Inferring the economic standard of living and health from cohort height: Evidence from modern populations in developing countries

Tanner's target height formula underestimates final adult height in Korean adolescents and young adults: reassessment of target height based on the Korean National Health and Nutrition Examination Survey 2010-2019

OBJECTIVE

Estimating children's target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner's formula to predict children's final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner's formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children.

DESIGN/SETTING

Data were derived from the Korean National Health and Nutrition Examination Survey 2010-2019.

PATIENTS

A total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner's formula could not be calculated because of missing parental height data.

MAIN OUTCOME MEASURES

Tanner-based TH was compared with the FAH.

RESULTS

The difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons' and daughters' heights, respectively.

CONCLUSIONS

Tanner's formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.

Secular trends and regional pattern in body height of Austrian conscripts born between 1961 and 2002

The human growth process is influenced not only by genetic factors but also by environmental factors. Therefore, regional differences in mean body heights may exist within a population or a state. In the present study, we described and evaluated the regional trends in mean body heights in the nine Austrian provinces over a period spanning more than four decades. Body height data of 1734569 male conscripts born in Austria with Austrian citizenship between 1961 and 2002 were anonymized and analyzed. From 1961 to 2002 birth cohorts, an overall increase in the mean body height of Austrian recruits was observed, although regional differences were evident. Regions with shorter body heights in the 1961-1963 birth cohorts showed a particularly pronounced increase in mean body heights. Meanwhile, the course of body height growth in the capital city, Vienna, was striking, where the highest body heights were documented for the 1961-1963 birth cohorts. In Vienna, mean body heights continued to decline until the 1984 birth cohort and increased again from the 1988 birth cohorts. In addition to economic factors, increased stress factors in an urban environment and a form of urban penalty are discussed as causes.

Secular trends in height, weight, and body mass index in the context of economic and political transformations in Russia from 1885 to 2021

OBJECTIVES

To study and analyze the impact of socio-economic factors on secular changes in height, weight, and body mass index (BMI) among Moscow's youth over the time interval from the late 19th-early 20th century to the present.

METHODS

Anthropometric data, including height, weight, and BMI, were collected through surveys conducted on youths aged 17-20 years in Moscow from the 1880s for males and from the 1920s for females to the present. The dataset includes information on 6434 individuals surveyed from 2000 to 2019, as well as previously published mean values. Economic development indicators, such as gross domestic product (GDP) per capita, monthly average income per capita, and the Gini coefficient, were examined to analyze the association between secular trends in body size and socio-economic conditions.

RESULTS

A positive secular trend in height and weight has been observed among Moscow's youth from the early 20th century to the present. Substantial increases in height occurred during the second half of the previous century, stabilizing in the 2000s. Over the analyzed period, both average body weight and BMI values showed a consistent rise. The pattern for BMI exhibited a U-shaped trend, with a decline from the 1970s to the mid-1990s, followed by a subsequent increase. Strong correlations were found between the secular changes in body size among Moscow's youth and temporal fluctuations in key socio-economic indicators, including GDP per capita, monthly average income per capita, and the Gini coefficient.

CONCLUSION

The study demonstrates the significant influence of socio-economic conditions on intergenerational changes in body size, as evidenced by the positive secular trend in physique indicators (height, weight, and BMI) among Moscow's youth.

Prevalence of root canal treatment worldwide: A systematic review and meta-analysis

BACKGROUND

The prevalence of root filled teeth (RFT) worldwide will inform about the amount of clinical activity of dentists dedicated to treat endodontic disease.

OBJECTIVES

To carry out a systematic review with meta-analysis answering the following question: What is the prevalence of RFT around the world? The percentage of people with at least one RFT was also investigated.

METHODS

A systematic review including population-based studies using the following databases: PubMed, EMBASE and Scielo. Studies related to prevalence of RFT were included. The outcome of interest of the study was the prevalence of RFT. The meta-analyses were calculated with the Open Meta Analyst software to determine the global prevalence of RFT. Subgroups analyses were performed comparing geographical distribution, radiographic method and year of the study (classified in 20th or 21th century). The prevalence of people with at least one RFT was also analysed.

