Body height and mortality - mortality follow-up of four Swiss surveys

Body height among adult male and female Swiss Health Survey participants in 2017: Trends by birth years and associations with self-reported health status and life satisfaction

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Increase in average body height had slowed down from around the 1970s birth cohorts.

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Women and men with tertiary education levels were taller than participants holding other education levels.

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Taller participants were less overweighted and were more satisfied with their lives than shorter participants.

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Taller participants had better overall health than shorter participants.

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Taller men were more likely to have lower back pain than shorter men.

The increase in adult height for 150 years is linked to overall improvements in nutrition, hygiene, and living standards. Height is positively associated with general health and success on various levels (e.g. quality of life, earnings or happiness). The aim of this study was to investigate whether different subgroups show different trends across birth cohorts. We wanted to know whether taller individuals considered themselves as healthier and their quality of life as better than shorter individuals.

We included 19,435 participants from the Swiss population-based Health Survey 2017. GAM were used to assess nonlinear associations between height and birth year. Multinomial logistic regression was used to predict probabilities of self-rated health in relation to height.

The increase in average height slows down from the 1970s birth cohorts. Participants with parents from Central/Northern/Western Europe (men 177.9 cm, women: 165.1 cm) or Eastern Europe (men 178.7 cm, women: 165.7 cm) were taller than participants with parents from South America (men 174.3 cm, women: 161. cm) and Asia (men 173.2 cm, women: 160.1 cm). Participants with tertiary education were taller than participants from education levels (mean difference men: 4.5 cm, women: 5.0 cm). Height was positively associated with self-declared aspects of health and life satisfaction.

These results support the conclusion that body height as a co-factor of health aspects should be considered in public health research. Although adult body height can no longer be influenced, nutritional status and thus also healthy growth can be influenced in childhood by public health programs, by eliminating social inequalities, and by strengthen healthy living conditions.

Body height in adult women and men in a cross-sectional population-based survey in Geneva: temporal trends, association with general health status and height loss after age 50

OBJECTIVE

On the one hand, trends in average height in adulthood mirror changes in living standard and health status of a population and its subgroups; on the other hand, height in general, as well as the loss of height in older age in particular, are associated in different ways with outcomes for health. For these aspects, there is hardly any information for Switzerland based on representative and measured body height data.

DESIGN

Repeated cross-sectional survey study.

SETTING

Fully anonymised data from the representative population-based Geneva Bus Santé Study between 2005 and 2017 were analysed.

METHODS

Data from N=8686 study participants were used in the trend analysis. Height was measured and sociodemographic information and self-rated health was collected via questionnaires. Follow-up (mean: 7.1 years) measurements from N=2112 participants were available to assess height loss after age 50.

RESULTS

Women were, on average, 166.2 cm (SD 6.5) tall and men 179.2 cm (SD 6.5). Among men and women, higher socioeconomic status was associated with taller average height. The flattening of the increase in height from the 1970s birth years appears to begin earlier in the subgroup with the highest education level. The tallest average height was measured for men and women from Central and Northern Europe, the shortest for South America and Asia. The likelihood that participants rated their health as 'very good' increased with greater body height. The follow-up data show that men lost -0.11 cm per follow-up year (95% CI -0.12 to -0.10), women -0.17 cm (95% CI -0.18 to 0.15).

CONCLUSIONS

The association of height and health status is currently understudied. Monitoring changes in average body height may indicate disparities in different subgroups of populations. Based on our study and a growing literature, we think that the multifaceted role of body height should be better considered in clinical practice.

Association of Adult Height with Cardiovascular Mortality: A Systematic Review and Meta-Analysis of Cohort Studies

BACKGROUND

Epidemiological studies on the association between adult height and cardiovascular disease (CVD) mortality have provided conflicting findings. We examined the association between adult height and the risk of CVD mortality.

METHODS

We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar for relevant studies published up to September 2021. Prospective cohort studies that reported the risk estimates for death from CVD, coronary heart disease (CHD), and stroke were included. The random-effects model was used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the highest vs. lowest categories of adult height.

RESULTS

In total, 20 prospective cohort publications were included in this systematic review and 17 in the meta-analysis. During 5 to 41 years of follow-up, the total number of deaths from CVD was 95,197 (51,608 from CHD and 20,319 from a stroke) among 2,676,070 participants. The summary RR comparing the highest and lowest categories of height was 0.80 (95% CI: 0.74-0.87, I ² = 59.4%, n = 15 studies) for CVD mortality, 0.82 (95% CI: 0.74-0.90, I ² = 70.6%, n = 12) for CHD mortality, 0.73 (95% CI: 0.67-0.80, I ² = 0%, n = 10) for stroke mortality, 0.70 (95% CI: 0.61-0.81, I ² = 0%, n = 4) for hemorrhagic stroke mortality, and 0.88 (95% CI: 0.72-1.08, I ² = 0%, n = 4) for ischemic stroke mortality.

