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Hasan NS, Thomas W. Mechanistic Association of Hepatoblastoma with Cerebral Palsy: A Narrative Review. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:203-209. [PMID: 39055079 PMCID: PMC11268547 DOI: 10.4103/sjmms.sjmms_519_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/26/2024] [Accepted: 03/31/2024] [Indexed: 07/27/2024]
Abstract
Hepatoblastoma is a rare liver cancer that occurs most often in children who present with lower birth weight. Cerebral palsy (CP) is a neurodevelopmental disorder distinguished by irregularities in muscle tone, movement, and motor skills. CP is caused by damage to the developing brain and is often associated with secondary complications such as severe constipation. Clinicians must be aware of sudden worsening constipation occurring in CP children because it can also be a sign of hepatoblastoma. The aim of this review is to summarize the current understanding of the risks for hepatoblastoma development in children with CP. Cancer risks likely include dysfunction of the immune system surveillance in CP children. Elevated C-reactive protein and tumor necrosis factor-alpha levels may be higher in children with CP, which weakens their innate immune system. Metabolic disruption increases the risk of some cancers, and poor nutrition and reduced growth that occur in CP patients may have an impact on cancer development through a loss in immune function. Increased mobility and physical activity can increase the T-cell, natural killer cell, and neutrophil population. Children with CP tend to engage poorly in physical activity, and consequently, their immune system is affected. There are multiple factors associated with CP that increase the risk of childhood cancers such as hepatoblastoma.
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Affiliation(s)
- Noor Saeed Hasan
- School of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Kingdom of Bahrain
| | - Warren Thomas
- School of Medicine, Royal College of Surgeons in Ireland, Medical University of Bahrain, Kingdom of Bahrain
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Al-Qerem W, Zumot R, Jarab A, Eberhardt J, Alasmari F, Hammad A. Evaluating the Validity of International Standards of Height, Weight, and Body Mass Index on Jordanian Children and Adolescents. Healthcare (Basel) 2024; 12:1295. [PMID: 38998830 PMCID: PMC11240996 DOI: 10.3390/healthcare12131295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND the variations in a child's overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of applying international growth standards to Jordanian children and adolescents aged 2-19 years old. METHODS 65,828 Jordanian children and adolescents (43% males; 57% females) aged 2-19 years old were selected from the Hakeem Program database and various private schools across Jordan. Height-for-age, weight-for-age, and body mass index (BMI)-for-age were analyzed comparatively for Jordanian children and adolescents against international growth standards. The z-score for each record was computed based on international equations. RESULTS Mean z-scores for height-for-age, weight-for-age, and BMI-for-age for both genders showed significant deviation from international standards across most age intervals. It was found that in most age groups, Jordanian children and adolescents were shorter and lighter than CDC and WHO standards, except for females at ages ≥ 16 years, who were heavier with higher BMI-for-age values than CDC standards based on weight-for-age and BMI-for-age equations. Moreover, Jordanian males at ages ≥ 12 years had lower BMI-for-age values than CDC standards. CONCLUSIONS Jordanian children and adolescents showed significant deviations in their measurements from international standards and growth reference values. The development of a population-specific growth chart is highly recommended to enhance the accuracy of evaluating children's and adolescents' wellness.
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Affiliation(s)
- Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (R.Z.); (A.H.)
| | - Ruba Zumot
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (R.Z.); (A.H.)
| | - Anan Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi 112612, United Arab Emirates;
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi 112612, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Judith Eberhardt
- Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Borough Road, Middlesbrough TS1 3BX, UK;
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Alaa Hammad
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan; (R.Z.); (A.H.)
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Prasad V, Sinha D, Joseph RJ. Global relevance of MGRS growth standards: the case of India. BMJ Paediatr Open 2024; 8:e002472. [PMID: 38490693 PMCID: PMC10946363 DOI: 10.1136/bmjpo-2023-002472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/03/2024] [Indexed: 03/17/2024] Open
Abstract
The most common measures of childhood undernutrition are based on anthropometric measures such as height-for-age (stunting/chronic undernutrition) and weight-for-height (wasting/acute undernutrition). It is well recognised that the determinants of undernutrition are multiple, including food intake, dietary diversity, health, sanitation and women's status. Currently, most countries across the world including India use the globally accepted WHO-Multicentre Growth Reference Study (MGRS) growth standards (2006) for the purposes of measurement as well as for evaluating progress on these metrics. However, there is some discussion on the universal relevance of these standards, and in the Indian context, whether these standards overestimate the prevalence of stunting, considering differences in genetic potential for growth. This is especially relevant in the context of increasing burden of obesity and non-communicable diseases in India. Based on a detailed review of literature, policy documents and expert inputs, this review paper discusses the relevance of the WHO growth standards for height/stunting, in the context of India. Issues discussed related to the MGRS methodology include pooling of data and intersite and intrasite variability, opting for standards as opposed to references, and external validity. Other issues related to plasticity of stunting and the influence of maternal heights are also discussed, in the context of analysing the appropriateness of using universal growth standards. Based on the review, it is recommended that the current standards may continue to be used until a newer global standard is established through a similar study.
