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

Spouse selection by health status and physical traits. Sardinia, 1856-1925

Military medical information and data from civil registers of death and marriage have been used to study the role of physical characteristics and health conditions in explaining access to marriage for the male population of Alghero, a small city located in Sardinia Island (Italy), at the turn of 19th century. Literature data about contemporary populations have already demonstrated the influence of somatic traits in the mate choice. The results presented here show that men with low height and poor health status at the age of 20 were negatively selected for marriage. This holds true also in a society where families often arranged marriages for their children. This pattern of male selection on marriage was found to be particularly marked among the richest and wealthiest SES groups. Our hypothesis is that this social group carefully selected for marriage those individuals who were apparently healthier and therefore more likely to guarantee good health status and better life conditions to offspring. In evolutionary terms, the mate choice component of sexual selection suggests that the height of prospective partners could be claimed as one of the determinants, along with other environmental causes, of the observed higher stature of men belonging to the wealthiest social strata of the Alghero population.

Secular trends in social class differences of height, weight and BMI of boys from two schools in Lisbon, Portugal (1910-2000)

Data on the physical growth of children can provide useful information about the temporal changes in the economic conditions of the society in which they live and the extent of social inequalities within that society as well. Several studies have documented secular changes in the physical growth of children or of adult height, but seldom have the socioeconomic differences in secular trend been reported. The aim of this study is to examine differences in the secular trend of height, weight and BMI of 10-16-year-old boys enrolled in two schools of opposite socioeconomic makeup in Lisbon, Portugal, in the early and late 20th century. The samples from the upper-middle class come from the Colégio Militar, a military boarding school, and the lower-class samples come from the Casa Pia de Lisboa, a residential school for underprivileged boys. While boys from both schools show an approximate increase of 13.6cm in height, 13.5kg in weight and 2.4kg/m(2) in BMI, the Casa Pia students were shorter and lighter than their Colégio Militar counterparts throughout the 90-year period. Social class differences in mean height, weight and BMI tend to be greater in 1910 than in 2000, but results are statistically significant for height alone. When the two periods are taken together, Colégio Militar boys differ from their Casa Pia counterparts by approximately 6.4cm in height, 4.8kg in weight and 0.4kg/m(2) in BMI. Both samples show a considerable increase in height, weight and BMI but class differences in height, weight and BMI decreased slightly if at all, throughout the 90-year period. This suggests that socioeconomic disparities are persistent, having diminished only slightly since the early 20th century.

Taller - Healthier - more equal? The biological standard of living in Switzerland in the second half of the 20th century

This paper analyzes the trends in physical stature and body mass of the Swiss population born between 1955 and 1985, based on data collected in the "Living in Switzerland Survey" (Swiss Household Panel) of 2004. Aside from the time trend, we investigate the impact of educational and marital status as well as spatial effects on height and BMI. The results corroborate previous studies: average height increased during the second half of the 20th century for both women and men, better educated individuals are tallest, divorced men are shorter than married men and urban populations enjoy a height advantage over rural ones. We also compare the level and the trend in height to other postindustrial populations to identify key causes of physical growth and conclude that the quality of the health care systems and equal access to it seem to have a greater impact than other redistributive aspects of the welfare state. The relatively low level of inequality in health led to average height in Switzerland that are similar to those obtained in the Scandinavian social-democratic welfare states. Other measures such as income inequality do not have a high explanatory power for the average stature of the Swiss population.

Are changes in body dimensions of adult females from Italy (Sardinia and Latium) related to secular trend?

This paper presents secular changes in height, weight, sitting height, relative sitting height, BMI and estimated lower limb length in two samples of Italian adult females from Sardinia (Cagliari) and Latium (Rieti). The samples consist of 579 healthy women from the province of Cagliari and 138 from the town of Rieti, aged 20.0-39.9 years, measured in the period 2003-2006. The women were divided into four 5-year age groups. The anthropometric variables were considered according to different socioeconomic status (SES) in the Cagliari sample, while the Rieti sample was considered as a whole, as the SES was homogeneous. ANOVA results suggest that the secular trend was very slow or had come to a halt in the Rieti sample but continues in the Cagliari sample, as shown by the statistically significant differences for estimated lower limb length (p<or=0.02), and relative sitting height (p<or=0.05). However, these differences disappear after ANCOVA with sibship size and socioeconomic status controlled for, suggesting that they depend mainly on the composition of the Cagliari sample in terms of SES. Therefore, it can be hypothesised that the secular trend might be very slow or has stopped in the Cagliari subsamples homogeneous for SES.

