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

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.

Vocal fundamental and formant frequencies affect perceptions of speaker cooperativeness

In recent years, the perception of social traits in faces and voices has received much attention. Facial and vocal masculinity are linked to perceptions of trustworthiness; however, while feminine faces are generally considered to be trustworthy, vocal trustworthiness is associated with masculinized vocal features. Vocal traits such as pitch and formants have previously been associated with perceived social traits such as trustworthiness and dominance, but the link between these measurements and perceptions of cooperativeness have yet to be examined. In Experiment 1, cooperativeness ratings of male and female voices were examined against four vocal measurements: fundamental frequency (F0), pitch variation (F0-SD), formant dispersion (Df), and formant position (Pf). Feminine pitch traits (F0 and F0-SD) and masculine formant traits (Df and Pf) were associated with higher cooperativeness ratings. In Experiment 2, manipulated voices with feminized F0 were found to be more cooperative than voices with masculinized F0(,) among both male and female speakers, confirming our results from Experiment 1. Feminine pitch qualities may indicate an individual who is friendly and non-threatening, while masculine formant qualities may reflect an individual that is socially dominant or prestigious, and the perception of these associated traits may influence the perceived cooperativeness of the speakers.

Effect of summer daylight exposure and genetic background on growth in growth hormone-deficient children

The response to growth hormone in humans is dependent on phenotypic, genetic and environmental factors. The present study in children with growth hormone deficiency (GHD) collected worldwide characterised gene–environment interactions on growth response to recombinant human growth hormone (r-hGH). Growth responses in children are linked to latitude, and we found that a correlate of latitude, summer daylight exposure (SDE), was a key environmental factor related to growth response to r-hGH. In turn growth response was determined by an interaction between both SDE and genes known to affect growth response to r-hGH. In addition, analysis of associated networks of gene expression implicated a role for circadian clock pathways and specifically the developmental transcription factor NANOG. This work provides the first observation of gene–environment interactions in children treated with r-hGH.

Geographical and temporal changes of anthropometric traits in historical Yemen

This study investigates secular changes of anthropometric variables among four geographic groups in historical Yemen, to evaluate possible regional differences in the evolution of living standards. Nineteen somatic and cephalic measures collected by Coon in 1939, and 8 anthropometric indices in 1244 Yemenite adult males were analyzed. The individuals were divided into 10-year age groups. Within-group variations were tested by One-way ANCOVA (age as covariate). ANCOVA (controlling for age), and Forward stepwise discriminant analysis were used to evaluate and represent regional differences. ANCOVA and discriminant analysis confirmed and enhanced previous findings. At the time, the Yemenite population presented high intergroup heterogeneity. The highest mean values of height at all ages were found in the "mountain" region, which is characterized by very fertile soils and where, nowadays, most of the cereals and pulses are grown and where most livestock is raised. Within-group variations were limited and generally inconsistent in all geographic regions and concern vertical dimensions, but mean values of height never differed. The prolonged internal isolation of these groups resulted in significant regional morphometric differentiation. The main evidence comes from height which suggests that socioeconomic factors have played a role. Nevertheless, the possible better living conditions experienced by the "mountain" group, with the highest mean values of stature in all periods, did not allow the secular trend to take place in that region, too.

Maternal nutritional status (as measured by height, weight and BMI) in Bangladesh: trends and socio-economic association over the period 1996 to 2007

Objective

To analyse trends in maternal nutritional status in Bangladesh over a 12-year period and to examine the associations between nutritional status and socio-economic variables.

Design

Maternal nutritional status indicators were height, weight and BMI. Socio-economic variables used were region, residency, education and occupation of the mothers and their husbands, house type, and possession score in the household.

Setting

Bangladesh Demographic and Health Surveys (1996, 2000, 2004 and 2007) were the source of data.

Subjects

A total of 16 278 mothers were included.

Results

All of the socio-economic variables showed significant associations with maternal nutritional status indicators. Regional variation was found to be present; all three indicators were found to be lowest in the Sylhet division. Upward trends in maternal height, weight and BMI were evident from no possessions to four possessions in households, and for no education to higher education of women and their husbands. Bangladeshi mothers measured in 2007 were found to be on average 0·34 cm taller and 3·36 kg heavier than mothers measured in 1996. Between 1996 and 2007 maternal underweight fell from nearly 50 % to just over 30 % while overweight and obesity increased from about 3 % to over 9 % (WHO cut-offs) or from 7 % to nearly 18 % (Asian cut-offs).

Conclusions

The study reveals that over the 12-year period in Bangladesh there has been a substantial reduction in maternal underweight accompanied by a considerable increase in obesity. It is also evident that malnutrition in Bangladesh is a multidimensional problem that warrants a proper policy mix and programme intervention.

Differences in height by education among 371,105 Dutch military conscripts

Adult height is associated with a variety of familial and socio-economic factors and large, well-defined populations are needed for a reliable assessment of their relative contributions. We therefore analyzed recorded heights from the military health examinations of 18-year conscripts in the Netherlands born between 1944 and 1947 and observed large differences by their attained education and by their father's occupation. The 5.1 cm height gradient from lowest to highest education level was more than twice as large as the gradient between father's occupation levels. The education gradient was not explained by common determinants of height including paternal occupation as a measure of familial background, region of birth, family size, or religion.

