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Am J Clin Nutr. 1992 May;55(5):955-8.

The cost of successful adolescent growth and development in girls in relation to iron and vitamin A status.

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Liverpool School of Tropical Medicine, UK.


The role of iron and vitamin A in adolescent growth and development is not well described. During adolescence iron requirements are increased, reaching a maximum at peak growth, but after menarche, menstrual iron loss must also be replaced. An observed rise in retinol-binding protein concentrations at puberty level 4 indicates a role for vitamin A in sexual maturation. Iron and vitamin A deficiencies may slow the tempo of growth. Conversely, for girls on marginal diets, an extended catch-up growth period may lead to depletion of these nutrients. The costs of achieving growth may also include cephalopelvic disproportion in girls becoming pregnant and increased risk of menorrhagia.


Few studies have investigated how nutrients such as iron and vitamin A promote adolescent growth or whether the effort of catching up on growth may result in a reduction of iron and vitamin A stores. The intake of these nutrients probably does not rise along with maturational requirements in many developing countries. In situations where adolescent females have a heavy workload, low social status, low priority in food distribution, and high infectious disease rates, growth may be achieved, but at the cost of reductions in stores of certain nutrients. Women's health will be compromised during pregnancy. It is proposed in this paper that growth requirements increase demands for iron and vitamin A and that deficiencies of these nutrients may be a consequence of growth and sexual development in adolescent females on marginal diets. One consequence of reduced iron and vitamin A stores in nonpregnant adolescents may be increased risk of menorrhagia, which contributes further to the problems of anemia in poorly nourished girls in their prereproductive years and beyond. The costs of achieving growth may also include cephalopelvic disproportion in girls becoming pregnant. Sections discuss iron and vitamin A requirements during adolescence, the cost of successful growth, and interactions of vitamin A and iron.

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