Height, wealth, and health: an overview with new data from three longitudinal studies

This overview, based on a literature review and new data from the three cohorts (Whitehall Studies I and II, and the Vietnam Experience Study), has four objectives: (a) to outline the major determinants of height, so providing an indication as to what exposures this characteristic may capture; (b) to summarise, by reviewing reports from large scale studies, the relation between adult height and a range of disease outcomes--both somatic and psychiatric--with particular emphasis on coronary heart disease (CHD) and stroke; (c) to discuss why these relationships may exist, in particular, the role, if any, of socioeconomic position in explaining the apparent associations; and, finally (d) to outline future research directions in this field. The large majority of evidence for predictors of height, and its health consequences, comes from observational studies. While genetic predisposition is a major determinant of height, secular rises in childhood and adult stature across successive birth cohorts suggest that early life environment also has an important impact. Plausible non-genetic determinants of height include nutrition, illness, socioeconomic status, and psychosocial stress. Evidence for an association between height and a series of health endpoints is accumulating. Thus, shorter people appear to experience increased risk of CHD, and these associations appear to be independent of socioeconomic position and other potentially confounding variables. For stroke, and its sub-types, findings are less clear. In contrast to CHD, some cancers, such as carcinoma of the colorectum, prostate, breast (in women), central nervous system, skin, endometrium, thyroid and blood (haematopoietic) are more common in taller people. While height may be negatively related to the risk of completed suicide, conclusions about the links between stature and other health endpoints is problematic given the paucity of evidence, which should be addressed. Ultimately, for want of better data, investigators in this area have used height as a proxy for a range of pre-adult exposures. In future, research should aim to explore the predictive capacity of direct measures of diet, psychosocial stress, childhood chronic illness and so on, rather than focus on height or its components. The problem is that extended follow-up of child cohorts with such data are required, and studies which hold these data are not currently available, although several are either maturing to the point where they offer sufficient clinical outcomes to facilitate analyses or are in the advanced planning stage.

Maternal height and child mortality in 42 developing countries

Previous research reports mixed results about the association between maternal height and child mortality. Some studies suggest that the negative association might be stronger in contexts with fewer resources. This hypothesis has yet not been tested in a cross-nationally comparative design. We use data on 307,223 children born to 194,835 women in 444 districts of 42 developing countries to estimate the association between maternal height and child mortality and test whether this association is modified by indicators at the level of the household (like sex, age and twin status of the child and socio-economic characteristics of the mother and her partner), district (regional level of development, public health facilities and female occupational attainment) and country (GDP per capita). We find a robust negative effect of logged maternal height on child mortality. The effect of maternal health is strongest for women with least education and is more important in the first year after birth and for twin births. The indicators of development at the district and country level do not modify the effect of maternal height.

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

BACKGROUND

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

AIM

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

SUBJECTS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Level of education and back pain in France: the role of demographic, lifestyle and physical work factors

PURPOSE

To investigate the pathways from level of education to low back pain (LBP) in the adult population, especially concerning the role of physical working constraints, and personal factors (overweight, tobacco consumption, and tallness).

METHODS

The study population consisted of 15,534 subjects from the National Health Survey, with data on LBP, level of education, personal factors, and physical working constraints. Logistic models for LBP (pain more than 30 days during the previous 12 months) were compared in order to check the consistency of the data with specific causal pathways.

