Height, weight and menarche in Swedish urban school children in relation to socio-economic and regional factors

Age at peak height velocity in Polish adolescents: Effect of socioeconomic factors

Age at peak height velocity (APHV) is an indicator of maturity timing which is applicable to both sexes, and which is influenced by environmental factors. The objective of this study was to assess variation in APHV associated with several indicators of socioeconomic status (SES) in a longitudinal sample of Polish adolescents. The sample included 739 boys born in 1983 and followed annually from 12 to 16 years, and 597 girls born in 1985 and followed annually from 9 to 13 years. The height records were fitted with the SITAR model to estimate APHV. SES was estimated using principal component analysis of indicators of familial status based on parental education, family size, living conditions and household possessions. Statistical analyses included analysis of variance (one-way for general SES and three-way for parental education and family size) and Tukey post-hoc tests for unequal samples. General SES (p <.001) and family size (p < .05) significantly influenced APHV among boys, while only maternal education (p < .05) significantly influenced APHV among girls. Among youth from families of higher SES, as defined by the respective indicators, APHV was attained significantly earlier, on average, than in peers from families of lower SES. Overall, the results showed a sex-dependent effect of SES on APHV, and highlighted the influence of favorable socioeconomic conditions for optimal growth and maturation during adolescence.

Reducing socioeconomic differences in anthropometric characteristics among young Polish women

The aim of this paper was to evaluate the socioeconomic differences in adult anthropometric parameters of young women in Poland. The study was cross-sectional and conducted in the years 2015 to 2018 among 1257 women aged 19-24 years. The heights, weights, wrist widths and waist, hip and chest circumferences of the subjects were measured. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist-to-chest ratio (WCR) and chest-to-height ratio (CHtR) were calculated. A survey was conducted to collect data on the women's socioeconomic characteristics. The application of the Generalized Linear Model (GLM) including all socioeconomic indicators (urbanization level of place of residence in childhood, parental education, number of siblings, material conditions) revealed no significant association of these with any of the analysed anthropometric traits. The results of the logistic regression showed no significant differences in the risk of underweight, too low abdominal adiposity or too high abdominal adiposity. However, the risk of overweight and obesity was significantly affected by the degree of urbanization of the women's place of residence in childhood and by their number of siblings. The results show that the socioeconomic factors that once had a significant influence on anthropometric traits currently do not play such an important role. This change can be explained by the equalization of living conditions and lifestyles of individual social groups in Poland.

Differentiating effects of socio-economic factors on relative weight and nutritional status in Polish schoolchildren across intergenerational changes

OBJECTIVE

The aim of this study was an assessment of the effects of urbanisation level, family size and parental education on body mass index (BMI) and mid-upper arm circumference (MUAC) among Polish schoolchildren in cross-sectional surveys conducted between 1966 and 2012.

DESIGN

The analysis involved schoolchildren measured in four Polish Anthropological Surveys (1966, 1978, 1988 and 2012). Socio-economic factors involved: urbanisation level (city, town and village), family size (one child, two children, three children, four or more children), and father's and mother's education (lower and higher education).

SETTING

Regions in Poland - cities: Warsaw, Lodz and Wroclaw; towns: Bystrzyca Klodzka, Pinczow, Siemiatycze, Wolsztyn and their rural surroundings.

PARTICIPANTS

A total sample consisted of 63 757 children (31 774 boys and 31 983 girls) aged 7-18 years.

RESULTS

Between 1966 and 1988, both BMI and MUAC had significantly higher values in children from cities, in families with one child and with higher parental education (P < 0·05). However, MUAC revealed significant differences between particular socio-economic groups more frequently than BMI. In 2012, urbanisation level and parental education ceased to show a differentiating effect on both indicators, while family size remained a significant social factor for both measures (BMI: P < 0·05; MUAC: P < 0·01).

CONCLUSIONS

Since MUAC reflected socio-economic differences more frequently than BMI, it could be a more sensitive and reliable anthropometric measure revealing the effects of socio-economic factors on children's nutritional status.

Association of mental health problems in childhood with prenatal and postnatal physical growth

Aims

The present study was conducted to examine (i) prenatal and postnatal patterns of growth in relation to the risk of later mental health problems in children and (ii) the possible mediating effect of these patterns of growth in the association between parental socioeconomic status (SES) and children’s mental health.

Subjects and methods

The present study is part of a blinded, matched case control study, involving a retrospective analysis of prospectively collected data from routine examinations at community health services for children and adolescents. The sample comprised 80 patients, referred between the age of 6–13 years to the Community Mental Health Centre in Maastricht, and 320 matched population controls.

Results

Children coming from unemployed families weighed less at birth, but postnatal growth was not associated with this or other indicators of SES. Although children using mental health care were somewhat smaller at birth, there was no evidence that leanness during childhood was a risk factor for the development of mental health problems.

Conclusions

The present results showed some evidence for the impact of intrauterine development on children’s mental health problems. In addition, neither prenatal nor postnatal physical growth were on the pathway between parental SES and children’s mental health problems.

Age at menarche in Korean adolescents: trends and influencing factors

Background

An increased incidence of central precocious puberty has been recently reported in South Korea, which suggests an ongoing downward trend in pubertal development in the Korean population. We aimed to verify the trend in age at menarche in young Korean women during the last decade and associated factors.

Methods

We analyzed a population-based sample of 3409 Korean girls, aged 10–18 years, using data from the Korean National Health and Nutrition Examination Surveys (KNHANES) II (2001), III (2005), IV (2007–2009), and V (2010 and 2011). Average age at menarche was studied using the Kaplan-Meier survival method and predictors were analyzed using Cox proportional hazards model. The percentage of subjects who had experienced menarche at each age level was compared by using the Cochran-Armitage test.