CONCLUSION

The present comprehensive meta-analysis provides evidence for an inverse association between adult height and the risk of CVD, CHD, and stroke mortality.

Prognostic factors for steroid-free remission in patients with idiopathic inflammatory myopathies: importance of anthropometric measurements

Background:

Several studies have been conducted on factors associated with mortality in idiopathic inflammatory myopathies (IIMs), but few studies have assessed prognostic factors for steroid-free remission in IIM. We investigated the various clinical factors, including body measurements, that affect IIM treatment outcomes.

Methods:

Patients who were newly diagnosed with IIM between 2000 and 2018 were included. Steroid-free remission was defined as at least 3 months of normalisation of muscle enzymes and no detectable clinical disease activity. The factors associated with steroid-free remission were evaluated by a Cox regression analysis.

Results:

Of the 106 IIM patients, 35 displayed steroid-free remission during follow-up periods. In the multivariable Cox regression analyses, immunosuppressants’ early use within 1 month after diagnosis [hazard ratio (HR) 6.21, 95% confidence interval (CI) 2.61–14.74, p < 0.001] and sex-specific height quartiles (second and third quartiles versus first quartile, HR 3.65, 95% CI 1.40–9.51, p = 0.008 and HR 2.88, 95% CI 1.13–7.32, p = 0.027, respectively) were positively associated with steroid-free remission. Polymyositis versus dermatomyositis (HR 0.21, 95% CI 0.09–0.53, p = 0.001), presence of dysphagia (HR 0.15, CI 0.05–0.50, p = 0.002) and highest versus lowest quartile of waist circumference (WC; HR 0.24, 95% CI 0.07–0.85, p = 0.027) were negatively associated with steroid-free remission.

Conclusion:

The early initiation of immunosuppressant therapy, type of myositis and presence of dysphagia are strong predictors of steroid-free remission in IIM; moreover, height and WC measurements at baseline may provide additional important prognostic value.

The SHORT Score for Preoperative Assessment of the Risk for Short-Term Survival in Glioblastoma

BACKGROUND

Despite recent improvements in treatment of glioblastoma (GBM), some patients still have a short survival. We sought to develop a new risk score for preoperative assessment of short-term survival (STS) (<6 months) in patients with GBM.

METHODS

All adult patients who underwent surgical resection of GBM between 2004 and 2014 were included (N = 379). Demographic and clinical parameters, which were available at admission, were assessed. Variables were evaluated in univariate and multivariate analyses. The score was validated in a separate cohort of patients with GBM who underwent surgical resection between 2015 and 2018.

RESULTS

The following independent predictors of STS were integrated into a new score: body height (<169 cm, 1 point), arterial hypertension (1 point), age (≤54 years, 0 points; 55-74 years, 1 points; ≥75 years, 2 points), and poor clinical status (Karnofsky performance scale [KPS] score: ≤60%, 2 points; 70%-80%, 1 point; ≥90%, 0 points). The new risk score, SHORT (Small body height, Hypertension, Older age, Reduced KPS score, short-Term survival), ranged from 0 to 6 points and showed good accuracy of risk estimation for STS in GBM (area under the curve: 0.715). STS rates were 9.7%, 23.1%, and 70% in patients with GBM scoring <2 points, 2-4 points, and >4 points (P < 0.0001). The score was successfully validated (area under the curve: 0.770).

CONCLUSIONS

This study presents the SHORT score for preoperative assessment of STS risk in patients with GBM. This risk score needs external validation in larger patient cohorts from other institutions. Our score might be a tool to facilitate treatment decisions in patients with GBM before surgery.

Adult height and risk of death from all-cause, cardiovascular, and cancer-specific disease: The Rural Chinese Cohort Study

BACKGROUND AND AIMS

We aimed to evaluate the sex-specific association of height and all-cause and cause-specific mortality in rural Chinese adults.

METHODS AND RESULTS

A total of 17,263 participants (10,448 women) ≥18 years old were randomly enrolled during 2007-2008 and followed up during 2013-2014. Sex-specific hazard ratios (HRs) for the height-mortality association, assessed in quintiles or 5 cm increments, were calculated by Cox proportional-hazards models. For both men and women, tall participants showed a baseline prevalence of high levels of socioeconomic factors including income and education but low systolic blood pressure and total cholesterol level. During a median of 6.01 years of follow-up, 620 men (in 39,993.45 person-years) and 490 women (in 61,590.10 person-years) died. With increasing height, the risk of all-cause mortality decreased in a curvilinear trend after adjustment for baseline age, socioeconomic and behavioral factors, and anthropometric and laboratory measurements. For men, height was inversely associated with all-cause mortality (HR per 5 cm increase: 0.89, 95% CI: 0.83-0.96) and cardiovascular mortality (HR per 5 cm increase: 0.81, 95% CI: 0.72-0.91). For women, height was inversely associated with all-cause mortality (HR per 5 cm increase: 0.88, 95% CI: 0.81-0.96) and other mortality (HR per 5 cm increase: 0.82, 95% CI: 0.71-0.96).

