Adult height, nutrition, and population health

Dynamic influence of maternal education on height among Chinese children aged 0-18 years

Background

Maternal education is one of key factors affecting nurturing environment which significantly impacts children's height levels throughout their developmental stages. However, the influence of maternal education on children's height is less studied. This study aims to investigate the dynamic influence of maternal education on children's height among Chinese children aged 0-18 years.

Methods

Children undergoing health examinations from January 2021 to September 2023 were included in this study. Clinical information including height, weight, maternal pregnancy history, blood specimens for bone metabolism-related indicators and maternal education level was collected. Children's height was categorized into 14 groups based on age and gender percentiles, following WHO 2006 growth standards. One-way analysis of variance (ANOVA), linear regression, chi-square test and Fisher's exact test were applied for data analysis.

Results

A total of 6269 samples were collected, including 3654 males and 2615 females, with an average age of 8.38 (3.97) for males and 7.89 (3.55) for females. Significant correlations between maternal education level, birth weight, birth order, weight percentile, vitamin D, serum phosphorus, alkaline phosphatase levels, and children's height were identified. Birth weight's influence on height varied across age groups. Compared with normal birth weight children, low birth weight children exhibited catch-up growth within the first 6 years and a subsequent gradual widening of the height gap from 6 to 18 years old. Remarkably, the impact of maternal education on height became more pronounced among children above 3-6 years old, which can mitigate the effect of low birth weight on height.

Conclusion

We found that weight percentile, birth weight, birth order, bone marker levels, and maternal education level have significant effect on height. Maternal education attenuates the impact of low birth weight on height. The findings indicated that maternal education plays a consistent and critical role in promoting robust and healthy growth.

Sugar-Sweetened Beverage Consumption and Height Loss in Adults: A Longitudinal Analysis in the EPIC-Norfolk Study

BACKGROUND

Height loss in aging has been recognized to reflect a decline in musculoskeletal health but not investigated in relation to dietary factors, such as sugar-sweetened beverages (SSBs), the consumption of which may deteriorate musculoskeletal health.

OBJECTIVES

This study aimed to evaluate the longitudinal association of habitual consumption of total SSBs and its subtypes with height loss and examine effect-modification by age, sex, and anthropometry.

METHODS

We evaluated 16,230 adults aged 40-79 y in the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort. At baseline (1993-1997), SSB consumption (soft drinks, squashes, sweetened milk beverages, sweetened coffee/tea, and sweetened alcoholic beverages) was assessed using 7-d food diaries. Height was objectively measured at the baseline, second (1997-2000), and third (2004-2011) health checks. Multivariable linear regression was used to examine baseline SSB consumption and the rate of height change over the follow-up.

RESULTS

The median (IQR) height change was -1.07 (-2.09 to -0.28) cm/10 y. Adjusted for potential confounders including behavioral factors, medications, and baseline body mass index (BMI), total SSB consumption was associated with height loss (β: -0.024; 95% CI: -0.046, -0.001 cm/10 y per 250 g/d of SSB), and similar results were seen for the individual beverages, except for sweetened milk beverages (β: +0.07; 95% CI: -0.16, 0.30), with wide CIs. No effect-modification by prespecified factors was evident, except for baseline BMI (P-interaction = 0.037). Total SSB consumption was associated with height loss (-0.038; 95% CI: -0.073, -0.004) in participants with BMI ≤ 25 kg/m2 but not apparently in those with BMI > 25 kg/m2.

CONCLUSIONS

SSB consumption was modestly associated with height loss, particularly in adults with normal weight status.

A comment on "Height and the standard of living in Puerto Rico from the Spanish Enlightenment to annexation by the United States, 1770-1924"

Using prisoner height data, Moreno-Lázaro (2023) claims that Puerto Rican living standards declined after US annexation and stagnated for decades. This conclusion is not supported by the prisoner data and is inconsistent with other welfare measures that show dramatic improvement, such as per capita GDP, life expectancy, and literacy.

The role of positive psychological wellbeing in walking speed differences among married and unmarried English older adults

Objectives: Walking speed has been identified as an important indicator of functional independence and survival among older adults, with marital status being related to walking speed differences. We explored explanatory factors, with a focus on positive psychological wellbeing, in walking speed differences between married and non-married individuals in later life. Methods: We used wave 8 (2016/17) cross-sectional data from adults aged 60-79 years who participated in the English Longitudinal Study of Ageing (n = 3,743). An Oaxaca-Blinder decomposition was used to compute walking speed differences between married and unmarried individuals, and the portion of those differences that could be explained by characteristic differences in those groups, particularly wellbeing. Results: Overall, married individuals had walking speeds that were 0.073 m/s (95% confidence interval: 0.055-0.092 m/s) faster than their unmarried counterparts. This was primarily driven by differences between the married and separated/divorced group, and the widowed group. Included covariates explained roughly 89% of the overall walking speed difference. Positive psychological wellbeing consistently explained a significant portion of walking speed differences, ranging between 7% to 18% across comparisons. Conclusion: Although wealth has been previously found to partially explain walking speed differences by marital status, we found that positive psychological wellbeing also demonstrated pertinence to these differences.

Lifetime occupational skill and later-life cognitive function among older adults in the United States, Mexico, India, and South Africa

INTRODUCTION

We conducted a cross-national comparison of the association between main lifetime occupational skills and later-life cognitive function across four economically and socially distinct countries.

METHODS

Data were from population-based studies of aging and their Harmonized Cognitive Assessment Protocols (HCAPs) in the US, South Africa, India, and Mexico (N = 10,037; Age range: 50 to 105 years; 2016 to 2020). Main lifetime occupational skill was classified according to the International Standard Classification of Occupations. Weighted, adjusted regression models estimated pooled and country-specific associations between main lifetime occupational skill and later-life general cognitive function in men and women.

RESULTS

We observed positive gradients between occupational skill and later-life cognitive function for men and women in the US and Mexico, a positive gradient for women but not men in India, and no association for men or women in South Africa.

DISCUSSION

Main lifetime occupations may be a source of later-life cognitive reserve, with cross-national heterogeneity in this association.

HIGHLIGHTS

No studies have examined cross-national differences in the association of occupational skill with cognition. We used data from Harmonized Cognitive Assessment Protocols in the US, Mexico, India, and South Africa. The association of occupational skill with cognitive function varies by country and gender.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

Spatiotemporal variations in mean height of 17-year-old students born in 1957-2002 across 47 Japanese prefectures: Evidence from School Health Surveys

This paper examines the secular trends and variations in mean height of 17-year-old students born in 1957-2002 across 47 prefectures in Japan. Mean height is consistently lower in southwest prefectures and greater in prefectures in the Greater Tokyo Area and from the south-central area to the north-western area facing Eurasia in the main island. Both the range and the coefficient of variation stay constant in the cohorts born during the 1970s or later, following rapid increases of mean height in the prefectures that initially have the lowest means. A comprehensive policy framework may be needed to address diverse factors affecting the physical growth of adolescents at the subnational level.

Height and political activism in rural Aragón (Spain) during the 20th century. A new perspective using individual-level data

This article explores the relationship between the political leanings of more than 1000 men born in the 1870-1970 s in 11 rural Aragonese villages and their biological well-being during childhood and adolescence, proxied by height. The aim is to test whether an individual was more likely to be left-wing if his level of biological well-being was lower and, therefore, with more incentives to fight against the social inequality that had negatively affected his family. Our results confirm that, for most of the study period, there was a strong relationship between shorter height and political activism1 in left-wing parties and organizations.