Results

Overall mean age at menarche was 12.7 years. The percentage of subjects who experienced menarche before the age of 12 years was 21.4 % in 2001 but increased to 34.6 % in 2010/2011 (p < 0.01). In addition, the percentage of girls who experienced menarche before the age of 14 years increased from 76 % in 2001 to 92 % in 2010/2011 (p < 0.005). Adolescents whose mothers who had experienced early menarche (HR 1.48, 95 % CI [1.22–1.80]), and adolescents who were overweight (HR 1.24, 95 % CI [1.04–1.49]) were more likely to have experienced menarche. Additionally, underweight adolescents (HR 0.27, 95 % CI [0.12–0.60]) and adolescents who had a mother having late menarche (HR 0.68, 95 % CI [0.59–0.79]) were expected to have late menarche. None of the socioeconomic factors assessed in our study showed an association with age at menarche.

Conclusions

A downward trend in age at menarche was defined in Korean adolescents during the last decade. Furthermore, influences of genetic and nutritional parameters on individual variance in age at menarche were defined.

Long-term changes of socioeconomic differences in height among young adult men in Southern Sweden, 1818-1968

The study explores the long-term trends in socioeconomic differences in height among young adult men. We linked information from conscript inspections to a longitudinal demographic database of five parishes in Southern Sweden. Detailed information on the occupation and landholding was used to investigate the differences in height. Even if there is indication of a reduction in the magnitude of the differences in height over time the reduction is neither dramatic nor uniform. The most systematic and consistent difference is that sons of fathers with white collar occupations were taller than others. They were 4cm taller than the sons of low-skilled manual workers in the first half of the 19th century, and almost 2cm taller in the mid-20th century. This difference is much smaller than those found between elite and destitute groups historically, in for example Britain, but comparable to that found in other studies on 19th century populations using information on family background. Most of the reduction in the socioeconomic differences in height was a result of reduced height penalty and premium for small disadvantaged and privileged groups. Changes in the distribution of income and the economic structure are plausible explanations for the changes in socioeconomic differences in height.

Height-based Indices of Pubertal Timing in Male Adolescents

It is important to account for timing of puberty when studying the adolescent brain and cognition. The use of classical methods for assessing pubertal status may not be feasible in some studies, especially in male adolescents. Using data from a sample of 478 males from a longitudinal birth cohort, we describe the calculations of three independent height-based markers of pubertal timing: Age at Peak Height Velocity (APHV), Height Difference in Standard Deviations (HDSDS), and Percent Achieved of Adult Stature (PAAS). These markers correlate well with each other. In a separate cross-sectional study, we show that the PAAS marker correlates well with testosterone levels and self-reported pubertal-stage scores. We conclude by discussing key considerations for investigators when drawing upon these methods of assessing pubertal timing.

Social inequalities in height: persisting differences today depend upon height of the parents

Background

Substantial increases in height have occurred concurrently with economic development in most populations during the last century. In high-income countries, environmental exposures that can limit genetic growth potential appear to have lessened, and variation in height by socioeconomic position may have diminished. The objective of this study is to investigate inequalities in height in a cohort of children born in the early 1990s in England, and to evaluate which factors might explain any identified inequalities.

Methods and Findings

12,830 children from The Avon Longitudinal Study of Parents and Children (ALSPAC), a population based cohort from birth to about 11.5 years of age, were used in this analysis. Gender- and age-specific z-scores of height at different ages were used as outcome variables. Multilevel models were used to take into account the repeated measures of height and to analyze gender- and age-specific relative changes in height from birth to 11.5 years. Maternal education was the main exposure variable used to examine socioeconomic inequalities. The roles of parental and family characteristics in explaining any observed differences between maternal education and child height were investigated.

Children whose mothers had the highest education compared to those with none or a basic level of education, were 0.39 cm longer at birth (95% CI: 0.30 to 0.48). These differences persisted and at 11.5 years the height difference was 1.4 cm (95% CI: 1.07 to 1.74). Several other factors were related to offspring height, but few changed the relationship with maternal education. The one exception was mid-parental height, which fully accounted for the maternal educational differences in offspring height.

Conclusions

In a cohort of children born in the 1990s, mothers with higher education gave birth to taller boys and girls. Although height differences were small they persisted throughout childhood. Maternal and paternal height fully explained these differences.

Socioeconomic differences in childhood growth trajectories: at what age do height inequalities emerge?

Background

Socioeconomic differentials in adult height are frequently observed, but the age at which these inequalities emerge and the patterns they follow through childhood are unknown.

Subjects and Methods

Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), height trajectories from birth to 10 years (N=12366) were modelled. Individual trajectories were estimated using mixed-effects models. Differences in trajectories by socioeconomic position (SEP) were investigated.

Results

There was a clear gradient in birth length across categories of maternal education; average birth length in boys was 0.41 cm lower in the lowest maternal education category compared with the highest, which is 0.9% of the average birth length for the highest SEP category (equivalent results for girls 0.65 cm, 1.3%). Socioeconomic differences in childhood growth were small, and only resulted in minimal widening of the height inequality with increasing age. By the age of 10 years, the mean difference between children in the lowest and highest maternal education categories was 1.4 cm for boys and 1.7 cm for girls; similar proportionate differences to those seen at birth (1.0% for boys and 1.2% for girls). Patterns were the same when father's education or household occupational social class were used to measure SEP.

Conclusions

The socioeconomic differential in height during childhood in this cohort of children born in the UK in the 1990s arises largely through inequalities in birth length, with small increases in the inequality from differences in growth in later childhood.

Update on age at menarche in Italy: toward the leveling off of the secular trend

PURPOSE

To update the information on age at menarche in the Italian population and to verify the influence of genetic, nutritional, and socioeconomic factors on menarcheal age. Recent studies suggest that the magnitude of the secular trend toward an earlier age at menarche is slackening in industrialized countries.

METHODS

This multicenter study was conducted on a large, population-based sample of Italian high school girls (n = 3,783), using a self-administered questionnaire. The questionnaire was used to gather information on the girls, including demography, anthropometry, menarcheal date, regularity of menses, behavioral habits, and physical activity. The questionnaire was also used to gather information on parents, including demography and mothers' and sisters' menarcheal ages. The median age at menarche and its 95% confidence interval were estimated by means of Kaplan-Meier survival analysis. To identify the independent predictive factors of age at menarche, multivariate mixed-effects models were applied.