RESULTS

Low back pain was strongly associated with level of education. This association was almost completely explained if present or past exposure to tiring work postures and handling of heavy loads were taken into account. For men, the OR for "no diploma", adjusted only for age, was 1.75; it was 1.02 after additional adjustment on physical work factors. Personal factors played also a role, especially overweight for women. Among them, the OR associated with a body mass index = 27 or more was 1.58 after adjustment on all the other factors.

CONCLUSIONS

In this national population the main pathways from education to LBP were through occupational exposure and lifestyle factors.

Height differences and the associations between food insecurity, percentage body fat and BMI among men and women

OBJECTIVE

The present study examined the associations between adult food insecurity (FI) and percentage body fat (%BF) and BMI, stratified by height (HT).

DESIGN, SETTING AND SUBJECTS

%BF, HT and BMI of 2117 men and 1909 women in the National Health and Nutrition Examination Survey 1999-2002 were analysed in relation to adult food security status using multiple regression procedures.

RESULTS

Compared with the fully food-secure, men's %BF, BMI and HT were lower as FI intensified. Marginal food security among women was associated with 1.3 cm shorter HT, P = 0.016. Marginal food security among women who were below median HT was associated with about 2.0 kg/m2 higher BMI, P = 0.042. %BF was not associated with FI among women.

CONCLUSIONS

FI is associated with shorter HT and lower %BF and BMI in men. Women's HT should be considered in the reported associations between FI and higher BMI.

Spanish growth studies 2008. New anthropometric standards

Cross-sectional and longitudinal growth studies have recently been conducted in Spain. These studies have allowed neonatal anthropometry in premature and term neonates and postnatal growth in children and adolescents to be evaluated. Moreover, a longitudinal study that allows pubertal growth to be evaluated for distinct groups according to maturation has also been published. Between 1999 and 2002, birth weight and vertex-heel length were evaluated in 9,362 newborns (4,884 boys and 4,478 girls), with a gestational age of 26-42 weeks. An increase in these values compared with previous Spanish studies (1987-1992) and sexual dimorphism were observed. Between 2000 and 2004, height, weight and body mass index (BMI) were evaluated in 32,064 individuals (16,607 males, 15,457 females) aged 0-24 years. An increasing secular trend was observed compared with data obtained 20 years previously. Increases in BMI exceeded those in height for BMI values above the 50th percentile. A longitudinal growth study of 458 healthy individuals (223 boys, 235 girls) born between 1978 and 1982 yielded pubertal growth and maturity standards for each of the five pubertal maturity groups. In addition, data on skinfolds, bone mass and intellectual development from birth to adulthood were also provided. Adult height in both studies was similar to that reported by European and American studies, but was lower than that reported for German, Swedish and Dutch populations. In males, BMI was higher than in other European populations and was close to that of the US population. In females, BMI was similar to that in European populations and was lower than that in the US population.

Cross-sectional study of height and weight in the population of Andalusia from age 3 to adulthood

BACKGROUND AND OBJECTIVES

In Andalusia there were no studies including a representative sample of children and adolescent population assessing growth and weight increase. Our objectives were to develop reference standards for weight, height and BMI for the Andalusian pediatric population, from 3 to 18 years of age for both genders, and to identify the final adult height in Andalusia.

SUBJECTS AND METHODS

Two samples were collected. The first included individuals from 3 to 18 years of age (3592 girls and 3605 boys). They were stratified according type of study center, size of population of origin, age (32 categories of 0.5 years) and gender, using cluster sampling. Subjects from >18 to 23 years of age (947 women and 921 men) were sampled in 6 non-university educational centers and several university centers in Granada. Exclusion criteria included sons of non-Spanish mother or father, and individuals with chronic conditions and/or therapies affecting growth. Two trained fellows collected the data through February to December 2004, for the first sample, and through January to May 2005, for the second.Reference curves were adjusted using Cole's LMS method, and the quality of the adjustment was assessed using the tests proposed by Royston. In addition, a sensitivity analysis was applied to the final models obtained.