Human height is positively related to interpersonal dominance in dyadic interactions

Across cultures, taller stature is linked to increased social status, but the potential reasons why this should be are unclear. One potential explanation is that taller individuals are more likely to win a dyadic confrontation with a competitor (i.e., they are more dominant), which leads to higher social rank. Although some previous studies have shown that perceptions of status or dominance are related to height, and are therefore consistent with such an explanation, there is surprisingly little research testing whether height actually has any influence on the behavioural outcomes in real-life social interactions. Here, we present three naturalistic observational studies demonstrating that height predicts interpersonal dominance during brief dyadic interactions. Study 1 investigated the likelihood of giving way in a narrow passage (N = 92); Study 2 investigated giving way in a busy shopping street, plus the likelihood of colliding with another individual (N = 1,108); and Study 3 investigated the likelihood of maintaining a linear path while walking, and potentially entering another individual’s personal space (N = 1,056). We conclude that human height is positively related to interpersonal dominance, and may well contribute to the widely observed positive association between height and social status.

Trends in physical stature across socioeconomic groups of Chilean boys, 1880-1997

This paper studies the trends in height-by-age across socioeconomic groups of Chilean boys aged 5-18 born between 1880 and 1997, by performing a meta-analysis of 38 studies reporting height-by-age published since 1898. We estimate the trends using quantile regressions and by analyzing detailed height data from five selected studies. Both methods yield an average decennial increase in height of 1-1.1cm, and 0.9 and 1.2-1.3 cm for boys of upper and lower socioeconomic status (SES), respectively. SES differences in heights of 9-11 cm are observed up to the late 1940s. However, boys born after the 1930s exhibit substantial convergence in height between socioeconomic groups, driven by an increase in height of middle and lower SES boys of 1.5 and 1.4-2 cm per decade, respectively. As a result, SES differences in height decreased to 5 cm in 1990s. Since these changes occurred in a context of moderate economic growth and persistent income inequality, we argue that our findings are associated with the emergence and expansion of social policies in Chile since the 1940s, which delivered steady improvements in health, nutrition and living conditions.

Determinants of height and biological inequality in Mediterranean Spain, 1859-1967

This article analyses not only the determinants of the height of Spain's male populations between 1859 and 1960 but also the influence that social inequality had upon biological well-being. The height data of 82,039 conscripts constitute the principal source for this analysis. The study area comprises the current Valencian region, located in central Mediterranean Spain. During the period under study, the average height of conscripts increased by 7.5cm, while the coefficient of variation decreased by 0.6 between the 1870s and 1930 indicating that height inequality declined, although it increased by 0.2 among the cohorts born during the period of Francoist regime. Our results show that, in the long run, the height and biological well-being of the populations conscripted in Mediterranean Spain were determined by socioeconomic status and environmental contexts: that there was a close correlation among education, occupation, income, and stature. Literate conscripts were always taller than illiterate ones (by nearly 1cm), and agricultural workers, with fewer economic resources, were significantly shorter (by 3.6cm) than highly qualified non-manual workers.

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

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

Are chronic diseases related to height? Results from the Portuguese National Health Interview Survey

This paper analyze the association between height and chronic diseases in Portugal and the extent to which this relationship is mediated by education. The sample upon which the analysis is based comprised those participants in the 2005/2006 Portuguese National Health Interview Survey (n=28,433) aged 25-79. Logistic regressions measured the association of height with ten chronic diseases, adjusting for age, lifestyle, education, and other socioeconomic factors. Among women, an additional centimeter in stature significantly decreased the prevalence of asthma, chronic pain, and acute cardiac disease, by 0.057, 0.221, and 0.033 percentage points, respectively. Also, mental disorders were significantly less prevalent in the last quartile of height. Among men, an additional centimeter in height was associated with a 0.074 lower prevalence of asthma, and men in the last quartile of height were significantly less at risk of acute cardiovascular disease. There was no significant association between height and the risk of diabetes, high blood pressure, cancer, and pulmonary diseases. As for the impact of education, women with a tertiary level were on average 5.3cm taller than those with no schooling; among men, the difference was almost 9cm. Adjusting for education reduced the height-related excess risk of ill health by 36% on average among men, and by 7% among women. The analysis indicates that there is a significant association of height with several chronic conditions, and that education plays a mediating role in the height-health connection. By emphasizing the role of height and education as determinants of chronic conditions, this paper also highlights the role of conditions related to childhood health and socioeconomic background.

High degree of BMI misclassification of malnutrition among Swedish elderly population: Age-adjusted height estimation using knee height and demispan

BACKGROUND/OBJECTIVES

The degree of misclassification of obesity and undernutrition among elders owing to inaccurate height measurements is investigated using height predicted by knee height (KH) and demispan equations.

SUBJECTS/METHODS

Cross-sectional investigation was done among a random heterogeneous sample from five municipalities in Southern Sweden from a general population study 'Good Aging in Skåne' (GÅS). The sample comprised two groups: group 1 (KH) including 2839 GÅS baseline participants aged 60-93 years with a valid KH measurement and group 2 (demispan) including 2871 GÅS follow-up examination participants (1573 baseline; 1298 new), aged 60-99 years, with a valid demispan measurement. Participation rate was 80%. Height, weight, KH and demispan were measured. KH and demispan equations were formulated using linear regression analysis among participants aged 60-64 years as reference. Body mass index (BMI) was calculated in kg/m(2).

