Relative leg length as a biological marker to trace the developmental history of individuals and populations: growth delay and increased body fat

Earlier Age at Menarche Is Associated with Body Fat and Negative Body Image in Adult Life

Earlier age at menarche is one of the well-documented antecedents of a range of adverse health effects in adulthood including obesity and psychopathological effects. Yet, few researchers have examined the potential association of menarcheal age with body fat distribution, self-perception, and body image. We retrospectively tested a sample (N = 392) of adult women (18-80 years) to examine the associations of age at menarche with body composition and body image indices. Analyses of covariance and multivariable logistic and linear regression were fitted adjusting for age, physical activity level, smoking, and alcohol consumption. Further adjustment was made for body mass index (BMI) and percentage of fat mass. Earlier age at menarche was associated with slightly increased odds of higher BMI and abdominal fat percentage; of note is the positive correlation with lower body composition indices including hip and calf circumferences/skinfolds. Additionally, earlier age at menarche was associated with higher scores in the negative body image scales, namely overweight preoccupation and self-classified weight, whereas lower risks were found for higher scores in the positive body image scales, namely appearance evaluation and body area satisfaction scales. These findings remained significant after correcting for body fat percentage. The present results showed positive associations for earlier age at menarche with gross indices of obesity with the associations mainly confined to distribution of body fat in the lower part of the body, whereas an increased risk of negative body image was also found. Future research could refine our understanding of the biological and psychological mechanisms underlying these associations.

Pulse wave velocity in South African women and children: comparison between the Mobil-O-Graph and SphygmoCor XCEL devices

BACKGROUND

Carotid-femoral pulse wave velocity (PWV) is the gold-standard noninvasive measure of arterial stiffness. Data comparing tonometry-based devices such as the SphygmoCor XCEL to simpler brachial-cuff-based estimates of PWV, such as from the Mobil-O-Graph in African populations are sparse. We therefore aimed to compare PWV measured by the Mobil-O-Graph and the SphygmoCor XCEL device in a sample of South African women and children.

METHODS

Women (n = 85) 29 years [interquartile range (IQR): 29-69] and their children/grandchildren (n = 27) 7 years (IQR: 4-11) were recruited for PWV measurement with Mobil-O-Graph and SphygmoCor XCEL on the same day. Wilcoxon signed-rank test, regression analysis, spearman correlation and Bland-Altman plots were used for PWV comparison between devices.

RESULTS

For adults, the SphygmoCor XCEL device had a significantly higher PWV (7.3 m/s, IQR: 6.4-8.5) compared with the Mobil-O-Graph (5.9 m/s, IQR: 5.0-8.1, P = 0.001) with a correlation coefficient of 0.809 (P ≤ 0.001). Bland--Altman analysis indicated an acceptable level of agreement but significant bias (mean difference PWV: 0.90 ± 1.02 m/s; limits of agreement: -1.10 to 2.90). The odds of having a PWV difference more than 1 m/s decreased with a higher age [odds ratio (OR): 0.95, 95% confidence interval (95% CI) = 0.92-0.98] and increased with greater height (OR: 1.10, 95% CI = 1.01-1.21, P = 0.03) in multivariable analysis. In children, the Bland-Altman indicated an excellent level of agreement (-0.03 ± 0.63 m/s; limits of agreement: -1.26 to 1.21), but no correlation was found (rs = 0.08, P = 0.71).

CONCLUSION

Particularly in younger and taller women, the Mobil-O-Graph significantly underestimated PWV compared with the SphygmoCor. Although no correlation was found between the two devices for children, further research is required due to the small sample size. Furthermore, the clinical value of both methods in young African populations requires further investigation.

Short-term fetal nutritional stress and long-term health: Child height

OBJECTIVE

This study examined the impact of in utero exposure to Ramadan, the Islamic fasting month, by trimester on height at ages 0 to 18 for a sample of children from Tehran, Iran. If exposure to Ramadan is associated with significant nutritional stress to the fetus, the fetus's adaptive responses to nutritional insufficiency could manifest as changes in height during childhood, long before any effects on aging or disease risk at older ages.

METHODS

Children who were exposed and not exposed to Ramadan in utero were compared to identify any systematic difference between their parents' and households' characteristics (including height, age, education, and indicators of wealth). Also, the seasonal pattern of food consumption in Tehran was analyzed. Finally, the association of child height with prenatal exposure to Ramadan was measured, controlling for seasonality and parent and household.

RESULTS

Ramadan associated fasting in the second trimester of gestation was associated with 0.091 age-adjusted SDs (ie, 0.60-0.67 cm) decrease in children's height at age 10 years or older. The negative association was largest in male children and was approximately 1 cm at age 12 years or older among male children.

CONCLUSION

Maternal Ramadan fasting in the second trimester, the critical period for long bone development, was associated with decreased height. Exposure to ritual fasting is important because approximately 75% of all Muslim children are exposed to Ramadan in utero.

Do components of adult height predict body composition and cardiometabolic risk in a young adult South Asian Indian population? Findings from a hospital-based cohort study in Pune, India: Pune Children's Study

OBJECTIVES

We investigated whether the relationship between components of height and cardiovascular disease (CVD) risk may be explained by body composition. We also examined relationships between parental heights and offspring CVD risk.

DESIGN

A cohort study using cross-sectional data.

SETTING

A secondary care hospital setting in Pune, India.

PARTICIPANTS

We studied 357 young adults and their parents in the Pune Children's Study. Primary and secondary outcomes: we measured weight, total height, leg length, sitting height, plasma glucose, insulin and lipids, and blood pressure (BP). Total and regional lean and fat mass were measured by dual X-ray absorptiometry.

RESULTS

Leg length was inversely related, and sitting height was directly related to BMI. Total height and leg length were directly related to lean mass, while sitting height was directly related to both lean and fat mass. Leg length was inversely related to systolic BP and 120 min glucose, independent of lean and fat mass. Sitting height was directly related to systolic BP and triglycerides; these relationships were attenuated on adjustment for lean and fat mass. When examined simultaneously, greater leg length was protective and greater sitting height was associated with a more detrimental CVD risk profile.

CONCLUSIONS

Shorter adult leg length and greater sitting height are associated with a more adverse CVD risk factor profile. The mechanisms need further study, but our findings suggest a role for lean and fat mass.