RESULTS

Seventy-four population-based studies fulfilled the inclusion criteria. Twenty-eight, forty-four and two studies reported high, moderate and low risk of bias, respectively. No obvious publication bias was observed. Prevalence of RFT was estimated with 1 201 255 teeth and 32 162 patients. The calculated worldwide prevalence of RFT was 8.2% (95% CI = 7.3%-9.1%; p < .001). The global prevalence of people with at least one RFT was 55.7% (95% CI = 49.6%-61.8%; p < .001). In 20th century, the prevalence of RFT was 10.2% (95% CI = 7.9%-12.5%; p < .001), whereas in the 21st century the overall calculated prevalence of RFT was 7.5% (95% CI = 6.5%-8.6%; p < .001). Brazilian people (12%) and the European population (9.3%) showed the highest prevalence of RFT. In Europe, 59.6% (95% CI = 52.4%-66.8%) of people has at least one RFT.

CONCLUSIONS

This review showed that root canal treatment is a very common therapy throughout the world. More than half of the studied population have at least one RFT. A limitation of the present study is that most of the studies did not consider random sampling for population selection.

REGISTRATION

PROSPERO Systematic review registration number: (CRD42022329053).

Growing taller unequally? Adult height and socioeconomic status in Spain (Cohorts 1940-1994)

Socioeconomic inequalities and their evolution in different historical contexts have been widely studied. However, some of their dimensions remain relatively unexplored, such as the role played by socioeconomic status in the trajectory of biological living standards, especially net nutritional status. The main objective of this article is to analyze whether the power of socioeconomic status (SES) to explain differences in the biological dimensions of human well-being (in this case, adult height, a reliable metric for health and nutritional status) has increased or diminished over time. Educational attainment and occupational category have been used as two different proxies for the SES of Spanish men and women born between 1940 and 1994, thus covering a historical period in Spain characterized by remarkable socioeconomic development and a marked increase in mean adult height. Our data is drawn from nine waves of the Spanish National Health Survey and the Spanish sample of two waves of the European Health Interview Survey (ENSE) for the period 1987 to 2017 (N = 73,699 citizens aged 23-47). A multivariate regression analysis has been conducted, showing that, as a whole, height differentials by educational attainment have diminished over time, whereas differences by occupational category of household heads have largely persisted. These results indicate the need for further qualification when describing the process of convergence in biological well-being indicators across social groups. For instance, the progressive enrollment of a greater proportion of the population into higher educational levels may lead us to underestimate the real differences between socioeconomic groups, while other proxies of SES still point to the persistence of such differences.

Assessing the effects of autarchic policies on the biological well-being: Analysis of deviations in cohort male height in the Valencian Community (Spain) during Francoist regime

This article aims to assess the impact of autarchic policies on the biological dimensions of human well-being during Francoist regime in Spain. This is done by examining the nutritional status of the population through the study of male adult heights. Our case study is the Valencian Community with the focus on the period 1940-59 which witnessed the implementation of such policies. The heights of 21-year old draftees born between 1900 and 1954 from nine municipalities (N = 87,510) were analyzed in the light of inter-cohort deviations from a secular trend established for cohorts that were not exposed to autarchy-related hardships. Height was regressed on infant mortality as a way to control for infection and therefore approach the net effect of nutrition on height outcomes. Contrarily to what was displayed by cohort height trends in themselves, the results reveal a significant worsening of the nutritional status of the male population at the time. Deviations from the expected height trend across municipalities ranged between -0.5 and -3.4 mm per year. The effects of malnutrition are found to be larger among cohorts born in the period 1920-34 in coherence with a longer exposure to autarchy hardships during adolescence. Pre-autarchy nutrition levels observed among the cohorts of 1900-14 were not regained until the cohorts 1945-49. The results also show that malnutrition had an unequal impact with the large industrial towns of our sample experiencing the poorest height outcomes. Overall, these results invite to revise conclusions obtained from the sole evidence of height trends and they question the efficiency of intervention policies implemented in Spain during the 1940s.

Economic development in Puerto Rico after US annexation: Anthropometric evidence

This paper considers economic development in Puerto Rico following its annexation by the United States in 1898, a watershed moment in the history of the island and the pinnacle of American imperialism in Latin America. Drawing on data from three surveys, I show that male height in Puerto Rico increased at more than twice the average rate for Latin America and the Caribbean between 1890 and 1940. I also show that Puerto Ricans at mid-century were among the tallest Latin Americans outside of Argentina and Uruguay. The evidence supports the conclusion that conditions improved substantially after US annexation, in contrast to the prevailing view in the literature.