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Affiliation(s)
| | - Dipa Sinha
- Dr BR Ambedkar University Delhi, New Delhi, India
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Lelijveld N, Cox S, Anujuo K, Amoah AS, Opondo C, Cole TJ, Wells JCK, Thompson D, McKenzie K, Abera M, Berhane M, Kerac M. Post-malnutrition growth and its associations with child survival and non-communicable disease risk: a secondary analysis of the Malawi 'ChroSAM' cohort. Public Health Nutr 2023; 26:1658-1670. [PMID: 36876519 PMCID: PMC10466107 DOI: 10.1017/s1368980023000411] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To explore patterns of post-malnutrition growth (PMGr) during and after treatment for severe malnutrition and describe associations with survival and non-communicable disease (NCD) risk 7 years post-treatment. DESIGN Six indicators of PMGr were derived based on a variety of timepoints, weight, weight-for-age z-score and height-for-age z-score (HAZ). Three categorisation methods included no categorisation, quintiles and latent class analysis (LCA). Associations with mortality risk and seven NCD indicators were analysed. SETTING Secondary data from Blantyre, Malawi between 2006 and 2014. PARTICIPANTS A cohort of 1024 children treated for severe malnutrition (weight-for-length z-score < 70 % median and/or MUAC (mid-upper arm circumference) < 110 mm and/or bilateral oedema) at ages 5-168 months. RESULTS Faster weight gain during treatment (g/d) and after treatment (g/kg/day) was associated with lower risk of death (adjusted OR 0·99, 95 % CI 0·99, 1·00; and adjusted OR 0·91, 95 % CI 0·87, 0·94, respectively). In survivors (mean age 9 years), it was associated with greater hand grip strength (0·02, 95 % CI 0·00, 0·03) and larger HAZ (6·62, 95 % CI 1·31, 11·9), both indicators of better health. However, faster weight gain was also associated with increased waist:hip ratio (0·02, 95 % CI 0·01, 0·03), an indicator of later-life NCD risk. The clearest patterns of association were seen when defining PMGr based on weight gain in g/d during treatment and using the LCA method to describe growth patterns. Weight deficit at admission was a major confounder. CONCLUSIONS A complex pattern of benefits and risks is associated with faster PMGr. Both initial weight deficit and rate of weight gain have important implications for future health.
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Affiliation(s)
- Natasha Lelijveld
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Emergency Nutrition Network (ENN), Oxford, UK
- Centre for Maternal, Adolescent & Reproductive Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
| | - Sioned Cox
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
| | - Kenneth Anujuo
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
| | - Abena S Amoah
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Charles Opondo
- Department of Medical Statistics, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Tim J Cole
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jonathan CK Wells
- Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Debbie Thompson
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | - Kimberley McKenzie
- Caribbean Institute for Health Research, The University of the West Indies, Kingston, Jamaica
| | | | | | - Marko Kerac
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, LondonWC1E 7HT, UK
- Centre for Maternal, Adolescent & Reproductive Child Health (MARCH), London School of Hygiene & Tropical Medicine, London, UK
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Zemel BS. From growth charts to growth status: how concepts of optimal growth and tempo influence the interpretation of growth measurements. Ann Hum Biol 2023; 50:236-246. [PMID: 37345213 PMCID: PMC10896072 DOI: 10.1080/03014460.2023.2189751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/27/2023] [Indexed: 06/23/2023]
Abstract
Growth measurements are largely uninterpretable without comparison to a growth chart. Consequently, the characteristics of a growth chart become an integral component of the interpretation of growth measurements. The concepts of optimal growth and tempo are well recognised by auxologists, yet their implications for interpretation of growth measurements remain problematic. This narrative review discusses the concept of optimal growth and how it serves as a guiding principle in the development and use of growth charts. The challenges of operationalising tempo for growth assessment are also discussed. Illustrative examples highlight the importance of these two central concepts in the use and interpretation of growth measurements.