RESULTS

Undernutrition prevalences in men and women were 3.9 and 8.6% by KH, compared with 2.4 and 5.4% by standard BMI, and more pronounced for all women aged 85+ years (21% vs 11.3%). The corresponding value in women aged 85+ years by demispan was 16.5% vs 10% by standard BMI. Obesity prevalences in men and women were 17.5 and 14.6% by KH, compared with 19.0 and 20.03% by standard BMI. Values among women aged 85+ years were 3.7% vs 10.4% by KH and 6.5% vs 12.7% by demispan compared with the standard.

CONCLUSIONS

There is an age-related misclassification of undernutrition and obesity attributed to inaccurate height estimation among the elderly. This could affect the management of patients at true risk. We therefore propose using KH- and demispan-based formulae to address this issue.

Socioeconomic differences in childhood length/height trajectories in a middle-income country: a cohort study

BACKGROUND

Socioeconomic disadvantage is associated with shorter adult stature. Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved, particularly in middle-income former Soviet settings.

METHODS

The sample included 12,463 Belarusian children (73% of the original cohort) born in 1996-1997, with up to 14 stature measurements from birth to 7 years. Linear spline multi-level models with 3 knots at 3, 12 and 34 months were used to analyse birth length and growth velocity during four age-periods by parental educational achievement (up to secondary school, advanced secondary/partial university, completed university) and occupation (manual, non-manual).

RESULTS

Girls born to the most (versus least) educated mothers were 0.43 cm (95% confidence interval (CI): 0.28, 0.58) longer at birth; for boys, the corresponding difference was 0.30 cm (95% CI: 0.15, 0.46). Similarly, children of the most educated mothers grew faster from birth-3 months and 12-34 months (p-values for trend ≤ 0.08), such that, by age 7 years, girls with the most (versus least) educated mothers were 1.92 cm (95% CI: 1.47, 2.36) taller; after controlling for urban/rural and East/West area of residence, this difference remained at 1.86 cm (95% CI: 1.42, 2.31), but after additionally controlling for mid-parental height, attenuated to 1.10 cm (95% CI: 0.69, 1.52). Among boys, these differences were 1.95 cm (95% CI: 1.53, 2.37), 1.89 cm (95% CI: 1.47, 2.31) and 1.16 cm (95% CI: 0.77, 1.55), respectively. Additionally controlling for breastfeeding, maternal smoking and older siblings did not substantively alter these findings. There was no evidence that the association of maternal educational attainment with growth differed in girls compared to boys (p for interaction = 0.45). Results were similar for those born to the most (versus least) educated fathers, or who had a parent with a non-manual (versus manual) occupation.

CONCLUSIONS

In Belarus, a middle-income former Soviet country, socioeconomic differences in offspring growth commence in the pre-natal period and generate up to approximately 2 cm difference in height at age 7 years. These associations are partly explained by genetic or other factors influencing parental stature.

TRIAL REGISTRATION

Current Controlled Trials: NCT01352247 assigned 9 Sept 2005; ClinicalTrials.gov. Identifier: NCT01561612 received 20 Mar 2012.

Height, socioeconomic and subjective well-being factors among U.S. women, ages 49-79

Background

A vast literature has associated height with numerous factors, including biological, psychological, socioeconomic, anthropologic, genetic, environmental, and ecologic, among others. The aim of this study is to examine, among U.S. women, height factors focusing on health, income, education, occupation, social activities, religiosity and subjective well-being.

Methods/Findings

Data are from the Women's Health Initiative (WHI) Observational Study. Participants are 93,676 relatively healthy women ages 49–79; 83% of whom are White, 17% Non-White. Statistical analyses included descriptive statistics, chi-square and multivariable covariance analyses.

The mean height of the total sample is 63.67 inches. White women are significantly taller than Non-White women, mean heights 63.68 vs. 63.63 inches (p = 0.0333).

Among both Non-White and White women height is associated with social behavior, i.e. attendance at clubs/lodges/groups. Women who reported attendance ‘once a week or more often’ were taller than those who reported ‘none’ and ‘once to 3 times a month’. Means in inches are respectively for: White women–63.73 vs. 63.67 and 63.73 vs. 63.67, p = 0.0027. p = 0.0298; Non-White women: 63.77 vs. 63.61 and 63.77 vs. 63.60, p = 0.0050, P = 0.0094. In both White and Non-White women, income, education and subjective well-being were not associated with height.

However, other factors differed by race/ethnicity. Taller White women hold or have held managerial/professional jobs–yes vs. no–63.70 vs. 63.66 inches; P = 0.036; and given ‘a little’ strength and comfort from religion’ compared to ‘none’ and ‘a great deal’, 63.73 vs. 63.66 P = 0.0418 and 63.73 vs. 63.67, P = 0.0130. Taller Non-White women had better health—excellent or very good vs. good, fair or poor–63.70 vs. 63.59, P = 0.0116.

Conclusions

Further research in diverse populations is suggested by the new findings: being taller is associated with social activities –frequent attendance clubs/lodges/groups”, and with ‘a little’ vs. ‘none’ or ‘great deal’ of strength and comfort from religion.

Adiposity among children in Norway by urbanity and maternal education: a nationally representative study

BACKGROUND

International research has demonstrated that rural residency is a risk factor for childhood adiposity. The main aim of this study was to investigate the urban-rural gradient in overweight and obesity and whether the association differed by maternal education.