Correlation of resting heart rate with anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN cohort study

Background

There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population.

Material and methods

It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test.

Results & conclusion

A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66–80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = − 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate.

Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments.

When is sitting height a better measure of adult body size than total height, and why? The contrasting examples of body mass, waist circumference, and lung volume

OBJECTIVES

We aimed to establish which of sitting height (SH) and total height (Ht) is most appropriately used in the scaling of adult body mass (BM), waist circumference (WC), and forced vital capacity (FVC), considering likely explanations and proposing a suitable index for each.

METHODS

Data were from the US Third National Health and Nutrition Survey for white and black American women and men aged 20 to 50 years. Statistical analysis involved mainly correlation coefficients, the multiple regression of BM, WC, or FVC on SH and leg length (LL), and fitting of allometric regression equations relating each of BM, WC, and FVC to SH or Ht.

RESULTS

BM and WC correlated more strongly with SH than with Ht, and FVC correlated more strongly with Ht. Associations with LL were negative for WC, negative or nonsignificant for BM, and positive for FVC. Using round-number exponents for Ht and SH, the allometric relationships indicated that appropriate indices are BM/SH³ , WC/SH, and FVC/Ht² .

CONCLUSIONS

Contrary to usual practice, BM and WC are better scaled in relation to SH than to Ht. FVC is slightly better scaled in relation to Ht, as is conventional. Interpretations involve the small influence of LL on BM and the influence both of gluteo-femoral fatness on measured SH and of childhood health and nutrition on adult LL, WC, and FVC. It is evident that SH should be measured more often for research purposes.

Early-life exposures and cardiovascular disease risk among Ghanaian migrant and home populations: the RODAM study

Early-life environmental and nutritional exposures are considered to contribute to the differences in cardiovascular disease (CVD) burden. Among sub-Saharan African populations, the association between markers of early-life exposures such as leg length and sitting height and CVD risk is yet to be investigated. This study assessed the association between leg length, sitting height, and estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk among Ghanaian-born populations in Europe and Ghana. We constructed sex-specific quintiles for sitting height and leg length for 3250 participants aged 40-70 years (mean age 52 years; men 39.6%; women 60.4%) in the cross-sectional multicenter Research on Diabetes and Obesity among African Migrants study. Ten-year risk of ASCVD was estimated using the Pooled Cohort Equations; risk ≥7.5% was defined as "elevated" CVD risk. Prevalence ratios (PR) were estimated to determine the associations between sitting height, leg length, and estimated 10-year ASCVD risk. For both men and women, mean sitting height and leg length were highest in Europe and lowest in rural Ghana. Sitting height was inversely associated with 10-year ASCVD risk among all women (PR for 1 standard deviation increase of sitting height: 0.75; 95% confidence interval: 0.67, 0.85). Among men, an inverse association between sitting height and 10-year ASCVD risk was significant on adjustment for study site, adult, and parental education but attenuated when further adjusted for height. No association was found between leg length and estimated 10-year ASCVD risk. Early-life and childhood exposures that influence sitting height could be the important determinants of ASCVD risk in this adult population.

Body proportions of 6–18-year-old children in Merida, Mexico

The purpose of this study was to find out the differences in body physique and its proportions between children from Creole, Maya and Mestizo ethnic groups living in Merida, Mexico. The study was conducted between 1996–1999 and comprised of 4636 children and youth aged 6–18 years from three ethnic groups: Maya, Mestizo, and Creole. There were 1362 boys and 1314 girls from Creole group and 803 boys and 857 girls from the pooled Maya/Mestizo group. Anthropometric measurements included body height, arm and leg length, shoulder and hip width. The following indexes were calculated: leg length-to-body height, upper-to-lower limb, shoulder-to-body height, hip-to-body height, and hip-to-shoulder. Two-way analysis of variance (two-way ANOVA) was used to test the main effect and the interaction effects of age and ethnicity on height, leg length and body proportions, separately for boys and girls. All statistical analyses were performed using Statistica software version 13.1. All p-values lower than 0.05 were considered significant. Results of this study revealed that average values of body height, leg length and upper-to-lower limb and shoulder width proportions were statistically significantly different between ethnic groups. Creole children were taller and longer-legged than their Maya/Mestizo peers, and the greatest difference was noted after puberty. Maya/Mestizo children had relatively longer arm as compared to Creoles. Results of two-way ANOVA revealed that age and ethnicity were combined (interaction effect) factors for variation in body height both in boys and girls, and upper-to-lower limb proportion in boys, shoulder-to-body height proportion in girls. Ethnicity was the main effect factor for leg length both in boys and girls, and for the body proportions: upper-to-lower limb in girls and shoulder-to-body height in boys. Age was the main effect factor for upper-to-lower limb proportion in girls, shoulder-to-body height in boys, hip-to-body height in boys and girls, and hip-to-shoulder, both in boys and girls. In conclusion it may be stated that variation in body physique and body proportions during the postnatal growth in different ethnic groups is under the influence of complex interaction between genetic and environmental factors to which the individual is exposed.

Short relative leg length is associated with overweight and obesity in Mexican immigrant women

Background

Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare – all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured by the leg length index, LLI) and measures of adiposity – based on body mass index (BMI) and waist circumference (WC) – in a population of recent Mexican immigrant women to the New York City Area.

Methods

The analysis was based on a cross-sectional survey of 200 Mexican immigrant women aged 18 to 70 years, whose data were collected between April and November 2008; although for purposes of the current study we restricted the sample to those aged 18 to 59 years. The dependent variables were BMI and WC, both transformed into categorical variables. The main independent variable was LLI, and other correlates were controlled for (i.e. age, education, having had children, characteristics of the community of origin, acculturation, chronic conditions, sedentary behaviors, access to fresh fruits and vegetables). Two probit models were estimated: the first one analyzed the effect of LLI on BMI categories and the second one estimated the effect of LLI on WC.

Results

The probit assessing the effect of LLI on overweight/obesity suggested that having a short LLI increased the probability of overweight/obesity by 21 percentage points. Results from the probit model estimating the effect of LLI on WC indicated that having a short LLI increased the probability of having abdominal adiposity by 39 percentage points. Both results were statistically significant at p < 0.05.