Cohort profile: Genetic data in the German Socio-Economic Panel Innovation Sample (SOEP-G)

The German Socio-Economic Panel (SOEP) serves a global research community by providing representative annual longitudinal data of respondents living in private households in Germany. The dataset offers a valuable life course panorama, encompassing living conditions, socioeconomic status, familial connections, personality traits, values, preferences, health, and well-being. To amplify research opportunities further, we have extended the SOEP Innovation Sample (SOEP-IS) by collecting genetic data from 2,598 participants, yielding the first genotyped dataset for Germany based on a representative population sample (SOEP-G). The sample includes 107 full-sibling pairs, 501 parent-offspring pairs, and 152 triads, which overlap with the parent-offspring pairs. Leveraging the results from well-powered genome-wide association studies, we created a repository comprising 66 polygenic indices (PGIs) in the SOEP-G sample. We show that the PGIs for height, BMI, and educational attainment capture 22∼24%, 12∼13%, and 9% of the variance in the respective phenotypes. Using the PGIs for height and BMI, we demonstrate that the considerable increase in average height and the decrease in average BMI in more recent birth cohorts cannot be attributed to genetic shifts within the German population or to age effects alone. These findings suggest an important role of improved environmental conditions in driving these changes. Furthermore, we show that higher values in the PGIs for educational attainment and the highest math class are associated with better self-rated health, illustrating complex relationships between genetics, cognition, behavior, socio-economic status, and health. In summary, the SOEP-G data and the PGI repository we created provide a valuable resource for studying individual differences, inequalities, life-course development, health, and interactions between genetic predispositions and the environment.

Inverse association between adult height and diabetes risk in a cohort study of Chinese population

Recent studies linking adult height to diabetes risk remain controversial and few were from Asia. This study, therefore, aimed to explore the association of adult height with diabetes risk in a Chinese population. This retrospective cohort study was a secondary analysis of data from the DATADRYAD website, involving 211,172 non-diabetic individuals aged ≥ 20 years from the health screening program in China. Cox regression models were employed to evaluate hazard ratios (HRs) with 95% confidence interval (CI) of diabetes related to height. During an average 3.12-year follow-up, 4156 (1.97%) subjects reported developing diabetes. After adjusting for potential confounding factors, an inverse association of height with diabetes risk was observed among men and women [HR per 10 cm (95% CI), 0.78 (0.73-0.83) and 0.76 (0.68-0.86), respectively]. Moreover, subgroup analyses indicated the inverse association was only detected in individuals with aged < 70 years, fasting plasma glucose (FPG) < 6.1 mmol/L, and men with body mass index (BMI) < 28 kg/m2. In brief, height is inversely associated with diabetes risk in Chinese adults. Specifically, this association appears to be more pronounced in individuals with aged < 70 years, FPG < 6.1 mmol/L, and men with BMI < 28 kg/m2.

Pubertal timing, sex hormone levels, and associations between early life adversity and accelerated development amongst 11-year-old children of parents with schizophrenia or bipolar disorder and controls: The Danish high risk and Resilience study via 11

Background

Children of parents with severe mental illness have several known risk factors for altered pubertal timing. Pubertal timing is important for children's physical and emotional development. We aimed to examine pubertal timing and associations between pubertal timing, early life adversity and child problem behavior including psychiatric diagnoses among children of parents with schizophrenia or bipolar disorder and controls.

Methods

Self-reported Tanner stage (mean age 11.9, range 10.87-12.67), sex hormone levels, home environment, placement out of home, and problem behavior including psychiatric diagnoses of children at familial high-risk (FHR) of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP) and population-based controls (PBC) were assessed.

Results

A total of 465 children participated in the study (Tanner assessment N = 417, sex hormones N = 293). Assessed with self-reported Tanner, no difference in pubertal timing was found between groups (p = 0.09). Hormone levels did not differ between groups except for inhibin B (mean (SD) = 55.86 (29.13) pg/mL for FHR-SZ girls vs 84.98 (47.98) pg/mL) for PBC girls (p < 0.001)) and for follicle stimulating hormone (FSH) (mean (SD) = 5.82 (1.45) U/L for FHR-BP girls vs 4.54 (1.68) U/L for PBC girls (p < 0.001)). FHR children who were placed out of home (17 children, 3.8% of participants) had higher Tanner stages than those living at home (p < 0.001). Timing was not associated with level of problem behavior or psychiatric diagnoses.

Conclusions

FHR children did not differ from controls in pubertal timing. Early life adversity assessed as placement out of home may be associated with accelerated pubertal timing among children of parents with schizophrenia or bipolar disorder.

Adult height improved over decades in patients with X-linked hypophosphatemia: a cohort study

OBJECTIVES

The aim of this study is to analyze height after cessation of growth (final height [FH]) and its evolution over the last decades in X-linked hypophosphatemia (XLH) patients in France, as the data on natural history of FH in XLH are lacking.

DESIGN

We performed a retrospective observational study in a large cohort of French XLH patients with available data on FH measurements.

MATERIALS AND METHODS

We divided patients into 3 groups according to their birth year: group 1 born between 1950 and 1974, group 2 born between 1975 and 2000, and group 3 born between 2001 and 2006, respectively, and compared their FHs.

RESULTS

A total of 398 patients were included. Mean FHs were the following: for group 1, -2.31 ± 1.11 standard deviation score (SDS) (n = 127), 156.3 ± 9.7 cm in men and 148.6 ± 6.5 cm in women; for group 2, -1.63 ± 1.13 SDS (n = 193), 161.6 ± 8.5 cm in men and 153.1 ± 7.2 cm in women; and for group 3, -1.34 ± 0.87 SDS (n = 78), 165.1 ± 5.5 cm in men and 154.7 ± 6 cm in women. We report a significant increase in mean FH SDS over 3 generations of patients, for both men and women (P < .001). Final height SDS in male (-2.08 ± 1.18) was lower than in female (-1.70 ± 1.12) (P = .002).

CONCLUSION

The FH of XLH patients in France increased significantly over the last decades. Even though men's FHs improved more than women's, men with XLH remain shorter reflecting a more severe disease phenotype. While the results are promising, most patients with XLH remain short leaving room for improvement.

The rise and fall of tobacco smoking and associated rise and fall of coronary atherosclerosis the lethal role of tobacco

In this review two new hypotheses are explored, one, that the decline in coronary heart disease is mainly due to a dramatic decline in the prevalence of underlying atherosclerosis and two, that tobacco smoking has been a much greater influence on atherosclerosis than previously estimated. The major outcome of coronary atherosclerosis is myocardial infarction. Between 1900 and 1960 the prevalence of coronary atherosclerosis dramatically rose in young male soldiers. Between 1960 and 2010 the prevalence of coronary atherosclerosis in young US soldiers equally dramatically fell. Understanding the reasons for this rise and fall offers important insights into the causes of atherosclerosis. In 1960 over 50% of US military personnel were tobacco smokers but by 1988 the rate had reduced to 30%. The increased prevalence of coronary atherosclerosis in young soldiers between 1900 and 1960 was mainly due to increased tobacco smoking. An additional influence was an increase in food and sugar consumption. The fall in atherosclerosis between 1960 and 2010 was probably due to a reduction in tobacco smoking and to a lesser extent, control of hypertension and lowering of high serum total cholesterol. In Western populations up to two thirds of the fall in deaths due to myocardial infarction has been shown to be due to declines in the incidence of heart attacks. Based on the data included in this review it is arguable that the main reason for the fall in the incidence of heart attacks is the fall in the prevalence of underlying coronary atherosclerosis. The adverse influences of tobacco have been well documented. However the enormity of these adverse influences has not been recognised. Over 50% of men continue to smoke tobacco in China, Indonesia, Russia and middle eastern countries. Based on the experience of Western countries over half of these men will die of smoking related conditions.

Trends in women's height and the effect of early childbearing on height retardation: An analysis of the height of Bangladeshi women born between 1974 and 1998

Background

Depending on race, ethnicity, and region, genetic variants determine human height by 65% to 80%, while the remaining variance of 20% to 35% is influenced by nutrition and other individual or environmental exposures in the early years of life. An improvement in nutrition and health in the early years in a population underprivileged in health and nutrition will likely increase the group's average height. Due to outstanding improvements in these areas in recent decades, we hypothesised that the average height of Bangladeshi women has increased. Moreover, because pregnancy at an early age affects women's health and nutrition, we hypothesised that women who began childbearing early would experience growth retardation compared to women who had pregnancies at a later age.

Methods

We used data from five national surveys conducted between 2004 and 2018 that collected height data from ever-married women aged 15-49 years. We analysed the height of women aged 20-29 years (born between 1974 and 1998) and examined the mean height by birth years, age at first birth (AFB), economic status, religion and region. We conducted multiple linear regression models, controlling for the differential effects of the socio-demographic characteristics on women's height over time and by AFB.