METHODS

Height, weight and waist circumference (WC) were measured in a nationally representative sample of 3166 Norwegian eight-year-olds in 2010. Anthropometric measures were stratified by area of residence (urbanity) and maternal education. Risk estimates for overweight (including obesity) and waist-to-height ratio ≥0.5 were calculated by log-binomial regression.

RESULTS

Mean BMI and WC and risk estimates of overweight (including obesity) and waist-to-height ratio ≥0.5 were associated with both urbanity and maternal education. These associations were robust after mutual adjustment for each other. Furthermore, there was an indication of interaction between urbanity and maternal education, as trends of mean BMI and WC increased from urban to rural residence among children of low-educated mothers (p = 0.01 for both BMI and WC), whereas corresponding trends for children from higher educational background were non-significant (p > 0.30). However, formal tests of the interaction term urbanity by maternal education were non-significant (p-value for interaction was 0.29 for BMI and 0.31 for WC).

CONCLUSIONS

In this nationally representative study, children living rurally and children of low-educated mothers had higher mean BMI and waist circumference than children living in more urban areas and children of higher educated mothers.

Are human mating preferences with respect to height reflected in actual pairings?

Pair formation, acquiring a mate to form a reproductive unit, is a complex process. Mating preferences are a step in this process. However, due to constraining factors such as availability of mates, rival competition, and mutual mate choice, preferred characteristics may not be realised in the actual partner. People value height in their partner and we investigated to what extent preferences for height are realised in actual couples. We used data from the Millennium Cohort Study (UK) and compared the distribution of height difference in actual couples to simulations of random mating to test how established mate preferences map on to actual mating patterns. In line with mate preferences, we found evidence for: (i) assortative mating (r = .18), (ii) the male-taller norm, and, for the first time, (iii) for the male-not-too-tall norm. Couples where the male partner was shorter, or over 25 cm taller than the female partner, occurred at lower frequency in actual couples than expected by chance, but the magnitude of these effects was modest. We also investigated another preference rule, namely that short women (and tall men) prefer large height differences with their partner, whereas tall women (and short men) prefer small height differences. These patterns were also observed in our population, although the strengths of these associations were weaker than previously reported strength of preferences. We conclude that while preferences for partner height generally translate into actual pairing, they do so only modestly.

Evidence of widespread selection on standing variation in Europe at height-associated SNPs

Strong signatures of positive selection at newly arising genetic variants are well-documented in humans^1–8, but this form of selection may not be widespread in recent human evolution⁹. Because many human traits are highly polygenic and partly determined by common, ancient genetic variation, an alternative model for rapid genetic adaptation has been proposed: weak selection acting on many pre-existing (standing) genetic variants, or polygenic adaptation^10–12. By studying height, a classic polygenic trait, we demonstrate the first human signature of widespread selection on standing variation. We show that frequencies of alleles associated with increased height, both at known loci and genome-wide, are systematically elevated in Northern Europeans compared with Southern Europeans (p<4.3×10⁻⁴). This pattern mirrors intra-European height differences and is not confounded by ancestry or other ascertainment biases. The systematic frequency differences are consistent with the presence of widespread weak selection (selection coefficients ~10⁻³–10⁻⁵ per allele) rather than genetic drift alone (p<10⁻¹⁵).

Use of national and international growth charts for studying height in European children: development of up-to-date European height-for-age charts

BACKGROUND

Growth charts based on data collected in different populations and time periods are key tools to assess children's linear growth. We analyzed the impact of geographic factors and the secular trend on height-for-age charts currently used in European populations, developed up-to-date European growth charts, and studied the effect of using different charts in a sample of growth retarded children.

METHODS AND FINDINGS

In an international survey we obtained 18 unique national height-for-age charts from 28 European countries and compared them with charts from the World Health Organization (WHO), Euro-Growth reference, and Centers of Disease Control and Prevention (CDC). As an example, we obtained height data from 3,534 children with end-stage renal disease (ESRD) from 13 countries via the ESPN/ERA-EDTA registry, a patient group generally suffering from growth retardation. National growth charts showed a clear secular trend in height (mean height increased on average 0.6 cm/decade) and a North-South height gradient in Europe. For countries without a recent (>1990) national growth chart novel European growth charts were constructed from Northern and Southern European reference populations, reflecting geographic height differences in mean final height of 3.9 cm in boys and 3.8 cm in girls. Mean height SDS of 2- to 17-year-old ESRD patients calculated from recent national or derived European growth charts (-1.91, 95% CI: -1.97 to -1.85) was significantly lower than when using CDC or WHO growth charts (-1.55, 95% CI: -1.61 to -1.49) (P<0.0001).

CONCLUSION

Differences between height-for-age charts may reflect true population differences, but are also strongly affected by the secular trend in height. The choice of reference charts substantially affects the clinical decision whether a child is considered short-for-age. Therefore, we advocate using recent national or European height-for-age charts derived from recent national data when monitoring growth of healthy and diseased European children.

The health transition and biological living standards: adult height and mortality in 20th-century Spain

This paper seeks new insights concerning the health transition in 20th century Spain by analyzing both traditional (mortality-based) and alternative (anthropometric-based) health indicators. Data were drawn from national censuses, vital and cause-of-death statistics and seven National Health Surveys dating from 1987 to 2006 (almost 100,000 subjects aged 20-79 were used to compute cohort height averages). A multivariate regression analysis was performed on infant mortality and economic/historical dummy variables. Our results agree with the general timing of the health transition process in Spain as has been described to date insofar as we document that there was a rapid improvement of sanitary and health care related factors during the second half of the 20th century reflected by a steady decline in infant mortality and increase in adult height. However, the association between adult height and infant mortality turned out to be not linear. In addition, remarkable gender differences emerged: mean height increased continuously for male cohorts born after 1940 but meaningful improvements in height among female cohorts was not attained until the late 1950s.

