation in males the following breeding season was also reduced. Salmon thus appear to trade off the benefits of short-term restoration of fat stores prior to winter against long-term performance.     

Problems in the aging of skeletal juveniles: Perspectives from maturation assessments of living children

We employ samples of children of known chronological age to demonstrate the significance of random and systematic effects on maturation in both dental and skeletal development. Differences between chronological age for dental age in young healthy Canadian children can be as much as 100% of the actual age of the children. For skeletal development by reference to Greulich-Pyle standards, three samples of known-age children from Mexico document parallel effects: 1) 183 six-year-old children have skeletal-based ages with a 95% confidence interval of 4–8 years; 2) 80% of 217 4.0–4.5-year-old children are underaged by 1–3 years; and 3) 130 children of skeletal age between 39 and 44 months are actually between 4 and 7.4 chronological years of age. The Mexican samples are drawn from a population living under conditions of environmental stress with chronic mild to moderate protein-energy malnutrition and moderate to high levels of infectious disease. These children may parallel those from the past, whose remains are studied by skeletal biologists or paleoanthropologists. Our findings reinforce concerns expressed in extant studies regarding the accuracy of age-at-death reconstructions. © 1996 Wiley-Liss, Inc.     

Growth and nutritional status of the Bharia--a primitive tribe of Madhya Pradesh

This study is an attempt to understand the physical growth and nutritional status of Bharia, a primitive tribe of Central India. A cross sectional study was conducted on 551 children (283 boys and 268 girls) aged 4 to 18 years. Body weight, height, sitting height, head circumference, upper arm circumference, chest circumference, biceps, triceps, sub scapular and calf skin fold thickness were measured. Body Mass Index was calculated as weight/height2 to calculate chronic energy deficiency. All anthropometric measurements except skin fold measurement exhibit uniform increase with age in both the sexes. Age-specific Body Mass Index (BMI) indicated substantial changes and falls during pre-school age and rise in adolescence. The BMI according to the Indian standard was normal, but when the data was compared with the International standard malnutrition in both sexes was noticed in childhood. Boys remained undernourished after adolescence, while girls reached the normal growth patterns.     

Effect of protein malnutrition on the metabolism of uteral collagen in the rat

Protein malnutrition in the rat resulted in a reduction in the syntehsis of collagen as determined by changes in the specific and total radioactivity incorporated following a single injection of [³H]-proline. It was also accompanied by a retardation in the maturation of soluble to insoluble collagen. In addition, protein deficiency was accompanied by decreased rates of catabolism of both soluble and insoluble collagen. Presented at Symposium of the Society of Biological Chemists, India, held at Lucknow in October, 1979.     

Anthropometric indices and nutritional deficiency signs in preschool children of the Pahariya tribe of the Rajmahal Hills, Bihar

The nutritional status of preschool children of the three sects of the Pahariya tribe (Rajmahal Hills, Bihar) was studied with the help of anthropometric indices like weight for age, height for age, weight for height und nutritional deficiency signs. The correlation between age and nutritional indices showed that the relationship was significant for % expected weight for age in the male children of all the three sects; r = +0.70 in Saurias, r = +0.32 in Mals and r = -0.72 in Kumarbhags (p > 0.01). Significant relationships were also observed in the correlations between weight for height in both sexes. Based on height for age and weight/height2 (Body Mass Index, BMI), 89% of the children of the Saurias, 92% of the Mals and 93% of the Kumarbhags were malnourished. Height for age of 50% of the children of the Pahariyas were below the 3rd percentile or below 90% of the Harvard standard. Chronic and current severe forms of malnutrition (i.e. height for age below 3rd percentile of standard and BMI 13.5) was highest in the Kumarbhags (17.5%). According to the modified Waterlow's classification chronic and current severe forms of malnutrition (i.e. height for age below 3rd percentile of the National Centre for Health Statistics, NCHS, and weight for height less than 80% of the standard) was highest in the Saurias (21.6%) and least in the Kumarbhags (15.4%). Kwashiorkor and marasmus for all the children of the Pahariyas ranged between 0.5-1.4% and 1.5-5.2%, respectively. Associated with signs of Protein Caloric Malnutrition (PCM), like moon face, dyspigmentation, sparseness and easy pluckability were more prevalent in all the three sects of the Pahariyas. Ocular manifestation of vitamin-A deficiency like conjunctiva xerosis and Bitos' spots were also frequent among these children.     