RESULTS

The median age at menarche of the subjects was 12.4 years (95% confidence interval: 12.34-12.46). The girls had their first menses approximately one-quarter of a year (median-0.13) earlier than did their mothers (p < .0001). Among all variables, parents' birth area, body mass index, family size, and the mother's menarcheal age were significantly and independently associated with age at menarche.

CONCLUSIONS

This study confirmed the reduction in the trend toward earlier menarche in Italy. The results also confirmed that genetic and nutritional factors are strong markers for early menarche. Currently, socioeconomic factors do not seem to play as significant a role as in the past.

Socio-economic status, growth, physical activity and fitness: The Madeira Growth Study

BACKGROUND

Within a country social conditions change over time and these conditions vary from country to country. The associations between these conditions, somatic growth, physical activity and fitness reflect these changes.

AIM

The study documented variation in somatic growth, physical activity and fitness associated with socio-economic status (SES).

SUBJECTS AND METHODS

The study involved 507 subjects (256 boys and 251 girls) from the Madeira Growth Study, a mixed longitudinal study of five cohorts (8, 10, 12, 14 and 16 years of age) followed at yearly intervals over 3 years (1996-1998). A total of 1493 observations were made. Anthropometric measurements included lengths, body mass, skeletal breadths, girths and skinfolds. Physical activity and SES were collected via questionnaire and interview. Physical fitness was assessed using the Eurofit test battery. Variation in somatic growth, physical activity and physical fitness by SES (high, average and low) was tested with analysis of variance.

RESULTS

Significant differences between SES groups were observed for height, body mass and skinfolds. Boys and girls from high SES groups were taller, heavier and fatter (subscapular and triceps skinfolds) than their peers from average and low SES groups. At some age intervals, the high SES group had larger skeletal breadths (girls) and girths (boys and girls) than low SES. Small SES differences were observed for physical activity (sport and leisure-time indices). SES was significantly associated with physical fitness. At some age levels, boys from the low SES group performed better for muscular and aerobic endurance whereas girls from the high SES group performed better for power.

CONCLUSION

Considerable variation in somatic growth and physical fitness in association with SES has been demonstrated, but little association was found for physical activity.

Swedish anthropometrics for product and workplace design

The present study describes the anthropometrics of the Swedish workforce, aged 18-65, and compares the measurements with data collected four decades earlier. This anthropometric information is based on measurements of a total of 367 subjects, 105 males and 262 females. Of the 367 subjects, 268 responded to advertisements (Study A) and 99 were randomly selected from a community register (Study B). Subjects were scanned in four positions. Manual measuring equipment was used for hands, feet, head and stature. As differences between significant measurements in Studies A and B were negligible, the data were merged. Anthropometric descriptive statistics of women and men are presented for 43 body dimensions. Participants represent the Swedish population fairly well when compared with national statistics of stature and weight. Comparing new anthropometric data with old shows that the breadth, depth, height, and length measurements of Swedes as well as weight have increased and that Swedish anthropometric homogeneity has decreased. The results indicate that there is a need to update ergonomic recommendations and adjust products and workplaces to the new information.

Socio-economic differentiation of the growth and the dietary intake of Polish boys aged 7-16 years

BACKGROUND

The period of the constitutional transformation, apart from many advantages, has generated a number of serious problems that may affect the biological state of children and adolescents in Poland.

AIM

The study documented socio-economic differentiation of growth and dietary intake of boys.

SUBJECTS AND METHODS

The research involved 523 boys aged 7-16; 54.4% of subjects came from Kielce (a city with a population of over 200 000) and 45.6% came from rural areas - from a region underprivileged in terms of economic development, with a majority of its inhabitants living off the land. Height and weight measurements of the subjects were taken, which allowed for computation of BMI. Dietary intake was assessed using the interview method for 24 h dietary recall. A multifactor variance analysis for unequal numbers in subclasses was applied to estimate the influence of socio-economic factors such as place of residence, mother's education and number of children in the family on somatic traits and on nutrient intake.

RESULTS

Urban boys whose mothers had experienced higher education were characterized by the greatest height (p<0.000). The percentage of the investigated subjects with an excessive body mass was over twice as high among boys in families with one or two children (15.0%) than among boys in families with three or more children (6.1%), and twice as high among urban boys (14.1%) in comparison with rural boys (7.0%). No significant differences in the energy value of daily food intake in each social group were found. The diet of rural boys included a lower percentage of energy intake derived from protein (10.7%) than that of urban boys (12.4%). This percentage decreased together with the lowering level of mother's education. The greatest amount of minerals and vitamins was found in the diets of boys whose mothers had higher education and lived in a city.

CONCLUSIONS

Diets of boys with the greatest body height were also characterized by a greater content of mineral components and vitamins, and a greater percentage of energy derived from protein. The relative body mass of the investigated subjects was probably more influenced by factors other than nutrition, i.e. mostly physical activity.

Childcare, height and BMI among female Polish university students, 2005

The aim of this study is to consider whether socio-economic factors are related to the type of childcare and whether the type of childcare, in turn, affects adult stature and BMI. The sample includes 783 female students aged 20-24 (birth cohort of 1981-1985) from the south of Poland. Those whose parents have university education, live in a city and have no siblings attend day-care facilities more frequently than others of the same age, while those who grew up at home under their mothers' care, most frequently live in villages, come from large families and their parents have vocational education. Variables which are associated with being taller include material conditions and the type of childcare received. Women who had attended day-care centres are 2.4cm shorter than girls brought up at home by their mothers. Adult BMI values are influenced by educational level of the mother. The results suggest that mothers who work often do so at the cost of time devoted to the family which influences health and the rate of their children's development.