Children of low socioeconomic status show accelerated linear growth in early childhood; results from the Generation R Study

OBJECTIVES

People of low socioeconomic status are shorter than those of high socioeconomic status. The first two years of life being critical for height development, we hypothesized that a low socioeconomic status is associated with a slower linear growth in early childhood. We studied maternal educational level (high, mid-high, mid-low, and low) as a measure of socioeconomic status and its association with repeatedly measured height in children aged 0-2 years, and also examined to what extent known determinants of postnatal growth contribute to this association.

METHODS

This study was based on data from 2972 mothers with a Dutch ethnicity, and their children participating in The Generation R Study, a population-based cohort study in Rotterdam, The Netherlands (participation rate 61%). All children were born between April 2002 and January 2006. Height was measured at 2 months (mid-90% range 1.0-3.9), 6 months (mid-90% range 5.6-11.4), 14 months (mid-90% range 13.7-17.9) and 25 months of age (mid-90% range 23.6-29.6).

RESULTS

At 2 months, children in the lowest educational subgroup were shorter than those in the highest (difference: -0.87 cm; 95% CI: -1.16, -0.58). Between 1 and 18 months, they grew faster than their counterparts. By 14 months, children in the lowest educational subgroup were taller than those in the highest (difference at 14 months: 0.40 cm; 95% CI: 0.08,0.72). Adjustment for other determinants of postnatal growth did not explain the taller height. On the contrary, the differences became even larger (difference at 14 months: 0.61 cm; 95% CI: 0.26,0.95; and at 25 months: 1.00 cm; 95% CI: 0.57,1.43)

CONCLUSIONS

Compared with children of high socioeconomic status, those of low socioeconomic status show an accelerated linear growth until the 18th month of life, leading to an overcompensation of their initial height deficit. The long-term consequences of these findings remain unclear and require further study.

The effect of female height on reproductive success is negative in Western populations, but more variable in non-western populations

OBJECTIVE

In this article we examine the association between female height and reproductive success in a US sample and present a review of previous studies on this association. We also outline possible biological explanations for our findings.

METHODS

We used data from a long-term study of 5,326 female Wisconsin high school graduates to examine the association between female height and reproductive success. Twenty-one samples on this association were covered by our literature review.

RESULTS

Shorter women had more children surviving to age 18 than taller women, despite increased child mortality in shorter women. Taller women had a higher age at first birth and age at first marriage and reached a higher social status, but the negative effect of height on reproductive success persisted after controlling for these variables. However, while these effects were quite consistent in Western populations, they were not consistently present in non-Western populations. Our review also indicated that child mortality was almost universally higher among shorter women.

CONCLUSIONS

We conclude that shorter women have a higher number of live births but that final reproductive success depends on the positive effect of height on child survival.

A curvilinear effect of height on reproductive success in human males

Human male height is associated with mate choice and intra-sexual competition, and therefore potentially with reproductive success. A literature review (n = 18) on the relationship between male height and reproductive success revealed a variety of relationships ranging from negative to curvilinear to positive. Some of the variation in results may stem from methodological issues, such as low power, including men in the sample who have not yet ended their reproductive career, or not controlling for important potential confounders (e.g. education and income). We investigated the associations between height, education, income and the number of surviving children in a large longitudinal sample of men (n = 3,578; Wisconsin Longitudinal Study), who likely had ended their reproductive careers (e.g. > 64 years). There was a curvilinear association between height and number of children, with men of average height attaining the highest reproductive success. This curvilinear relationship remained after controlling for education and income, which were associated with both reproductive success and height. Average height men also married at a younger age than shorter and taller men, and the effect of height diminished after controlling for this association. Thus, average height men partly achieved higher reproductive success by marrying at a younger age. On the basis of our literature review and our data, we conclude that men of average height most likely have higher reproductive success than either short or tall men. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00265-011-1283-2) contains supplementary material, which is available to authorized users.

Heritability of Body Mass Index: A Comparison Between The Netherlands and Spain

Ahigh body mass index (BMI) is commonly used as an index of overweight and obesity. There is persistent evidence of high heritability for variation in BMI, but the effects of common environment appear inconsistent across different European countries. Our objective was to compare genetic and environmental effects on BMI in a sample of twins from two different European countries with distinct population and cultural backgrounds. We analysed data of adult female twins from the Netherlands Twin Register (222 monozygotic [MZ] and 103 dizygotic [DZ] pairs) and the Murcia Twin Register (Spain; 202 MZ and 235 DZ pairs). BMI was based on self-reported weight and height. Dutch women were taller and heavier, but Spanish women had a significantly higher mean BMI. The age related weight increase was significantly stronger in the Spanish sample. Genetic analyses showed that genetic factors are the main contributors to variation in height, weight, and BMI, within both countries. For height and weight, estimates of genetic variances did not differ, but for height, the estimate for the environmental variance was significantly larger in Spanish women. For BMI, both the genetic and the environmental variance components were larger in Spanish than in Dutch women.

