Human Growth and Development

Britteny M Howell. 21st Century Anthropology: A Reference Handbook. Editor: H James Birx. Volume 2. Thousand Oaks, CA: Sage Reference, 2010.

Physical anthropology, developed in the 19th century before Darwin’s theories of natural selection and Mendel’s work on genetics, is one of the oldest subfields of anthropology. Physical, or biological, anthropology was originally defined as “the natural history of the genus homo” by its principle founder, Paul Broca (1871). In 1918, Aleš Hrdlička defined physical anthropology as the study of man’s variation, including racial anatomy, physiology, and pathology (p. 4). Today, biological anthropology includes the study of the mechanisms of biological evolution, genetic inheritance, human adaptation and variation, human growth and development, primate behavior and morphology, and our hominin ancestry.

Many anthropologists specializing in human growth and development are found in departments of medicine, health sciences, and anatomy (Stein & Rowe, 2005, p. 2). However, it is not just biological anthropologists who study growth and development. The development of medical anthropology as a subfield has, among many other contributions, brought attention to the relationships among growth, development, and culture. There are also countless specialties in the health care professions that concentrate on human growth and development studies.

Human growth and development is an extensive field of study. A thorough investigation of the field would include a study of measurement, mathematical models, assessment strategies, birth weight standards, fetal growth, breast-feeding, weight and height ratios, childhood maturation, disease, and treatments, to name just a few components. Here, anthropometry as a means of quantifying human growth will be discussed, along with measurement, rates of growth, and fetal and childhood development. The history of anthropometry will also be discussed at length because it is integral to human growth and development studies. In addition, the use of statistical models, anthropometric instruments of body measurements, and standards of measurements are all important developments in the field. With this, the current and new directions of the discipline will be introduced.

Last, the chapter will cover how malnutrition is a major barrier to proper growth and development and how anthropologists use anthropometry to assess malnutrition. The four major classifications of malnutrition will be addressed, along with malnutrition’s effect on growth and development, how culture can contribute to malnutrition, and examples from around the world of chronically malnourished populations. In its many forms, malnutrition remains a global health challenge around the world and an obstacle to proper growth and development (World Health Organization [WHO], 2004).

Anthropometry

Anthropometry, defined as the measurement of the body and its proportions, is one of the oldest branches of biological anthropology. Frenchman Alphonse Bertillon first defined anthropometry in 1883 as an early system of classifying individuals. The beginnings of forensic anthropology are rooted in anthropometry because it was understood that certain measurements of the body and the skeleton could distinguish individuals.

Anthropometry as a scientific endeavor entered mainstream anthropology in the 19th century as a reliable, quantitative way to study the human body. While anthropometry has a wide variety of uses, here we are concerned with this methodology in determining health and patterns of growth and development. Anthropometric data consist of important metrics of growth and development such as stores of fat, muscle, and even calcium in the form of bone mineral. Anthropometry is a dynamic field as changes in lifestyles, nutrition, and ethnic composition of populations can lead to changes in body dimensions around the world. A major challenge for anthropologists, then, is the troubling issue of setting standards suitable for people across the globe with very diverse diets and cultural practices. To assist, a standard defines a recommended pattern of growth that is associated with specific health outcomes (Butte, Garza, & de Onis, 2007, p. 154). Anthropologists are continuously updating the standards and searching for new measurement techniques.

Anthropometry is important for measuring growth and health status because it is generally noninvasive. The standardized methods and relatively inexpensive medical instruments of anthropometry are also used around the world. Since anthropometry measures the body’s surfaces rather than the precise growth and development of cells or organs (Johnston, 1998, p. 27), it is only one of many tools that can be used in diagnoses. This is an important distinction to make, because while abnormal nutritional status begins with cellular changes, chronic malnutrition is later manifested in altered body measurements (Devlin & Horton, 1988; Waterlow, 1986).