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Affiliation(s)
- Babette S Zemel
- The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Scholtz J, Ellis SM, Kruger HS. Weight gain in children from birth to 10 years on antiretroviral treatment. South Afr J HIV Med 2022; 23:1413. [DOI: 10.4102/sajhivmed.v23i1.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
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van Zadelhoff SJN, Haisma HH. How Is Context Addressed in Growth Monitoring? A Comparison of the Tanzanian, Indian, and Dutch Manuals. Curr Dev Nutr 2022; 6:nzac023. [PMID: 35434471 PMCID: PMC9007241 DOI: 10.1093/cdn/nzac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/09/2022] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background To address malnutrition in all its forms, context should be taken into account in growth-monitoring (GM) practices. Objectives The aim was to compare GM manuals of countries with different nutrition problems, and to assess how these manuals are adapted to the different biological, socioeconomic, and cultural contexts. Methods GM manuals from Tanzania, India, and the Netherlands were compared with each other, and with the materials for the WHO training course on child growth assessment. First, the aims of GM, growth measurements, interpretation of these measurements, and counseling approaches are compared. Second, contextual determinants of malnutrition are identified using the UNICEF framework for malnutrition as an analytical model. Results Our results show that the GM manuals differ in their descriptions of the aim of GM, growth measurements, their interpretation, and counseling approaches. Assessing normal growth and detecting growth problems are among the aims of GM in all of the analyzed countries. In Tanzania and India, the focus is mainly on undernutrition, whereas the Dutch manuals focus on overweight and on underlying pathologies that contribute to poor linear growth. The findings of our analysis of contextual factors within the UNICEF framework show that the Tanzanian protocol is only minimally adapted to the local context. Of the manuals examined in our study, the Indian manual is most focused on the contextual determinants of malnutrition, and stresses the importance of taking customs and beliefs into account. The Dutch protocol, by contrast, emphasizes the importance of the biological environment, including parental height and ethnicity, as determinants of child growth. Conclusions The country manuals we analyzed only partly reflect the contexts in which children live. To address malnutrition in all its forms, the GM manuals should take children's biological, socioeconomic, and cultural contexts into account, as this would help health professionals to tailor counseling messages for parents.
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Affiliation(s)
- Saskia J N van Zadelhoff
- Population Research Center, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | - Hinke H Haisma
- Population Research Center, Department of Demography, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
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Azcorra H, Dickinson F, Mendez-Dominguez N, Mumm R, Valentín G. Development of birthweight and length for gestational age and sex references in Yucatan, Mexico. Am J Hum Biol 2022; 34:e23732. [PMID: 35179265 PMCID: PMC9285606 DOI: 10.1002/ajhb.23732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To develop sex- and gestational age specific reference percentiles and curves for birth weight and length for Yucatec neonates using data from birth registers of infants born during 2015-2019. MATERIAL AND METHODS Observational, descriptive, epidemiologic study in a 5-year period including every registered birth in the state of Yucatan, Mexico using birth registries. A total of 158 432 live, physically healthy singletons (76 442 females and 81 990 males) between 25 and 42 weeks of gestation were included in the analysis. We used the LMS method to construct smoothed reference centiles (3rd, 10th, 25th, 50th, 75th, 95th, and 97th) and curves for males and females separately. RESULTS Mean maternal age was 26 (SD = 6.22) years. Fifty-two percent of births occurred by vaginal delivery, 37% were firstborn and similar proportions were second (33%) and third or more (30%) born. 5.5% of newborns included in the references corresponds to neonates born before 37 weeks of gestation (5.9% boys and 5.1% girls). In both sexes, the percentage of infants with a birthweight less than 2500 g was 6.7%. The birthweight at the 50th percentile for males and females at 40 weeks of gestation in this cohort was 3256 and 3167 g, respectively, and the corresponding values for birth length were 50.23 and 49.84 cm (mean differences between sexes: 89 g and 0.40 cm, respectively). CONCLUSION The reference percentile and curves developed in this study are useful for research purposes and can help health practitioners to assess the biological status of infants born in Yucatán.