Interpopulation variation in height among children 7 to 18 years of age

The objective of this review is to examine the degree of variation that exists in the achieved height of preadolescent and adolescent children across populations experiencing favorable conditions that support linear growth. Fifty-three population groups were identified that reported mean heights for economically privileged populations from all major continents. Graphic representation of the heights for these populations indicates that the mean height of preadolescent children differs by 3 to 5 cm, whereas population means begin to diverge from the National Center for Health Statistics/World Health Organization (NCHS/WHO) reference at puberty, with most non-European populations falling to approximately 5 cm below the reference and northern European populations exceeding the reference by a similar amount. We conclude that the evidence for limited interpopulation variation in the height of preadolescents supports consideration of a single growth reference for children up to puberty, but the uncertainty of the causes of the divergence in achieved height during puberty requires further research in order to establish an appropriate adolescent growth reference.

Two centuries of growth among Czech children and youth

The trend of increasing height can be interpreted as a reflection of the unfolding progress of civilization. Height changes among children and adolescents are good markers of this trend. We analyze the secular trend in the heights of children and adolescents in the Czech Republic on the basis of data from anthropological surveys. The earliest height data pertain to Czech youths who attended the Military Schools in Austria in 1800-1809. Data also exist for 1895 and continue in 1951 and at 10-year intervals thereafter. Growth curves were obtained for separate age groups by fitting mean values via third-order polynomial smoothing splines. Between 1951 and 2001, the mean heights of boys and girls aged 2.5 years increased by 2.7 and 3 cm, respectively. Since 1895, the mean height of 13-year-old boys has increased by 19.4 cm, and the mean height of girls has increased by 18.3 cm.

Menarcheal age and socio-economic factors in Poland

BACKGROUND

Menarcheal age is the most important measure of sexual maturation in girls and a sensitive indicator of environmental conditions during childhood.

OBJECTIVE

The study analysed the association between age at menarche and socio-economic characteristics (urbanization, population size, education of parents and number of children in the family).

SUBJECTS AND METHODS

Questionnaire data were collected from 3271 female schoolchildren born between 1981 and 1984, living in three provinces of southern Poland. Menarcheal age was estimated by the recall method and based on the date of menarche given by the study participants. ANCOVA and multiple regression analyses were applied to test statistical significance of differences between groups.

RESULTS

Girls from families with high socio-economic status experience menarche at an earlier age than girls from families with lower socio-economic status. However, depending on the geographical region and the population size, other factors influence menarcheal age. In the Krakow province, factors that significantly differentiate age at menarche are urbanization, father's education and number of children in the family; in the Opole province, these factors include urbanization and number of children in the family, while in the Nowy Sacz province, number of children in the family is significant.

CONCLUSIONS

Socio-economic differences are greater in a large urban city (Krakow), and affect variation in age at menarche. However, within smaller populations (Opole, Nowy Sacz) living in towns and villages, the difference in age at menarche is less visible. In addition, variation between areas reveals a lower age at menarche in urban as compared with non-urban areas.

Parental age, family size, and risk of multiple sclerosis

BACKGROUND

Family structure, such as having siblings, provides proxy measures for a variety of characteristics relevant to disease risk. The etiology of multiple sclerosis (MS) is not well defined and analysis of family structure may provide etiologic clues. We conducted a case-control study to examine possible associations.

METHODS

Using the Swedish Inpatient Register, we identified 4443 patients with a diagnosis of MS. From the general Swedish population, using birth and death registers, we selected 24,194 controls with similar characteristics for year, county of birth, and survival until at least age at diagnosis of the matched cases. The Multi-Generation Register linked data on siblings and parents. The Census provided father's social class based on occupation.

RESULTS

Having 3 or more younger siblings, compared with none, produced an adjusted odds ratio (OR) for MS (with 95% confidence interval) of 0.80 (0.70-0.92) (adjusting for number of siblings, twins, maternal and paternal age, parental MS, sex, father's social class, county and year of birth). With 3 or more older siblings, the adjusted OR was 0.83 (0.72-0.96). Different-sex twin pairs compared with singletons had an OR of 0.59 (0.37-0.95) for MS. The risk of MS increased steadily with father's age but not mother's age, up to 2.00 (1.35-2.96) for 51- to 55-year-old fathers (compared with 21- to 25-year-old fathers).

CONCLUSIONS

Parents who have offspring with MS may have subtly impaired fertility. The unexpected association with paternal age may be the result of an increased risk of accumulating germ cell mutations among older men.

Timing of pubertal maturation in girls: an integrated life history approach

Life history theory provides a metatheoretical framework for the study of pubertal timing from an evolutionary-developmental perspective. The current article reviews 5 middle-level theories--energetics theory, stress-suppression theory, psychosocial acceleration theory, paternal investment theory, and child development theory--each of which applies the basic assumptions of life history theory to the question of environmental influences on timing of puberty in girls. These theories converge in their conceptualization of pubertal timing as responsive to ecological conditions but diverge in their conceptualization of (a) the nature, extent, and direction of environmental influences and (b) the effects of pubertal timing on other reproductive variables. Competing hypotheses derived from the 5 perspectives are evaluated. An extension of W. T. Boyce and B. J. Ellis's (in press) theory of stress reactivity is proposed to account for both inhibiting and accelerating effects of psychosocial stress on timing of pubertal development. This review highlights the multiplicity of (often unrecognized) perspectives guiding research, raises challenges to virtually all of these, and presents an alternative framework in an effort to move research forward in this arena of multidisciplinary inquiry.

Prevalence and regional differences in overweight in 2001 and trends in BMI distribution in Swedish children from 1987 to 2001

AIMS

This study was undertaken to assess current prevalence and regional differences of overweight in 2001 and changes in body mass index (BMI) distribution between 1987 and 2001 in Swedish adolescents.

METHODS

Comparison was made of two independent samples. For assessment of prevalence and regional differences in 2001, a total of 1732 subjects were used. For trend analyses a total of 1,949 children (516 and 1,470 in 1987 and 2001, respectively), aged 10, 13, and 16 years.