History of Anthropometry and Growth Studies

Human growth and development have been studied for centuries, possibly as early as 2000 BCE with ancient Sumerian references to the stages of human gestation (Boyd, 1980, pp. 2-4). By the end of the 18th century, the field of medicine had well-established vital statistics of birth and death, as well as standards of body measurements, especially those of fetuses and neonates. In 1806, Sir Charles Bell, a Scottish anatomist and surgeon, published Anatomy and Philosophy of Expression, which detailed the changes in proportions of the human face and head from birth through adulthood. This was remarkable work for the time because it disregarded classical ideas of facial proportions and focused on the underlying structures of the face and head (as cited in Boyd, p. 313).

Georges-Louis Leclerc de Buffon’s Natural History: General and Particular, translated and updated in 1812 by William Smellie, contained the first comprehensive study of human growth rates from birth to maturity and served as an integral treatise on rates of growth in the 19th and early 20th centuries. This book underwent hundreds of editions and is considered by many to mark the beginning of modern anthropometry (Hrdlička, 1918).

In 1833, Lambert Adolphe Quetelet, a statistician and astronomer, published an article accompanied by drawings that acknowledged the differences between modern rates of growth and those body proportions idealized by ancient Greek and Roman sculptors. Quetelet also took into account that people’s rates of growth may vary around the world and that people with certain diseases, such as dwarfism, may grow at different rates. Quetelet’s 1835 landmark work, titled Sur l’homme et le développement de ses facultés, ou essai de physique sociale, marked the origins of the systematic and quantitative study of rates of human growth and development. His theory of anthropometry was based on the notion that the distributions of anthropometric data follow the laws of chance (Boas, 1982, p. 77). Quetelet also developed a simple but revolutionary measure that classified people’s weight compared with an ideal weight-to-height ratio. The Quetelet index, more commonly called body mass index (BMI), is the most widely used measure of malnutrition and obesity worldwide (Eknoyan, 2008, pp. 47-51).

Sir Francis Galton was another important figure in the development of anthropometry. Like Quetelet, he began as a statistician and branched out into measuring human growth and development. Galton started an anthropometry laboratory in which he published research from 1874 until the turn of the century. His innovative research during this period included the use of “fingerprints” in criminology studies, a technique already in use in Bengal, India.

Fetal and Childhood Growth

The study of fetal and childhood growth is almost as old as the study of growth and development itself. An early article titled “Foetus” published in the Dictionnaire des Science (1816) by Murat reported the length of fetuses during their 9-month gestation. Quetelet used Murat’s values and in 1835 constructed an equation for the total period of fetal and childhood growth (Boyd, 1980, p. 303). However, the study of child growth rates was still considered underdeveloped at the turn of the 20th century. Hrdlička stated in 1918 that the study of fetal and childhood growth was far from complete despite the progress of neonate studies in America. He recognized that studying child growth and development had an impact on the health of individuals later in life and that anthropometry was especially helpful in detecting and treating individuals with abnormal growth or pathological development (Hrdlička, 1918, pp. 20-21).

In 1876, Galton had discovered what appeared to be a correlation between weight and height for 14-year-old boys: As their height increased by an inch, their weight increased by 4 pounds (Galton, 1876, pp. 174-180). Growth status and rates of growth in children are related to later growth, composition, and proportions of the body in those individuals. These growth measures can be associated with current and future risk factors for serious diseases, such as the various forms of malnutrition.

Population Growth

Investigators of human growth and development did not recognize the degree of population differences for quite some time. Louis René Villermé was the first statistician of public health in the early 19th century to note that the height of a population correlated positively with the productivity of the soil. He found that stature was greater and rates of growth were faster in wealthier countries. Villermé may have been one of the first scientists to recognize a correlation between malnutrition and growth stunting of different populations.

Emmanuel Le Roy Ladurie also crossed an important threshold as one of the first historians to systematically investigate the geographic variation and the socioeconomic correlates of human height in 19th-century France. In a series of publications beginning in 1969, he showed that the physical stature of French soldiers born in the late 1840s correlated positively with their education and wealth. Those who were able to read and write were 1.2 cm taller than their illiterate counterparts. It was presumed that literate men came from wealthier families and spent more time and money on education and less at manual labor than did illiterate people (Komlos, Hau, & Bourginat, 2003, p. 1).

