Early influences on the secular change in adult height between the parents and children of the 1958 birth cohort

Intergenerational transmission of height in a historical population: From taller mothers to larger offspring at birth (and as adults)

Changes in growth and height reflect changes in nutritional status and health. The systematic surveillance of growth can suggest areas for interventions. Moreover, phenotypic variation has a strong intergenerational component. There is a lack of historical family data that can be used to track the transmission of height over subsequent generations. Maternal height is a proxy for conditions experienced by one generation that relates to the health/growth of future generations. Cross-sectional/cohort studies have shown that shorter maternal height is closely associated with lower birth weight of offspring. We analyzed the maternal height and offspring weight at birth in the maternity hospital in Basel, Switzerland, from 1896 to 1939 (N = ∼12,000) using generalized additive models (GAMs). We observed that average height of the mothers increased by ∼4 cm across 60 birth years and that average birth weight of their children shows a similarly shaped and upward trend 28 years later. Our final model (adjusted for year, parity, sex of the child, gestational age, and maternal birth year) revealed a significant and almost linear association between maternal height and birth weight. Maternal height was the second most important variable modeling birth weight, after gestational age. In addition, we found a significant association between maternal height and aggregated average height of males from the same birth years at time of conscription, 19 years later. Our results have implications for public health: When (female/maternal) height increases due to improved nutritional status, size at birth-and subsequently also the height in adulthood of the next generation-increases as well. However, the directions of development in this regard may currently differ depending on the world region.

Temporal mapping of the closure of the anterior fontanelle and contiguous sutures using computed tomography, in silico models of modern infants

The aim of this study is to quantify and statistically model the age-related decline in the fibrous connective tissue interface of the anterior fontanelle in modern Australian infants, using three-dimensional, semi-automated computed-assisted design protocols. Non-linear regression with variance models, using power functions, combined with quantile regression of the 5th and 95th population percentiles, were utilised to assess absolute anterior fontanelle surface area (AFSA) as a function of age, using multi-slice cranial computed tomography scans obtained from 256 infants aged < 30 months (males: n = 126, females: n = 109) from Brisbane children's hospitals. Normalised AFSA (NFSA), standardised for variation in cephalic size, followed a progressive decline from birth, the greatest velocity change occurring between the 3-6 and 6-9 month cohorts. Growth of the neurocranium is the most significant within the first 8 months postpartum, with a mean increase of 19.03 mm in maximum cranial length and 10.04 mm in breadth. Directionality of fontanelle closure, quantified using spline curves refutes fundamental assumptions that the anterior fontanelle is consistent with a quadrilateral, and contiguous sutures exhibit constant velocity of closure. The present study provides normative values for fontanelle size and diameters as well as new predictive non-linear models for age substantiation, screening of developmental abnormalities and indicators of suspected child maltreatment in modern infants aged birth to 30 months.

Intergenerational effect of early-life growth on offspring height: Evidence from the Hertfordshire Cohort Study

BACKGROUND

Previous intergenerational (parent to child) and transgenerational (grandparent to grandchild) studies have shown there is a link between parental and offspring birthweight.

OBJECTIVES

The aim was to explore the association between the early-life weight gain of an individual and the adult height of their children and grandchildren.

METHODS

Study participants across three generations of the Hertfordshire Cohort Study (HCS) were included in this study. Health visitors recorded the birthweight (kg) and weight at 1 year (kg) of the original (F0 generation) HCS participants when they were born in Hertfordshire between 1931 and 1939. A conditional infant weight gain score for F0 participants was calculated using birthweight and weight at 1 year, and self-reported height (cm) of their children (F1 generation) and their grandchildren (F2 generation) was obtained from postal questionnaires. Due to the lack of clustering within family lines, linear regression analysis was used to compare intergenerational relationships.

RESULTS

Data were available from 139 F0, 148 F1, and 198 F2 participants. A positive association was found between parental birthweight (F0) and offspring adult height; on average, a 1 kg increase in F0 birthweight was associated with a 2.04 cm increase in F1 adult height (beta 2.04, 95% confidence interval [CI] -0.03, 4.10). A positive association was found between F0 conditional weight gain during the first year of life and offspring (beta 1.53, 95% CI 0.45, 2.62) and grandchild height (beta 1.06, 95% CI 0.03, 2.10). Positive associations were also found between F0 weight at 1 year and offspring (beta 1.83, 95% CI 0.79, 2.87) and grandchild height (beta 0.91, 95% CI -0.10, 1.91).

CONCLUSION

This study demonstrates an association between grandparental weight gain in early life and the heights of their children and grandchildren. The results of these analyses highlight the importance of early-life weight gain on the adult stature of subsequent offspring.

Are our Babies Becoming Bigger?

I have tried to show, using a contemporary international data set, the overall consistency in shape of curves of national birthweight distributions which reflect the biological and social characteristics of the population from which they are derived, and the effects of changes in these characteristics. For several countries, including the United States and England and Wales, the trends in recent years have been such as to shift the main distribution upwards, so that the median weight has increased.

Also shown has been the close and specific relationship within each population group between infant mortality and birthweight, with sharp falls of mortality with increasing birthweight. It has been shown elsewhere that similar patterns are seen with short- and long-term morbidity, thus underlining the importance to be attached to increasing birthweight particularly in underprivileged groups. In the short term this can be done by reducing the frequency of parental smoking, where this is a problem, and in the longer term by improving maternal health and nutrition. The shift towards higher birthweights if it persists, should make an important contribution towards the improvement of the public health of the next generation.

Effects of socioeconomic position and social mobility on linear growth from early childhood until adolescence

OBJECTIVE

To assess the effect of socioeconomic position (SEP) in childhood and social mobility on linear growth through adolescence in a population-based cohort.

METHODS

Children born in Cuiabá-MT, central-western Brazil, were evaluated during 1994 - 1999. They were first assessed during 1999 - 2000 (0 - 5 years) and again during 2009 - 2011 (10 - 17 years), and their height-for-age was evaluated during these two periods.Awealth index was used to classify the SEP of each child's family as low, medium, or high. Social mobility was categorized as upward mobility or no upward mobility. Linear mixed models were used.