Results

The average height of women born between 1974 and 1998 significantly increased by 0.03 cm annually, with fluctuations between 150.3 and 151.6 cm. We also found an association between age at childbearing and height in adulthood - women who began childbearing before age 17 were approximately one centimetre shorter in adulthood than those who began childbearing at a later age.

Conclusions

We found evidence of an increasing trend in women's height in Bangladesh and an inhibiting effect of early teenage childbearing on attaining the potential growth of women. The findings call for further studies to investigate early childbearing and its consequences on women's and their children's growth in diverse settings, considering socio-cultural customs influencing early marriage and childbearing.

Dietary Patterns of Children from the Amazon Region of Ecuador: A Descriptive, Qualitative Investigation

Many young children in Ecuador suffer from high rates of malnutrition and stunting that affect their long-term growth and development. Little is known about the dietary patterns of children from the Amazon region who experience some of the highest rates of stunting (height-for-age) within Ecuador. Semi-structured interviews were conducted with 50 mothers of young children living in the Ecuadorian Amazon. In addition to descriptions of overall dietary patterns, three themes emerged from the interviews relating to strengths mothers have in feeding their children healthy diets: knowledge, autonomous and independent children, and supportive and responsive parenting. Five themes were found relating to barriers mothers have in feeding their children healthy diets. The first four themes concerned barriers (lack of knowledge of healthy foods, lack of access to healthy foods, not enough money, and child's health) related to multidimensional poverty. All these influenced the last theme found, namely, how difficult of an eater the child was. The implications of intervention efforts to reduce undernutrition and promote children's development by building on specific family and community strengths and identified barriers are also discussed in this paper.

Effects of the energy balance transition on bone mass and strength

Chronic positive energy balance has surged among societies worldwide due to increasing dietary energy intake and decreasing physical activity, a phenomenon called the energy balance transition. Here, we investigate the effects of this transition on bone mass and strength. We focus on the Indigenous peoples of New Mexico in the United States, a rare case of a group for which data can be compared between individuals living before and after the start of the transition. We show that since the transition began, bone strength in the leg has markedly decreased, even though bone mass has apparently increased. Decreased bone strength, coupled with a high prevalence of obesity, has resulted in many people today having weaker bones that must sustain excessively heavy loads, potentially heightening their risk of a bone fracture. These findings may provide insight into more widespread upward trends in bone fragility and fracture risk among societies undergoing the energy balance transition.

Height, wealth, and schooling outcomes in young women from lower- and middle-income countries

This study evaluates a large (N > 366,000) sample of young women (15-18 years) from 64 lower- and middle-income countries for associations between height, household wealth, and schooling outcomes, with a focus on secondary school attendance. A pooled sample and regional samples (Latin America, South/Southeast Asia, East Africa, and West Africa) are evaluated. A dual purpose is to evaluate both associations between height and schooling, and potential height-wealth interactions such that height associations to schooling vary over levels of wealth. Ordered probit analysis indicates positive marginal probabilities from height on secondary school attendance in all samples, with diminishing probabilities in the Latin America and South/SE Asia samples, and flat/increasing probabilities in the African samples. For South/SE Asia and taller women in Latin America, height associations are stronger at lower household wealth. For both African samples and shorter women in Latin America, height associations are stronger at higher wealth. The findings suggest that the height-schooling relationship may derive from the influence from early-life health, and may also be affected by differences in health and education environments as suggested by variations across regions and height-wealth interactions within regions.

"What Did You Do in the War, Daddy?": Paternal Military Conscription During WWII, Economic Hardship and Family Violence in Childhood, and Health in Late Life in Japan

Childhood adversity is a risk factor for poor health in late life and includes economic hardship and family violence, whose prevalence is high among offspring of military conscripted father. We assessed the association between paternal military conscription (PMC) and paternal war death (PWD) during Second World War and self-rated health (SRH) among older adults in Japan. Data were obtained from a population-based cohort of functionally independent people aged 65 years or older from 39 municipalities across Japan in 2016. Information on PMC and SRH was obtained through a self-report questionnaire. A total of 20,286 participants were analyzed with multivariate logistic regression to investigate the association between PMC, PWD, and poor health. Causal mediation analysis was performed to see whether childhood economic hardship and family violence mediated the association. Among participants, 19.7% reported PMC (including 3.3% PWD). In the age- and sex-adjusted model, older people with PMC showed higher risk of poor health (odds ratio [OR]: 1.16, 95% confidence interval [CI] [1.06, 1.28]), while those with PWD were not associated (OR: 0.96, 95% CI [0.77, 1.20]). Causal mediation showed a mediation effect of childhood family violence exposure on the association between PMC and poor health (proportion mediated: 6.9%). Economic hardship did not mediate the association. PMC, but not PWD, increased the risk of poor health in older age, which was partially explained by the exposure to family violence in childhood. There appears to be a transgenerational health impact of war which continues to affect the health of offspring as they age.

Short Stature Modifies the Waist-to-height Ratio cut-off Points as an Indicator of Cardiovascular Risk in Mexican Adult Women and Men

BACKGROUND

Waist-to-height ratio (WHtR) is one of the anthropometric measures associated with cardiovascular risk (CVR). However, WHtR cut-off points may vary depending according to population characteristics, including sex and height.

OBJECTIVE

To identify optimal WHtR cut-off points to predict CVR factors by sex in Mexican adults according to height.

MATERIAL AND METHODS

Information from adults >20 years (n = 3550) from the 2016 National Health and Nutrition Survey were analyzed. Prevalence of high WHtR, CVR factors (glucose and insulin, lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and blood pressure were estimated by sex and height (short height <1.60 and <1.50 m in men and women, respectively). The maximum proximity procedure was used to establish the point of maximum simultaneous sensitivity and specificity using the operating characteristic curve of the receiver. The estimates were stratified by sex and height condition.

RESULTS

The WHtR cut-off points identified to predict CVR were higher than those suggested for international use (≥0.5), being significantly higher (p <0.0001) for women (0.61) than for men (0.56). Also, the WHtR cut-off points were higher for short stature (men 0.58 and 0.56, women 0.63 and 0.58, with short and normal stature, respectively).

CONCLUSIONS

The WHtR cut-off points for predicting CVR in the Mexican population were higher than 0.5 in both sexes and it was higher for individuals with short stature. The identified cut-off points may be an additional tool in screening the adult population in Mexico to predict CVR.

Growth patterns in children and adolescents with cerebral palsy from Argentina and Germany

To analyze growth patterns of children with CP between countries; to examine differences in growth; and to assess the fit of growth charts. Cross-sectional study in children with CP from 2 to 19 years old, 399 from Argentina and 400 from Germany. Growth measures were converted into z-scores and compared to WHO reference and US CP growth charts. Generalized Linear Model was used to analyze the growth expressed as mean z-scores. 799 children. Mean age 9 years (± 4). Compared to the WHO reference, the decrease in Height z-scores (HAZ) with age in Argentina (- 0.144/year) was double that in Germany (- 0.073/year). For children in GMFCS IV-V, BMI z-scores (BMIZ) decreased with age (- 0.102/year). Using the US CP charts, both countries showed decreasing HAZ with age, in Argentina (- 0.066/year) and in Germany (- 0.032/year). BMIZ increased more among children with feeding tubes (0.062/year), similar in both countries. Argentinian children with oral feeding decrease their Weight z-score (WAZ) by - 0.553 compared to their peers. With WHO charts BMIZ presented an excellent fit for GMFCS I-III. HAZ presents a poor fit to growth references. BMIZ and WAZ presented a good fit to US CP Charts. Growth differences due to ethnicity also act in children with CP, and are related to motor impairment, age and feeding modality, possibly reflecting differences in environment or health care.

Height, social position and coronary heart disease incidence: the contribution of genetic and environmental factors

BACKGROUND

The associations between height, socioeconomic position (SEP) and coronary heart disease (CHD) incidence are well established, but the contribution of genetic factors to these associations is still poorly understood. We used a polygenic score (PGS) for height to shed light on these associations.