During the late 19th and early 20th centuries, anthropologists were preoccupied with measurements of skulls, cranial capacities, and facial angles of both the dead and the living, which were often used to reach racist conclusions. In fact, much of the history of anthropometry is published in books and articles about race and evolution. William Stanton’s 1960 work highlights the history of anthropometry in America in the context of race, evolution, and religious debates.

In 1842, Anders Adolf Retzius introduced an equation of head-width to head-length ratios to distinguish the dolichocephalic (long-headed) from the brachycephalic (short-headed), which remained the main cephalic index used through the 20th century. Many Native American skeletal remains were unearthed and beheaded for such measurements, often used to conclude their smaller cranial capacities or differing cranial dimensions indicated aboriginal inferiority (Wade, 2000).

Instruments to measure cranial angles and capacities were in heavy use in the late 19th century by biological anthropologists. These instruments included sliding calipers, craniographs, stereographs, goniometers, a number of instruments for studying the interior of the skull, and osteo-metric boards. Many of these were developed and/or modified by physician Paul Broca (as cited in Hoyme, 1953, pp. 418-419), the most prolific scientist of cranial measurements in the 1860s and 1870s.

The emphasis on cranial measurements declined in popularity in the late 1800s, and many anthropologists shifted to studying the total physical type of man. They attempted to describe and compare tribes and races as biological units, and define the normal physical status of man, “preferably the white race” (Hrdlička, 1918, p. 9). Additionally, Hrdlička stated that the paramount scientific aim of biological anthropology was the complete study of the “normal white man living under ordinary conditions” (p. 9). Contemporary anthropologists believed that “the yellow-brown or black man would serve equally well, if not better, were we of his blood and were he as readily available” for anthropometric study (Hrdlička, p. 18). At this time, “abnormal” ethnic and racial composition and admixture of populations was considered a messy situation that could not be properly studied. Some studies in the early 20th century, however, were without implications of racial inferiority. These studies provided the research essential for anthropometry to become a legitimate field of study that contributed to the larger study of human growth and development of populations (Hoyme, 1953, pp. 422-423).

Despite this change in status of biological anthropology and anthropometry, Hrdlička wrote that not many institutions were devoted to instruction of anthropometry and complained that the more “attractive” subfields of anthropology—namely archaeology and ethnology—were diverting average anthropology students away from anthropometric studies. He stated that progress of anthropometric studies at the turn of the century was stalled due to a lack of trained professionals and interested students, and that “a new competent physical anthropologist is almost an accident” (Hrdlička, 1918, p. 11).

Franz Boas, credited as a pioneer of the four-fields approach to American anthropology, was also well versed in German mathematics and applied his research to human growth rates from 1883 to 1912. He is most well-known for his research with Eskimo and Inuit populations, but he also collected anthropometric data on the Cheyenne, Cherokee, Oglalla, Omaha, Chippewa, and Winnebago tribes as well as European migrants, among others (American Philosophical Society, 2006).

Although anthropometric data between populations were gathered in the 19th century, it has been only recently that these data were systematically collected around the world. Documenting and analyzing the growth patterns of people around the world can tell us much about adaptability and the complex human-environment interactions. The greatest differences found in human growth and development are largely attributed to environmental factors, as they are between industrial and nonindustrial nations, and between wealthy and poor groups within nations. For example, developing countries tend to exhibit low birth weight.

Current and Future Trends in Anthropometry

Today, many anthropologists specialize in biological or anthropometric studies. Current trends in anthropometry seek to understand the genetic component of human growth and development that may account for interpopulation growth differences. Anthropometric instruments and measurements have been standardized for international reference. These measurements are referred to as either standards or references in the literature. A reference describes the growth pattern of a defined population that is not necessarily associated with good health (Butte et al., 2007, p. 154). A growth reference is a table or chart that is meant to account for differences of age and sex in anthropometry (Cole, 1998, p. 80). A challenge to using a growth reference is the variability in rates of growth that occur in school-age and pubescent children. The “peaks” of weight and height are obtained over a wide range of ages, and thus a reference tends to flatten out the median curve, especially during puberty. Also, modern anthropologists are concerned with the validity of international standards because, even after socioeconomic factors are controlled for, there remain differences in rates of growth between populations of the world (Ulijaszek, 1998).

