Nutritional dwarfism

A clinical syndrome similar to that of "adolescent nutritional dwarfism has been identified in younger children in Iran, though failure of sexual maturation is not evident prior to adolescence. This syndrome is most common in small, rural communities in which there is also a high incidence of adolescent nutritional dwarfism. 

Zinc Deficiency. A nutritional problem associated with consumption of large amounts of whole wheat products is the unavailability of dietary zinc, first observed in a patient with immature development and dwarfism in southern Iran (17). The patient showed marked improvement when placed on a well-balanced, nutritious diet for a year. In 1962, similar patients were observed in Egyptian villages. A deficiency of zinc was identified as the primary reason for the development of this condition. This deficiency of zinc results from the binding of that metal by the phytates present in whole wheat (18). Even when an excess of zinc is present in the diet, if conditions are right, that zinc may be complexed with the phytate and thus rendered unavailable to the body (see Mineral nutrients). Thus, a zinc deficiency may develop when its dietary level appears adequate but the diet contains large amounts of a food, such as whole wheat, that is high in phytates. 

To understand Marandn s meaning properly, it should be noted that he used the word cretinism as he was used to observe it, in sporadic congenital hypothyroidism, and that his reference to a pluriglandular lesion included short stature and dwarfism. It appears that it was conceptually difficult for him to accept that a nutritional deficiency could underly such complex and apparently unrelated manifestations, and he concluded that intermarriage, poverty, etc., were the most important etiological factors. This was most unfortunate, as Marandn was greatly respected, but his efforts in favour of iodine prophylaxis lacked complete conviction. 

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