METHODS

Finnish population-based health surveys in 1992-2011 (response rates 65-93%) were linked to population registers providing information on SEP and CHD incidence up to 2019. The participants (N=29 996; 54% women) were aged 25-75 at baseline, and there were 1767 CHD incident cases (32% in women) during 472 973 person years of follow-up. PGS-height was calculated based on 33 938 single-nucleotide polymorphisms, and residual height was defined as the residual of height after adjusting for PGS-height in a linear regression model. HRs of CHD incidence were calculated using Cox regression.

RESULTS

PGS-height and residual height showed clear gradients for education, social class and income, with a larger association for residual height. Residual height also showed larger associations with CHD incidence (HRs per 1 SD 0.94 in men and 0.87 in women) than PGS-height (HRs per 1 SD 0.99 and 0.97, respectively). Only a small proportion of the associations between SEP and CHD incidence was statistically explained by the height indicators (6% or less).

CONCLUSIONS

Residual height associations with SEP and CHD incidence were larger than for PGS-height. This supports the role of material and social living conditions in childhood as contributing factors to the association of height with both SEP and CHD risk.

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.

Education, incident cancer, and rate of memory decline in a national sample of US adults in mid-to-later-life

INTRODUCTION

Middle-aged and older adults who develop cancer experience memory loss following diagnosis, but memory decline in the years before and after cancer diagnosis is slower compared to their cancer-free counterparts. Educational attainment strongly predicts memory function during aging, but it is unclear whether education protects against memory loss related to cancer incidence or modifies long-term memory trajectories in middle-aged and older cancer survivors.

MATERIALS AND METHODS

Data were from 14,449 adults (3,248 with incident cancer, excluding non-melanoma skin cancer) aged 50+ in the population-based US Health and Retirement Study from 1998 to 2016. Memory was assessed every two years as a composite of immediate and delayed word recall tests and proxy assessments for impaired individuals. Memory scores all time points were standardized at to the baseline distribution. Using multivariate-adjusted linear mixed-effects models, we estimated rates of memory decline in the years before cancer diagnosis, shortly after diagnosis, and in the years after diagnosis. We compared rates of memory decline between incident cancer cases and age-matched cancer-free adults, overall and according to level of education (<12 years, "low"; 12 to <16 years, "intermediate"; ≥16 years, "high").

RESULTS

Incident cancer diagnoses were followed by short-term declines in memory averaging 0.06 standard deviation (SD) units (95% confidence interval [CI]: -0.084, -0.036). Those with low education experienced the strongest magnitude of short-term decline in memory after diagnosis (-0.10 SD units, 95% CI: -0.15, -0.05), but this estimate was not statistically significantly different from the short-term decline in memory experienced by those with high education (-0.04 SD units, 95% CI: -0.08, 0.01; p-value for education as an effect modifier = 0.15). In the years prior to and following an incident cancer diagnosis, higher educational attainment was associated with better memory, but it did not modify the difference in rate of long-term memory decline between cancer survivors and those who remained cancer-free.

DISCUSSION

Education was associated with better memory function over time among both cancer survivors and cancer-free adults aged 50 and over. Low education may be associated with a stronger short-term decline in memory after a cancer diagnosis.

Use of personal care products during pregnancy and birth outcomes - A pilot study

Prenatal exposure to endocrine disrupting chemicals (EDCs) from personal care products may be associated with birth outcomes including preterm birth and low birth weight. There is limited research examining the role of personal care product use during pregnancy on birth outcomes. Our pilot study consisted of 164 participants in the Environmental Reproductive and Glucose Outcomes (ERGO) study (Boston, MA), with data on self-reported personal care product use at four study visits throughout pregnancy (product use in the 48 h before a study visit and hair product use in the month before a study visit). We used covariate-adjusted linear regression models to estimate differences in mean gestational age at delivery, birth length, and sex-specific birth weight-for-gestational age (BW-for-GA) Z-score based on personal care product use. Hair product use in the past month prior to certain study visits was associated with decreased mean sex-specific BW-for-GA Z-scores. Notably, hair oil use in the month prior to study visit 1 was associated with a lower mean BW-for-GA Z-score (V1: -0.71, 95% confidence interval: -1.12, -0.29) compared to non-use. Across all study visits (V1-V4), increased mean birth length was observed among nail polish users vs. non-users. In comparison, decreased mean birth length was observed among shave cream users vs. non-users. Liquid soap, shampoo, and conditioner use at certain study visits were significantly associated with higher mean birth length. Suggestive associations were observed across study visits for other products including hair gel/spray with BW-for-GA Z-score and liquid/bar soap with gestational age. Overall, use of a variety of personal care products throughout pregnancy was observed to be associated with our birth outcomes of interest, notably hair oil use during early pregnancy. These findings may help inform future interventions/clinical recommendations to reduce exposures linked to adverse pregnancy outcomes.

Mendelian randomization analyses clarify the effects of height on cardiovascular diseases

An inverse correlation between stature and risk of coronary artery disease (CAD) has been observed in several epidemiologic studies, and recent Mendelian randomization (MR) experiments have suggested causal association. However, the extent to which the effect estimated by MR can be explained by established cardiovascular risk factors is unclear, with a recent report suggesting that lung function traits could fully explain the height-CAD effect. To clarify this relationship, we utilized a well-powered set of genetic instruments for human stature, comprising >1,800 genetic variants for height and CAD. In univariable analysis, we confirmed that a one standard deviation decrease in height (~6.5 cm) was associated with a 12.0% increase in the risk of CAD, consistent with previous reports. In multivariable analysis accounting for effects from up to 12 established risk factors, we observed a >3-fold attenuation in the causal effect of height on CAD susceptibility (3.7%, p = 0.02). However, multivariable analyses demonstrated independent effects of height on other cardiovascular traits beyond CAD, consistent with epidemiologic associations and univariable MR experiments. In contrast with published reports, we observed minimal effects of lung function traits on CAD risk in our analyses, indicating that these traits are unlikely to explain the residual association between height and CAD risk. In sum, these results suggest the impact of height on CAD risk beyond previously established cardiovascular risk factors is minimal and not explained by lung function measures.

Weakening of the cognition and height association from 1957 to 2018: Findings from four British birth cohort studies

Background

Taller individuals have been repeatedly found to have higher scores on cognitive assessments. Recent studies have suggested that this association can be explained by genetic factors, yet this does not preclude the influence of environmental or social factors that may change over time. We thus tested whether the association changed across time using data from four British birth cohorts (born in 1946, 1958, 1970, and 2001).

Methods

In each cohort height was measured and cognition via verbal reasoning, vocabulary/comprehension, and mathematical tests; at ages 10/11 and 14/17 years (N=41,418). We examined associations between height and cognition at each age, separately in each cohort, and for each cognitive test administered. Linear and quantile regression models were used.

Results

Taller participants had higher mean cognitive assessment scores in childhood and adolescence, yet the associations were weaker in later (1970 and 2001) cohorts. For example, the mean difference in height comparing the highest with lowest verbal cognition scores at 10/11 years was 0.57 SD (95% CI = 0.44-0.70) in the 1946 cohort, yet 0.30 SD (0.23-0.37) in the 2001 cohort. Expressed alternatively, there was a reduction in correlation from 0.17 (0.15-0.20) to 0.08 (0.06-0.10). This pattern of change in the association was observed across all ages and cognition measures used, was robust to adjustment for social class and parental height, and modeling of plausible missing-not-at-random scenarios. Quantile regression analyses suggested that these differences were driven by differences in the lower centiles of height, where environmental influence may be greatest.

Conclusions

Associations between height and cognitive assessment scores in childhood-adolescence substantially weakened from 1957-2018. These results support the notion that environmental and social change can markedly weaken associations between cognition and other traits.

Funding

DB is supported by the Economic and Social Research Council (grant number ES/M001660/1); DB and LW by the Medical Research Council (MR/V002147/1). The Medical Research Council (MRC) and the University of Bristol support the MRC Integrative Epidemiology Unit [MC_UU_00011/1]. NMD is supported by an Norwegian Research Council Grant number 295989. VM is supported by the CLOSER Innovation Fund WP19 which is funded by the Economic and Social Research Council (award reference: ES/K000357/1) and Economic and Social Research Council (ES/M001660/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Nuances in the effect of types of intimate partner violence on aspects of child development: Evidence from the Philippines

BACKGROUND

Most studies on the effect of intimate partner violence (IPV) do not distinguish between the effects of the different types of IPVs on the various aspects of child development.