To combat some of the challenges of using international standards for all children around the world regardless of their current health status, growth charts have been made for children suffering from specific diseases. Growth charts currently exist for such diseases as achondroplasia, Marfan syndrome, sickle cell disease, and Turner syndrome that allow the growth of affected children to be judged in relation to others with the same disease (Roche & Sun, 2003, pp. 66-67). Identifying unusual growth patterns in children given their primary diagnosis can help to identify comorbidity, children with more than one disease or illness.

Height and weight are highly heritable traits, and limited data are available for interpopulation effects of genes on growth during childhood and adolescence. In an attempt to eliminate genetic or cultural bias, the WHO Multicentre Growth Reference Study of 2006 collected primary growth data from 8,440 children from Brazil, Ghana, India, Norway, Oman, and the United States. The resulting growth curves constituted new international standards for growth and development for children from birth to 5 years old (WHO Multicentre Growth Reference Study Group, 2006). Growth rates vary more for children over age 5 between populations. The current WHO growth reference for older children and adolescents is based on 1977 data and growth charts that are in need of updating. Cole (1998) states that growth references need to be updated every 10 to 15 years to capture secular trends in height and weight (p. 82). In order to produce international growth and development standards for older children, Butte et al. (2007) outline a number of factors that need to be considered with new data collection. Samples of healthy children from around the world must take into account the environmental influences on growth of children and adolescents: proper nutrition, lack of endemic infections, socioeconomic status that does not limit growth, low levels of environmental pollution, and populations without high levels of psychosocial stress (p. 155).

Three-dimensional body imaging, an emerging trend in anthropometry, was first developed in 1973 using light sectioning. These early attempts were laborious, time-consuming, and not entirely accurate. Today’s computer three-dimensional systems have dramatically increased the usability of 3D body scans for surface anthropometry. There are currently at least four body-imaging systems in use in the United Kingdom, the United States, and Japan. The primary use of body-imaging technology is to identify distortions of body shape, such as those related to skeletal pathologies like scoliosis or facial abnormalities. Body imaging can also be used for producing prosthetics or measuring arthritic swelling and tumors, among other important applications (Jones & Peters, 1998, pp. 30-33). However, 3D body imaging has its limitations. First, the human body has external and internal factors that are always changing its form. These small-shape changes cause the computers to record an error factor that is even affected by skin and body-hair pigmentations. Additionally, no current medical computer system is able to record 100% of the body’s surfaces. Despite these current limitations, 3D imaging may become more useful in the future as technology becomes better able to handle the unique challenges of measuring the human body.

Malnutrition

Now that we have discussed how to measure the body, let us discuss conditions in which measuring the body is important for diagnosis. Anthropometric measurements are compared with international standards in order to identify diseases such as malnutrition. Malnutrition is defined as a medical condition that is caused by improper diet. Nutrition is a multidisciplinary science including food science, physiology, biochemistry, genetics, epidemiology, anthropology, and psychology. Nutrition studies are relatively young compared with growth studies and biological anthropology, which developed over the past 150 years. Today, there are four recognized manifestations of malnutrition: overnutrition, secondary malnutrition, micronutrient malnutrition, and protein-energy malnutrition:

  1. Overnutritionoccurs when nutrients are oversupplied relative to the amounts required for normal growth, development, and metabolism. The term can refer to obesity brought on by general overeating, as well as the oversupply of a specific nutrient.
  2. Secondary malnutritionis not a direct result of the person’s diet but describes an illness or condition that prevents absorption of nutrients, increasing excretion, or causes the body other damage that is triggering a response to increase its required nutrients.
  3. Micronutrient malnutritionis caused by lack of sufficient micronutrients, such as vitamin A or zinc, in the diet that can impair normal growth and development, as well as make the individual susceptible to diseases.
  4. Protein-energy malnutrition (PEM)is caused by underfeeding and is expressed in two forms: kwashiorkor and marasmus. Kwashiorkor is caused by a diet consisting of carbohydrates with insufficient protein intake and is identified by the potbelly-like appearance of sufferers that is caused by edema and an enlarged liver. Kwashiorkor usually presents at age 2 to 3 years and lasts for a few weeks, resulting in either recovery, if one is given proper nutrition, or death. Marasmus presents as a result of low caloric intake and is also referred to as wasting, where the sufferer has an emaciated appearance. Marasmus, more common than the fatal kwashiorkor, often develops before the child is 1 year old due to lack of breastfeeding and lasts several months.

Micronutrient and PEM malnutrition are both classified as primary malnutrition, or undernutrition. Within the category of undernutrition, varying degrees of severity are expressed as either first-, second-, or third-degree malnutrition with third degree being the most severe. In addition, some authors also use the terms acute and chronic undernutrition to refer to the length of time the sufferer has experienced periods of undernutrition. Case studies used in this chapter discuss second- (acute) and third-degree (chronic) malnutrition in populations in various regions of the world.

Effect of Malnutrition on Growth and Development

Deficiencies in protein and calories are more severe than the specific nutrient deficiencies mentioned above because protein and calories are essential for growth, health, activity, and survival. Calories provide the energy the body needs for involuntary functions such as blood circulation, breathing, and maintaining body temperature. Protein is needed in the diet because the body does not produce enough amino acids to build essential proteins—it is essential for building cells, carrying nutrients to and from the body’s cells, and developing antibodies.

Anthropologists can assess malnutrition visually in a number of ways. Radiographs can indicate the presence of lines of arrested bone growth. These lines are generally believed to be caused by undernutrition. They are identified as dense lines that form at the epiphyses of long bones and can continue to form parallel lines down the bone shaft if periods of undernutrition are chronic and recurring. They occur most often in the bones of the leg, particularly the distal tibia. Regular occurrences of dense lines may be an indication of repeated periods of undernutrition or seasonal food shortages (Walimbe & Gambhir, 1990).

Dense lines on the leg bones were first detected and described by Ludloff in 1903, but in 1921 Stettner was the first to interpret them in terms of arrested growth. Asada (1924) and Harris (1933) induced line formation in experimentally starved laboratory animals, and it was Harris’s research that dubbed them Harris lines. The precise mechanism of line formation remained obscure until the research of Park and Richter in 1953 (as cited in Mays, 1985, p. 207). They were able to show that periods of undernutrition cause the bone growth to form transversely, instead of in normal, vertical columns. The impact of Harris lines on bones was articulated by Scrimshaw, Taylor, and Gordon (1968), who stated that Harris lines can result in permanent stunting of the skeleton (pp. 56-57) and result in short-statured individuals.

Park (1964) has stated that Harris lines do not form with a mere slowing of growth; arrested growth needs to be complete to form Harris lines (p. 823). In addition, after growth arrest, sufficient recovery from undernutrition is needed to restore bone growth (Mays, 1985, p. 209). Marshall’s 1968 longitudinal study has found there is a significant correlation between periods of malnutrition/ infection and the presence of Harris lines. Mays states that the probability of line formation is significantly increased by a period of nutritional stress or disease, but there is not a simple, direct correlation where Harris lines always indicate undernutrition.

Another way to assess undernutrition is by visual inspection of teeth. Dental hypoplasia can be identified as striations on the teeth that indicate severe periods of undernutrition. Dental hypoplasia is the loss of thickness of surface enamel due to periods of arrested growth during the development of the teeth; it can be viewed as a line or a groove in the tooth, called linear enamel hypoplasia (LEH). LEH can be present in adult or deciduous (baby teeth) dentitions. Like Harris lines, LEH indicates a recovery from malnutrition, in that the tooth shows a period of arrested growth in the form of a groove or line and the recovering period of normal enamel deposition below the LEH. Researchers sometimes use dental hypoplasia analyses to assess adults who have experienced childhood undernutrition and its recovery and to document famine cycles.