Conclusion

The study found an association between having shorter legs relative to one’s height and increased risk of overweight/obesity and abdominal adiposity. Findings support the epidemiological evidence regarding the association between short leg length, early life socioeconomic conditions (i.e. limited access to basic rights), and increased risk of adverse health effects later in life.

Electronic supplementary material

The online version of this article (10.1186/s12939-019-0988-0) contains supplementary material, which is available to authorized users.

Individual mesh size for open anterior inguinal hernia repair: an anthropometric study in Turkish male patients

PURPOSE

To conduct a study to determine the measurements of the inguinal region in male patients with inguinal hernias to reveal the proper mesh size for each patient.

METHODS

In this prospective study, the anthropometric measurements were obtained from 100 consecutive adult male patients with unilateral primary inguinal hernias. First, the distance between the pubic tubercle and the medial border of the deep inguinal ring was measured (x). Second, the distance between the inner edge of the inguinal ligament and the uppermost level of the internal oblique aponeurosis at the midpoint of the inguinal ligament corresponding to the Hesselbach triangle was measured (y). Individual mesh sizes were calculated according to the original recommendations for mesh overlap.

RESULTS

The mean x value was 41.6 mm (22-55 mm), the mean y value was 45.2 mm (30-68 mm). The mean dimensions of the mesh were 126.6 mm × 65.2 mm. The largest mesh was 140 mm × 88 mm, and the smallest one was 107 mm × 62 mm. The mean mesh area was 8320 mm². It was larger than the index mesh area recommended by the Lichtenstein Hernia Institute in 45 patients and smaller in 55 patients.

CONCLUSIONS

The intraoperative measurements for ideal mesh size in Lichtenstein repair of inguinal hernias may present somewhat different mesh dimensions in many patients. Individualization of mesh size may be of importance in surgical outcomes.

Body proportionality and adiposity are not related in 6- to 8-year-old Yucatec Maya children

OBJECTIVE

The aim of this study was to analyze the association between relative leg length (RLL) (leg length × 100/height) and adiposity in a sample of 6- to 8-year-old children of Maya ancestry from Motul and Merida, Mexico.

METHODS

This cross-sectional study included 260 children (128 girls) measured between 2011 and 2015. The RLL was used as a measure of body proportionality. Linear regression models were performed to examine the association between RLL (predictor) and three adiposity indicators (outcome variables): fat mass index (kg/m² ), waist circumference (z-score), and sum of triceps and subscapular skinfolds (z-score).

RESULTS

The prevalence of stunting was 12%, and a higher prevalence (19%) of short RLL (leg stunting) was found. The prevalence of overweight and obesity were 16% and 20%, respectively, but the highest prevalence was found for abdominal obesity (40%). None of the adiposity indicators were related to RLL (P > .05), even after adjusting for the influence of children's sex and age.

CONCLUSIONS

Our results suggest that the coexistence of short RLL and high body adiposity is not observed in all populations. Our findings do not discount the possibility that a negative association between RLL and adiposity is expressed at older ages.

Rural-urban variations in age at menarche, adult height, leg-length and abdominal adiposity in black South African women in transitioning South Africa

Background: The pre-pubertal socioeconomic environment may be an important determinant of age at menarche, adult height, body proportions and adiposity: traits closely linked to adolescent and adult health.

Aims: This study explored differences in age at menarche, adult height, relative leg-length and waist circumference between rural and urban black South African young adult women, who are at different stages of the nutrition and epidemiologic transitions.

Subjects and methods: We compared 18–23 year-old black South African women, 482 urban-dwelling from Soweto and 509 from the rural Mpumalanga province. Age at menarche, obstetric history and household socio-demographic and economic information were recorded using interview-administered questionnaires. Height, sitting-height, hip and waist circumference were measured using standardised techniques.

Results: Urban and rural black South African women differed in their age at menarche (at ages 12.7 and 14.5 years, respectively). In urban women, a one-year increase in age at menarche was associated with a 0.65 cm and 0.16% increase in height and relative leg-length ratio, respectively. In both settings, earlier age at menarche and shorter relative leg-length were independently associated with an increase in waist circumference.

Conclusions: In black South African women, the earlier onset of puberty, and consequently an earlier growth cessation process, may lead to central fat mass accumulation in adulthood.

The influence of stunting on obesity in adulthood: results from the EPIPorto cohort

Objective

To retrospectively investigate the association between short stature and increased sitting height ratio (SHR) – indicators of stunting – and obesity markers in adults.

Design

Cross-sectional evaluation of the EPIPorto cohort. Weight, height, sitting height and waist circumference were measured. Obesity was assessed for men and women through BMI and waist-to-height ratio (WHtR). Short stature (women, <152 cm; men, <164 cm) and high SHR (women, ≥54·05 %; men, ≥53·25 %) were taken as stunting measures. OR with 95 % CI were computed using logistic regression models.

Setting

Representative sample of adults from EPIPorto, an adult cohort study from Porto, Portugal.

Subjects

A sample of 1682 adults, aged 18–86 years, was analysed.

Results

Higher obesity prevalence was found among women (BMI≥30·0 kg/m2: 25·5v.13·3 %,P<0·001) and a higher proportion of men presented abdominal obesity (WHtR≥0·5: 80·1v.71·1 %,P<0·001). A positive association was found between short stature and obesity measures for women (multivariate-adjusted OR; 95 % CI: 1·75; 1·17, 2·62 for BMI≥30·0 kg/m2; 1·89; 1·24, 2·87 for WHtR≥0·5). Increased SHR was associated with higher likelihood of having BMI≥30·0 kg/m2in both sexes (multivariate-adjusted OR; 95 % CI: 2·10; 1·40, 3·16 for women; 1·92; 1·07, 3·43 for men) but not with WHtR≥0·5.

Conclusions

Different growth markers are associated with obesity in adults. However, this association depends on the population and anthropometric measures used: short stature is associated with a higher risk of presenting excessive weight in women but not in men; SHR is more sensitive to detect this effect in both sexes.

Early-life nutritional status and metabolic syndrome: gender-specific associations from a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

OBJECTIVE

In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old.

DESIGN

Cross-sectional analysis.