RESULTS

We evaluated 1,716 children (71.4% of baseline) after 10 years, and 60.6% of the families showed upward mobility, with a higher percentage among the lowest economic classes. A higher height-for-age was also observed among those from families with a high SEP both in childhood (low SEP= -0.35 z-score; high SEP= 0.15 z-score, p < 0.01) and adolescence (low SEP= -0.01 z-score; high SEP= 0.45 z-score, p < 0.01), whereas upward mobility did not affect their linear growth.

CONCLUSION

Expressive social mobility was observed, but SEP in childhood and social mobility did not greatly influence linear growth through childhood in this central-western Brazilian cohort.

Pubertal height gain is inversely related to peak BMI in childhood

BACKGROUND

Childhood BMI may influence subsequent growth in height as well as the timing of puberty. The aim of the present study was to investigate associations between BMI in childhood and subsequent height gain/pubertal growth.

METHODS

Longitudinal growth data were used (GrowUp₁₉₉₀Gothenburg cohort, n = 1,901). The QEPS growth-model was used to characterize height gain in relation to the highest BMI_SDS value between 3.5 and 8 y of age. Children were defined as overweight/obese (OwOb) or normal weight/underweight (NwUw), using the 2012 International Obesity Task Force criteria.

RESULTS

A negative association between childhood BMI_SDS and pubertal height gain was observed. Already at birth, OwOb children were heavier than NwUw children, and had a greater height velocity during childhood. Onset of puberty was 3.5/3.0 mo earlier in OwOb girls/boys, and they had 2.3/3.1 cm less pubertal height gain from the QEPS-models specific P-function than NwUw children. Adult height was not related to childhood BMI.

CONCLUSION

We found that pubertal height gain was inversely related to peak BMI in childhood. Higher childhood BMI_SDS was associated with more growth before onset of puberty, earlier puberty, and less pubertal height gain, resulting in similar adult heights for OwOb and NwUw children.

Early Life Conditions and Physiological Stress following the Transition to Farming in Central/Southeast Europe: Skeletal Growth Impairment and 6000 Years of Gradual Recovery

Early life conditions play an important role in determining adult body size. In particular, childhood malnutrition and disease can elicit growth delays and affect adult body size if severe or prolonged enough. In the earliest stages of farming, skeletal growth impairment and small adult body size are often documented relative to hunter-gatherer groups, though this pattern is regionally variable. In Central/Southeast Europe, it is unclear how early life stress, growth history, and adult body size were impacted by the introduction of agriculture and ensuing long-term demographic, social, and behavioral change. The current study assesses this impact through the reconstruction and analysis of mean stature, body mass, limb proportion indices, and sexual dimorphism among 407 skeletally mature men and women from foraging and farming populations spanning the Late Mesolithic through Early Medieval periods in Central/Southeast Europe (~7100 calBC to 850 AD). Results document significantly reduced mean stature, body mass, and crural index in Neolithic agriculturalists relative both to Late Mesolithic hunter-gatherer-fishers and to later farming populations. This indication of relative growth impairment in the Neolithic, particularly among women, is supported by existing evidence of high developmental stress, intensive physical activity, and variable access to animal protein in these early agricultural populations. Among subsequent agriculturalists, temporal increases in mean stature, body mass, and crural index were more pronounced among Central European women, driving declines in the magnitude of sexual dimorphism through time. Overall, results suggest that the transition to agriculture in Central/Southeast Europe was challenging for early farming populations, but was followed by gradual amelioration across thousands of years, particularly among Central European women. This sex difference may be indicative, in part, of greater temporal variation in the social status afforded to young girls, in their access to resources during growth, and/or in their health status than was experienced by men.

Intergenerational influences on the growth of Maya children: The effect of living conditions experienced by mothers and maternal grandmothers during their childhood

OBJECTIVES

To test the hypothesis that living conditions experienced by maternal grandmothers (F1 generation) and mothers (F2 generation) during their childhood are related to height and leg length (LL: height - sitting height) of their 6-to-8 year old children (F3 generation).

METHODS

From September 2011 to June 2012 we obtained height and LL, and calculated z-score values of these measurements for 109 triads (F1 , F2 , F3 ) who are Maya living in Merida, Yucatan, Mexico. Multiple regression models were adjusted to examine the relation of anthropometric and intergenerational socioeconomic parameters of F1 (house index and family size during childhood) and F2 (paternal job loss during childhood) with the z-score values of height and LL of F3 .

RESULTS

Children's height and LL were positively associated with maternal height and LL. This association was relatively stronger in LL. Better categories of grand-maternal house index were significantly associated with higher values of height and LL in grandchildren. Grand-maternal family size was positively related with LL, but not with height.

CONCLUSIONS

Our findings partially support the hypothesis that living conditions experienced by recent maternal ancestors (F1 and F2 ) during their growth period influence the growth of descendants (F3 ). Results suggest that LL is more sensitive to intergenerational influences than is total height and that the transition from a traditional rural lifestyle to urban conditions results in new exposures for risk in human physical growth.

Intergenerational correlations in size at birth and the contribution of environmental factors: The Uppsala Birth Cohort Multigenerational Study, Sweden, 1915-2002

Sizes at birth of parents and their children are known to be correlated, reflecting in part the influence of fetal and maternal genes. Sociodemographic factors, regarded as aspects of the shared environment across generations, would also be expected to contribute, but evidence is limited. In the present study, the authors aimed to quantify the role of the shared environment in explaining intergenerational correlations in birth weight and length by using data across 3 consecutive generations from the Uppsala Birth Cohort Multigenerational Study in Uppsala, Sweden. That study included birth and sociodemographic data on 7,657 singletons born in Uppsala in 1915-1929 (generation 1) and their grandchildren (generation 3). Standard regression and biometric models were used to study the correlations in size at birth of generation 1-generation 3 pairs. The data showed stronger correlations in maternal pairs than in paternal pairs for birth weight (0.125 vs. 0.096, P = 0.02) but not for birth length (0.097 vs. 0.093, P = 0.77). These correlations were not reduced by adjustment for sociodemographic factors in regression models. In contrast, significant shared-environment contributions to the intergenerational correlations were identified in biometric models, averaging 14% for both birth measures. These models assumed a common latent factor for the sociodemographic variables. The present results show that the shared environment moderately but significantly contributes to intergenerational correlations.