RESULTS

The prevalence of overweight in 2001 was between 21.7% and 13.3% for boys and girls aged 10 to 16 years and the prevalence of obesity was between 2.9% and 6.2%. Mean BMI as well as prevalence of overweight and obesity was higher in subjects from schools in smaller towns or from the countryside. Median BMI among adolescents changed from 1987 to 2001, most notably in 13- and 16-year-old children. The prevalence of overweight and obesity combined has changed more than 2.5-fold in children aged 10 to 16 years. In this study, the most pronounced elevation in BMI is found in the upper part of the BMI spectrum. This change is especially apparent in girls.

CONCLUSION

The change in mean BMI and prevalence of overweight and obesity in children in this study is mainly due to the pronounced change in BMI at the upper end of the spectrum, indicating that the factors leading to overweight or obesity have changed in only a subgroup of the child population.

Are inequalities in height narrowing? Comparing effects of social class on height in two generations

OBJECTIVE

To determine whether social inequalities in height change across generations.

METHODS

The target population was from the 1958 British birth cohort, all born 3rd-9th March 1958, followed to 1991, and the offspring of one third of this population. Main outcomes were height measured at 7, 11, 16, and 33 years (cohort members) and once at 4-18 years (offspring). Multilevel models applied to associations of social class of origin with (a) child-to-adult growth trajectory (cohort members), (b) height (offspring), and (c) generational height increment.

RESULTS

Height inequalities were observed among cohort members, with differences >2.0 cm at all ages between classes I and II, and IV and V. By adulthood, the difference in mean height had declined significantly in boys and slightly in girls. A secular trend was seen between the two generations. While male offspring had a similar mean height to their fathers in classes I and II, boys in classes IV and V gained 2.1 cm (p<0.001). Height gains of female offspring were evident in all classes, with a greater gain in classes IV and V (non-significant). The social class effect on height was weaker among offspring, with a difference between classes I and II, and IV and V of less than 1 cm.

CONCLUSIONS

Social inequalities in height observed among the cohort weakened substantially in the next generation due to a greater height gain among offspring from manual classes. Inequalities in childhood height have narrowed between the two generations in this study.

Children's growth and socio-economic status in Hungary

The Hungarian National Growth Study comprises data on 39,035 children and youth aged 3-18 years. We examine the relationship between 15 body measurements and nine family background variables in this data set. After multiple regression analysis which removed curvilinear age effects, family size and population size of the place of residence showed consistent associations with the body measurements. Children from larger families tended to be shorter on average, and have lower weight and skinfold thicknesses whereas children from Budapest were, on average, taller and heavier than children from elsewhere with bigger chest and calf circumferences and lower skinfold thicknesses. Paternal age, mother's profession and birth order showed few associations with body measurements in both sexes and father's profession did not associate significantly with any of the measurements in boys.

Age at menarche in Coimbra (Portugal) school girls: a note on the secular changes

The age at menarche and several menstrual symptoms were reported by 516 Portuguese school girls who took part in a cross-sectional anthropometric study in Coimbra, Portugal. The mean ages of menarche calculated using the recall method and also using probit analysis were 12.53 +/-1.27 and 12.03 +/- 1.26 years, respectively. Parents'educational level, place of residence and size of the family did not have any significant effect on the mean age at menarche in this sample of adolescents. The order of birth was the only variable that indicated a significative effect: the first borns reported a lower mean age at menarche (12.34 years) than the later borns (12.6 years). In this sample, 47% of the girls had a cycle length of >or = 29 days, 23.4% had irregular cycles, 59% reported that the duration of bleeding was 3-5 days and the majority, 49%, did not report any pain during the bleeding days. However, 14.3% and 24.45% reported severe and medium pain. The age at menarche has declined from 15.0 (girls born in 1880-1890) to 12.03 (girls born in 1970-1980) years in the Portuguese population. This decrease in age, and also the lack of influence of the family characteristics, appear as a result of the great improvements in the social and economic living conditions that occurred in Portugal, especially after the 1970s. These improvements are mainly related to better nutrition and better health care along with many other environmental factors.

Social background and age at menarche in Portuguese university students: a note on the secular changes in Portugal

Menarcheal age of a sample of Portuguese university students (n = 3366), born between 1972 and 1983, age 18-23 years, was analyzed. The influence of parents' educational level and occupation, family size, birth order, and degree of urbanization of girl's locality of residence during childhood and adolescence were analyzed as well as secular trend in the Portuguese population. Mean age at menarche for girls born in 1983 was 12.32 years. Parents' educational level and occupation did not show any significant influence on mean age at menarche. Place of residence during childhood years and adolescence showed a significant effect on mean age at menarche, with girls from rural places with a later age at menarche than those who spent their childhood or adolescence in urban areas (P <or= 0.01 and P <or= 0.05 for childhood and adolescence, respectively). Family size and birth order showed the highest effect. Girls born in small families, with one child, matured earlier (12.32 years) than those born in large families with four or more children (12.67 years), (P <or= 0.01). Also, girls that were first-born had an earlier menarche (12.41 years) than those who were third or later (12.58 years, P <or= 0.01). Regression analysis selected family size and place of residence in childhood as the most important determinants of mean age at menarche in our university students. In this sample, from 1972 to 1983, mean age at menarche remained stable. When we considered published data from all the Portuguese population we found a decrease in mean age at menarche from 15 years for girls born in 1880 to 12.44 for those born in the 1980s. This decrease was the result of great improvements in the social and economic living conditions that occurred in Portugal especially after the 1970s concerning nutrition and health care, among many other environmental factors.

Social inequalities and children's height in Trinidad and Tobago

OBJECTIVE

The aim of the study was to report the association of socio-economic factors with child's height.

DESIGN

Cross-sectional study based on a representative national sample of government schools.

SETTING

Trinidad and Tobago in 1999.

SUBJECTS

A total of 2608 boys and girls mean age 5.8 y, range 4.38-6.99 y and 3080 mean age 8.6 y, range 7.00-10.44 y olds.

OUTCOME

Measurement of height and a questionnaire completed by parents. In the analysis height was expressed as standard deviation scores (s.d.s.) based on the British height curves (1990) or height below -1.5 s.d.s.