RESULTS

Data for 9065 cases (4539 women and 4526 men) were obtained; 79.39% (n = 7197) in the up to 18 years of age group. In the first sampling only 0.07% (3 girls and 2 boys) refused to participate in the study. In addition, 327 students (4.5%) were absent when sampling was done. We present mean and standard deviation fort height, weight and BMI at 0.5 years intervals, from 3 to 23 years of age, for both genders. After adjustment with the different models, percentiles for height, weight (percentiles 3, 5, 10, 25, 50, 75, 90, 95, and 97) and BMI (percentiles 3, 5, 50, 85, 95, and 97) are presented for both genders.

CONCLUSION

This is the first study in Andalusia with a representative sample from the child-juvenile population to investigate weight, height and BMI in subjects from 3 to 23 years of age. The great variability observed in the values from sample of 18 to 23 years of age individuals, ensures the inclusion of extreme values, although random sampling was not used. There still is a lack of standard reference values for the Andalusian population younger done 3 years of age.

Comparison of self-reported and measured height and weight: implications for obesity research among young adults

BACKGROUND

The use of self-reported data in epidemiological surveys leads to misclassification of the prevalence of obesity as the participants overestimate or underestimate height, weight and/or both. Such misclassifications vary according to gender, age, status and ethnicity.

OBJECTIVES

To estimate on a sample of youth of both sexes (1) the difference between self-reported data and measured height and weight and (2) the extent of misclassification of BMI deriving from such differences.

METHODS

Self-reporting in questionnaires and subsequent measurements of height and weight conducted by trained personnel. The mean values and the BMIs were calculated.

RESULTS

Both sexes overestimate height (2.1 and 2.8cm for males and females, respectively), and underestimate weight (1.5 and 1.9kg for males and females, respectively). Consequently the BMI is underestimated (1.1 and 1.5 points for males and females, respectively). The classification of BMI from self-reported data shows underestimation of overweight in both sexes (8 percentage points) and of obese males (3.3 percentage points), an overestimation of normal weight (12.2 and 4.3 percentage points for males and females, respectively) and an excessive underweight in the girls (4.3 percentage points).

CONCLUSIONS

There is a difference between self-reported and measured data and self-reported biases are reflected in the classification of the participants in the 4 categories of BMI.

Generational effects and gender height dimorphism in contemporary Spain

We examine the influence of socio-environmental (and birth cohort specific) effects on both adult height and gender dimorphism (height gap). Our data set is from contemporary Spain, a country governed by an authoritarian regime for about 40 years. Both OLS and quantile regression approaches are used to examine these patterns. Furthermore, we then draw upon a Blinder-Oaxaca decomposition approach to explain the influence of socio-political environment in explaining gender dimorphism. Our findings point to a significant increase in adult height in the generations that benefited from the country's economic liberalization in the 1950s, and especially among those brought up after the transition to democracy in the 1970s. In contrast, individual heterogeneity suggests that only in recent generations has "height increased more among the tallest". We also find that the effects of education on height are greater among shorter individuals. Although the mean gender difference in height is 11.7cm, birth cohort and capabilities effects along with other controls explain on average roughly 4% of the gender height dimorphism, irrespective of the quantile considered.

Stature and sexual stature dimorphism in Sweden, from the 10th to the end of the 20th century

Mean stature in a population has been observed to vary with living conditions. If, and how, this affects sexual dimorphism in stature is not fully understood. We analyzed stature data from Swedish populations from the 10th to the end of the 20th century to investigate if male stature is more plastic than female stature in response to environmental changes. Further, we examined if there, as a consequence of this, exists an allometric relationship between male and female stature that is not caused by genetic factors, coupling greater stature with greater dimorphism. We found no significant change in stature from the 10th century to the 17th century, but a clear increase in both male and female stature during the 20th century, most likely because of improved living conditions. Regression analyses revealed no consistent change in sexual stature dimorphism over time for any of the time periods, including the 20th century. Further, we found no significant allometric relationship between male and female stature, and could consequently not identify any significant relationship between stature and stature dimorphism. Thus, contrary to previous suggestions, the regressions did not provide support for the assertion that male stature is more sensitive to environmental changes than female stature, nor that stature dimorphism increases with increasing stature.

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

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

Is height associated with cardiovascular risk in Chinese adults?