Sexual Dimorphism in Stature (SDS), Jealousy and Mate Retention

Previous research has investigated the manner in which absolute height impacts on jealousy and mate retention. Although relative height is also important, little information exists about the potential influence of sexual dimorphism in stature (SDS) within established relationships. The current study investigated the relationship between SDS and the satisfaction, jealousy and mate retention behaviors reported by men and women. Heterosexual men ( n = 98) and women ( n = 102) completed a questionnaire. Men in high SDS relationships reported the lowest levels of cognitive and behavioral jealousy, although the impact of SDS on relationship satisfaction was less clear. SDS was not associated with the overall use of mate retention strategies; SDS did however affect the use of three specific strategies (vigilance, monopolization of time, love and care). SDS did not affect women's relationship satisfaction, jealousy (cognitive, behavioral, or emotional) or the use of mate retention strategies (with the exception of resource display).

The recognition and treatment of growth disorders - a 50-year retrospective

The past 50 years have seen great progress in the understanding and treatment of classic growth disorders. Advances such as the recognition of hormone receptor defects, the development of recombinant growth hormone, and the expanding awareness of epigenetic phenomena affecting growth are among these great achievements. Yet growth failure remains a pervasive problem among children with complex health conditions, such as survivors of childhood cancers, premature infants, organ transplant recipients, and children with cystic fibrosis. The significant increases in life expectancy among these groups underscores the potential consequences of poor growth, whether due to the underlying conditions or medical treatments, as they may have long-lasting effects into adulthood. The ongoing contributions of human biologists to the study of human growth remain essential in the recognition and treatment of growth disorders, by defining normal patterns of growth and body composition, the interplay of growth and maturation, the role of environmental, behavioral and genetic factors, and the long-term consequences of growth patterns. Examples will be given based on two common genetic disorders, cystic fibrosis and sickle-cell anemia, to highlight the relationships between growth failure, survival, and malnutrition. Also, a study of bone mineral accretion in children with cystic fibrosis will illustrate the importance of understanding patterns of growth in healthy children, and their application in the diagnosis and management of children with chronic disease. These examples accentuate the need for continued participation of human biologists in the study of growth and development and the care of children.

Developmental origins of life history: Growth, productivity, and reproduction

There is now much evidence that early life undernutrition elevates risk of diseases like cardiovascular disease. Less clear is whether the underlying developmental plasticity in metabolism and physiology evolved to serve an adaptive function, beyond these effects on pathophysiology. This review builds from principles of life history theory to propose a functional model linking early environments with adult biology. An organism has metabolic potential in excess of survival requirements, called productivity, that supports growth before being shunted into reproduction after growth ceases. This concept from inter-specific studies leads to the prediction that plasticity in growth rate will be positively correlated with components of future adult reproductive expenditure. Consistent with this idea, evidence is reviewed that early nutrition or growth rate predict offspring size in females, and increased somatic investment related to reproductive strategy in males. Thus, population birth weight and sexual size dimorphism are predicted to increase in response to improvements in early nutrition. A striking feature of the continuity of metabolic production is its perpetuation not merely during the lifecycle but across generations: in females, growth rate predicts future nutritional investment in reproduction, which in turn determines fetal growth rate in the next generation. Growth and reproduction serve as mutually-defining templates, thus creating a phenotypic bridge allowing ecologic information to be maintained during ontogeny and transmitted to offspring. Resetting of metabolic production in response to maternal nutritional cues may serve a broader goal of integrating nutritional information within the matriline, thus providing a more reliable basis for adjusting long-term strategy.

Association Between Birth Weight and Blood Pressure Is Robust, Amplifies With Age, and May Be Underestimated

Data on the early life origins of adult hypertension have been widely reported: however, recent research shows that the strength of association between small size at birth and higher blood pressure weakens as study size increases. In this article, we retest the association between birth weight and systolic blood pressure in a large cohort, examine whether age interacts with birth weight to predict blood pressure, and explore reasons why birth weight-blood pressure associations tend to weaken with increasing study size. Measurements from 25874 employees of a large United Kingdom company (mean [SD] age: 38.0 [7.9] years), undertaking voluntary occupational health screening, were available. Using linear regression analysis, we observed that systolic blood pressure changed −0.8 (95% CI: −1.1 to −0.5) mmHg per 1-kg increase in birth weight ( P <0.001) adjusted for age and sex and −1.1 (95% CI: −1.3 to −0.8) mmHg/kg ( P <0.001) after further adjustment for body size. This inverse association amplified with age (age/birth weight interaction term P <0.001). In participants reporting birth weight from hospital records (n=744), systolic blood pressure changed −1.4 (95% CI: −3.1 to 0.2) mmHg/kg compared with −0.8 (95% CI: −1.0 to −0.5) mmHg/kg in all of the other participants. Finally, the data show evidence of “fixed-category blood pressure allocation,” where participants are allocated certain blood pressure values, such as 120/80 mmHg, independent of actual blood pressure. Although the association between birth weight and systolic blood pressure was weaker than observed in smaller studies, recalled birth weight and fixed blood pressure measurement error may generate a trend toward weaker associations in larger studies.

Clinical features affecting final adult height in patients with pediatric-onset Crohn's disease

BACKGROUND

Growth failure is a recognized complication of pediatric-onset Crohn's disease, but there are few data on final adult height.

OBJECTIVE

Our purpose with this work was to determine adult height and the clinical features that influence long-term growth impairment.