OBJECTIVE

This study explores the effect of multiple dimensions of IPV, specifically physical violence, controlling behavior, and emotional abuse, on children's physical and cognitive development.

PARTICIPANTS AND SETTING

The study uses data from the Cebu Longitudinal Health and Nutritional Survey (CLHNS). The study uses a final sample of n = 1506 index children in Cebu, Philippines.

METHODS

We use information pertaining to: (1) presence of IPV in the household, (2) demographic characteristics, (3) mother's status and autonomy, (4) anthropometric data, and (5) children's scores on mathematics, English, language, and nonverbal reasoning tests. We employ a Propensity Score Matching (PSM) technique to analyze the effect of IPV on child development outcomes, conditional on observed characteristics.

RESULTS

Maternal exposure to physical violence significantly reduces child's body mass index (BMI) (ATE: -0.344, p ≤ 0.05). On the other hand, mother's vulnerability to controlling behavior decreases children's test scores in mathematics (ATE: -3.346, p ≤ 0.01), English (ATE: -2.289, p ≤ 0.01), and nonverbal reasoning (ATE: -2.103, p ≤ 0.01). We do not find a significant link between emotional abuse and height, body mass index, and test scores.

CONCLUSIONS

Our study shows that the deleterious effect of IPV on child development is IPV-specific. Exposure to physical violence tends to affect children's physical development while cognitive abilities are negatively associated with exposure to controlling behavior. These results suggest different types of ex-post interventions on both children and mothers to ensure their physical and mental well-being.

Do the short die young? Evidence from a large sample of deceased Polish adults

Body height is associated with various socioeconomic and health-related outcomes. Despite numerous studies, the relationship between stature and longevity remains uncertain. This study explores the association between self-reported height and lifespan. Data from 848,860 adults who died between 2004 and 2008 in Poland were collected. After excluding a small proportion of records due to missing data or errors, we examined records for 848,387 individuals (483,281 men, age range: 20–110 years; 365,106 women, age range: 20–112 years). Height was expressed as standardized residual variance derived from linear regression in order to eliminate the variance of year of birth on height. After the elimination of the cohort effect, five height classes were designated using centiles: very short, short, medium, tall and very tall. The differences between sexes and among classes were evaluated with two-way ANOVA and post hoc Tukey’s test. The effect size was assessed using partial eta squared (η2). Pearson’s r coefficients of correlation were calculated. The effect of sex on lifespan was nearly 17 times stronger than the effect of height. No correlation between height and lifespan was found. In conclusion, these findings do not support the hypothesis that taller people have a longevity advantage. We offer tentative explanations for the obtained results.

Adult Body Height Is Associated with the Risk of Type 2 but Not Type 1 Diabetes Mellitus: A Retrospective Cohort Study of 783,029 Individuals in Germany

Background: Diabetes mellitus is a major global health burden associated with high morbidity and mortality. Although a short adult body height has been associated with increased risk of type 2 diabetes (T2D), there are large inconsistencies between the studies. Therefore, we aimed to investigate the association between body height and T2D in a large cohort of adult outpatients in Germany. Methods: A total of 783,029 adult outpatients with available body height data from the Disease Analyzer (IQVIA) database were included in Germany between 2010 and 2020. The incidence of diabetes mellitus (type 1 and type 2) was evaluated as a function of the patients’ body height stratified by age, sex, and body-mass-index (BMI). Results: In both women and men in all age groups, incidence of T2D decreased with the increasing body height (<50, 51–60, 61–70, and >70 years). There was no association between the body height and the individual HbA1c value. In multivariable Cox regression analyses adjusted for patient age and BMI, hazard ratios for the development of T2D were 1.15 (95% CI: 1.13–1.17) for each 10 cm decrease in body height in women and 1.10 (95% CI: 1.09–1.12) in men. No significant association was found between body height and the development of T1D. Conclusions: We present the first data from a large cohort of outpatients in Germany, providing strong evidence for an association between adult body height and T2D. These data add to the current literature and might help in implementing body height into existing diabetes risk stratification tools to further reduce morbidity and mortality worldwide.

Amplified disparities: The association between spousal education and own health

Positive associations between own educational attainment and own health have been extensively documented. Studies have also shown spousal educational attainment to be associated with own health. This paper investigates the extent to which spousal education contributes to the social gradient in health, net of own education; and whether parts of a seeming spousal education effect are attributable to differences in early-life human capital, as measured by respondents' height and childhood living standard. Furthermore, we investigate the relative contribution of predictors in the regression analysis by use of Shapley value decomposition. We use data from a comprehensive health survey from Northern Norway (conducted in 2015/16, N = 21,083, aged 40 and above). We apply three alternative health outcome measures: the EQ-5D-5L index, a visual analogue scale (EQ-VAS) and self-rated health. In all models considered, spousal education is generally positively significant for both men and women. The results also suggest that spousal education is generally more important for men than women. In the sub-sample of individuals having a spouse, decomposition analyses showed that the relative contribution of spousal education to the goodness-of-fit in men's (women's) health was 13% (14%) with the EQ-5D-5L; 25% (20%) with the EQ-VAS and; 30% (21%) with self-rated health. Heterogeneity analyses showed stronger spousal education effects in younger age groups. In conclusion, we have provided empirical evidence that spousal education may contribute to explaining the amplified health gradient in an egalitarian country like Norway.

Emmetropization and nonmyopic eye growth

Most eyes start with a hypermetropic refractive error at birth, but the growth rates of the ocular components, guided by visual cues, will slow in such a way that this refractive error decreases during the first 2 years of life. Once reaching its target, the eye enters a period of stable refractive error as it continues to grow by balancing the loss in corneal and lens power with the axial elongation. Although these basic ideas were first proposed over a century ago by Straub, the exact details on the controlling mechanism and the growth process remained elusive. Thanks to the observations collected in the last 40 years in both animals and humans, we are now beginning to get an understanding how environmental and behavioral factors stabilize or disrupt ocular growth. We survey these efforts to present what is currently known regarding the regulation of ocular growth rates.

Human height: a model common complex trait

CONTEXT

Like other complex phenotypes, human height reflects a combination of environmental and genetic factors, but is notable for being exceptionally easy to measure. Height has therefore been commonly used to make observations later generalised to other phenotypes though the appropriateness of such generalisations is not always considered.

OBJECTIVES

We aimed to assess height's suitability as a model for other complex phenotypes and review recent advances in height genetics with regard to their implications for complex phenotypes more broadly.

METHODS

We conducted a comprehensive literature search in PubMed and Google Scholar for articles relevant to the genetics of height and its comparatibility to other phenotypes.

RESULTS

Height is broadly similar to other phenotypes apart from its high heritability and ease of measurment. Recent genome-wide association studies (GWAS) have identified over 12,000 independent signals associated with height and saturated height's common single nucleotide polymorphism based heritability of height within a subset of the genome in individuals similar to European reference populations.

CONCLUSIONS

Given the similarity of height to other complex traits, the saturation of GWAS's ability to discover additional height-associated variants signals potential limitations to the omnigenic model of complex-phenotype inheritance, indicating the likely future power of polygenic scores and risk scores, and highlights the increasing need for large-scale variant-to-gene mapping efforts.

The Interacting Effects of Height and Shoulder-to-Hip Ratio on Perceptions of Attractiveness, Masculinity, and Fighting Ability: Experimental Design and Ecological Validity Considerations

Previous research has shown that men's height and upper body size are both associated with the perception of attractiveness, because they might be cues to men's genetic fitness, fighting ability, and resource holding power. However, the combined effects of men's height and upper body size have not been explored. In this research, across four studies (N = 659 heterosexual women), we systematically explored the perception of men's muscular upper body at different heights on perceptions of attractiveness, masculinity, and fighting ability. Women rated male stimuli with heights ranging from 160 cm (5'3″) to 190 cm (6'3″) and three values of shoulder-to-hip ratio (SHR). In general, results showed that women considered taller men and men with larger SHR as more attractive, masculine, and better in fighting ability. However, a robust interaction between height and SHR was dependent on participants being exposed to variation on both variables and the ecological validity of the stimuli (silhouettes vs. more realistic rendered figures).