Height and cancer incidence in the Million Women Study: prospective cohort, and meta-analysis of prospective studies of height and total cancer risk

Background

Epidemiological studies have shown that taller people are at increased risk of cancer, but it is unclear if height-associated risks vary by cancer site, or by other factors such as smoking and socioeconomic status. Our aim was to investigate these associations in a large UK prospective cohort with sufficient information on incident cancer to allow direct comparison of height-associated risk across cancer sites and in relation to major potential confounding and modifying factors.

Methods

Information on height and other factors relevant for cancer was obtained in 1996–2001 for middle-aged women without previous cancer who were followed up for cancer incidence. We used Cox regression models to calculate adjusted relative risks (RRs) per 10 cm increase in measured height for total incident cancer and for 17 specific cancer sites, taking attained age as the underlying time variable. We also did a meta-analysis of published results from prospective studies of total cancer risk in relation to height.

Findings

1 297 124 women included in our analysis were followed up for a total of 11·7 million person-years (median 9·4 years per woman, IQR 8·4–10·2), during which time 97 376 incident cancers occurred. The RR for total cancer was of 1·16 (95% CI 1·14–1·17; p<0·0001) for every 10 cm increase in height. Risk increased for 15 of the 17 cancer sites we assessed, and was statistically significant for ten sites: colon (RR per 10 cm increase in height 1·25, 95% CI 1·19–1·30), rectum (1·14, 1·07–1·22), malignant melanoma (1·32, 1·24–1·40), breast (1·17, 1·15–1·19), endometrium (1·19, 1·13–1·24), ovary (1·17, 1·11–1·23), kidney (1·29, 1·19–1·41), CNS (1·20, 1·12–1·29), non-Hodgkin lymphoma (1·21, 1·14–1·29), and leukaemia (1·26, 1·15–1·38). The increase in total cancer RR per 10 cm increase in height did not vary significantly by socioeconomic status or by ten other personal characteristics we assessed, but was significantly lower in current than in never smokers (p<0·0001). In current smokers, smoking-related cancers were not as strongly related to height as were other cancers (RR per 10 cm increase in height 1·05, 95% CI 1·01–1·09, and 1·17, 1·13–1·22, respectively; p=0·0004). In a meta-analysis of our study and ten other prospective studies, height-associated RRs for total cancer showed little variation across Europe, North America, Australasia, and Asia.

Interpretation

Cancer incidence increases with increasing adult height for most cancer sites. The relation between height and total cancer RR is similar in different populations.

Funding

Cancer Research UK and the UK Medical Research Council.

Socioeconomic inequalities in height, leg length and trunk length among children aged 6.5 years and their parents from the Republic of Belarus: evidence from the Promotion of Breastfeeding Intervention Trial (PROBIT)

BACKGROUND

Lower socioeconomic position is associated with shorter stature, in particular shorter leg length, but the magnitude of these associations in non-Western countries has received little attention.

AIM

To examine socioeconomic differentials in height, leg and trunk length in 6.5 year olds from the Republic of Belarus and compare these to differentials in parental height.

METHODS

Multivariable linear regression was used to examine associations in a cohort of 13 889 children.

RESULTS

Children from non-manual households were 1.0 cm (95% confidence interval: 0.7-1.3 cm) taller than those from manual households. Mothers and fathers from non-manual backgrounds were 0.7 cm (0.5-0.8) and 1.8 cm (1.6-2.0) taller than those from manual backgrounds, respectively. Associations with higher parental educational attainment were similar. The magnitudes of the associations of socioeconomic position with leg length were similar to those with trunk length. Adjusting for mid-parental height and number of older siblings attenuated associations markedly.

CONCLUSIONS

In Belarus, similar socioeconomic differentials in height were observed in both children and their parents. Among children, height differentials were partly explained by mid-parental height and number of older siblings. Leg length was not a more sensitive indicator of childhood socioeconomic conditions than trunk length.

Height of nations: a socioeconomic analysis of cohort differences and patterns among women in 54 low- to middle-income countries

Background

Adult height is a useful biological measure of long term population health and well being. We examined the cohort differences and socioeconomic patterning in adult height in low- to middle-income countries.

Methods/Findings

We analyzed cross-sectional, representative samples of 364538 women aged 25-49 years drawn from 54 Demographic and Health Surveys (DHS) conducted between 1994 and 2008. Linear multilevel regression models included year of birth, household wealth, education, and area of residence, and accounted for clustering by primary sampling units and countries. Attained height was measured using an adjustable measuring board. A yearly change in birth cohorts starting with those born in 1945 was associated with a 0.0138 cm (95% CI 0.0107, 0.0169) increase in height. Increases in heights in more recent birth year cohorts were largely concentrated in women from the richer wealth quintiles. 35 of the 54 countries experienced a decline (14) or stagnation (21) in height. The decline in heights was largely concentrated among the poorest wealth quintiles. There was a strong positive association between height and household wealth; those in two richest quintiles of household wealth were 1.988 cm (95% CI 1.886, 2.090) and 1.018 cm (95% CI 0.916, 1.120) taller, compared to those in the poorest wealth quintile. The strength of the association between wealth and height was positive (0.05 to 1.16) in 96% (52/54) countries.

Conclusions

Socioeconomic inequalities in height remain persistent. Height has stagnated or declined over the last decades in low- to middle-income countries, particularly in Africa, suggesting worsening nutritional and environmental circumstances during childhood.

What Do Drawings Reveal About People’s Attitudes Toward Countries and Their Citizens?