METHODS

We retrospectively studied 123 patients with Crohn's disease (65 male and 58 female) who had reached adult height. All of the case subjects were diagnosed before age 16.0 years. Heights were converted to SD scores and univariate analysis performed of factors postulated to influence final height, that is, interval from onset of symptoms to diagnosis, prepubertal onset of symptoms, gender, jejunal disease present at diagnosis, systemic steroid therapy, intestinal surgery, and midparental height SD scores. Significant univariate factors were additional analyzed in regression models.

RESULTS

Mean height deficit at diagnosis was -0.50 SD scores, which improved to -0.29 SD scores at final height. Mean final height compared with target height, calculated from parental height, was -2.4 cm (range: -20.0 to 9.0 cm). Nineteen percent of the case subjects achieved a final height >8.0 cm below target height. The length of the interval between symptom onset and diagnosis correlated negatively with height SD scores at diagnosis. Height SD scores at diagnosis were related to final height SD scores, independent of midparental height. The presence of jejunal disease was negatively related to final height.

CONCLUSIONS

Mean final adult height showed a modest deficit compared with target height, but in one fifth of patients, final height was significantly less than target height. Earlier diagnosis and improved treatment of jejunal disease would be likely to improve final height.

Association of birth weight with adult lung function: findings from the British Women's Heart and Health Study and a meta-analysis

BACKGROUND

The aim of this study was to examine the associations between birth weight and lung function in a cohort of women aged 60-79 years and to combine these results with those from other published studies in a systematic review and meta-analysis.

METHODS

The associations of self-reported birth weight with adult lung function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and forced expiratory flow rate during mid expiration (FEF(25-75)), all measured using standard procedures, were assessed in a cross sectional study of 2257 British women aged 60-79 years. A detailed literature search was used to identify all published studies of the association, and meta-analysis was used to pool the results from our study and all published studies.

RESULTS

There were positive linear associations between birth weight and all three measures of lung function in simple age and examining nurse adjusted regression models. However, with adjustment for height (squared), all three associations attenuated towards the null: adjusted (age, nurse, height2) change in FEV1 per 1 kg birth weight was 0.01 l (95% CI -0.02 to 0.04); in FVC was 0.02 l (95% CI -0.02 to 0.07), and in FEF(25-75) was 0.00 l (95% CI -0.04 to 0.04). Further adjustment for life course socioeconomic position, adult body mass index, and smoking did not alter these associations. The results were similar among life long non-smokers and those who had ever smoked. A meta-analysis of eight studies of adults suggested that there was a positive association between birth weight and FEV1: pooled increase in FEV1 per 1 kg in birth weight 0.048 l (95% CI 0.026 to 0.070) adjusted for age, smoking, and height (or height squared). There was no evidence of small study bias in this meta-analysis.

CONCLUSIONS

There is a modest positive association between birth weight and lung function which indicates that intrauterine factors might have a role in lung development.

Fetal origins of developmental plasticity: are fetal cues reliable predictors of future nutritional environments?

Evidence that fetal nutrition triggers permanent adjustments in a wide range of systems and health outcomes is stimulating interest in the evolutionary significance of these responses. This review evaluates the postnatal adaptive significance of fetal developmental plasticity from the perspective of life history theory and evolutionary models of energy partitioning. Birthweight is positively related to multiple metabolically costly postnatal functions, suggesting that the fetus has the capacity to distribute the burden of energy insufficiency when faced with a nutritionally challenging environment. Lowering total requirements may reduce the risk of negative energy balance, which disproportionately impacts functions that are not essential for survival but that are crucial for reproductive success. The long-term benefit of these metabolic adjustments is contingent upon the fetus having access to a cue that is predictive of its future nutritional environment, a problem complicated in a long-lived species by short-term ecologic fluctuations like seasonality. Evidence is reviewed suggesting that the flow of nutrients reaching the fetus provides an integrated signal of nutrition as experienced by recent matrilineal ancestors, which effectively limits the responsiveness to short-term ecologic fluctuations during any given pregnancy. This capacity for fetal nutrition to minimize the growth response to transient ecologic fluctuations is defined here as intergenerational "phenotypic inertia," and is hypothesized to allow the fetus to cut through the "noise" of seasonal or other stochastic influences to read the "signal" of longer-term ecologic trends. As a mode of adaptation, phenotypic inertia may help the organism cope with ecologic trends too gradual to be tracked by conventional developmental plasticity, but too rapid to be tracked by natural selection. From an applied perspective, if a trait like fetal growth is designed to minimize the effects of short-term fluctuations by integrating information across generations, public health interventions may be most effective if focused not on the individual but on the matriline.

The relation between birth weight and intima-media thickness in middle-aged adults

BACKGROUND

Birth weight has been found to be inversely associated with the risk of coronary heart disease and stroke, although the mechanisms for this association remain unclear. Here, we investigate the relation between reported birth weight and atherosclerosis in middle age.

METHODS

We included the 9817 participants (age 44-65) in the Atherosclerosis Risk in Communities (ARIC) study who were neither a twin nor born prematurely. Carotid atherosclerosis was assessed as intima-media thickness measured by B-mode ultrasound. We studied the association with recalled exact birth weight, and for those unable to recall exact birth weight, with recalled birth weight category.

RESULTS

Mean intima-media thickness (+/- standard deviation) was 0.73 +/- 0.17 mm. Mean birth weight for the 4635 participants recalling exact birth weight was 3.49 +/- 0.71 kg. A further 4946 participants recalled birth weight category, with 4730 (96%) reporting "medium" birth weight. In univariate analysis, birth weight and intima-media thickness were positively related. However, adjustment for confounding factors reduced the association to only a 0.004 mm higher intima-media thickness (95% CI = - 0.003 to 0.011) mm per 1 kg of birth weight. The same pattern of univariate positive relationship and attenuation with adjustment was seen for birth weight category and intima-media thickness. There was no evidence of interaction between adult body mass index (BMI) and birth weight, or of interaction between category of adult BMI and birth weight category. An inverse relation between birth weight category and intima-media thickness was seen only for those in the lowest category of adult BMI (BMI <25 kg/m).