BACKGROUND

Better childhood conditions, proxied by greater height, are usually protective against ischemic heart disease in western countries. These relations are less evident in other settings.

METHODS

We used multivariable logistic regression to examine the relation of height to the metabolic syndrome and its components in a rapidly developed Asian population using a representative, cross-sectional Hong Kong Chinese sample of 2860 adults from 1994 to 1996.

RESULTS

Height was inversely associated with increased blood pressure (odds ratio = 0.74; 95% confidence interval = 0.58-0.94) and raised fasting plasma glucose (0.71; 0.55-0.91), but only after adjustment for central obesity. Central obesity was also positively associated with height (2.09; 1.67-2.62) for tallest compared with shortest tertile, confounding these relationships. The association between height and central obesity was much stronger in men than in women.

CONCLUSION

The relation of height to cardiovascular risk may relate to a society's history and stage of socioeconomic development.

Does body weight affect wages? Evidence from Europe

We use data from the European Community Household Panel to investigate the impact of body weight on wages in nine European countries. When we pool the available data across countries and years, we find that a 10% increase in the average body mass index reduces the real earnings of males and females by 3.27% and 1.86%, respectively. Since European culture, society and labour market are heterogeneous, we estimate separate regressions for Northern and Southern Europe and find that the negative impact of the body mass index on earnings is larger--and statistically significant--in the latter area.

Was there an urban height penalty in Spain, 1840-1913?

We explore whether there was an urban height penalty in Spain during the period of early industrialization from 1840 to 1913, using data from Spain's Southeastern coast and from Castile-Leon. Our results indicate that in the Mediterranean Coast of Southeastern Spain urban heights were well above rural ones for most of the period considered. In Castile-Leon, however, urban and rural heights were about the same until 1870 but urban heights were intermittently above rural ones thereafter. Hence, in Spain urban heights were not always below rural ones in stark contrast to the pattern obtained in other parts of Europe and North America.

Diabetes and coronary heart disease in Filipino-American women: role of growth and life-course socioeconomic factors

OBJECTIVE

To investigate associations between adult markers of childhood growth and the prevalence of diabetes and coronary heart disease (CHD) in Filipino-American women and to determine the role of social and educational differences, including the influence of social mobility between childhood and adulthood.

RESEARCH DESIGN AND METHODS

Socioeconomic disadvantage and poor infant growth, resulting in short leg length, may contribute to the dramatically increased risk of diabetes and CHD in Filipino-American women, but this has not been investigated. This study is a cross-sectional study of 389 Filipino-American women (age 58.7 +/- 9.4 years [mean +/- SD]). Diabetes was defined by 1999 World Health Organization criteria and CHD by ischemic electrocardiogram changes, Rose angina, a history of myocardial infarction, or revascularization surgery. A score of social mobility (0-4) was calculated by summarizing childhood and adult financial circumstances.

RESULTS

Diabetes prevalence (31.4%) was not associated with measures of growth but was significantly lower in women with greater education, childhood and adult income, or social mobility score. Compared with Filipinas who were poorest in childhood and adulthood, respective odds ratios (95% CI) for diabetes were 0.55 (0.18-1.68), 0.19 (0.06-0.62), and 0.11 (0.03-0.42), down to 0.07 (0.01-0.51) in the most advantaged women (P < 0.0001). Family history of diabetes [5.14 (2.72-9.70)] and larger waist [1.07 per cm (1.03-1.10)] were also significant predictors in multiple adjusted models. In contrast, CHD prevalence (22.4%) was most strongly associated with leg length, but not trunk length; compared with individuals with the shortest legs, respective odds ratios (95% CI) for CHD were 0.60 (0.31-1.19), 0.53 (0.26-1.05), and 0.44 (0.22-0.91) in the tallest group, in age- (P(trend) = 0.02) and multiple-adjusted models (P(trend) = 0.01).

CONCLUSIONS

Socioeconomic disadvantage contributes to the high prevalence of diabetes in Filipinas. Factors limiting early growth of the legs may increase the risk of CHD in this comparatively short population.