Participants (N = 567) from six countries (Belgium, Ivory Coast, Italy, Kosovo, Portugal, and Switzerland) drew borders of their own and of neighbor countries on boundary-free maps. It was predicted and found that the tendency to overestimate versus underestimate the sizes of the countries, compared to the original maps, reflects the perceiver’s attitudes toward the target country, status asymmetries, and the quality of relations between the ingroup and outgroup countries. The findings are discussed with regard to the use of drawings in revealing people’s attitudes toward outgroups.

The contribution of risk factors to the higher incidence of invasive and in situ breast cancers in women with higher levels of education in the European prospective investigation into cancer and nutrition

The authors investigated the role of known risk factors in educational differences in breast cancer incidence. Analyses were based on the European Prospective Investigation Into Cancer and Nutrition and included 242,095 women, 433 cases of in situ breast cancer, and 4,469 cases of invasive breast cancer. Reproductive history (age at first full-term pregnancy and parity), exposure to endogenous and exogenous hormones, height, and health behaviors were accounted for in the analyses. Relative indices of inequality (RII) for education were estimated using Cox regression models. A higher risk of invasive breast cancer was found among women with higher levels of education (RII = 1.22, 95% confidence interval (CI): 1.09, 1.37). This association was not observed among nulliparous women (RII = 1.13, 95% CI: 0.84, 1.52). Inequalities in breast cancer incidence decreased substantially after adjusting for reproductive history (RII = 1.11, 95% CI: 0.98, 1.25), with most of the association being explained by age at first full-term pregnancy. Each other risk factor explained a small additional part of the inequalities in breast cancer incidence. Height accounted for most of the remaining differences in incidence. After adjusting for all known risk factors, the authors found no association between education level and risk of invasive breast cancer. Inequalities in incidence were more pronounced for in situ breast cancer, and those inequalities remained after adjustment for all known risk factors (RII = 1.61, 95% CI: 1.07, 2.41), especially among nulliparous women.

Altered growth patterns of a mountain Ok population of Papua New Guinea over 25 years of change

CONTEXT

The Mountain Ok (Mt Ok) people of Telefomin, who live at the interior of Papua New Guinea (PNG), were documented over 25 years ago to be one of the shortest populations on record, with average adult height below the fifth percentile (US). Serum Growth Hormone was detectable, Insulin-like Growth Factor-1 and serum indicators of protein nutritional status fell within the normal range, suggesting that these were not primary factors for their relative short stature.

OBJECTIVE

Since the Telefolmin people have experienced recent socioeconomic changes, they were re-evaluated in 2008, to examine height, weight, and body mass index (BMI), for insight into relative contributions of environment and other factors that modulate stature in children and adults.

STUDY DESIGN AND SETTING

Cross-sectional anthropometric data were collected from 474 individuals at Telefomin in 2008, and compared with anthropometric data from 342 individuals measured in 1983.

RESULTS

The height of Telefolmin subjects, below the fifth percentile in 1983, remained below the fifth percentile in 2008. Weight and BMI of peripubertal and adult age groups increased from 1983 to 2008. Male and female heights at peripubertal ages were significantly greater in 2008. Nevertheless, final adult height did not change significantly over the 25 years.

CONCLUSIONS

Recent socioeconomic changes appear to contribute to increased weight, BMI, and stature at younger ages in the Mt Ok at Telefomin. In contrast, unchanging adult stature may reflect a delay in the impact of socioeconomic changes, or genetic influences that modulate responsiveness to other growth regulators.

Trends in the association between height and socioeconomic indicators in France, 1970-2003

Average physical stature has increased dramatically during the 20th century in many populations across the world with few exceptions. It remains unclear if social inequalities in height persist despite improvements in living standards in the welfare economies of Western Europe. We examined trends in the association between height and socioeconomic indicators in adults over three decades in France. The data were drawn from the French Decennial Health Surveys: a multistage, stratified, random survey of households, representative of the population, conducted in 1970, 1980, 1991, and 2003. We categorised age into 10-year bands, 25-34, 35-44, 45-54 and 55-64 years. Education and income were the two socioeconomic measures used. The slope index of inequality (SII) was used as a summary index of absolute social inequalities in height. The results show that average height increased over this period; men and women aged 25-34 years were 171.9 and 161.2 cm tall in 1970 and 177.0 and 164.0 cm in 2003, respectively. However, education-related inequalities in height remained unchanged over this period and in men were 4.48 cm (1970), 4.71 cm (1980), 5.58 cm (1991) and 4.69 cm (2003), the corresponding figures in women were 2.41, 2.37, 3.14 and 2.96 cm. Income-related inequalities in height were smaller and much attenuated after adjustment for education. These results suggest that in France, social inequalities in adult height in absolute terms have remained unchanged across the three decades under examination.

Long run trends in the heights of European men, 19th-20th centuries

This paper presents 5-yearly data on the height of young adult men in 15 Western European countries for birth cohorts from the middle of the 19th to the end of the 20th century. The results indicate that from the 1870s to the 1970s average height increased by around 11 cm, or more than 1cm per decade. The main finding is that for the northern and middle European groups of countries the gains in height were most rapid in the period 1911-15 to 1951-55, a period that embraced two World Wars and the Great Depression but also witnessed advances in public health and hygiene. For the southern countries growth was fastest in the period 1951-55 to 1976-80. These findings suggest that advances in height were determined not only by income and living standards but also by a variety of other socioeconomic trends.