Most commonly, individuals can also be assessed by anthropometric measurements of skin-fold thicknesses, BMI, and weight:height, weight:age, and height:age ratios. These ratios can be interpreted differently by researchers, and many studies have differing parameters to determine malnutrition. Today, the various WHO standards tend to be the reference point that anthropometric measurements are evaluated against. The WHO standards indicate measurements of healthy individuals, and deviations from these standards can aid in malnutrition diagnoses.

Consequences of Malnutrition

Comorbidity refers to the presence of one or more diseases in addition to a primary disease in an individual. Undernutrition lowers resistance to infectious diseases resulting in comorbidity. Of most concern to malnourished children of developing countries are diarrheal disease and pneumonia. Tuberculosis, malaria, measles, whooping cough, and intestinal worms follow. Measles is another concern, which results in extremely high mortality rates in the developing world because of malnutrition at weaning age and lack of vaccinations. In developing countries, childhood death rates due to measles can be up to 83 times higher than in the United States.

There is another manifestation of undernutrition called nutritional growth failure, or stunting. Stunting appears as children, and then later adults, come to lie outside the normal range of body weight and/or height for their age. Short-term undernutrition is indicated by wasting, and long-term, chronic undernutrition can result in growth stunts (McElroy & Townsend, 1996, p. 220). While growth stunting does not present itself with kwashiorkor or marasmus symptoms, individuals are likely to suffer from physical underdevelopment and mental impairments.

Culture and Malnutrition

Culture plays an important role in dictating food consumption, as well as defining and treating nutritional illnesses. Since food is a basic necessity that is often part of a frequently repeated family routine, attitudes and usages centered on food are intimately connected with individual and family life (Black, 1943, p. 142). Acceptable foods to eat, dietary restrictions, religious fasting, healing rituals, and many other cultural factors may hinder proper nutritional status. For example, African mothers often put children affected by diarrheal diseases on a prolonged starvation diet that causes acute forms of malnutrition, also making them susceptible to other infections (Konczacki, 1972).

Differences in the nutritional status of children in Mexico are attributed largely to cultural food styles and/or available income of a household. In many studies, it has been concluded that nutrition is better in rural mestizos, individuals of mixed native and Spanish ancestry, than rural Indians and worst in urban mestizos (Balam & Gurri, 1992; Malina, Himes, Stepick, Guiterrez Lopez, & Buschang, 1981; Muñoz de Chávez et al., 1974). Rural Indians and mestizos may both be extremely poor, but nutritional differences may lie in the narrow scope of foods used by more “traditional” Indian families, who rely mainly on staples such as maize and beans. However, in Mexico, Baer (1998) states that women are contributing more to household income and are thus making more important spending decisions. As this area is largely reliant on imported and store-bought foods, the mother’s education level is thought to be directly related to the dietary status of her children. Baer goes on to state that the imported foods in the local stores are unfamiliar and that women do not know their nutritional value—a problem exacerbated by local advertising of these unfamiliar and high-priced foods as being “healthy” regardless of their nutritive qualities (p. 5). Baer’s study concluded that people of low income in the Sonoran region consume greater amounts of beans and grains while the higher income households consume more fruits, vegetables, dairy, and meat (p. 43). These findings are consistent with areas where there is a high prevalence of malnutrition and diet is restricted to local or ethnic foods such as maize and beans. These foods do not contain sufficient amounts of protein or calories. However, this is not to say that all “traditional” foods are deleterious.

In addition to providing food, in many societies the family also delivers most of the health care. Studies have shown a positive correlation between poor health outcomes and the level of stress in the home (Loustaunau & Sobo, 1997, p. 24). This implies that stressed families of malnourished individuals may not be seeking or have access to outside health care. In the following examples, it becomes apparent that different forms of malnutrition are prevalent in different areas of the world due to cultural norms of food consumption and recognizing malnutrition.