SUBJECTS

Baseline data from 12 602 participants (35-74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008-2010.

SETTING

MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance.

RESULTS

MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations.

CONCLUSIONS

Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.

Early Homo, plasticity and the extended evolutionary synthesis

The Modern Synthesis led to fundamental advances in understandings of human evolution. For human palaeontology, a science that works from ancestral phenotypes (i.e. the fossil record), particularly important have been perspectives used to help understand the heritable aspects of phenotypes and how fossil individuals might then be aggregated into species, and relationships among these groups understood. This focus, coupled with the fragmentary nature of the fossil record, however, means that individual phenotypic variation is often treated as unimportant 'noise', rather than as a source of insight into population adaptation and evolutionary process. The emphasis of the extended evolutionary synthesis on plasticity as a source of phenotypic novelty, and the related question of the role of such variation in long-term evolutionary trends, focuses welcome attention on non-genetic means by which novel phenotypes are generated and in so doing provides alternative approaches to interpreting the fossil record. We review evidence from contemporary human populations regarding some of the aspects of adult phenotypes preserved in the fossil record that might be most responsive to non-genetic drivers, and we consider how these perspectives lead to alternate hypotheses for interpreting the fossil record of early genus Homo. We conclude by arguing that paying closer attention to the causes and consequences of intraspecific phenotypic variation in its own right, as opposed to as noise around a species mean, may inspire a new generation of hypotheses regarding species diversity in the Early Pleistocene and the foundations for dispersal and regional diversification in Homo erectus and its descendants.

Age at menarche and risk of major cardiovascular diseases: Evidence of birth cohort effects from a prospective study of 300,000 Chinese women

Background

Previous studies of mostly Western women have reported inconsistent findings on the association between age at menarche and risk of cardiovascular disease (CVD). Little is known about the association in China where there has been a large intergenerational decrease in women's mean age at menarche.

Methods

The China Kadoorie Biobank recruited 302,632 women aged 30–79 (mean 50.5) years in 2004–8 from 10 diverse regional sites across China. During 7 years follow-up, 14,111 incident cases of stroke, 14,093 of coronary heart disease (CHD), and 3200 CVD deaths were reported among 281,491 women who had no prior history of CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) relating age at menarche to CVD risks.

Results

The mean (SD) age of menarche was 15.4 (1.9) years, decreasing from 16.2 (2.0) among women born before 1940 to 14.7 (1.6) for those born during the 1960s–1970s. The patterns of association between age at menarche and CVD risk appeared to differ between different birth cohorts, with null associations in older generations but U-shaped or weak positive associations in younger women, especially those born after the 1960s. After minimizing the potential confounding effects from major CVD risk factors, both early and late menarche, compared with menarche at age 13 years, were associated with increased risk of CVD morbidity and mortality, which was more pronounced in younger generations.

Conclusion

Among Chinese women the associations between age at menarche and risk of CVD differed by birth cohort, suggesting other factors may underpin the association.

Stunting and the Prediction of Lung Volumes Among Tibetan Children and Adolescents at High Altitude

This study examines the extent to which stunting (height-for-age Z-scores ≤ -2) compromises the use of low altitude prediction equations to gauge the general increase in lung volumes during growth among high altitude populations. The forced vital capacity (FVC) and forced expiratory volume (FEV1) of 208 stunted and 365 non-stunted high-altitude Tibetan children and adolescents between the ages of 6 and 20 years are predicted using the Third National Health and Nutrition Examination Survey (NHANESIII) and the Global Lung Function Initiative (GLF) equations, and compared to observed lung volumes. Stunted Tibetan children show smaller positive deviations from both NHANESIII and GLF prediction equations at most ages than non-stunted children. Deviations from predictions do not correspond to differences in body proportions (sitting heights and chest circumferences relative to stature) between stunted and non-stunted children; but appear compatible with the effects of retarded growth and lung maturation that are likely to exist among stunted children. These results indicate that, before low altitude standards can be used to evaluate the effects of hypoxia, or before high altitude populations can be compared to any other group, it is necessary to assess the relative proportion of stunted children in the samples. If the proportion of stunted children in a high altitude population differs significantly from the proportion in the comparison group, lung function comparisons are unlikely to yield an accurate assessment of the hypoxia effect. The best solution to this problem is to (1) use stature and lung function standards based on the same low altitude population; and (2) assess the hypoxic effect by comparing observed and predicted values among high altitude children whose statures are most like those of children on whom the low altitude spirometric standard is based-preferably high altitude children with HAZ-scores ≥ -1.

Anthropometric difference of the knee on MRI according to gender and age groups

The purpose of this study was to analyze the anthropometric data from MRI images that were obtained from the non-arthritic knees in Asian adults, and to identify the existence of morphologic differences between age groups. This cross-sectional study included knee MR images of 535 patients (273 males, 262 females) taken for the evaluation of soft-tissue injuries, excluding cases with cartilage defect and malalignment. The age, gender, height, and BMI were also assessed. The patients were grouped into three different 20-year age groups (20-39, 40-59, and 60-79). The MRI analysis was performed on the anthropometric parameters of distal femur and posterior tibial slope. Age-related differences were found in femoral width, distance from the distal and posterior cartilage surface to the medial/lateral epicondyle, medial posterior condylar offset (PCO), and posterior condylar angle (PCA) (all P < 0.001), but not in lateral PCO, and medial/lateral tibial slopes. In the analysis of covariance analyses, significant interaction between gender and age groups was found in most parameters, but not in PCA, distance from the posterior cartilage surface to the medial epicondyle, or medial tibial slope. We found anthropometric differences among age groups exist in most of distal femoral parameters, but not in posterior tibial slope. The results of this study can be used by manufacturers to modify prostheses to be suitable for the future Asian elderly population.

Chest circumference and sitting height among children and adolescents from Lhasa, tibet compared to other high altitude populations

OBJECTIVES

The adaptation of human beings to a high altitude environment during growth has been reported in several populations but is less known for Tibetans. The objective of this study was to investigate similarities and differences of Tibetans in patterns and characteristics of physical growth and development in comparison to other high altitude populations.