Time trends in body height according to educational level. A descriptive study from the Tromsø Study 1979-2016

OBJECTIVES

The objective of our study was to describe time trends in body height according to attained educational level in women and men in Norway.

METHODS

We used previously collected data from six repeated cross-sectional studies in the population based Tromsø Study 1979-2016. Measured body height in cm and self-reported educational level were the primary outcome measures. We included 31 466 women and men aged 30-49 years, born between 1930 and 1977. Participants were stratified by 10-year birth cohorts and allocated into four groups based on attained levels of education. Descriptive statistics was used to estimate mean body height and calculate height differences between groups with different educational levels.

RESULTS

Mean body height increased by 3.4 cm (95% confidence interval (CI) 3.0, 3.8) in women (162.5-165.9 cm) and men (175.9-179.3 cm) between 1930 and 1977. The height difference between groups with primary education compared to long tertiary education was 5.1 cm (95% CI 3.7, 6.5) in women (161.6-166.7 cm) and 4.3 cm (95% CI 3.3, 5.3) in men (175.0-179.3 cm) born in 1930-39. The height differences between these educational groups were reduced to 3.0 cm (95% CI 1.9, 4.1) in women (163.6-166.6 cm) and 2.0 cm (95% CI 0.9, 3.1) in men (178.3-180.3 cm) born in 1970-77.

CONCLUSIONS

Body height increased in women and men. Women and men with long tertiary education had the highest mean body height, which remained stable across all birth cohorts. Women and men in the three other groups had a gradual increase in height by birth cohort, reducing overall height differences between educational groups in our study population.

Do brachycephaly and nose size predict the severity of obstructive sleep apnea (OSA)? A sample-based geometric morphometric analysis of craniofacial variation in relation to OSA syndrome and the role of confounding factors

Obstructive sleep apnea is a common disorder that leads to sleep fragmentation and is potentially bidirectionally related to a variety of comorbidities, including an increased risk of heart failure and stroke. It is often considered a consequence of anatomical abnormalities, especially in the head and neck, but its pathophysiology is likely to be multifactorial in origin. With geometric morphometrics, and a large sample of adults from the Study for Health in Pomerania, we explore the association of craniofacial morphology to the apnea-hypopnea index used as an estimate of obstructive sleep apnea severity. We show that craniofacial size and asymmetry, an aspect of morphological variation seldom analysed in obstructive sleep apnea research, are both uncorrelated to apnea-hypopnea index. In contrast, as in previous analyses, we find evidence that brachycephaly and larger nasal proportions might be associated to obstructive sleep apnea severity. However, this correlational signal is weak and completely disappears when age-related shape variation is statistically controlled for. Our findings suggest that previous work might need to be re-evaluated, and urge researchers to take into account the role of confounders to avoid potentially spurious findings in association studies.

Combined assisted bone age assessment and adult height prediction methods in Chinese girls with early puberty: analysis of three artificial intelligence systems

BACKGROUND

The applicability and accuracy of artificial intelligence (AI)-assisted bone age assessment and adult height prediction methods in girls with early puberty are unknown.

OBJECTIVE

To analyze the performance of AI-assisted bone age assessment methods by comparing the corresponding methods for predicted adult height with actual adult height.

MATERIALS AND METHODS

This retrospective review included 726 girls with early puberty, 87 of whom had reached adult height at last follow-up. Bone age was evaluated using the Greulich-Pyle (GP), Tanner-Whitehouse (TW3-RUS) and China 05 RUS-CHN (RUS-CHN) methods. Predicted adult height was calculated using the China 05 (CH05), TW3 and Bayley-Pinneau (BP) methods.

RESULTS

We analyzed 1,663 left-hand radiographs, including 155 from girls who had reached adult height. In the 6-8- and 9-11-years age groups, bone age differences were smaller than those in the 12-14-years group; however, the differences between predicted adult height and actual adult height were larger than those in the 12-14-years group. TW3 overestimated adult height by 0.4±2.8 cm, while CH05 and BP significantly underestimated adult height by 2.9±3.6 cm and 1.3±3.8 cm, respectively. TW3 yielded the highest proportion of predicted adult height within ±5 cm of actual adult height (92.9%), with the highest correlation between predicted and actual adult heights.

CONCLUSION

The differences in measured bone ages increased with increasing bone age. However, the corresponding method for predicting adult height was more accurate when the bone age was older. TW3 might be more suitable than CH05 and BP for predicting adult height in girls with early puberty. Methods for predicting adult height should be optimized for populations of the same ethnicity and disease.

Drivers of Stunting Reduction in Yogyakarta, Indonesia: A Case Study

BACKGROUND

Chronic malnutrition in children is a severe global health concern. In Yogyakarta, the number of children who are too short for their age has dropped dramatically over the past few decades.

OBJECTIVE

To perform an analysis of trends, policies, and programs; and an assessment of government, community, household, and individual drivers of the stunting reduction in Yogyakarta, Indonesia.

METHOD

Using a mixed-methods approach, there were three types of research: (1) analysis of quantitative data, (2) evaluation of stunting policy, and (3) focus group discussions and in-depth interviews to collect qualitative data.

RESULTS

The prevalence of stunting has decreased from year to year. Mean height-for-age z-scores (HAZ) improved by 0.22 SDs from 2013 to 2021. Male and female toddlers aged <20 months have relatively the same body length as the WHO median, but it is lower for children >20 months old. The COVID-19 pandemic has contributed to an increase in stunting-concurrent wasting. Nutrition-specific and -sensitive interventions have been carried out with coverage that continues to increase from year to year, although in 2020, or at the beginning of the COVID-19 pandemic, the coverage of specific interventions decreased. The government has committed to tackling stunting by implementing the five pillars of stunting prevention and the eight convergent stunting actions. As the drivers of stunting reduction, national and community stakeholders and mothers, at the village level, cited a combination of poverty reduction, years of formal education, prevention of early marriage, access to food, enhanced knowledge and perception, and increased access to sanitation and hygiene.

CONCLUSIONS

Nutrition-specific and -sensitive sector improvements have been crucial for decreasing stunting in Yogyakarta, particularly in the areas of poverty reduction, food access, preventing child marriage, sanitation, education, and increasing knowledge and perception.

Is height related to fertility? An evaluation of women from low- and middle-income countries

OBJECTIVES

To present an empirical description of the association between height and lifetime fertility in women from low- and middle-income countries, allowing for flexible functional relationships.

METHODS

A pooled sample (N = 846 257) of women ages 35-49 in Demographic and Health Surveys (DHS) from 64 countries, with regional samples for Latin America, South Asia, and sub-Saharan Africa. Flexibly-estimated structured additive regression models estimate variations in the height-fertility relationship over the height distribution.

RESULTS

Across samples, height is shown to have nonlinear relationships with number of children ever born and age at first birth. Number of children increases with height until a maximum below average height, after which the number of children decreases. Age at first marriage decreases with height until a minimum below average height, and then increases. Except at the shortest heights, much of the variation in fertility is suggested to reflect socioeconomic differences across heights. At the shortest heights, variation is suggested to reflect later ages at first birth, except for women in sub-Saharan Africa.

CONCLUSION

A nonlinear relationship is indicated between height and fertility. Much of the relationship is suggested to reflect height-variations in socioeconomic status and age at first birth.