Examples of Malnutrition Worldwide

Protein-Calorie Malnutrition in Mesoamerica

In 1988, 14.2% of children under age 5 in Mexico were considered underweight, and 22.8% of them were short for their age, as stated by Long-Solis and Vargas (2005). These authors also stated that short stature is a sign of chronic malnutrition and higher risk of disease. They also conducted a survey in 1999 and found that the percentage of underweight children dropped to 7.5 and those considered to be short for their age was down to 17.7%, reduced by 22%. In addition, the authors found that half of the indigenous children surveyed were considered to be too short for their age, or stunted, with implications on their nutritional status (Long-Solis & Vargas, 2005, p. 165).

Malina et al. (1981) researched undernutrition in Oaxaca because it is among the poorest states in Mexico, with high child mortality rates. They analyzed children by weighing and measuring stature, arm circumference, and the triceps skin fold of 1,410 children 6 to 14 years of age. Excluding the children of wealthier families, the authors found that in categories of weight and stature, the rural mestizo children were healthier than the rural, indigenous Zapotec children. In addition, urban mestizo and indigenous children were found to be smaller and more underweight than the rural mestizos. This study shows that the move to cities does not necessarily lead to improved growth status (p. 269).

However, within chronically malnourished areas, there exist children with good nutrition; not every child in the community will be undernourished. Muñoz de Chávez et al. (1974) examined the epidemiology of good nutrition in these areas to find factors that lead to some children being better nourished than others in families of similar size and economic status. It was found that large family size was not a factor because many well- as well as ill-nourished children were from families of the same size. The difference lies in the composition of the family; those with more working adults had better nourished children while families with more children than adults did not have good nutrition (p. 224). The families with more working adults had greater income and were observed to have spent more of their earnings on food than the families of undernourished children. In addition, in support of Baer, this study found that families that were more “indigenous” had more undernourished children than the “occidentalized” families. Maize and beans were the staple foods in the families with more traditional cultural views, while the families that had more Western concepts and culture actively sought out other food items for their children (p. 225).

Secondary Malnutrition in Africa

Individuals suffering from certain diseases may become susceptible to undernutrition due to the nature of their illness. In many parts of Africa, adults and children have been found to have high rates of secondary malnutrition due to HIV infection. The undernutrition is due to decreased nutrient intake, malabsorption, and altered metabolic rates due to HIV infection. Secondary malnutrition of this nature has even been identified as the cause of death in AIDS patients due to the depletion of body mass (Gramlich & Mascioli, 1995, p. 2).

In fact, HIV-infected African children were 17 times more likely to suffer from undernutrition than uninfected children (Mgone et al., 1997). In South Africa, marasmus, or wasting, was more strongly associated with HIV-infected children than kwashiorkor. This study also found that HIV-infected children had higher rates of mortality than uninfected children (Yeung, Wilkonson, Escott, & Gilks, 2000, p. 108).

Micronutrient Malnutrition in Asia

Micronutrient malnutrition can occur in any population in which the local diet lacks one or more essential nutrients for proper growth and development. In Southeast Asia, many people subsist on a diet lacking in green and yellow fruits and vegetables that contain vitamin A. The symptoms of vitamin A deficiency begin with impaired vision and night blindness, leading to xerophthalmia and total blindness. Xerophthalmia is an ocular condition that leads to opaque spots on the eye and degeneration of the cornea. Additionally, individuals suffering from micronutrient malnutrition may also exhibit signs of undernutrition such as wasting or stunting.

Vitamin A deficiency is considered a significant public health problem in India, Pakistan, Bangladesh, Indonesia, and the Philippines. A study in India estimated that the prevalence of xerophthalmia in children under age 6 was 8.7%. A study among children in Yemen showed that night blindness was found in 0.5% of the children. In northeastern Thailand, the prevalence of night blindness in rural areas was 1.3%, and among children of the Orang Asli of Malaysia night blindness was found in 16.0% of the children (Ngah et al., 2002, p. 88).