Social class-specific secular trends in height among 19-year old Polish men: 6th national surveys from 1965 till 2010

The results presented in this study concern the assessment of the secular trend of body height in 10 % a random national sample (N = 134,224) representing all regions of Poland in 8 homogeneous social groups over 45 years in Poland (1965-2010). Very significant political, social and economic changes in Poland occurred in the period studied. The political revolution that began in Poland at the turn of the 1980s and 1990s dramatically changed the picture of social inequalities in the country. It rapidly transformed (in different directions and to a different degree) the economic situation, working conditions, lifestyles and the prestige of particular social classes and professional groups. A positive secular trend was observed in 19-year-old participants in the period analysed in all homogeneous socio-professional groups, however, with different intensity in each group. The highest body height increases in 1965-2010 were observed in the sons of farmers with post-primary father's education (7.77 cm). The lowest were observed among the sons of professionals, only 5.45 cm. Although social distances between extreme socio-economic groups significantly decreased (from 4.89 cm in 1965 to 2.76 cm in 2010), social gradients of body height, despite the improvement in the standards of living of the entire society remained exceptionally stable and unchanged for nearly half a century.

The association between obesity and secular trend of stature: a nationwide study of 2.8 million adolescents over five decades

BACKGROUND/OBJECTIVES

It is unclear whether adolescent obesity is associated with limited linear growth. We assessed this association in a nationwide sample of adolescents.

METHODS

We conducted a population-based, study of 2,785,227 Israeli adolescents (60% males) who were examined before military service since 1967 through 2015. Height and weight were measured along with assessment of medical status at age 17.4 ± 0.4 years. The secular trend of height was plotted using United States Center for Disease Control (US CDC) age- and sex-adjusted BMI percentile groups. We accounted for health status at enrollment and computed the expected height based on parental data that was available for 512,978 examinees.

RESULTS

Over five decades, the mean height increased by 3.1 cm among males, but remained unchanged among females. Among males, gain in height was attained predominantly during the first 25 years and has stabilized since. Males with obesity were taller than their normal-weight and underweight counterparts. Underweight girls had a prominent increase in mean height during the first two decades, exceeding the mean height of their counterparts with obesity by over 2 cm. There was a gradual decrease in the difference between measured and expected height in males and females regardless of BMI status, with the exception of the underweight females who achieved consistently higher stature than expected (≥3 cm).

CONCLUSIONS

During five decades, excessive BMI was not a limiting factor in growth potential compared with normal BMI in both sexes. The only group that exceeded its growth potential, when accounting for expected mid-parental height, were underweight females with unimpaired health.

Women's height in several African countries in the first half of the 20th century

Height and its variations in time are considered useful indicators of living conditions in countries and in periods where no written sources are available. Majority of data refer to male stature, whereas data concerning female stature are limited and cover only a short span. This paper investigates the height of 456 women in 6 African countries, born around the end of the 19th century and the beginning of the 20th century. The objective is to provide information on the stature of females from those areas at that time and to compare the results with those from the literature, which refer to more recent times. Data were recovered from original individual forms and/or monographs of the time, and when possible, changes in mean statures were reported, considering two age classes: 20.0-29.9 years and 30.0 years and over. Individual heights were plotted according to year of birth. The main results show tendencies toward height increases in Eritrea and Ethiopia, stable values of stature in Somalia and decreasing heights in women mainly from the oases in Cyrenaica. It has been suggested that these results may reflect the synergic action, with different local modes and intensity, of a changing model of slavery in force at the time, lack of constituted states and continuing civil wars among different ethnic groups, and of an effect of severe droughts in the period under consideration. A comparison with data available on modern populations from 4 of the investigated countries shows that this trend has since changed. Further insights into this suggested trend may be gained from the study of male series.

Age at menarche in Polish University students born before, during and after World War II: Economic effects

Although the relationships between economic conditions and biological variables over the past two centuries in Poland are reasonably well-documented, the influence of economic and political disruptions, including nutritional privation, during the years immediately before, during and shortly after World War II (WWII) has received less attention. This paper considers the association between age at menarche and body size of university students born before, during and after WWII and father's level of education, a commonly used indicator of family economic status in Poland. Subjects were 518 university students surveyed between 1955 and 1972, birth years 1931 through 1951. The sample was divided into three birth cohorts: before (n=237), during (n=247) and after (n=34) WWII. Age at menarche was compared among birth cohorts, and by weight status and father's level of education. Age at menarche increased slightly but significantly among women born during WWII (14.4 yrs) compared to those born before (14.2 yrs) and after (13.9 yrs) the war. Controlling for year of birth and age of the student, age at menarche was significantly earlier in overweight (13.42±0.35 yrs) than in normal weight (14.33±0.06 yrs) and thin (14.54±0.21 yrs) women. Adjusted mean ages at menarche in small samples of overweight women did not differ by father's level of education, and were earlier than corresponding ages of thin and normal weight women. Adjusted mean ages at menarche did not differ between thin and normal weight women with fathers having primary or no education, but were slightly later in thin than in normal weight women with fathers having a vocational, secondary or higher education. Although age at menarche was associated with father's level of education, young adult weight status was a somewhat more important correlate.