CONCLUSIONS

We found no evidence of a clinically significant relation between birth weight and carotid atherosclerosis.

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.

Low birth weight is associated with higher adult total cholesterol concentration in men: findings from an occupational cohort of 25,843 employees

BACKGROUND

The majority of studies investigating the association between birth weight and adult total cholesterol (TC) concentration have been small and underpowered: not surprisingly, the findings have been inconsistent. We aimed to determine whether birth weight predicted adult TC in a large sample population.

METHODS AND RESULTS

Between 1994 and 1996, 132,000 British Telecom employees undertook voluntary occupational health screening. Birth weight and lifestyle factors were self-reported; TC concentration and body size were measured by occupational health nurses. Complete measurements were available for 18,286 men and 7557 women (age range, 17 to 64 years). We found that sex and birth weight significantly interacted to predict adult TC (birth weight/sex interaction term, P=0.002). In men, lower birth weight was associated with higher adult TC levels (a -0.07 reduction in TC for each 1-kg increase in birth weight; 95% CI, -0.09 to -0.04 mmol/L; P<0.001), whereas no association was observed in women. Adjustment for potential confounding factors, including current body size and menopausal status, did not alter the findings. Analysis by SD score showed that in men, a 1-SD decrease in body mass index lowered TC concentration approximately 5-fold more than a 1-SD increase in birth weight.

CONCLUSIONS

This is the largest study to investigate the association between birth weight and TC and suggests that the association may be dependent on sex. The absence of an association in women was not explained by menopausal status. The influence of fetal environment on adult TC is small compared with the influence of adult adiposity.

The association of grandmaternal and maternal factors with maternal adult stature

BACKGROUND

Stature is an important determinant of several reproductive and non-reproductive health problems. Documentation of secular trends in stature has been based primarily on cross-sectional studies of special populations, primarily of men. The objective of this study is to determine how growth and socio-economic status (SES) factors relate to stature changes among lineal female relatives, maternal grandmothers to mothers.

METHODS

The study base was derived from a population-based intergenerational cohort which linked several statewide databases to data from the mothers' own birth certificates: the Washington State Intergenerational Cohort. Mothers in these ethnic groups were separately studied: non-Hispanic Whites, African Americans, Native Americans, Hispanics. We generated simple, partial, and multiple correlation coefficients to investigate the association between stature and other growth and SES factors.

RESULTS

A mother's stature is determined partly by her own mother's stature and partly by her birthweight. These two measures are individually stronger predictors of stature than are several available SES factors considered in combination-grandmother's age, parity, marital status, and mother's age. The maximal multiple correlation models yielded R2 values from 18% to 28%.

CONCLUSIONS

Growth measures are stronger predictors of intergenerational changes in stature than are the several available socio-economic factors. However, socio-economic factors are partly responsible for the level of achieved prenatal and postnatal growth. Since grandmother's stature is a determinant of mother's birthweight, which in turn is a determinant of infant birthweight, some environmentally influenced determinants of some birth outcomes are already established before a prospective mother is conceived or born.

Comparison of linear growth patterns in the first three years of life across two generations in Guatemala

OBJECTIVE

The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is not known whether these improvements have an impact on the growth of subsequent generations. Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's early childhood.

METHODS

We studied 283 mother-child pairs (mothers born 1969-1977; children born 1996-1999). The mothers had received nutritional supplementation--either atole (enhanced protein-energy) or fresco (moderate energy, no protein), with both containing vitamins and minerals--prenatally and up to age 7 y as part of a community trial conducted in 4 villages in Guatemala. Length was measured on repeated occasions to 36 months of age in both mothers and children. Growth was modeled as a fractional polynomial.

RESULTS

Children grew faster than their mothers. Children of mothers who received atole grew faster than children of women who received fresco. In both groups, lengths of individual children were positively correlated with lengths of their own mothers at the same ages. Correlations were generally stronger when the mothers had received atole in early life.

CONCLUSION

We have confirmed a secular trend in growth of children in a developing country setting. The rate of child growth reflects, in part, the growth pattern of the mother, including improvements to that pattern resulting from nutritional supplementation.

Small-for-gestational-age births in the United States: an age-period-cohort analysis

BACKGROUND

During the last 2 decades, the rate of low birthweight has increased, as has the rate of preterm delivery, among both whites and blacks. Examination of causes for these secular trends has focused largely on changes in the distributions of maternal age and, less commonly, on birth cohort. Little is known as to how age, period, and birth cohort interact on trends in small births at term.

METHODS

The U.S. natality files were used to assess trends in term (>/=37 weeks gestation) small-for-gestational age (SGA) births for 7 5-year maternal age groups (15-19 through 45-49 years), 6 delivery periods (1975, 1980, 1985, 1990, 1995, and 2000), and 12 5-year maternal birth cohorts (1926-1930 through 1981-1985). SGA births were defined as sex-specific birthweight below the 10th percentile for gestational age based on 1995 livebirths in the United States. Logistic regression models were fit to determine the independent effects of age, delivery period, and birth cohort on term SGA trends, separately for blacks and whites.

RESULTS

Between 1975 and 2000, term SGA births declined by 23% (from 21% to 16%) among blacks and by 27% (from 12% to 9%) among whites. Term SGA births declined with increasing age up to 30-34 years, but increased among older women. Within strata of maternal age, the risk also declined with later maternal birth cohorts, among both blacks and whites. The strongest influence on SGA trends was from maternal age, followed by maternal birth cohort, and lastly by delivery period. In general, for any combination of age, period, and birth cohort, blacks showed 1.5- to 2-fold higher rates of term SGA than whites.

CONCLUSIONS

The persistence of strong maternal age effects on risk of term SGA births suggests that the effect of age is at least partly the result of biologic factors. Term SGA trends were generally consistent for blacks and whites, although the magnitude of difference in the risks for combinations of age, period, or mother's birth cohort was higher among blacks than whites.