METHODS

We measured the stature, weight, chest circumference and sitting height of 2,813 healthy children and adolescents aged 6- to 21-year-old living at 3,658-4,500 m in Tibet, China, and compared them with published data from other high altitude populations. Eligible participants must have been born and raised in Tibet, and both their parents' families have to be Tibetan for at least the past three generations.

RESULTS

The physical growth and development of children and adolescents in Tibet and the Andes followed similar patterns, such as delayed growth, short stature and sitting height, and large chest dimensions. Relative to stature, Tibetan sitting heights are similar to Andeans, but chest circumferences are smaller.

CONCLUSIONS

Findings from this study reinforce the conclusion that Tibetan and Andean populations have adapted differently to high altitude hypoxia. The physical features of each population may result from unique adaptation to hypoxia, as well as socio-ecological factors, such as poor nutrition.

Association between leg length-to-height ratio and metabolic syndrome in Chinese children aged 3 to 6 years

Objective

The aim of this study is to investigate the association between leg-length-to-height ratio (LLHR) and metabolic syndrome (MetS) among Chinese children.

Methods

1236 children (619 obese and 617 nonobese children) aged 3–6 years participated in a cross-sectional survey in 2005 in Tianjin, China. Information on body adiposity, metabolic traits, and related covariates was obtained using a standardized protocol. LLHR was calculated as the ratio of leg length to stature.

Results

In the multivariable logistic regression analyses, compared with those in the lowest quartile, odds ratios (OR) and 95% confidence intervals (CI) of MetS among children in the second through the highest quartiles of LLHR Z-score were 0.89 (95% CI, 0.64–1.25), 0.45 (95% CI, 0.32–0.63), and 0.37 (95% CI, 0.26–0.53), respectively, (P_{for trend} < 0.0001 across LLHR Z-score quartiles). Compared with children with both higher levels of LLHR and lower levels of adipose indices, the corresponding ORs of MetS for those with both lower levels of LLHR and higher levels of anthropometric indices were 4.51 (95% CI, 3.08–6.62) for BMI Z-score, 3.86 (95% CI, 2.60–5.73) for waist circumference, and 2.75 (95% CI, 1.85–4.10) for waist-to-hip ratio, respectively.

Conclusions

Greater LLHR is inversely associated with MetS in Chinese children.

•

Leg-length-to-height ratio (LLHR) is negatively associated with childhood obesity.

•

Greater LLHR is inversely associated with childhood metabolic syndrome (MetS).

•

LLHR and adiposity have a synergistic effect in relation to pediatric MetS.

Relative leg length is associated with type 2 diabetes differently according to pubertal timing: the Brazilian longitudinal study of adult health

OBJECTIVES

Studies from developed societies have shown that individuals with short legs relative to height have higher risk of type 2 diabetes. This has been much less explored in less developed populations where influences on relative leg length and diabetes may differ. The Brazilian Longitudinal Study of Adult Health (in Portuguese, ELSA-Brasil) allows us to test, in a cohort born (1934-1975) and raised when undernutrition was common, whether short legs relative to height is positively associated with diabetes, independent of early-life factors, including birth weight, age at menarche, and young-adult BMI.

METHODS

We used baseline, cross-sectional data from 15,105 participants aged 35-74 years participating in ELSA-Brasil. We created age-and-sex-specific Z scores for leg length index (leg length/height × 100) according to an external reference. Diabetes was defined by self-reported physician diagnosis, medication use, fasting and 2-h post-75-g-load glucose, and A1C.

RESULTS

A one-unit decrement in leg-length-index Z score was associated with 12% (8-17%) higher prevalence of diabetes in Brazilian adults, after adjustment through Poisson regression for confounders, including race, maternal education, and birth weight. This association persisted after further adjustment for menarche age, BMI (at age 20), buttocks circumference, and waist circumference. It was stronger among women with early menarche (P interaction = 0.02). Leg length index was also inversely associated with fasting glucose, fasting insulin, 2-h glucose, and A1C (P < 0.05).

CONCLUSIONS

In contemporary Brazilian adults, short legs relative to height is positively associated with diabetes independent of measures of intrauterine growth, pubertal timing, and young-adult adiposity. This association is stronger in women with early menarche.

Leg length is associated with lower values of inflammatory markers in older Chinese: The Guangzhou Biobank Cohort Study

BACKGROUND

In developed western populations, longer legs are a biomarker of better childhood conditions and negatively associated with cardiovascular disease risk factors. These associations are less obvious in non-western settings. However, early life is also a key immune system development phase.

AIM

To examine the associations of height, leg length, sitting height and leg length/sitting height ratio with inflammatory markers (white blood, lymphocyte and granulocyte cell counts and C-reactive protein (CRP)) in a developing population of southern China.

SUBJECTS AND METHODS

This study used multivariable linear regression to examine the adjusted associations in 30,499 Chinese (50+ years).

RESULTS

Height z-score was associated with lower white blood, lymphocyte and granulocyte cell counts. Leg length z-score was associated with lower white blood, lymphocyte and granulocyte cell counts and CRP. Sitting height z-score was associated with lower white blood and granulocyte cell counts, but not with lymphocyte cell count or CRP. Leg length/sitting height ratio z-score was associated with lower white blood, lymphocyte and granulocyte cell counts and CRP.

CONCLUSION

Factors enabling more early growth may also lead to changes in immunity that are associated with reduced CVD risk.

Identification of Fall Risk Predictors in Daily Life Measurements

Background. Gait characteristics extracted from trunk accelerations during daily life locomotion are complementary to questionnaire- or laboratory-based gait and balance assessments and may help to improve fall risk prediction. Objective. The aim of this study was to identify gait characteristics that are associated with self-reported fall history and that can be reliably assessed based on ambulatory data collected during a single week. Methods. We analyzed 2 weeks of trunk acceleration data (DynaPort MoveMonitor, McRoberts) collected among 113 older adults (age range, 65-97 years). During episodes of locomotion, various gait characteristics were determined, including local dynamic stability, interstride variability, and several spectral features. For each characteristic, we performed a negative binomial regression analysis with the participants’ self-reported number of falls in the preceding year as outcome. Reliability of gait characteristics was assessed in terms of intraclass correlations between both measurement weeks. Results. The percentages of spectral power below 0.7 Hz along the vertical and anteroposterior axes and below 10 Hz along the mediolateral axis, as well as local dynamic stability, local dynamic stability per stride, gait smoothness, and the amplitude and slope of the dominant frequency along the vertical axis, were associated with the number of falls in the preceding year and could be reliably assessed (all P < .05, intraclass correlation > 0.75). Conclusions. Daily life gait characteristics are associated with fall history in older adults and can be reliably estimated from a week of ambulatory trunk acceleration measurements.