CONCLUSIONS

Our study demonstrated a sex-specific inverse effect of height on mortality from different major causes in rural Chinese adults.

Does adult height predict later mortality?: Comparative evidence from the Early Indicators samples in the United States

In this paper, I supplement widely used demographic data on white veterans of the Union Army with large and newly collected data on blacks and urban white veterans to explore the question of whether adult height predicts late-life mortality at the individual level. The data are partitioned into four demographic groups based on individual characteristics at the time of enlistment: white veterans enlisting in rural areas, mid-size cities, and large cities, and African-American veterans of the U.S. Colored Troops (USCT). Across the three groups of white veterans, mean height is positively associated with life expectancy at age 60, while both mean height and life expectancy for black veterans are very close to levels measured among the highly urbanized white veterans. I examine whether these group-level differences are robust to individual-level analysis by estimating two types of models, separately for each group: 1) 10-year mortality at age 60 using a linear probability model with company-level fixed effects and 2) a Cox proportional hazard that tracks veterans from age 60 to death. For rural whites, I find a significant U-shaped relationship between height and 10-year mortality, with both the short and the tall at significantly higher risk of death. This pattern becomes more pronounced when excluding younger recruits (under aged 24) from the analysis. But this relationship does not extend to urban whites or to blacks, where no significant height effects are found, and in which the height-mortality relationship among the highest mortality groups (whites from the largest cities and blacks) appears to be a generally positive one. Overall, the robust positive relationship between height and life expectancy at the group level does not exist at the individual level.

Have Swiss adult males and females stopped growing taller? Evidence from the population-based nutrition survey menuCH, 2014/2015

Data from the National Nutrition Survey for adults (menuCH) allow for the assessment of recent trends in measured height by year of birth for adult men and women from a population-based sample. The aim of the present study was to test if - similarly to conscripts and schoolchildren - the Swiss adult population stopped growing taller in recent birth cohorts, and if so, when the change occurred. We found that - when self-reported - height was overestimated on average by about 1 cm in both men and women, with an increasing tendency with older age and with shorter height. Average measured height increased by 4.5-5.0 cm for adult men and women between the birth years 1937-1949 and 1990-1995. However, this increase was not linear, and starting with the 1970s birth years, average height plateaued on a level of about 178 cm for men and 166 cm for women. Being born outside of Switzerland or adjustment for potential shrinkage with increasing age did not change this temporal pattern. We also found shorter average height among participants from the Italian part of Switzerland and those with lower educational level. It remains unclear if the phenomenon of stabilisation affects all subgroups of the Swiss population. Future studies should combine a larger number of population-based surveys to enhance the sample size, for example, for people with a migration background or with different educational levels. Continuing growth monitoring needs to be performed to assess if environmental and demographic changes with an impact on body growth (adverse trends in nutrition, increasing social inequality in health, ethnic composition of the population) positively or negatively influence future trends in average height.

Association Between Height and Clinical Outcome in Metastatic Colorectal Cancer Patients Enrolled Onto a Randomized Phase 3 Clinical Trial: Data From the FIRE-3 Study

BACKGROUND

Previous studies have found significant relationships between height and colorectal cancer (CRC) risk. Increased growth has been associated with activated pathways such as insulin-like growth factor 1. This study examined the impact of height on outcomes in metastatic CRC patients enrolled onto the FIRE-3 study, a randomized phase 3 clinical trial.

PATIENTS AND METHODS

A total of 695 patients with metastatic CRC were studied and height was measured in centimeters. Male patients were grouped as ≤ 165, 166-175, 176-185, and ≥ 186 cm in height; female patients were grouped as ≤ 154, 155-164, 165-174, and ≥ 175 cm in height. Primary end point was overall survival (OS); secondary end point was progression-free survival.

RESULTS

When patients' heights were categorized into 4 groups, the tallest group showed a worse OS compared to the shortest group; however, there was no linear relationship between height and OS. To investigate this, we showed the association between height as a continuous variable and OS. Patients shorter than 172 cm had a worse OS as their height decreased. Patients taller than 172 cm had a worse OS as their height increased. Moreover, patients with heights between 165 and 179 cm had a better OS compared to other patients (P = .05). This effect was independent of treatment arm and gender.

CONCLUSION

Patients shorter than 165 cm and taller than 179 cm have a worse OS, while those between 165 and 179 cm have a better OS. Hence, clinicians should consider height as an important prognostic factor when treating metastatic CRC patients. Future prospective studies are warranted to shed light on the mechanisms underlying the worse OS in taller patients.