A review of the evidence linking child stunting to economic outcomes

Background

To understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition.

Methods

We review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies.

Results

Long-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed.

Conclusions

Countries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing poverty and inequities.

A tall order: Small area mapping and modelling of adult height among Swiss male conscripts

Adult height reflects an individual's socio-economic background and offers insights into the well-being of populations. Height is linked to various health outcomes such as morbidity and mortality and has consequences on the societal level. The aim of this study was to describe small-area variation of height and associated factors among young men in Switzerland. Data from 175,916 conscripts (aged between 18.50 and 20.50 years) was collected between 2005 and 2011, which represented approximately 90% of the corresponding birth cohorts. These were analysed using Gaussian hierarchical models in a Bayesian framework to investigate the spatial pattern of mean height across postcodes. The models varied both in random effects and degree of adjustment (professional status, area-based socioeconomic position, and language region). We found a strong spatial structure for mean height across postcodes. The range of height differences between mean postcode level estimates was 3.40cm according to the best fitting model, with the shorter conscripts coming from the Italian and French speaking parts of Switzerland. There were positive socioeconomic gradients in height at both individual and area-based levels. Spatial patterns for height persisted after adjustment for individual factors, but not when language region was included. Socio-economic position and cultural/natural boundaries such as language borders and mountain passes are shaping patterns of height for Swiss conscripts. Small area mapping of height contributes to the understanding of its cofactors.

Height inequalities and their change trends in China during 1985-2010: results from 6 cross-sectional surveys on children and adolescents aged 7-18 years

Background

Great health inequalities have been reported in China over the past few years. Height has been used as an important parameter of health and it may also be distributed unequally in different regions. By studying height data of Chinese children and adolescents aged 7 to 18 years, we analyze height inequalities and their change trends during 1985–2010.

Methods

On the base of data from 6 successive cross-sectional surveys of the Chinese National Survey on Student’s Constitution and Health(CNSSCH) conducted in 1985,1991,1995,2000,2005 and 2010, we calculated difference of height for children and adolescents aged 7–18 years in different regions. Coefficients of Variation (CVs) of height were computed in urban and rural areas during 1985–2010.

Results

Great height difference existed between urban and rural, eastern and western, Shanghai and Guizhou children and adolescents aged 7–18 years. The urban-rural difference averagely decreased from 4.24 cm to 2.85 cm for boys and 3.72 cm to 1.31 cm for girls since 1985. Urban-rural difference tend to be more obvious in the poorer provinces, which has short mean statures. From 1985 to 2010, height difference became larger in eastern-western and Shanghai-Guizhou which represented the comparison between the richest and poorest regions. We also found there was a larger height inequality in rural areas compared with that in urban areas, and difference in rural subjects increased greater than their urban peers in eastern-western and Shanghai-Guizhou.

Conclusions

There were obvious height inequalities in China and the urban-rural difference narrowed, while increasing differences happened between regions with different socioeconomic levels especially in their rural residents. More attention should be paid to these differences and policies and strategies should be developed to reduce inequalities in height.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4402-9) contains supplementary material, which is available to authorized users.

Economics, human biology and inequality: A review of "puzzles" and recent contributions from a Deatonian perspective

The Nobel laureate Angus Deaton concentrated his work on puzzling developments and phenomena in economics. Puzzles are exciting elements in economics, because readers feel challenged by the question of how they can be solved. Among the puzzles analyzed by Deaton are: (1) Mortality increase of white, U.S. non-Hispanic men (2000 to today); (2) Why are height and income sometimes closely correlated, but not always?; (3) Height inequality among males and females; and (4) The Indian puzzle of declining consumption of calories during overall expenditure growth. This article reviews these "puzzles" and the main insights that Deaton derived from their discussion insofar as they pertain to the biological aspects of human development. I will focus on the field of this journal, Economics and Human Biology, in which Deaton has been very active over the last two decades. I will also document some of the responses by other scholars and their contributions to these puzzles, as they relate to the field of economics and human biology.