Associations between arterial oxygen saturation, body size and limb measurements among high-altitude Andean children

Objectives

The relative influences of hypoxia and other environmental stressors on growth at altitude remain unclear. Previous work demonstrated an association between peripheral arterial oxygen saturation (S_pO₂) and anthropometry (especially tibia length) among Tibetan and Han children at altitude. We investigated whether similar associations exist among Andeans, and the patterning of associations between S_pO₂ and anthropometry.

Methods

Stature, head-trunk height, total upper and lower limb lengths, zeugopod (ulna and tibia) and autopod (hand and foot) lengths were measured in Peruvian children (0.5–14 years) living at >3000 m altitude. S_pO₂ was measured by pulse oximetry. Anthropometry was converted to internal z scores. Correlation and multiple regression were used to examine associations between anthropometry z scores and S_pO₂, altitude, or S_pO₂ adjusted for altitude since altitude is a major determinant of variation in S_pO₂.

Results

S_pO₂ and altitude show weak, significant correlations with zeugopod length z scores and still weaker significant correlations with total upper and lower limb length z scores. Correlations with z scores for stature, head-trunk height, or autopod lengths are not significant. Adjusted for altitude, there is no significant association between anthropometry and S_pO₂.

Conclusions

Associations between S_pO₂ or altitude and total limb and zeugopod length z scores exist among Andean children. However, the relationships are relatively weak, and while the relationship between anthropometry and altitude may be partly mediated by S_pO_2, other factors that covary with altitude (e.g., socioeconomic status, health) are likely to influence anthropometry. The results support suggestions that zeugopod lengths are particularly sensitive to environmental stressors. Am. J. Hum. Biol., 25:629–636, 2013. © 2013 Wiley Periodicals, Inc.

Population differences in the relationship between height, weight, and adiposity: an application of Burton's model

The study of human variation in adiposity and lean mass is important for understanding core processes in human evolution, and is increasingly a public health concern as the "obesity epidemic" expands globally. The dominant measure of population differences in adiposity is Body Mass Index (BMI), which suffers from systematic biases across populations due to variation in the relationship between true body fat, height and weight. Here we develop simplified corrections for such anthropometric-based measures of adiposity that can take into account this population variation. These corrections derive from a recent model proposed by Burton that assumes humans accrue mass in two ways-growth in height that adds bone and muscle, and growth in body fat and the ancillary fat-free mass (FFM) needed to support this additional body fat. We analyze two ethnically diverse datasets with dual X-ray absorptiometry-measured (DXA) fat mass, assessing the fit of Burton's model and deriving novel corrections based on estimated musculoskeletal slenderness. The resulting model provides excellent fit to fat mass within populations (average R2 = 0.92 for women and R2 = 0.83 for men). World populations differ dramatically in musculoskeletal slenderness (up to a difference of 4.4 kg/m2), as do men and women (differences of 3.3-4.5 kg/m2), leading to clear population corrections. These findings point to a conceptually straightforward tool for estimating true differences in adiposity across populations, and suggest an alternative to BMI that provides a more accurate and theoretically based estimate of body fat than that traditionally derived from height and weight measures.

Bony pelvic canal size and shape in relation to body proportionality in humans

Obstetric selection acts on the female pelvic canal to accommodate the human neonate and contributes to pelvic sexual dimorphism. There is a complex relationship between selection for obstetric sufficiency and for overall body size in humans. The relationship between selective pressures may differ among populations of different body sizes and proportions, as pelvic canal dimensions vary among populations. Size and shape of the pelvic canal in relation to body size and shape were examined using nine skeletal samples (total female n = 57; male n = 84) from diverse geographical regions. Pelvic, vertebral, and lower limb bone measurements were collected. Principal component analyses demonstrate pelvic canal size and shape differences among the samples. Male multivariate variance in pelvic shape is greater than female variance for North and South Africans. High-latitude samples have larger and broader bodies, and pelvic canals of larger size and, among females, relatively broader medio-lateral dimensions relative to low-latitude samples, which tend to display relatively expanded inlet antero-posterior (A-P) and posterior canal dimensions. Differences in canal shape exist among samples that are not associated with latitude or body size, suggesting independence of some canal shape characteristics from body size and shape. The South Africans are distinctive with very narrow bodies and small pelvic inlets relative to an elongated lower canal in A-P and posterior lengths. Variation in pelvic canal geometry among populations is consistent with a high degree of evolvability in the human pelvis.

Trade-offs in relative limb length among Peruvian children: extending the thrifty phenotype hypothesis to limb proportions

Background and Methods

Both the concept of ‘brain-sparing’ growth and associations between relative lower limb length, childhood environment and adult disease risk are well established. Furthermore, tibia length is suggested to be particularly plastic under conditions of environmental stress. The mechanisms responsible are uncertain, but three hypotheses may be relevant. The ‘thrifty phenotype’ assumes that some components of growth are selectively sacrificed to preserve more critical outcomes, like the brain. The ‘distal blood flow’ hypothesis assumes that blood nutrients decline with distance from the heart, and hence may affect limbs in relation to basic body geometry. Temperature adaptation predicts a gradient of decreased size along the limbs reflecting decreasing tissue temperature/blood flow. We examined these questions by comparing the size of body segments among Peruvian children born and raised in differentially stressful environments. In a cross-sectional sample of children aged 6 months to 14 years (n = 447) we measured head circumference, head-trunk height, total upper and lower limb lengths, and zeugopod (ulna and tibia) and autopod (hand and foot) lengths.

Results

Highland children (exposed to greater stress) had significantly shorter limbs and zeugopod and autopod elements than lowland children, while differences in head-trunk height were smaller. Zeugopod elements appeared most sensitive to environmental conditions, as they were relatively shorter among highland children than their respective autopod elements.

