To study the relationship between diet and growth, a longitudinal anthropometric study was conducted in a Dutch population consuming a macrobiotic diet. Measurements (anthropometry and food habit questionnaire) were taken in 1985 (0-7 y), 1987, and in 1993 (7-16 y, n = 209). Z-scores were calculated for anthropometric measures and changes expressed as the differences between 1993 and the mean of 1985 and 1987. Analysis indicated significant (P < 0.002) catch-up in height [(mean Z-score +/-sEM) +0.59 +/- 0.071 and arm circumference (+0.34 +/- 0.09) for age (boys and girls combined). In 1993, both girls and boys were still significantly (P < 0.05) below the reference for height and sum of four skinfolds for age, and girls were below reference for weight-for-height and arm circumference for age. In girls, multiple regression analyses showed a significant positive effect of the consumption frequency of dairy products on catch-up growth in height, weight and arm circumference, after adjustment for menarche, age, and baseline height, weight and arm circumference (P < 0.05). The addition of moderate amounts of dairy products to a vegan type of diet improved growth of children, especially girls.