Maternal height and child health and schooling in sub-Saharan Africa: Decomposition and heterogeneity

Maternal height is associated with mortality and anthropometry in low-and-middle-income countries. This paper explored residual associations and potential underlying mechanisms linking maternal height to several child outcomes using regression models with neighborhood and half-sibling fixed effects and Gelbach decomposition on 108 Demographic and Health Surveys from 37 sub-Saharan African countries. When adjusting for time of birth, twinning, sex, and survey, a single z-score (6.5 cm) increase in mother's height was associated with a 22% reduction in the average deficit in height-for-age among children under five (according to the WHO 2006 growth standard), 16% lower neonatal mortality (age <1 month) , 10% lower postneonatal mortality (age 1-11 months), 11% lower child mortality (age 12-59 months) , and 2% increase in school attendance among 7-16-year-olds. Adjusting further for maternal education, household living standards, maternal fertility and birth related factors, and neighborhood reduced the coefficients for maternal height by 22% for child height-for-age, 26% for neonatal mortality, 46% for postneonatal mortality, 56% for child mortality, and 90% for school attendance. The decomposition showed that adjusting for neighborhood had a substantial impact on the association of maternal height with all outcomes, especially child mortality. Adjusting for unobserved father and household factors also had a particularly large impact on the association with child mortality. The robustness of the relationship with neonatal mortality suggests that pregnancy and perinatal factors are an important link between maternal height and child outcomes. Adult living standards and socioeconomic and related behavioral factors likely play a small role. Genetics may also play a large role in linking maternal height and child height-for-age, especially for educated mothers, whose height was presumably impacted less by early life adversity.

The association between the body height and cardiovascular diseases: a retrospective analysis of 657,310 outpatients in Germany

Background

Cardiovascular disease (CVD) represents the leading cause of death worldwide. The identification of individuals at increased risk of CVD is essential to reduce its morbidity and mortality globally. Based on existing data on a potential association between the individual body height and the risk for CVD, we investigated this association in a large cohort of outpatients in Germany.

Methods

A total of 657,310 adult outpatients with available body height data from the Disease Analyzer (IQVIA) database were included in Germany between 2019 and 2021. The prevalence of common CVD diagnoses (hypertension, coronary heart disease, atrial fibrillation and flutter, heart failure, ischemic stroke, and venous thromboembolism) was evaluated as a function of the patients’ body height stratified by age and sex.

Results

In both sexes, the prevalence of hypertension, coronary heart disease, heart failure, and ischemic stroke was higher among patients of smaller body height. In contrast, the prevalence of atrial fibrillation and venous thromboembolism was higher in taller patients. In age- and BMI-adjusted logistic regression analyses, an increased body height was negatively associated with coronary heart disease (OR = 0.91 in women and OR = 0.87 in men per 10-cm increase in height) and strongly positively associated with atrial fibrillation (OR = 1.25 in women and men) and venous thromboembolism (OR = 1.23 in women and OR = 1.24 in men).

Conclusion

We present the first data from a large cohort of outpatients in Germany providing strong evidence for an association between the body height and common CVD. These data should stimulate a discussion as to how far the body height should be implemented as a parameter in stratification tools to assess CVD risk in order to further reduce cardiovascular morbidity and mortality in the future.

What explains the large disparity in child stunting in the Philippines? A decomposition analysis

OBJECTIVE

About one-third of under-five Filipino children are stunted, with significant socio-economic inequality. This study aims to quantify factors that explain the large gap in stunting between poor and non-poor Filipino children.

DESIGN

Using the 2015 Philippine National Nutrition Survey, we conducted a linear probability model to examine the determinants of child stunting and then an Oaxaca-Blinder decomposition to explain the factors contributing to the gap in stunting between poor and non-poor children.

SETTING

Philippines.

PARTICIPANTS

1881 children aged 6-23 months participated in this study.

RESULTS

The overall stunting prevalence was 38·5 % with a significant gap between poor and non-poor (45·0 % v. 32·0 %). Maternal height, education and maternal nutrition status account for 26 %, 18 % and 17 % of stunting inequality, respectively. These are followed by quality of prenatal care (12 %), dietary diversity (12 %) and iron supplementation in children (5 %).

CONCLUSIONS

Maternal factors account for more than 50 % of the gap in child stunting in the Philippines. This signifies the critical role of maternal biological and socio-economic circumstances in improving the linear growth of children.

Body Mass Index Trajectories Across the Adult Life Course and Pancreatic Cancer Risk

BACKGROUND

Body mass index (BMI) during adulthood has been associated with pancreatic ductal adenocarcinoma (PDAC), however, patterns of body size across the adult life course have not been studied extensively. We comprehensively evaluated the association between adiposity across adulthood and PDAC.

METHODS

We conducted a prospective analysis of 269 480 (162 735 males, 106 745 females) National Institutes of Health-AARP Diet and Health Study participants, aged 50-71 years (1995-1996) who self-reported height and weight history. Participants were followed through December 31, 2011. We examined associations between BMI (kg/m2) at ages 18, 35, 50, and 50-71 (baseline) years, their trajectories determined from latent-class trajectory modeling, and incident PDAC. Cox proportional hazard models were used to calculate multivariable adjusted hazards ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

During up to 15.2 years of follow-up, 3092 (2020 males, 1072 females) patients with incident PDAC were identified. BMI at all 4 ages were statistically significantly associated with increased PDAC (per 5-unit increase, HR = 1.09-1.13) with higher magnitude associations in males than females at ages 35 years and older (Pinteraction < .05). Four BMI trajectories were created. Compared with normal-weight maintainers, normal-to-overweight, normal-to-obese class I, and overweight-to-obese class III trajectories had hazard ratios of 1.15 (95% CI = 1.06 to 1.25), 1.39 (95% CI = 1.25 to 1.54), and 1.48 (95% CI = 1.18 to 1.87), respectively (Pinteraction by sex = .07).

CONCLUSIONS

High BMI and BMI trajectories that result in overweight or obesity during adulthood were positively associated with PDAC, with stronger associations among those with early onset adiposity and those with male sex. Avoidance of excess body weight throughout the adult life course may prevent PDAC.

Socioeconomic factors and intergenerational differences in height of Portuguese adults born in 1990: results from the EPITeen cohort

Average adult height is an indicator of population health and a marker of socioeconomic inequalities. This study aimed to assess how socioeconomic differences affect intergenerational height increase between adults born in 1990 and their parents. Data from a population-based cohort of subjects born in 1990 (EPITeen) were analysed. Participants' adult height was objectively measured. Parental height, education, and occupation were reported by the parents. The height difference between daughters and their mothers (n=707), and sons and their fathers (n=647) was calculated. A generalised linear model was used to assess the association between parental education and occupation, separately, and the intergenerational height difference, adjusted for maternal age at birth, smoking during pregnancy, birthweight adjusted for gestational age, and birth order. Females were on average 1.46cm (SD=6.62) taller than their mothers, and males 3.00cm (SD=7.26) taller than their fathers. The highest height gain was shown in those with less advantaged socioeconomic background. In the adjusted model, sons whose mothers had 0-6 years of education grew 3.9cm taller (β=3.894; 95%CI:2.345;5.443) and daughters 1.5cm taller (β=1.529; 95%CI:0.180;2.878) (compared to >12y maternal education); for paternal education, sons and daughters grew 3.5cm (β=3.480; 95%CI:1.913;5.047) and 1.9cm taller (β=1.895; 95%CI:0.526;3.265), respectively. A higher height increase was found in participants with less advantaged maternal and paternal occupational level. Adults born in 1990 are taller than their parents, and height gain was higher in males than females. Adults from a lower socioeconomic status experienced the highest height gain, suggesting a reduction in height inequality.

Associations between early-life growth pattern and body size and follicular lymphoma risk and survival: a family-based case-control study

BACKGROUND

The influence of early-life growth pattern and body size on follicular lymphoma (FL) risk and survival is unclear. In this study, we aimed to investigate the association between gestational age, growth during childhood, body size, changes in body shape over time, and FL risk and survival.

METHODS

We conducted a population-based family case-control study and included 706 cases and 490 controls. We ascertained gestational age, growth during childhood, body size and body shape using questionnaires and followed-up cases (median=83 months) using record linkage with national death records. We used a group-based trajectory modeling approach to identify body shape trajectories from ages 5-70. We examined associations with FL risk using unconditional logistic regression and used Cox regression to assess the association between body mass index (BMI) and all-cause and FL-specific mortality among cases.