Discussion

The results suggest that functional traits (hand, foot, and head) may be partially protected at the expense of the tibia and ulna. The results do not fit the predictions of the distal blood flow and temperature adaptation models as explanations for relative limb segment growth under stress conditions. Rather, our data support the extension of the thrifty phenotype hypothesis to limb growth, and suggest that certain elements of limb growth may be sacrificed under tough conditions to buffer more functional traits.

Low birth weight does not predict the ontogeny of relative leg length of infants and children: an allometric analysis of the NHANES III sample

Previous research links both low birth weight (LBW) and relative leg length (RLL) to a similar set of adult pathologies, including type II diabetes, coronary vascular disease, and some cancers. Historically, LBW has been frequently used as a broad indicator of the quality of the intrauterine environment, while RLL has been considered a sensitive measure of childhood environmental quality. While these observations have been taken to suggest that these measures reflect independent exposures at different life-stages, their mutual association with a similar set of later pathologies makes this assumption less certain than it may have previously seemed. Nationally representative data from the Third National Health and Nutrition Examination Survey (NHANES III) are used to test the hypothesis that LBW predicts reductions in the development of leg length relative to stature. After controls for important socioeconomic exposures that might confound measurement of such a relationship, we find statistical and biological evidence that variation in birth weight and variation in the development of leg length relative to stature (RLL) are independent. The results suggest that these two measures may represent independent information on prenatal and postnatal environmental quality.

Use of leg length to height ratio to assess the risk of childhood overweight and obesity: results from a longitudinal cohort study

PURPOSE

To determine whether leg-length to height ratio (LLHR) measured in children can be used to assess overweight and obese status 3 years later.

METHODS

A total of 1166 children from South Ontario, Canada, were assessed in grade five and again in grade eight were included in this analysis. On the basis of LLHR gender-specific quartile cutoffs in grade five, children were categorized into four groups (Q1[low]-Q4). Gender and age specific cutoffs of body mass index were used to categorize children as overweight/obese or normal weight in grade eight. Multiple logistic regression models were used to examine the overweight/obesity risk association with LLHR.

RESULTS

In comparing those in Q1 of LLHR, we found the odds ratios (OR, 95% confidence interval) of overweight/obese for those in the Q2-Q4 were 0.60 (0.29-1.21), 0.43 (0.21-0.89), and 0.32 (0.15-0.70) for boys and 0.77 (0.36-1.64), 0.60 (0.28-1.29), and 0.27 (0.12-0.62) for girls, respectively. The overweight/obesity risk association with LLHR remains after removing those who were considered overweight/obese at grade five.

CONCLUSIONS

LLHR is associated with risk of childhood overweight/obesity. Further studies are warranted to investigate the role of LLHR on development of obesity.

The use of biocultural data in interpreting sex differences in body proportions among rural Amazonians

Variation in height and body proportions is relatively well-understood at the inter-population level, but less is known about intra-population variation. This study explores intra-population variation in body proportions among 172 (88 female; 84 male) adult rural Amazonians. We test the hypotheses that: (1) stunting is associated with changes in proportions and fatness; (2) the sexes express different proportions in response to similar environmental stress; and (3) female growth is negatively affected by the costs of reproduction. We examined height, sitting height, and total leg length in subsamples based on sex and nutritional status (stunted/nonstunted) in relation to biocultural factors including access to food and healthcare and female reproductive history parameters. Differences in proportions were examined using the Quick-Test (Tsutakawa and Hewett: Biometrics 33 (1977) 215-219); correlation analyses were used to detect associations between anthropometric data and body fatness, and female reproductive history parameters. We found significantly higher rates of stunting among females (X(2) = 5.31; P = 0.02; RR = 1.4). Stunted individuals exhibited relatively shorter legs than nonstunted individuals (P = 0.02), although this was not found in within-sex analyses. A significant negative correlation was found between leg length index and fatness (P < 0.01). Lastly, females exhibited relatively shorter legs than males (P = 0.0003) and, among females, height and leg length were significantly positively correlated with age-at-first-birth (P < 0.02) suggesting that adolescent pregnancy may negatively affect growth in this population. Our findings provide insights for the study of intra-population variation in body proportions and highlight the importance of biocultural data in interpreting the pattern of variation observed in living and past populations.

Why socially deprived populations have a faster resting heart rate: impact of behaviour, life course anthropometry, and biology--the RECORD Cohort Study

Although studies have shown that resting heart rate (RHR) is predictive of cardiovascular morbidity/mortality, few studies focused on the epidemiology and social aetiology of RHR. Using the RECORD Cohort Study (7158 participants, 2007-2008, Paris region, France), we investigated individual/neighbourhood socioeconomic variables associated with resting heart rate, and assessed which of a number of psychological factors (depression and stress), behaviour (sport-related energy expenditure, medication use, and alcohol, coffee, and tobacco consumption), life course anthropometric factors (body mass index, waist circumference, and leg length as a marker of childhood environmental exposures), and biologic factors (alkaline phosphatase and gamma-glutamyltransferase) contributed to the socioeconomic disadvantage-RHR relationship. Combining individual/neighbourhood socioeconomic factors in a socioeconomic score, RHR increased with socioeconomic disadvantage: +0.9 [95% credible interval (CrI): +0.2, +1.6], +1.8 (95% CrI: +1.0, +2.5), and +3.6 (95% CrI: +2.9, +4.4) bpm for the 3 categories reflecting increasing disadvantage, compared with the lowest disadvantage category. Twenty-one percent of the socioeconomic disadvantage-RHR relationship was explained by sport practise variables, 9% by waist circumference, 7% by gamma-glutamyltransferase, 5% by alkaline phosphatase, and 3% by leg length. Future research should further clarify the mechanisms through which socioeconomic disadvantage influences resting heart rate, as a pathway to social disparities in cardiovascular morbidity/mortality.

How useful is BMI in predicting adiposity indicators in a sample of Maya children and women with high levels of stunting?

OBJECTIVES

Body mass index (BMI) is used frequently to estimate adiposity levels in children and adults. However, the applicability of BMI to populations with high levels of stunting has been questioned. Stunted people can have disproportionately short legs, which may increase BMI without increasing body fat because of the relatively larger trunk compared with the legs.