Prospective study of protein-energy supplementation early in life and of growth in the subsequent generation in Guatemala

BACKGROUND

The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is unknown whether these improvements can be transmitted to subsequent generations.

OBJECTIVE

Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's childhood.

DESIGN

We studied 263 children born in 1996-1999 to 231 women who had received nutritional supplementation, ie, atole (high-protein, moderate-energy drink) or fresco (nonprotein, low-energy drink), prenatally and up to age 7 y as part of a community trial in Guatemala between 1969 and 1977. Child length was measured at different times to age 36 mo.

RESULTS

Children born to women who received the enhanced supplement were taller (age-adjusted difference: 0.80 cm; 95% CI: 0.16, 1.44 cm) than were children whose mothers received the low-energy supplement. This increment was independent of the children's birth weight or socioeconomic status but was substantially attenuated and no longer significant after adjustment for maternal height (adjusted difference: 0.43 cm; 95% CI: -0.10, 0.96 cm; P > 0.10). The effect of maternal nutritional supplementation was more pronounced in boys than in girls (P for interaction < 0.10) and in children born to women who received supplements at ages 3-7 y than in children born to women who received supplements at ages 0-3 y (P for interaction < 0.01).

CONCLUSION

Nutritional supplementation in childhood has positive effects on both the supplemented persons and on the subsequent generation.

Association between leg length and offspring birthweight: partial explanation for the trans-generational association between birthweight and cardiovascular disease: findings from the British Women's Heart and Health Study

Low birthweight individuals not only have increased risk of cardiovascular disease themselves, but cardiovascular disease risk is also increased in their parents. The mechanisms underlying these trans-generational associations are not fully understood. We hypothesise that, in part, they reflect the trans-generational effects of poor maternal environmental circumstances in early childhood. Adverse environmental factors acting early in the mother's life will not only influence her own predisposition to cardiovascular disease but will also result in adverse consequences - low birthweight and increased cardiovascular disease risk in later life - for her offspring. Adult leg length is a valid indicator of early life environmental circumstances, in particular of infant nutrition. If our hypothesis is correct, then adult leg length should be positively associated with offspring birthweight. In this study of 4286 randomly selected women aged 60-79 years from 23 towns across England, Scotland and Wales, the magnitude of the association between leg length and offspring birthweight was greater than the association between trunk length and offspring birthweight. After control for potential confounding factors, offspring birthweight increased by 89.8 g [95% confidence interval 66.1, 113.5 g] for each standard deviation increase in maternal leg length, and by 55.2 g [32.2, 78.1 g] for each standard deviation increase in maternal trunk length. The association between leg length and offspring birthweight was unaffected by adjustment for maternal birthweight, but the association between trunk length and offspring birthweight was attenuated to 38.0 g [1.0, 74.9 g]. These findings support the hypothesis that adverse early childhood environmental circumstances affect not only the vitality and health of the woman in later life but also the birthweight of her offspring, and suggest that the trans-generational association between birthweight and cardiovascular disease is in part explained by early childhood maternal environmental circumstances.

Anthropometric indices of school children and familiar risk factors

BACKGROUND

Overweight in adolescence predicts adverse health effects in adulthood. We carried out a primary school health program and assessed children's growth and body composition.

METHODS

Were screened 869 (448 M, 421 F) primary school children: height, weight, four skinfolds, and four circumferences were measured. A family-reported questionnaire was used to determine family composition, history, and lifestyle.

RESULTS

Age was 118 +/- 5 months, BMI 18 +/- 3 kg/m(2). No difference by gender was observed as for BMI or blood pressure. Girls had higher skinfold thickness at the biceps (BCF), triceps (TCF), subscapular (SSF), and suprailiac (SIF) areas (P < 0.001), hip and thigh circumferences (P < 0.01), body fat percentage (P < 0.001). Boys had higher waist circumference (P < 0.01), waist/thigh ratio, and conicity index (P < 0.001). Offspring BMI was correlated with birth weight (P < 0.05), parental BMI and scholarship level (P < 0.001), children blood pressure (P < 0.001), and hours per day spent in television viewing (P < 0.01). Family history for diabetes was associated with higher BMI, SSF, waist circumference (P < 0.05), and upper thigh (P < 0.01). Family history for hypertension was associated with higher SSF/TCF ratio (P < 0.05).

CONCLUSIONS

Three of 869 children had BMI >30 kg/m(2) (2 boys and 1 girl), 33 had BMI >25 kg/m(2) (17 boys and 16 girls). The percentages of children who could be considered overweight (BMI >/=95(th) percentile of age- and sex-specific NHANES I reference data) were boys, 10.0%, and girls, 9.3%. Anthropometric and anamnestic data on child and family yield more accurate estimates of risk profile: fat distribution seems relevant for metabolic and cardiovascular disorders.

The treatment of parental height as a biological factor in studies of birth weight and childhood growth

Parental height is frequently treated as a biological variable in studies of birth weight and childhood growth. Elimination of social variables from multivariate models including parental height as a biological variable leads researchers to conclude that social factors have no independent effect on the outcome. This paper challenges the treatment of parental height as a biological variable, drawing on extensive evidence for the determination of adult height through a complex interaction of genetic and social factors. The paper firstly seeks to establish the importance of social factors in the determination of height. The methodological problems associated with treatment of parental height as a purely biological variable are then discussed, illustrated by data from published studies and by analysis of data from the 1958 National Childhood Development Study (NCDS). The paper concludes that a framework for studying pathways to pregnancy and childhood outcomes needs to take account of the complexity of the relation between genetic and social factors and be able to account for the effects of multiple risk factors acting cumulatively across time and across generations. Illustrations of these approaches are given using NCDS data.