Overnutrition in the Western World

Overnutrition often refers to being overweight or obese, the general condition of overeating foods high in calories, surpassing the amounts needed for proper growth and development. Overweight is defined by a BMI of between 25 and 29.9 (kg/m2), and obesity is defined by a BMI greater than 30. Overnutrition is a growing problem in developed countries. In 2006, Dr. Barry Popkin from the University of North Carolina stated there were now more overweight people worldwide than undernourished people. He reported to the International Association of Agricultural Economists that the number of overweight people had topped one billion (of which 300 million are obese), compared with 800 million undernourished.

In 2003 and 2004, 17.1% of U.S. children and adolescents were overweight and 32.2% of adults were obese. Approximately 30% of non-Hispanic white adults were obese, 45.0% of African American adults, and 36.8% of Mexican American adults. Among adults age 20 to 39, 28.5% were obese, 36.8% of adults age 40 to 59 years were obese, and 31.0% of those age 60 or older were obese in 2003 and 2004 in the United States (Ogden et al., 2006, p. 1549). In England, rates of overweight and obesity are also growing, with 23.1% of men and 24.8% of women classified as obese in 2005 (The Information Center, 2006).

Overnutrition and excessive body weight in developed countries is brought on by a host of conditions. Increased sedentism, lack of exercise, increased use of packaged and processed foods, fast-food consumption, poor diet choices, and general overeating are all contributing factors. Excessive body weight is associated with various diseases such as cardiovascular diseases, type 2 diabetes, sleep apnea, certain types of cancer, and osteoarthritis. As a result, obesity has been found to reduce life expectancy.

Conclusion

This chapter examined human growth and development through two perspectives: anthropometry as a means of quantifying growth and development, and malnutrition as a major obstacle to proper growth and development worldwide. The long history of anthropometry began in 1883, contemporaneous to the development of physical, or biological, anthropology. Anthropometry benefited the field of anthropology as it provided a quantifiable way to measure the human body and its parts.

Many scientists played a part in the development of anthropometry as a scientific endeavor, including Quetelet, Broca, Boas, Galton, and Hrdlička. These individuals developed mathematical and statistical models of human growth rates, developed the instruments of anthropometry, and set standards for anthropometric measurements and population studies. These “founding fathers” of anthropometry helped pave the way for anthropometry as a widely accepted means of measurement of the human body worldwide. But of course, this was not a totally smooth transition. The history of anthropometry was marred by a period of racist thinking and conclusions. The fields of anthropometry and biological anthropology have since distanced themselves from those racist ways of thinking and have developed into reputable fields of scientific inquiry. Today, anthropometric measurements and methods are widely accepted and practiced, and can even be used to diagnose abnormal growth patterns such as those characteristic of malnutrition.

A major barrier to proper growth and development is malnutrition. Malnutrition comes in four major forms: (1) overnutrition, (2) protein-calorie malnutrition, (3) micronutrient malnutrition, and (4) secondary malnutrition. Taken together, malnutrition remains a formidable obstacle to proper growth and development worldwide, and much of the earth’s population suffers from one type of malnutrition or another. Protein-calorie malnutrition is referred to as undernutrition and manifests as wasting or stunting. Chronically stunted populations, like those of Mexico, provide an example of where culture and diet may play a part in the prevalence of undernutrition.

Micronutrient malnutrition refers to a condition where individuals are not receiving adequate amounts of the vitamins and minerals the human body needs for proper growth and development. In Asia, populations that subsist mainly on rice and have low intakes of green and yellow fruits and vegetables tend to be deficient in vitamin A. Vitamin A deficiency leads to blindness and remains a problem in certain areas of India and Southeast Asia.

Overnutrition tends to be a disease of the developed nations but is now found all over the world in people with abundant food resources. The United States remains one of the fattest countries in the world, where overindulgence has led to high rates of cardiovascular disease, diabetes, and cancer.

There are many ways to approach a synthesis of human growth and development. Much of the literature in the field today is housed in medical journals. However, biological anthropologists remain at the forefront of developments in anthropometric techniques and instruments. Anthropologists are also leaders in the study of how culture and population differences play a part in proper growth and development around the world.