Table of Contents 21-4

Idiopathic Short Stature Children Are Poor Eaters and Are Thin

Data on the eating behaviors and nutritional status of children with idiopathic short stature (ISS) are lacking. The paper by Wudy et al assessed 214 patients with ISS from 123 families and recorded the BMI and eating behaviors with the Child Eating Behavior Questionnaire and the Food Frequency Questionnaire. Endocrine markers of body weight regulation (leptin and ghrelin) were also measured. The ISS patients had a decreased BMI (–0.33 SDS) as compared with population norms. Furthermore, they also had a decreased food responsiveness with a score of 1.9 on the Child Eating Behavior Questionnaire, as compared with a score of 2.4 for the population mean. They had reduced enjoyment of food (3.2 vs 3.9), emotional under-eating (2.6 vs 3.0), and showed increased fussiness over food (3.2 vs 2.9). “Poor” eaters showed more marked alterations in BMI and behavioral characteristics than those who were “good” eaters. Total serum ghrelin was not different among good and poor eaters, and serum leptin was moderately increased but did not differ between the groups. The authors concluded that ISS patients present altered eating behaviors that possibly contribute to their short stature.

Wudy SA, Hagemann S, Dempfle A, et al. Children with idiopathic short stature are poor eaters and have decrease body mass index. Pediatrics. 2005;116:e52–57.

Editor’s Comment: There are countless papers dealing with ISS and other forms of short stature, but the nutritional status and eating behaviors of the patients are rarely addressed. Indeed, low IGF-I levels are most often analyzed and considered essential for diagnosis and treatment of short stature patients, as well as for the publication of scientific papers, often without addressing body weight, dietary intake, or nutritional status. Thus, I am delighted to note the paper by Wudy and colleagues showing ISS patients presenting with alterations in eating patterns and decreased BMIs. Hopefully, these data will stimulate an interest in evaluating the role of suboptimal nutrition on the growth patterns of children with ISS and other short stature patients. This assessment should be a must before embarking in other more costly medical interventions.

Fima Lifshitz, MD