Nutrition and obstructed labor

Obstructed labor is one of the most common preventable causes of maternal and perinatal morbidity and mortality in developing countries. Among the common causes are cephalopelvic disproportion, malpresentation, and malposition. Recognizing the causes of obstructed labor is important if the complications are to be prevented. Adequate prevention, however, can be achieved only through a multidisciplinary approach aimed in the short term at identifying high-risk cases and in the long term at improving nutrition. Early motherhood should be discouraged, and efforts are needed to improve nutrition during infancy, childhood, early adulthood, and pregnancy. Improving the access to and promoting the use of reproductive and contraceptive services will help reduce the prevalence of this complication.

Influence of parental height and sociodemographic factors on adolescent height in Brazil

OBJECTIVE

To analyze the influence of parental stature and environmental factors on the stature of adolescents from a national survey sample.

METHODS

A nationwide survey was carried out in 1989 among a stratified, two-stage, probability cluster sample of 14,455 Brazilian households to provide estimates of anthropometric deficits for urban and rural populations from the five regions of the country. Stature was measured for 5681 boys and girls age 14-18 years, 78.9% of their fathers, and 93.8% of their mothers. Associations between explanatory variables and adolescent height in centimeters were assessed by fitting multiple linear models to the data.

RESULTS

The predicted effects of parental stature and environmental conditions together sum to a total of 17 cm when comparing a boy born to parents with stature below the median and living in the underdeveloped rural Northeast region (1.56 m) with one born to parents with stature above the median and living in the partially industrialized urban South region (1.73 m). For girls, this estimated difference was 12 cm. For boys, the overall influence of parents' stature was 10 cm (R(2)= 0.40) and the sociodemographic factors had an overall influence of 7 cm (R(2) = 0.29). For girls, these values were 7 cm (R(2)= 0.35) for the parental influence and 5 cm (R(2) = 0.11) for the sociodemographic factors.

CONCLUSIONS

Mother's stature had the same influence on adolescent's stature as father's stature. Independent of parental stature, environmental factors have a strong influence on adolescent stature, particularly among boys.

Secular change in craniofacial morphology

Five craniofacial variables (glabella-occipital length, basion-bregma height, maximum cranial breadth, nasion-prosthion height, and bizygomatic breadth) were used to examine secular change in morphology from the mid-19(th) century to the 1970s. The 19(th) century data were obtained from the Terry and Hamann-Todd anatomical collections, and the 20(th) century data were obtained from the forensic anthropology databank. Data were available for Blacks and Whites of both sexes. Secular change was evaluated by regressing cranial variables on year of birth. Two analyses were conducted, one using the original variables and one using size and shape. Size is defined as the geometric mean of the cranial variables, and shape is the ratio of each variable to size. The results show remarkable changes in the size and shape of the cranial vault. Vault height increases in all groups in both absolute and relative terms. The vault also becomes longer and narrower, but these changes are less pronounced. Face changes are less than the vault changes, but to the extent that they occur, the face becomes narrower and higher. Overall cranial vault size has increased, but shape changes are greater than size changes. The magnitude of secular change in vault height exceeds that for long bones over a comparable time period, but follows a similar course, which suggests that vault height and bone length respond to the same forces. Changes in vault dimensions must occur by early childhood because of the early development of the vault. Am. J. Hum. Biol. 12:327-338, 2000. Copyright 2000 Wiley-Liss, Inc.

Secular change in long bone length and proportion in the United States, 1800-1970

We examine secular change in long bone lengths and allometry of Americans dating from the mid-19th century to the 1970s. Skeletal samples were derived from the Huntington Collection, Terry Collection, World War II casualties, and the Forensic Anthropology Data Bank. Regression of bone length on year of birth allowed evaluation of the secular change in bone length. Size was computed as the geometric mean of all bone lengths, and shape as the ratio of each bone to size. These variables were then regressed on year of birth, allowing evaluation of allometric secular change. The results revealed a pattern of change that can be summarized as follows: male secular change is stronger than female, lower limb bone secular change is more pronounced than upper limb bone change, and distal bones change more than proximal bones, particularly in the lower limb. In males, white changes are uniformly higher than black but these differences do not rise to the level of statistical significance. Environmental forces, such as nutrition and disease, are the usual causes of secular changes in overall size. This paper shows that long bone proportions also respond to these same environmental factors. Moreover, the changes in body proportion are likely to be due to allometric consequences of growth changes that occur early in life. Am J Phys Anthropol 110:57-67, 1999.

Evidence of environmental suppression of familial resemblance: height among US Civil War brothers

This study examines, with historical data, whether within family correlations in height varied across environments and whether variability in height was greater in worse environments. To investigate these hypotheses, brothers were identified who were mustered into the Union Army of the US Civil War, using linked records from the 1850 and 1860 censuses and military and medical records. Heights were available for 3898 men aged 18 and older, of whom 595 were further identified as belonging to 288 family sets of two, three or four brothers. Generalized estimating equations were used to concurrently model the mean height, the variance and the correlation between brothers as a function of county population. Heights decreased as county population size increased (p<0.001). The correlation between brothers' heights decreased significantly (p = 0.032) with increasing county population, and the variance increased (p = 0.026). The correlation ranged approximately from 0.63 in the least populous to 0.24 in the most populous counties. The degree of familial resemblance was lower in environments where mean height was lower, and the variability in height was greater, suggesting that the environmental contribution to the variability in height is of greater relative importance in populations reared, on average, in worse environments.

Role of intergenerational effects on linear growth

Current knowledge on the role of intergenerational effects on linear growth is reviewed on the basis of a literature search and recent findings from an ongoing study in Guatemala. Fourteen studies were identified, most of which examined the intergenerational relationships in birth weight. Overall, for every 100 g increase in maternal birth weight, her child's birth weight increased by 10-20 g. The study samples were primarily from developed countries, and birth weight data were extracted from hospital records and/or birth registries. Among the few studies that examined associations between the adult heights of parents and their offspring, correlation coefficients of 0.42-0.5 were reported. None of the studies examined intergenerational relationships in birth length or linear growth patterns during early childhood, preadolescence and/or adolescence. Prospectively collected data from long-term studies being carried out in rural Guatemala provide the first evidence of intergenerational relationships in birth size in a developing country setting. Data were available for 215 mother-child pairs. Maternal birth size was a significant predictor (P < 0.05) of child's birth size after adjusting for gestational age and sex of the child and other potential confounders. Child's birth weight increased by 29 g/100 g increase in maternal birth weight which is nearly twice that reported in developed countries. Similarly, child's birth length increased by 0.2 cm for every 1 cm increase in mother's birth length. The effect of maternal birth weight remained significant even after adjusting for maternal adult size. More evidence from developing countries will help explain the underlying mechanisms and identify appropriate interventions to prevent growth retardation.

