Growth and Sexual Development of Adolescent Egyptian Village Boys

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Abstract
Two hundred and seventy-nine boys attending the Sindion Preparatory School in the United Arab Republic were examined for growth retardation, delayed sexual development, and signs of nutritional deficiencies. One-third, or 90 boys, were found to be greater than two standard deviations below the Iowa mean for height. One quarter of the boys showed signs of B-complex deficiency. Eighty percent were infected with Schistosoma hematobium and complained of intermittent hematuria or dysuria, or both. Hookworm infection was uncommon. All of the boys 2 standard deviations below the Iowa mean for height and a randomly selected control group of 30 of the taller boys were studied in greater detail. Periodic physical examinations were done and included heights, weights and clinical findings. Blood specimens were collected for hemoglobin, hematocrit, serum iron, plasma zinc, and alkaline phosphatase determinations. Urinary riboflavin levels were also determined. X-Rays were taken for bone age. Serial photographs were taken to assess genital development. The examinations were performed at intervals of 3-5 months for a year. The laboratory examinations showed hypoferremia and low plasma zinc levels. Bone age was retarded 2-3 years in both the physically retarded boys and in the controls. Height age was more severely retarded than bone age in the retarded boys. The onset of puberty was slightly delayed in the physically retarded boys by American standards. A double-blind therapeutic trial was carried out giving a daily supplement of 300 mg reagent grade FeSO4·7H2O, 60 mg reagent grade ZnSO4·7H2O, and a placebo. The therapeutic trial was continued for 5½ months. No other additional foods or nutritional supplements were given, and the basic village diet remained unchanged. At the end of 1 year, there was no difference in growth, as measured by increase in height, and no difference in sexual development, as measured by analysis of the clinical examinations and serial photographs, between the three therapeutic groups. The supplements of zinc and iron were effective in raising the serum levels of zinc and iron, respectively, and thus were absorbed. A diet survey using the recall method was done and showed that the diets of the retarded boys were limiting in calories, vitamin A, riboflavin, and possibly calcium and ascorbic acid. Composite food samples were also collected and analyzed and showed the same deficiencies. The zinc content of the diets was normal. Phytate may have interfered with absorption, however.