RESULTS

Ethnicity, parental heights, birthweight, maternal age at child's birth and number of children in the family were the main factors associated with children's height. Lack of piped water supply in the home was the only socio-economic factor consistently associated with height (mean difference in s.d.s. adjusted only for age group, gender and ethnicity -0.192, 95% CI -0.257 to -0.127 and in addition adjusted for the variables listed above -0.080, 95% CI -0.141 to -0.019). Parental education, household overcrowding and employment status were weakly associated with height in the partially adjusted model only. Analysis of severe growth failure gave similar results.

CONCLUSION

The impact of socio-economic factors on height is marginal in Trinidad and Tobago. As socio-economic factors may have an impact on a broad range of health indicators, height and rates of undernutrition should not be used as sole criteria for assessing progress in decreasing health differentials caused by social inequalities.

The rise of childhood type 1 diabetes in the 20th century

The incidence of childhood type 1 diabetes increased worldwide in the closing decades of the 20th century, but the origins of this increase are poorly documented. A search through the early literature revealed a number of useful but neglected sources, particularly in Scandinavia. While these do not meet the exacting standards of more recent surveys, tentative conclusions can be drawn concerning long-term changes in the demography of the disease. Childhood type 1 diabetes was rare but well recognized before the introduction of insulin. Low incidence and prevalence rates were recorded in several countries over the period 1920-1950, and one carefully performed study showed no change in childhood incidence over the period 1925-1955. An almost simultaneous upturn was documented in several countries around the mid-century. The overall pattern since then is one of linear increase, with evidence of a plateau in some high-incidence populations and of a catch-up phenomenon in some low-incidence areas. Steep rises in the age-group under 5 years have been recorded recently. The disease process underlying type 1 diabetes has changed over time and continues to evolve. Understanding why and how this produced the pandemic of childhood diabetes would be an important step toward reversing it.

Secular trends in growth among urban Brazilian children of European descent

PRIMARY OBJECTIVE

The purpose of this paper is to describe and discuss a significant secular trend in stature and weight in an urban Brazilian population.

METHODOLOGY

Anthropometric measurements of 7878 children and adolescents from São Paulo, Brazil, obtained in 1997/98 were compared with data from a previous study carried out in 1978. Both samples include children of middle-class urban families of European ancestry.

MAIN OUTCOMES AND RESULTS

Comparisons between the two samples reveal strong positive secular trends in both height and weight. Furthermore, the 1997/98 sample shows no growth deficits in relation to the WHO/NCHS international reference.

CONCLUSIONS

The positive trend can be explained as the result of economic development and improvement of social indicators, while the absence of growth deficits, contrary to what is reported in other studies carried out in developing countries, follows from the common genetic background of the Brazilian sample surveyed here and the US sample which is the basis of the NCHS/WHO reference.

Familial resemblance for the age at menarche in Basque population

A cross-sectional sample from Biscay province (Basque Country, Spain) composed of 296 subjects from 143 nuclear families was analysed. The aim of this research was to study familial resemblance for the age at menarche and to investigate the influence that BMI, fatness and several socio-familial variables have on the menarcheal age. The influence of these variables on the degree of similarity of mother-daughter and sister-sister pairs for the age at onset of menstruation will be determined. Mean ages at menarche of mothers estimated by retrospective methodology (12.88 years, SD = 1.57) and daughters assessed by probit analysis (12.34 years. SD= 1.00) showed no statistically significant differences. Mother-daughter and sister-sister correlations increased after controlling for BMI, fatness and several socio-familial variables (0.25 vs 0.36 and 0.28 vs 0.44, respectively). The results revealed the importance of BMI, fatness, socio-economic level and the number of people living together in the household on menarcheal age and on the estimation of correlations. However, no influence from sibship size (possibly because this variable is a part of the people living together in the household) nor from birth order of the subjects was observed.

Why did they lie? Socio-economic bias in reporting menarcheal age

PRIMARY OBJECTIVE

To show that socio-economically dependent cultural bias distorts results of the status quo method of estimating age at first menstruation.

METHODS

Questionnaires asking for menstrual status and the recalled age at menarche were distributed to approximately 1000 Javanese girls who attended junior and senior high schools in Malang. Age of participants ranged from 11.98 to 18.89 years. Probit analysis was applied to the status quo data while average menarcheal age recalled by girls > or =16 year old was also calculated. t-test, F-test, ANOVA and chi2 tests were applied to test significance of differences between groups.

MAIN OUTCOMES AND RESULTS

Girls of low occupational status fathers (Group 1) had a probit average menarcheal age of 13.99 years (SD = 1.33, n = 524). Girls of medium occupational status fathers (Group 2), had a lower probit average menarcheal age (13.06 SD = 1.38, n = 315). Girls of fathers with the highest occupational score (Group 3) rarely reported premenarcheal status (less than 10% in all age groups studied) and the probit analysis of their reports yielded an unbelievable average of 9.61 (SD = 3.41, n = 157) years. Group 3 girls tend to report their menarcheal status incorrectly, probably due to a 'fashion' of appearing mature or to 'contagion' during filling out of a questionnaire. The recalled average menarcheal age of Group 3 females questioned when they were aged 16 years and above, yields an average that seems to be more reliable (12.74 years, SD = 1.41, n = 7), because at a fully postmenarcheal age there is no need to enhance one's status by falsely claiming maturity.

Persistent variations in average height between countries and between socio-economic groups: an overview of 10 European countries

PRIMARY OBJECTIVES

This paper aims to provide an overview of variations in average height between 10 European countries, and between socio-economic groups within these countries.

DATA AND METHODS

Data on self-reported height of men and women aged 20-74 years were obtained from national health, level of living or multipurpose surveys for 1987-1994. Regression analyses were used to estimate height differences between educational groups and to evaluate whether the differences in average height between countries and between educational groups were smaller among younger than among older birth cohorts.