Secular change in height in Austria: an effect of population stratification?

The records of height on some 700,000 18-year-old Austrian males, called for examination as to their fitness for conscription, were analysed. The data covered 14 conscription years (1980-93), representing males born in the years 1962-75. The sample covered over 90% of the total male population of those cohorts in Austria. The data were analysed by birth year to show the secular trend in 18-year-old stature and its rate, which overall amounted to 0.53 cm/decade. Analysis by urban-rural residence showed that both participated in the trend, but that the urban-rural differences were appreciably less than the differences between the types of school the young men had attended. The rate of increase over the 14 years was less within each of the eight subgroups (urban-rural, four school categories). It is argued that the secular trend in height that has occurred is largely attributable to the change in social stratification, as evidenced by the changed proportion of subjects who attended schools of different types.

Adult outcome of normal children who are short or underweight at age 7 years

OBJECTIVES

To evaluate the adult growth outcome (at age 23) of children who are short or underweight at age 7 years in whom no identifiable pathological cause exists for their poor growth.

DESIGN

Longitudinal follow up of a birth cohort.

SETTING

The national child development study (1958 birth cohort) of Great Britain.

SUBJECTS

523 children with a height or a weight below the fifth centile at age 7. Of these, 70 (13.4%) were excluded because they had a longstanding illness that could account for their poor growth. The remaining 453 subjects, who were followed to age 23, provided the base group from which those with additional data, such as parental height, were obtained.

RESULTS

55/174 (31.6%) boys who were short at age 7 became short men; 60/211 (28.4%) girls who were short at age 7 became short women. Among boys who were underweight at age 7, 46/160 (28.7%) were still underweight at age 23, while 61/200 (30.5%) girls underweight at age 7 became underweight women. Having short parents did not increase the probability of being small as an adult. Children with delayed puberty were as likely to remain small as those in whom puberty was not delayed.

CONCLUSIONS

One in three normal children who was short or underweight at age 7 became a short or underweight adult. This informs the management of short children and may be valuable when prolonged growth hormone treatment for short stature is being considered.

Intergenerational studies of human birthweight from the 1958 birth cohort. II. Do parents who were twins have babies as heavy as those born to singletons?

OBJECTIVE

To ascertain whether maternal twinning influences the previously described association between the birthweight of singleton mothers and their infants.

DESIGN AND SUBJECTS

The association between the birthweight of singleton parents and their offspring and that between twin parents and their offspring was compared using data from the 23-year-old sample of the 1958 British national birth cohort. The numbers available for full comparison were 1027 female and 611 male singleton cohort members, and 26 female and 17 male twin cohort members and their first singleton livebirths.

RESULTS

Of the mothers who had been twins, half had been of low birthweight, and overall their mean weight was 700 g less than that of their singleton counterparts. Nevertheless, the mean birthweight of babies of twin mothers was 133 g, and of twin fathers 94 g, greater than of babies of corresponding singletons. For female, but not male, parents this difference persisted after adjustment for confounding variables.

CONCLUSIONS

We suggest two possible reasons for the difference between the weight of babies of twin and singleton mothers. Firstly, the growth of twins becomes retarded late in pregnancy, possibly after a period critical in determining long-term reproductive effects. Secondly, the twin survivors were of higher birthweight than the original twin cohort, whilst the singleton survivors were more representative of all singleton births, thus introducing a possible bias.

Intergenerational studies of human birthweight from the 1958 birth cohort. 1. Evidence for a multigenerational effect

OBJECTIVE

To investigate possible multigenerational influences on birthweight.

DESIGN

Data from the longitudinal study of one week's births in 1958 up to the age of 23 years, the British National Child Development Study, were utilized. These provide socio-biological information on the parents of the cohort, on the cohort members from birth onwards, and on the pregnancies and the birthweight of any babies born to the cohort members.

MAIN OUTCOME MEASURE

The main outcome was the birthweight of babies born to the cohort members, for whom complete intergenerational data were available for 1638 firstborn. Multiple regression modelling was used to investigate any associations between their birthweight and characteristics of their parents and grandparents.

RESULTS

Significant positive associations were found between babies' birthweight and parental birthweight but not gestational age. For the babies born to female cohort members additional findings included associations between their birthweight and the height of the maternal grandmother and the social class of the maternal grandfather, even after adjustment for such strong predictors of birthweight as maternal weight, smoking habit in pregnancy and baby's sex and birth order.

CONCLUSION

These results thus offer support for a multigenerational influence on birthweight passed through the maternal line.

A review of child health in the 1958 birth cohort: National Child Development Study

In the week 3-9 March 1958, 98% of all births in England, Scotland and Wales (approximately 17,000) were studied in the Perinatal Mortality Survey. The follow-up of surviving children, known as the National Child Development Study, comprises four major sweeps at ages 7, 11, 16 and 23. Medical examinations were conducted at each age, except at 23 when health was self-reported. Details of the child's family background and socio-economic circumstances were recorded, together with assessments of their social development and educational attainment. Seventy-six per cent of the target population were interviewed at age 23. The health of subjects in the 1958 cohort has been described in over 200 publications but there is no comprehensive account of findings from birth to age 23. This overview attempts to redress this. As new data are gathered from the study subjects at age 33, opportunities will exist to investigate associations between childhood factors and health in midlife. Data on their partners and children will be included, allowing studies of inter-generational and family health. Further indications of changing illness patterns will be possible from comparisons with data collected on earlier and later born cohorts.