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The growth patterns of five measures of second metacarpal cortical bone are described for a mixed-longitudinal sample of 710 rural Guatemalan preschool children with mild to moderate protein-calorie malnutrition, and are compared to well-nourished children. The Guatemalan children are severely retarded in metacarpal growth compared to the well-nourished children of the same age and sex. Further, when compared to well-nourished children of the same stature and weight, the Guatemalan children have less metacarpal cortex for a given body size. Retardation in metacarpal cortical bone in the moderately malnourished children is not only a reflection of an overall smaller body size, but suggests a differential skeletal response to nutritional stress.