RESULTS

Men and women were on average tallest in Norway, Sweden, Denmark and the Netherlands and shortest in France, Italy and Spain (range for men: 170-179 cm; range for women: 160-167 cm). The differences in average height between northern and southern European countries were not smaller among younger than among older birth cohorts. In most countries average height increased linearly with increasing birth-year (approximately 0.7-0.8 cm/5 years for men and approximately 0.4 cm/5 years for women). In all countries, lower educated men and women on average were shorter than higher educated men (range of differences: 1.6-3.0 cm) and women (range of differences: 1.2-2.2 cm). In most countries, education-related height differences were not smaller among younger than among older birth cohorts.

CONCLUSIONS

The persistence of international differences in average height into the youngest birth cohorts indicates a high degree of continuity of differences between countries in childhood living conditions. Similarly, the persistence of education-related height differences indicates continuity of socio-economic differences in childhood living conditions, and also suggests that socio-economic differences in childhood living conditions will continue to contribute to socio-economic differences in health at adult ages.

The growth and development of the Annals of Human Biology: a 25-year retrospective

The history of the founding in 1958 of the Society for the Study of Human Biology is outlined, and the circumstances in which the Annals of Human Biology began publication in 1974. The contents of the papers published 1974-1997 are reviewed; about 40% concern Population Biology, 40% Auxology and 20% Population Physiology. Some outstanding contributions in the first two of these fields are mentioned. Many consist of groups of papers from an ongoing study: 11 papers from the Otmoor villages study by Harrison and colleagues, and 11 concerning the growth of children in the Zurich Longitudinal Study, by Gasser and colleagues. Papers concerning the analysis of growth data and modelling of the growth curve, especially by Healy, are noted, and papers giving evidence of mini-spurts in growth and the saltation-stasis growth model are recalled. Wilson's papers on catch-up and growth regulation in twins are reviewed; also the contribution to growth-as-a-mirror of social conditions by workers at the Stockholm Institute of Education. The National Study of Health and Growth, led by Rona, contributed 13 papers over 14 years to the Annals, and there were outstanding one-off papers from the National Child Development Study, and the Cuban National Growth Study of 1972, and concerning the secular trend towards greater leg length in Japan, the upward social mobility of the taller of pairs of brothers, the growth of 18th century children in Vienna and Stuttgart and the measurements of 19th century slaves in the USA.

Changes in growth patterns in Zagreb school children related to socio-economic background over the period 1973-1991

The purpose of this paper is to present the changes in growth patterns in different socio-economic classes of Zagreb school children over the period 1973-1991. Classes are defined by parental occupation. Surveys were performed in 1973, 1982 and 1991 covering 8938, 10700, and 7400 examinees aged 7 to 19 respectively. In all three observed generations boys and girls belonging to social group I (nonmanual workers' families) were taller than their peers in group III (manual workers' families). Differences were most pronounced in 1973. Mean height of children from 'mixed' families (class II) were mostly between two other groups. Positive secular changes in both genders were most pronounced in children belonging to manual workers' families--girls observed in 1991 being 2-4cm and boys 2-6cm taller than their peers in 1973. In children from nonmanual workers' families the secular increase was small in younger age groups--in boys up to 11 hardly noticeable, while in both genders from the age of 13 on, the mean height increase reached or even surpassed that observed in manual workers' children. Positive changes in all observed groups were more pronounced in the period 1973-1982 than in 1982-1991. Mean weight changes, in general over period 1973-1991 corresponded to changes in height. However, the average weight gain in girls in class I was somewhat lower compared to the gain in height, particularly in older age groups. In the same period, 19731991 the mean menarcheal age in girls showed the reversed trend i.e. a shift towards the older age. In class I the reversal was noticed in the first period, parallel to intensive height increase, while in class III positive changes in height were accompanied by significant lowering of menarcheal age. In this group the reversal was observed in the second period 1982-1991.

Socioeconomic factors and growth during childhood and early adolescence in Jena children

The influence of socioeconomic parameters (number of children in the family, birth order of subject, professional status of the father, education of the mother) and background characteristics (birth length, birth weight and age of the mother at birth of the child) of growth in body height in children from 4 to 12 years of age was investigated. The analysis is based on data from a longitudinal growth survey, which started with 207 children (98 males and 109 females) from Jena (Germany) in 1985. Multiple regression analysis was used to estimate the degree of relationship between height and the social or background factors. In this study no differences in growth between children of different social groups were found. Variation in height of girls was mainly affected by the biological factor length at birth of the child.

The impact of caste on the growth of male Sikhs in Punjab, India

This study is based on a cross-sectional sample of 442 Sikh boys and young male adults who were born in and around the town of Phagwara, in the state of Punjab, India, and stayed there all their lives. The sample comprised Sikh boys at three crucial phases of growth, at 5-6, 10-11 and 15-16 years, and young adults around 18 years of age. The sample comprised three distinct caste groups, viz. Jats, Ramgarhias and Ravidassias, belonging respectively to upper, middle and lower socioeconomic strata of the Sikh community. Differences in stature and body weight are particularly marked around early adolescence, and there is some indication of caste differences reappearing in young adults. In the case of body mass index, however, the differences seem most marked in late adolescence. There is no clear directional pattern to the way skinfolds change, but inter-caste differences become more marked with age. There is a suggestion of continuing growth beyond 16 years of age, and indications that the well-off groups grow more, as compared to the poor groups, during this period. Comparisons of young adults with older groups of the same caste indicate an increase in body weight with age, but smaller stature in the older groups. There is thus evidence for a secular stature increase among present-day Punjabi Sikhs.

Delayed puberty in girls with cystic fibrosis despite good clinical status

BACKGROUND

Previous studies have shown that puberty is delayed among patients with cystic fibrosis (CF). Malnutrition has been considered the main etiologic factor. Today with improved medical therapy and nutritional support, most CF patients obtain an almost normal nutritional status.

OBJECTIVES

To investigate whether pubertal development among female CF patients at the Stockholm CF Center was normal and, if not, what other parameters besides nutrition might influence this.