Nature versus nurture: death of a dogma, and the road ahead

Interaction between the genome and the environment has been widely discussed in the literature, but has the importance ascribed to understanding these interactions been overstated? In this opinion piece, we critically discuss gene-environment interactions and attempt to answer three key questions. First, is it likely that gene-environment interactions actually exist? Second, what is the realistic value of trying to unravel these interactions, both in terms of understanding disease pathogenesis and as a means of ameliorating disease? Finally, and most importantly, do the technologies and methodologies exist to facilitate an unbiased search for gene-environment interactions? Addressing these questions highlights key areas of feasibility that must be considered in this area of research.

Determinants of infant growth: Evidence from Hong Kong's "Children of 1997" birth cohort

PURPOSE

A high rate of infant growth may be associated with adult cardiovascular disease. We investigated factors associated with infant weight growth in a large sample from the recently transitioned population of Hong Kong.

METHODS

We used a nonlinear shape invariant model with random effects among 5949 term, singletons (77% follow-up) from a population-representative Hong Kong Chinese birth cohort "Children of 1997" to investigate factors associated with weight growth in the first year of life.

RESULTS

Overall birth weight was lower but infant growth was more rapid than the 2006 WHO standards. Shorter gestation and lower birth order were associated with lower birth weight and faster infant growth. Female sex, maternal smoking in pregnancy, and a mother born in Hong Kong were associated with lower birth weight, but not with faster growth. Higher maternal education was associated with faster infant growth, grades 10-11 (1.03, 95% confidence interval [CI] = 1.03-1.05), greater than or equal to grade12 (1.07, CI = 1.04-1.09) compared with less than or equal to grade 9.

CONCLUSIONS

Infant growth may respond more rapidly to socio-economic development than birth weight. Whether mother's education is associated with rapid infant growth via current conditions or her own "constitution" is unclear, nevertheless we believe this study illustrates the importance of contextually specific research for understanding the determinants of population health.

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

Background

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

Subjects and Methods

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

Results

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

Conclusions

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

Body height and occupational success for actors and actresses

The association of body height with occupational success has been frequently studied, with previous research mainly finding a positive effect among men and positive or null effects among women. Occupational success has almost exclusively been measured so far by short-term success variables (e.g., annual income). In the present study, the relationship of success and height was examined in a group of actors and actresses using a large online database about movies (Internet Movie Database) where heights of actors and actresses are stated. The number of roles played in movies and television series during each actor's lifetime was used as a measure of long-term occupational success. No height effect was found for male actors but a significant negative effect was found for actresses, even after controlling for possible confounding influences (age and birth year). Compared to the general population, actors and actresses were significantly taller; however, actresses who were shorter than average were more likely to achieve greater occupational success, in terms of being featured in more movies.

Development of new demi-span equations from a nationally representative sample of adults to estimate maximal adult height

Various measures have been used to estimate height when assessing nutritional status. Current equations to obtain demi-span equivalent height (DEH(Bassey)) are based on a small sample from a single study. The objectives of this study were to develop more robust DEH equations from a large number of men (n = 591) and women (n = 830) aged 25-45 y from a nationally representative cross-sectional sample (Health Survey for England 2007). Sex-specific regression equations were produced from young adults' (aged 25-45 y) measured height and demi-span to estimate new DEH equations (DEH(new)). DEH in people aged >or= 65 y was calculated using DEH(new). DEH(new) estimated current height in people aged 25-45 y with a mean difference of 0.04 in men (P = 0.80) and -0.29 in women (P = 0.05). Height, demi-span, DEH(new), and DEH(Bassey) declined by age group in both sexes aged >or=65 y (P < 0.05); DEH were larger than the measured height for all age groups (mean difference between DEH(new) and current height was -2.64 in men and -3.16 in women; both P < 0.001). Comparisons of DEH estimates showed good agreement, but DEH(new) was significantly higher than DEH(Bassey) in each age and sex group in older people. The new equations that are based on a large, randomly selected, nationally representative sample of young adults are more robust for predicting current height in young adults when height measurements are unavailable and can be used in the future to predict maximal adult height more accurately in currently young adults as they age.

Childhood conditions and education as determinants of adult height and obesity among Greenland Inuit

Height and obesity are risk factors for cardiovascular disease and other physical and mental health conditions. Their association with childhood socioeconomic position has been demonstrated in studies among European and a few third world populations. In a random sample of adult Greenland Inuit (N = 2302) we studied the association between childhood socioeconomic conditions and height as well as prevalence of obesity (BMI > or = 30) in a cross sectional design. In block recursive graphical independence models, height was associated with mother's place of birth, birth cohort, childhood residence, alcohol problems in childhood home, and education among both men and women. Obesity was associated with mother's place of birth (for men) and with alcohol problems (for women). In General Linear Models, men with an all rural background and no education beyond primary school measured on average 165.1 cm compared with 172.1 cm for men with an all urban background (P < 0.001); women measured 153.9 and 161.1 cm (P < 0.001). Rural-urban differences in prevalence of obesity were not statistically significant. The height differences were considerably larger than between educational groups in European countries and of the same order of magnitude as those reported between men from the 17th century and men from 400 BC in the European and Mediterranean region. The rural-urban gradient in height follows the socioeconomic gradient and may negatively affect cardiovascular risk among the rural Greenlanders, while their physically active lifestyle and high consumption of n-3 fatty acids may counteract this.