The mountains of giants: an anthropometric survey of male youths in Bosnia and Herzegovina

The aim of this anthropometric survey, conducted between 2015 and 2016 in Bosnia and Herzegovina (BiH), was to map local geographical differences in male stature and some other anthropometric characteristics (sitting height, arm span). In addition, to investigate the main environmental factors influencing physical growth, the documented values of height would be compared with available nutritional and socioeconomic statistics. Anthropometric data were collected in 3192 boys aged approximately 18.3 years (17-20 years), from 97 schools in 37 towns. When corrected for population size in the examined regions, the average height of young males in BiH is 181.2 cm (181.4 cm in the Bosniak-Croat Federation, 180.9 cm in Republika Srpska). The regional variation is considerable-from 179.7 cm in the region of Doboj to 184.5 cm in the region of Trebinje. These results fill a long-term gap in the anthropological research of the Western Balkans and confirm older reports that the population of the Dinaric Alps is distinguished by extraordinary physical stature. Together with the Dutch, Montenegrins and Dalmatians, men from Herzegovina (183.4 cm) can be regarded as the tallest in the world. Because both nutritional standards and socioeconomic conditions are still deeply suboptimal, the most likely explanation of this exceptional height lies in specific genetic factors associated with the spread of Y haplogroup I-M170. The genetic potential for height in this region could then be the greatest in the world. Future studies should further elucidate the roots of this intriguing phenomenon, which touches an important aspect of human biodiversity.

The biological standard of living in Suriname, c. 1870-1975

The physical stature of Surinamese soldiers is estimated to have increased by more than 3cm between 1870 and 1909. In the subsequent four decades, the increase in adult male and female height amounted to 0.3-0.5cm and 0.9-1.0cm per decade, respectively. This increase in height continued and accelerated during the second half of the twentieth century. Height increase among African and Hindustani Surinamese males and females was similar. Height differences between African and Hindustani Surinamese were therefore fairly constant over time, at 4-5cm. Other indicators of nutritional and health status, such as infant mortality, showed continuous improvement, whereas per capita calorie and protein availability improved in the twentieth century.

Height of Northern Jordanian middle-class adults, born 1960-1990 in the response to improving socio-economic conditions

The purpose of this study is to document and explain secular trends in stature among Northern Jordanian men and women between the years of birth 1960 and 1990, as they relate to overall per capita socio-economic improvement, the stature of 360 adults from two Northern governorates, those of Jerash and Irbid, was measured. General linear model (GLM) was used to examine the effect of birth-decade, education level of subject, and their interaction on mean stature of each sex separately. GLM results revealed that women who were born during the following three decades pooled together (1951-1980) did not differ significantly in mean stature from those born during (1981-1990). Among men, stature of those born in the two pooled birth-decades together (1951-1970) did not significantly differ of those were born in the two pooled birth-decades (1971-1990).

Plasma Tryptophan and the Kynurenine-Tryptophan Ratio are Associated with the Acquisition of Statural Growth Deficits and Oral Vaccine Underperformance in Populations with Environmental Enteropathy

Early childhood enteric infections have adverse impacts on child growth and can inhibit normal mucosal responses to oral vaccines, two critical components of environmental enteropathy. To evaluate the role of indoleamine 2,3-dioxygenase 1 (IDO1) activity and its relationship with these outcomes, we measured tryptophan and the kynurenine–tryptophan ratio (KTR) in two longitudinal birth cohorts with a high prevalence of stunting. Children in rural Peru and Tanzania (N = 494) contributed 1,251 plasma samples at 3, 7, 15, and 24 months of age and monthly anthropometrics from 0 to 36 months of age. Tryptophan concentrations were directly associated with linear growth from 1 to 8 months after biomarker assessment. A 1-SD increase in tryptophan concentration was associated with a gain in length-for-age Z-score (LAZ) of 0.17 over the next 6 months in Peru (95% confidence interval [CI] = 0.11–0.23, P < 0.001) and a gain in LAZ of 0.13 Z-scores in Tanzania (95% CI = 0.03–0.22, P = 0.009). Vaccine responsiveness data were available for Peru only. An increase in kynurenine by 1 μM was associated with a 1.63 (95% CI = 1.13–2.34) increase in the odds of failure to poliovirus type 1, but there was no association with tetanus vaccine response. A KTR of 52 was 76% sensitive and 50% specific in predicting failure of response to serotype 1 of the oral polio vaccine. KTR was associated with systemic markers of inflammation, but also interleukin-10, supporting the association between IDO1 activity and immunotolerance. These results strongly suggest that the activity of IDO1 is implicated in the pathophysiology of environmental enteropathy, and demonstrates the utility of tryptophan and kynurenine as biomarkers for this syndrome, particularly in identifying those at risk for hyporesponsivity to oral vaccines.