METHODS

Seventeen patients were studied retrospectively regarding age at peak height velocity and menarche. Menarcheal age (MA) was compared with normal population data and related to clinical and nutritional status, genotype, oral glucose tolerance test (OGTT), and essential fatty acid levels.

RESULTS

The mean age at peak height velocity (12.9 +/- 0.8 years) and at menarche (14.9 +/- 1.4 years) was significantly higher in the CF patients compared with normal controls (11.9 +/- 1.0 years and 13.0 +/- 1.0 years, respectively). No correlation was found between menarchal age and nutritional or clinical parameters. The patients with pathological OGTT without overt diabetes were significantly older at menarche (15.8 +/- 1.7 years) compared with the patients with normal OGTT (14.3 +/- 0.9 years). The patients who were homozygous for the most common mutation, deltaF508, were significantly older at menarche (15.2 +/- 1.9 years) than those who were not (14.7 +/- 0.9 years).

CONCLUSIONS

Pubertal delay still existed among the CF patients despite good clinical status. The patients homozygous for deltaF508 and those with pathological OGTT showed the most delayed puberty.

Body composition of rural and urban children from the central region of Spain

Body composition components are considered in a cross-sectional sample of 2564 children (age range 6-14 years) from Central Spain. The sample was divided depending on rural or urban residence. Weight, and skinfold at the triceps, biceps, subscapular and suprailiac site were measured. Body composition was represented by percentage fat (%F), lean body mass (LBM), fat mass (FM) and sum of skinfolds (SSK). Sex differences were found to be highly significant for all variables and rural-urban differences were small. Rural boys show slightly larger fat content, in %F, FM and SSK, than their urban peers, but significant (p < 0.05) differences appear only for SSK. No statistically significant environmental effect was found for LBM. The improvement of living conditions, the urban influence on the rural area and the degree of urbanization of the urban settlement are suggested as the main determinants influencing obtained results.

Recreational patterns, body composition and socioeconomic status of Western Australian secondary school students

A study of 4672 secondary school students was carried out in order to assess the relationship between body composition, recreational patterns, and socioeconomic status as indicated by parental occupation and the school attended. Results indicated that there were more girls than boys participating in organized sport, and health and fitness activities; and more boys than girls involved in informal recreational activities and home-based passive pursuits. A higher proportion of participants came from the higher socioeconomic status (SES) group. More high-SES students revealed weight appropriate to their height.

Swedish population reference standards for height, weight and body mass index attained at 6 to 16 years (girls) or 19 years (boys)

Swedish population reference standards for height, weight and body mass index (BMI) attained at 6 to 16 years (girls) or 19 years (boys) are presented. Data were obtained from two independent nationwide samples of Swedish children; one (740 children) born in 1955, the other (2907 children) born in 1967. The weights of the children born in 1955 were adjusted to equal those born in 1967; heights did not differ. These reference standards refer therefore to Swedish children born at around 1970. The observations were fitted by the power transformation, or L, M, S method of Cole and Green. Weights and BMIs were thus normalized and valid SD scores for individuals obtained. Centile charts are given for clinical use. The means of the present, nationwide standards were 1-2 cm and 1-2 kg greater than those of the Solna-based standards currently in use.

Short stature as an effect of economic and social conditions in childhood

Only a few studies on the effect of environmental factors on height are based on adults and none, that we could find, relates adult height to both economic and psycho-social conditions in childhood. The aim of this study is to investigate whether four indicators of economic and psycho-social conditions during childhood are related to a variation in adult height and whether these factors can explain the variation in height between men and women from different childhood classes. The study is based on data derived from a study of living conditions in Sweden conducted in 1991. Beside childhood socio-economic group, indicated by father's occupation, we employ four indicators of economic and psycho-social conditions during the childhood period, previously employed elsewhere. These are economic hardship, large family, dissension in the family and disunited family during childhood. The prevalence of short stature differs significantly by three of the four indicators on economic and psycho-social childhood conditions. It is also more common if the person has grown up in a disunited family, but this effect is not significant. The proportion of short persons also varied significantly by childhood socio-economic group. On the whole, short stature in adulthood seems to be a reflection of a number of adverse conditions in childhood, both economic, status related and psycho-social, and can, consequently, be seen as summing up the whole childhood period rather than merely reflecting differences in nutrition or any other specific condition.

Height and social mobility. A study of the height of 10 year olds in relation to socio-economic background and type of formal schooling

Based on a representative sample of Stockholm school-children born in 1943, the association between the height at 10 years of age and the selection to higher and lower education at the same age was examined for upper and lower social groups defined by the father's occupational status. The hypothesis that there is a link between height and change of social position even among children was examined. Upwardly mobile boys (lower class boys selected for higher education) were taller than those staying in their social position. Downwardly mobile boys (higher class boys selected only for elementary education) were smaller than those remaining in their social position. The same tendency was found for girls--although not statistically significant.

Average menarcheal age of higher socioeconomic status urban Cape coloured girls assessed by means of status quo and recall methods

The age of the onset of menstruation has been determined for the urban middle-class Cape Coloured population. From 1987 to 1992 data were collected from 857 girls aged 8 to 20 years attending primary and secondary schools in Cape Town. The schools were specifically selected for the highest socioeconomic status (SES) of pupils' parents. Three-quarters of parents fell into the higher three categories of the 5-category SES standard. Girls were interviewed with respect to their menarcheal status and those who were postmenarcheal were also asked to report when they had started to menstruate. The probit analysis of the status quo data yielded average of 12.61 years and a standard deviation (s) of 1.25 years. The retrospective method was applied only to recall data of 258 girls falling into fully postmenearcheal categories (16-20 years). It yielded an average of 12.75 (s = 1.32), insignificantly different from that obtained from the probit analysis. The menarcheal age of higher SES Cape Coloured girls is significantly lower than that of white girls in Cape Town (13.30 years) and much lower than that of any group of black South African girls. It falls close to the lower limit of the range reported worldwide. Body heights, weights, and Body Mass Index indicate good growth status of girls studied.