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Physical growth in relation to earlier nutritional status

The children in this study were linked with the earlier cohort of the already completed study and were categorized it in four nutritional groups on the basis of weight for age at the age of 5-7 years, according to Gomez classification using the NCHS as standard. The children falling in grade II or III malnutrition were combined as there were very few children in grade III. It was possible to obtain earlier nutritional status in 65 (Delhi urban slums) to more than 98, per cent, (Vellore urban slums) of female children and in 64 (Delhi urban slums) to 98 per cent (Vellore) of male children in the current study. The physical growth during adolescence was studied in three groups viz. Normal, grade I malnutrition and grade II and III malnutrition at the age of 5-7 years. The number of male and female children available in each nutritional status at each age point are given in Tables 18 and 19.

It was observed at all the participating centres that children, both boys and girls who had normal weight for age at the age of 5-7 years continued to have higher weight and height and children with grade II and III malnutrition, lower weight and height throughout adolescence as compared to children in grade I malnutrition.

The maximum difference in weight of male children in the normal group and grade 1 malnutrition, grade I and, grade II & III malnutrition ranged between centres from 3 to 9 kg. .at some age points excluding the age points where the number of observations was very smallڳ). There did not appear to be any evidence of patching up phenomenon with advancing age (Table 20). This was also observed for girls, with maximum differences in weight ranging between centres from 3 to 7 kg. at some of the age points in relation to earlier nutritional status !(Table 21).

Similar observations were also made with regard to height of boys and girls in three groups of nutritional status with maximum differences between centres ranging from 3 to 11 for boys and 3 to 8 for girls. As with the weight, the children in the normal group remained taller and in the malnutrition grade II & III remained smaller compared to the children who had grade I malnutrition at the age of 5-7 years (Tables 22-23, Fig. 9-36).

SEXUAL DEVELOPMENT

The children in this study were also observed for appearance of secondary sexual characteristics at six monthly follow ups. Boys , were observed for appearance of facial hair, pubic hair, axillary hair, change of voice and different stages of genitalia development. The girls were observed for appearance of axiltary hair, pubic hair, onset of menarche and different Stages of breast development. The age

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