RESULTS

We found no association between gestational age, childhood height and FL risk. We observed a modest increase in FL risk with being obese 5 years prior to enrolment (OR=1.43, 95 %CI=0.99-2.06; BMI ≥30 kg/m²) and per 5-kg/m² increase in BMI 5 years prior to enrolment (OR=1.14, 95 %CI=0.99-1.31). The excess risk for obesity 5 years prior to enrolment was higher for ever-smokers (OR=2.00, 95 %CI=1.08-3.69) than never-smokers (OR=1.14, 95 %CI=0.71-1.84). We found no association between FL risk and BMI at enrolment, BMI for heaviest lifetime weight, the highest categories of adult weight or height, trouser size, body shape at different ages or body shape trajectory. We also observed no association between all-cause or FL-specific mortality and excess adiposity at or prior to enrolment.

CONCLUSION

We observed a weak association between elevated BMI and FL risk, and no association with all-cause or FL-specific mortality, consistent with previous studies. Future studies incorporating biomarkers are needed to elucidate possible mechanisms underlying the role of body composition in FL etiology.

The natural history of alpha angle in the last seventeen centuries

INTRODUCTION

Hip osteoarthritis is one of the most important and debilitating diseases affecting thousands of people all over the world. On the other hand, femoroacetabular impingement (FAI) is one of the known important causes of hip osteoarthritis. Cam deformity frequently presents in FAI showing an increased alpha angle. Increased alpha angle has been observed among young patients involved in demanding physical activities such as in sports (40-60%), whereas among the non-athletic population, increased alpha angle was observed in 15-20%. Although femoroacetabular pathology has been described over the recent years, it is not possible to determine when the angle increase actually begins prior to diagnosis. The aim of our study is to evaluate the femoral alpha angle in different human femurs in different civilization eras in West Mediterranean area.

MATERIALS AND METHODS

Available ancient femurs were selected from the Collection Center belonging to the archeological archives (ancient necropolis) from the fourth, fourteenth and eighteenth centuries. A comparison of the alpha angle was made of the measurements from the different groups accompanied by a sample of present-day femurs from the radiology database of CT scans. Data from 243 femoral bones were collected, 50 of which from the fourth century, 26 from the fourteenth century, 68 from the eighteenth century, and 99 femurs from the 20/twenty-first century.

RESULTS

Alpha angles in all historical samples showed pathological values (> 55º) up to a maximum of 11.5% of the cases. Meanwhile, the actual series showed pathological alpha angle in 60.1% of the cases with statistical significant differences.

CONCLUSION

The studied femurs of the western Mediterranean region from the fourth, fourteenth and eighteenth centuries showed pathological alpha angles in a smaller proportion than the actual sample.

LEVEL OF EVIDENCE

Level III, retrospective studies.

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

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

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

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

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Taller participants had better overall health than shorter participants.

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

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

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

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

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

Sexual stature difference fluctuations in pre- and post-Black Death London as an indicator of living standards

OBJECTIVES

The degree of sexual stature difference (SSD), the ratio of male to female height, is argued to be an indicator of living standards based on evidence that physical growth for males is more sensitive to environmental fluctuations. In a resource-poor environment, the degree of SSD is expected to be relatively low. The aim of this study is to comparatively assess SSD in medieval London in the context of repeated famine events and other environmental stressors before the Black Death (BD) and the improved living conditions that characterized the post-Black Death period.

METHODS

To test the hypothesis that a poor nutritional environment resulted in decreased SSD in medieval London, this study compares adult individuals from early pre-Black Death (c. 1000-1200), late pre-Black Death (c. 1200-1250) and post-Black Death (c. 1350-1540) cemetery contexts from London. Maximum tibial,femoral, and lower limb lengths were used as a proxy for stature, and SSD was calculated using the Chakraborty and Majumber index.

RESULTS

Compared to the late pre-BD period, we find a slighter higher degree of SSD in the post-BD period for all three stature proxies used. This increase is attributed to more exaggerated increases in stature for estimated males post-BD.

CONCLUSIONS

This study demonstrates the importance of examining variables that are considered indicators of living standards in light of factors like selective mortality, catch-up growth, and urban migration patterns. Future research needs to further investigate how cultural and biological processes influence the mechanisms that produce adult stature.

Disparities in Lung-Protective Ventilation in the United States

Background The objective of our study was to determine whether disparities exist in the use of lung-protective ventilation for critically ill mechanically ventilated patients in the United States based on gender, race/ethnicity, or insurance status. Methods This was a secondary data analysis of a prospective multicenter cohort study conducted from 2010 to 2012. The outcome of interest was the proportion of patients receiving tidal volume > 8 mL/kg predicted body weight (PBW). Results There were 1,595 patients in our primary analysis (710 women, 885 men). Women were more likely to receive tidal volumes > 8 mL/kg PBW than men (odds ratio [OR] = 3.42, 95% confidence interval [CI] = 2.67-4.40), a finding largely but not completely explained by gender differences in height. The underinsured were significantly more likely to receive tidal volume > 8 mL/kg PBW than the insured in multivariable analysis (OR = 1.54, 95% CI = 1.16-2.04). The prescription of > 8 mL/kg PBW tidal volume did not differ by racial or ethnic categories. Conclusions In this prospective nationwide cohort of critically ill mechanically ventilated patients, women and the underinsured were less likely than their comparators to receive lung-protective ventilation, with no apparent differences based on race/ethnicity alone.

Infant Growth Trajectories and Lipid Levels in Adolescence: Evidence From a Chilean Infancy Cohort

Growth in early infancy is hypothesized to affect chronic disease risk factors later in life. To date, most reports draw on European-ancestry cohorts with few repeated observations in early infancy. We investigated the association between infant growth before 6 months and lipid levels in adolescents in a Hispanic/Latino cohort. We characterized infant growth from birth to 5 months in male (n = 311) and female (n = 285) infants from the Santiago Longitudinal Study (1991-1996) using 3 metrics: weight (kg), length (cm), and weight-for-length (g/cm). Superimposition by translation and rotation (SITAR) and latent growth mixture models (LGMMs) were used to estimate the association between infant growth characteristics and lipid levels at age 17 years. We found a positive relationship between the SITAR length velocity parameter before 6 months of age and high-density lipoprotein cholesterol levels in adolescence (11.5, 95% confidence interval; 3.4, 19.5), indicating higher high-density lipoprotein cholesterol levels occurring with faster length growth. The strongest associations from the LGMMs were between higher low-density lipoprotein cholesterol and slower weight-for-length growth, following a pattern of associations between slower growth and adverse lipid profiles. Further research in this window of time can confirm the association between early infant growth as an exposure and adolescent cardiovascular disease risk factors.

The trend in mean height of Guatemalan women born between 1945 and 1995: a century behind

BACKGROUND

Adult height is a cumulative indicator of living standards with mean height increasing with a greater socio-economic level. Guatemalan adult women have the lowest mean height worldwide. The country's population is ethnically divided between indigenous and non-indigenous groups. This study aims to identify trends in the mean height for indigenous and non-indigenous adult women born between 1945 and 1995 in Guatemala and the association with individual, household and environmental factors.

METHODS

We used pooled data of adult women from five Demographic and Health Surveys. Mixed-effects multilevel linear regression models estimate the mean height associated with the explanatory variables. Mean height was modelled as a function of birth year cohort, wealth, education, geo-administrative regions and elevation.

RESULTS

The mean height increased 0.021 cm per year on average. The annual increase for indigenous women was 0.027 cm, while 0.017 cm for non-indigenous women. Height is associated with household wealth and women's education level. We found an interaction effect between ethnicity and household wealth, with indigenous women at the lowest quintile 0.867 cm shorter than the corresponding non-indigenous group. Height is associated with the geo-administrative region, those women in western regions being shorter than those in the metropolis. Mean height is reduced 0.980 cm for each 1000 m increase in elevation.

CONCLUSIONS

Guatemalan women have grown only 1 cm over half century, a slow improvement between 1945 and 1995, a period characterised by political instability and civil war. There are persistent inequalities in women's height associated with socio-economic status, education and attributes of the geographical context. These aspects need to be considered when implementing strategies to encourage growth. Further research is required to understand the evolution of adult height and the standard of living in post-war Guatemala.