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Affiliation(s)
- Hugo Azcorra
- Centro de Investigaciones Silvio Zavala, Universidad Modelo, Mérida, Yucatán, Mexico
| | | | - Nina Mendez-Dominguez
- Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, Mexico
| | - Rebekka Mumm
- Department of Human Biology, University of Potsdam, Germany
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Faizi N, Zubair MY, Tasleem F. Pathologizing normal height or identifying chronic malnutrition: Public health concerns of calling stunting normal. Am J Hum Biol 2022; 34:e23735. [PMID: 35170819 DOI: 10.1002/ajhb.23735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 12/21/2022] Open
Affiliation(s)
- Nafis Faizi
- Department of Community Medicine, Jawaharlal Nehru Medical College & Hospital, Aligarh Muslim University (AMU), Aligarh, India
| | - Mohd Yasir Zubair
- Department of Community Medicine, Jawaharlal Nehru Medical College & Hospital, Aligarh Muslim University (AMU), Aligarh, India
| | - Fazeelah Tasleem
- Department of Community Medicine, Jawaharlal Nehru Medical College & Hospital, Aligarh Muslim University (AMU), Aligarh, India
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Burris ME, Caceres E, Chester EM, Hicks KA, McDade TW, Sikkink L, Spielvogel H, Thornburg J, Vitzthum VJ. Socioeconomic impacts on Andean adolescents’ growth. Evol Med Public Health 2022; 10:409-428. [PMID: 36090675 PMCID: PMC9454678 DOI: 10.1093/emph/eoac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/10/2022] [Indexed: 11/14/2022] Open
Abstract
Background/Objectives We evaluated potential socioeconomic contributors to variation in Andean adolescents’ growth between households within a peri-urban community undergoing rapid demographic and economic change, between different community types (rural, peri-urban, urban) and over time. Because growth monitoring is widely used for assessing community needs and progress, we compared the prevalences of stunting, underweight, and overweight estimated by three different growth references. Methods Anthropometrics of 101 El Alto, Bolivia, adolescents (Alteños), 11.0–14.9 years old in 2003, were compared between households (economic status assessed by parental occupations); to one urban and two rural samples collected in 1983/1998/1977, respectively; and to the WHO growth reference, a representative sample of Bolivian children (MESA), and a region-wide sample of high-altitude Peruvian children (Puno). Results Female Alteños’ growth was positively associated with household and maternal income indices. Alteños’ height averaged ∼0.8SD/∼0.6SD/∼2SDs greater than adolescents’ height in urban and rural communities measured in 1983/1998/1977, respectively. Overweight prevalence was comparable to the WHO, and lower than MESA and Puno, references. Stunting was 8.5/2.5/0.5 times WHO/MESA/Puno samples, respectively. Conclusions/Implications Both peri-urban conditions and temporal trends contributed to gains in Alteños’ growth. Rural out-migration can alleviate migrants’ poverty, partly because of more diverse economic options in urbanized communities, especially for women. Nonetheless, Alteños averaged below WHO and MESA height and weight medians. Evolved biological adaptations to environmental challenges, and the consequent variability in growth trajectories, favor using multiple growth references. Growth monitoring should be informed by community- and household-level studies to detect and understand local factors causing or alleviating health disparities.
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Affiliation(s)
- Mecca E Burris
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
| | | | - Emily M Chester
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
- Evolutionary Anthropology Laboratory, Indiana University , Bloomington, IN 47405, USA
| | - Kathryn A Hicks
- Department of Anthropology, University of Memphis , Memphis, TN 38152, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University , Evanston, IL 60208, USA
| | - Lynn Sikkink
- Department of Anthropology, Western Colorado University , Gunnison, CO 81231, USA
| | - Hilde Spielvogel
- Instituto Boliviano de Biología de Altura (IBBA) , La Paz , Bolivia
| | - Jonathan Thornburg
- Department of Astronomy & Center for Spacetime Symmetries, Indiana University , Bloomington, IN 47405, USA
| | - Virginia J Vitzthum
- Department of Anthropology, Indiana University , Bloomington, IN 47405, USA
- Evolutionary Anthropology Laboratory, Indiana University , Bloomington, IN 47405, USA
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Scheffler C, Hermanussen M. Stunting is the natural condition of human height. Am J Hum Biol 2021; 34:e23693. [PMID: 34761833 DOI: 10.1002/ajhb.23693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Human body height differs within a wide range and has conventionally been associated with genetic, nutritional, and environmental conditions. In this study, we try to broaden this perspective and add the evolutionary aspect of height differences. SAMPLE AND METHOD We revisited height from archeological data (10 000-1000 BC), and historical growth studies (1877-1913). We analyzed height, weight, and skinfold thickness of 1666 Indonesian schoolchildren from six representative rural and urban elementary schools in Bali and West Timor with a stunting prevalence of up to 50%. RESULTS Stature in the Holocene prehistory of the Near East and Europe varied with maxima for women usually ranging below 160 cm, and maxima for men between 165 and 170 cm. Stature never rose above 170 cm. European and white US-American schoolchildren of the 19th and 20th century were generally short with average height ranging between -1.5 and -2.2 hSDS, yet in the absence of any evidence of chronic or recurrent undernutrition or frequent illness, poverty, or disadvantageous living conditions. The same is found in contemporary Indonesian schoolchildren. CONCLUSION Stunting is frequently observed not only in the poor, but also in affluent and well-nourished social strata last 10 000 years. Only in very recent history, and only in a few democratic, modern societies, stature has increased beyond the long-lasting historic height average. Viewed from an evolutionary perspective, and considering adaptive plasticity of and community effects on growth, competitive growth and strategic growth adjustments, stunting appears to be the natural condition of human height.
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