Growth and somatotype patterns of manus children,territory of Papua and New Guinea: Application of a modified somatotype method to the study of growth patterns

The growth and somatotype patterns of Manus children, Territory of Papua and New Guinea, reflected in anthropometric measurements and somatotype photographs, is reported for 438 children, ranging from 15 months of age to maturity. Somatotype distributions and individual somatotype photographs indicate little difference between boys and girls from age 1 to 4 years; between age 5 and 9 years boys shift toward higher second component ratings; between age 10 and 18 years boys shift toward higher second and third component ratings, while girls shift toward higher first and third component ratings. Four sample somatotype photographs are representative of the population at age 10 and 14 years, and show age and sex characters easily noted visually. Comparison of height, weight and subscapula skinfold values show that the Manus children resemble the Kaiapit and Bundi children of the New Guinea highlands populations reported by Malcolm in the form of their growth curves but not in growth rates. Manus children grow more slowly than the British, but faster than the Kaiapit and Bundi children. While low skinfold values and height/weight ratios derived from means for height and weight suggest somatotypic similarity of the Manus, Kaiapit and Bundi populations, somatotype photographs are needed for confirmation. Lacking historical information and genetic evidence, we can speculare that diet, nutrition, climate and perhaps physical activity are factors which influence the growth patterns of these populations. The protein intake derived from fish and other seafood may be an important factor in the relatively fast growth and earlier maturation of the Manus. Malcolm thinks that low protein intake plays an important role with the Kaiapit and Bundi, but does not rule out survival value of slow growth and short stature.     

Breast feeding and vitamin A deficiency among children attending a diarrhoea treatment centre in Bangladesh: a case-control study.

OBJECTIVE--To determine the effect of breast feeding on the risk of xerophthalmia in children aged 6 months to 3 years attending a diarrhoea treatment centre in Bangladesh. DESIGN--Case-control study based on stratified analysis (Mantel-Haenszel) and multivariate analysis (logistic regression) of data from a treatment centre based surveillance system. SETTING--A large diarrhoea treatment centre in Dhaka, Bangladesh. PATIENTS--2687 children aged 6 months to 3 years representing a 4% systematic sample of all children in this age group treated yearly at the centre over three consecutive years. 66 of the children were cases of xerophthalmia (that is, they had Bitot''s spots or corneal lesions or night blindness or night blindness plus conjunctival xerosis or any combination of these) and the remaining 2621 did not have signs or symptoms of vitamin A deficiency. This second group served as controls. MAIN OUTCOME MEASURE--Xerophthalmia and breast fed at onset of diarrhoea or presentation. RESULTS--The odds ratio relating breast feeding to vitamin A deficiency after adjustment for a large number of confounding variables (0.26 (95% confidence interval 0.14 to 0.49); p less than 0.001) reflected a 74% reduction in the risk of vitamin A deficiency among breast fed children. The estimated reduction of risk did not decline with age, and some 49% of children aged 24-35 months were still being breast fed. The odds ratio relating breast feeding to xerophthalmia in the third year of life (0.35 (95% confidence interval 0.35 to 0.86) reflected a 65% reduced risk of vitamin A deficiency. Other important risk factors or prognostic indicators for xerophthalmia as identified by multivariate analysis were recent measles, prolonged diarrhoea, severe protein energy malnutrition, and poor socioeconomic state. CONCLUSIONS--These results indicate that breast feeding was associated with a substantial reduction of the risk of vitamin A deficiency extending to the third year of life and support the recommendation that mothers in developing countries should be advised to breast feed for as long as possible.     

The impact of exercise on thyroid hormone metabolism in children and adolescents.

Thyroid hormones are important regulators of energy metabolism and may influence energy processes during physical exercise. There are controversial results concerning thyroid hormone metabolism during strenuous exercise in adult athletes and only scant data concerning the impact of strenuous exercise on thyroid hormone metabolism in children and adolescents. Although some studies demonstrate a transient change in thyroid hormones during intense physical performance, most studies agree that these changes are of minor impact, practically reflecting the relative negative energy balance during strenuous exercise. This state of hypometabolism during intense physical performance has also been confirmed in highly trained female young athletes, who may be also characterized by reproductive axis dysfunction, manifested either as luteal-phase deficiency or amenorrhea, alongside the typical constellation of low T3, insulin and leptin levels. More importantly, strenuous exercise during childhood or adolescence is mostly accompanied by a delay of skeletal maturation, and height and may have a long-lasting negative effect on growth and acquisition of maximum bone mass. In conclusion, although thyroid hormones are only transiently or insignificantly changed during strenuous exercise, adequate caloric intake should be guaranteed in highly performing young athletes in order to counteract the relative negative energy balance and prevent alterations in endocrine-metabolic profile. Moreover, when growth and pubertal progression in very young athletes are significantly impaired, a reduction in the intensity of the physical exercise should be advocated in order to guarantee better final height and adequate acquisition of bone mass.