METHODS

A sample of 57 urban Maya schoolchildren, aged 7-9 years (31 boys), and 53 adult women underwent anthropometric assessments and bioelectrical impedance analysis. Multiple linear regression was performed to determine whether the ability of BMI to predict adiposity indicators is altered by stunting and sitting height ratio (SHR). The adiposity indicators were waist circumference, sum of skinfolds, upper arm muscle area, upper arm fat area, and arm fat index.

RESULTS

BMI was the strongest predictor of all adiposity indicators and in most cases, explained more of the variance in adiposity of Maya children than Maya women. Abdominal adiposity was better predicted by BMI than peripheral adiposity in Maya women and Maya children. Stunting was significant in predicting adiposity in some models but never substantially changed the variance explained. SHR was never a significant predictor.

CONCLUSIONS

The relationship between BMI and adiposity indicators is not changed by stunting status or body proportions in this short population of urban Maya children and women. BMI can be used as an indicator of adiposity for these children but not the women. It is recommended that BMI is used in conjunction with other estimates of body composition.

Adult stature, body proportions and age at menarche in the United States National Health and Nutrition Survey (NHANES) III

BACKGROUND

Previous studies have found that age at menarche is associated with stature, primarily via leg length. However, the effects appear to vary by population and/or time period. Improving socioeconomic conditions might amplify the association.

AIM

To test whether the association between early menarche and reduced stature in industrialized countries is mediated by leg length. To further test whether these effects are modified by years of education, as a proxy for socioeconomic conditions.

SUBJECTS AND METHODS

The study used data on from 3174 21-40 year-old women who participated in the third National Health and Nutrition Survey of the US (NHANES III). The anthropometric measurements employed were stature, sitting height and upper leg length. Leg length, lower leg length and ratio of sitting height to leg length were calculated.

RESULTS

Earlier menarche was associated with shorter stature, by ~ 3.9 mm per year of advancement, all of which was attributable to shorter leg length. Almost two-thirds of the effect was in the lower (distal) leg. Years of education did not significantly modify effects of pubertal timing on stature or body proportions.

CONCLUSION

Socioeconomic conditions might not explain variable associations between linear body proportions and pubertal timing.

Femoral neck bone mineral density in ambulatory men with poliomyelitis

We evaluated bilateral femoral neck bone mineral densities (FNBMDs) in 32 men with poliomyelitis and their matched controls. Men with poliomyelitis had significantly lower FNBMD in both legs, and FNBMD was lowest in their shorter legs. Knee extensor strength and regular exercise were important predictive factors associated with decreased FNBMD.

INTRODUCTION

People with poliomyelitis (polio) are prone to leg fractures after mild trauma. The flaccid paralysis, asymmetric involvement, and underdeveloped growth of afflicted legs may lead to osteoporosis of either leg, characterized by different patterns. This study aimed to measure their femoral FNBMD and to explore the factors associated with changes in FNBMD in either leg.

METHODS

We did a prospective study to evaluate bilateral FNBMD with dual-energy X-ray absorptiometry in 32 men with polio (age range, 41-57 years; mean, 47 years) and 32 age- and body mass index-matched controls. Measuring the difference in leg length, we classified the legs of each polio subject as "longer" or "shorter." In addition, we chose the right leg of each control as a reference leg. We then used the Mann-Whitney U test to compare FNBMD of these three groups of legs and searched for the factors associated with FNBMD using stepwise multiple regression analyses.

RESULTS

Compared to the reference leg, men with polio had significantly lower FNBMD in both their longer and shorter legs, by 13% and 23%, respectively. The difference in FNBMD between the two legs of polio subjects was significant. Knee extensor strength and regular exercise were two important factors associated with bilateral FNBMD in men with polio.

CONCLUSIONS

Men with polio had lower bilateral FNBMD. FNBMD of the shorter leg should be the choice for predicting the risk of hip fracture in men with polio because on average, the shorter leg has lower BMD.

Why no adult stunting penalty or height premium? Estimates from native Amazonians in Bolivia

Among adults of industrial nations, growth stunting (<-2 SD height Z score) is associated with worse indicators of adult well-being (e.g., income). Does adult stunting also inflict private costs in traditional societies? Adult stunting penalties or height premiums might only emerge when traditional societies modernize. Here we estimate the association between adult stunting and indicators of adult well-being using data from a panel study in progress among the Tsimane', a foraging-farming society of native Amazonians in Bolivia. Subjects included 248 women and 255 men >or=age 22 measured annually during 5 consecutive years (2002-2006). Nine outcomes (wealth, monetary income, illness, access to credit, mirth, schooling, math skills, plant knowledge, forest clearance) were regressed separately against a stunting dummy variable and a wide range of control variables. We found no significant association between any of the indicators of own well-being and adult stunting. Additional analysis showed that stunting bore an association only with poorer mid-arm muscle area. Height premiums and stunting penalties, though evident and marked in modern societies, might not be common in all traditional societies.

Height and relative leg length as indicators of the quality of the environment among Mozambican juveniles and adolescents

The growth status of Mozambique adolescents was assessed to test the hypothesis that relative leg length is a more sensitive indicator of the quality of the environment than the total height. The sample comprised 690 boys and 727 girls, aged between 9 and 17 years, from Maputo. It is divided between those living in the Centre of Maputo and those living in the slums on the periphery of the city. Height, weight, and sitting height were measured and the sitting height ratio was calculated. The hypothesis that relative leg length is more sensitive than total stature as an indicator of environmental quality is not uniformly confirmed. Overall, mean stature is greater for the centre group than the slum group, but relative leg length as measured by the sitting height ratio does not differ. Compared with African-American references (NHANES II), all centre girls, 9- to 14-year-old slum girls, all slum boys, and the oldest centre boys show relatively shorter legs. These findings show that within the Mozambique sample, relative leg length is not sensitive enough to distinguish the quality of the living environment. Mozambique was a colony of Portugal until 1975. Civil unrest and warfare characterized the late Colonial period and the postindependence period until a peace settlement was concluded in 1992. It is possible that all socioeconomic status groups within the country suffered sufficiently to reduce relative leg length compared with the better-off African-American reference sample. Possible genetic influences on relative leg length are also discussed.