[Importance of genetics for health inequalities]

In Germany it has rarely been assessed in a systematic way, if and how genetic disposition and genetic testing are linked to health inequality. The paper aims to be a contribution towards closing this gap. In a first step, it is pointed out that the discussion about potential links between genetic causes of social inequalities has concentrated on issues such as body height and intelligence. It is stressed that, of course, social status is mainly determined socially and not genetically. In the second step, medical benefits of genetic testing are discussed. It can be assumed that low status groups are using these tests less often than high status groups, and that they are less capable of interpreting the results. Tests that can have a positive effect on health could thus lead to an increase of health inequalities. However, empirical studies for testing these hypotheses are hardly available. In the third step, the question is raised whether genetic information could lead to social discrimination (e.g. concerning health insurance, life insurance or employer). According to the current empirical literature, to date, this risk is (still) rather small. Thus, it is stressed that more research is needed, and that already today there is some need for intervention (e.g. concerning equal access to genetic testing, better information of low status groups).

Effects of socioeconomic change from birth to early adulthood on height and overweight

BACKGROUND

In this work we explored the association of height and overweight with change in socioeconomic position between birth and 19 years of age.

METHODS

A birth cohort has been followed-up in Pelotas, Brazil, since 1982. All 5914 hospital births were enrolled in the study just after delivery. In 2001, 27% of the cohort subjects were sought, and 1031 (69% of the survivors) were interviewed. Weight and height were obtained for women; men had been examined 6 months earlier. Information on family income in 1982 and 2001 was used to classify the sample into tertiles, the lowest classified as 'poor' and the other two as 'non-poor'. Four trajectories resulted: always poor, never poor, poor at birth/non-poor at 19, and non-poor at birth/poor at 19-which were compared in terms of mean height and prevalence of overweight.

RESULTS

Height showed a similar behaviour for men and women, with the never poor presenting the highest mean, followed by those who were non-poor at birth and later became poor. Those who were poor at birth, regardless of later status, were shortest. Overweight was approximately twice as common among men who were never poor in relation to the others. Among women, those who were always poor presented the highest prevalence of overweight. In this case, social determination seems to be complex and may involve aspects of lifestyle and behaviour acting differently for each gender.

CONCLUSION

Socioeconomic trajectories affected both height and overweight, the effect on the latter being different for each gender.

Maternal education, lone parenthood, material hardship, maternal smoking, and longstanding respiratory problems in childhood: testing a hierarchical conceptual framework

BACKGROUND

Maternal smoking and low socioeconomic status are known to be associated with each other and with longstanding respiratory problems in childhood but their interrelation has received little attention. In this paper, the interrelations is studied using a conceptual hierarchical framework among children aged 0-11 years in a representative sample of British households with children.

METHOD

With data from the family and children study, this paper tested a conceptual hierarchical framework, in which maternal education acting through lone parenthood would influence material hardship and all three would have effects on maternal smoking increasing the risk of children's longstanding respiratory problems.

RESULTS

Among children 0-2, maternal education and material hardship had indirect effects on respiratory problems mediated through more proximal variables. After adjustment for maternal education, the effect of lone parenthood was partially mediated through material hardship and maternal smoking. Adjustment for socioeconomic status variables attentuated but did not eliminate the effect of maternal smoking (odds ratio=2.04, 95% confidence interval=1.30, 3.20). Among children 3-11, the effect of maternal education was partially mediated through proximal variables. Lone parenthood and material hardship had indirect effects only. Adjustment for confounding eliminated the effect of maternal smoking (odds ratio=1.06, 95% confidence interval=0.88, 1.26).

CONCLUSIONS

Reducing childhood longstanding respiratory problems will require attention to background socioeconomic status factors in addition to maternal smoking.

Height at age 18 years is a strong predictor of attained education later in life: cohort study of over 950,000 Swedish men

BACKGROUND

Adult body height has been related to socioeconomic position in cross-sectional studies. Intelligence, shared family factors, and non-familial circumstances may contribute to associations between height and attained education, but their relative importance has been difficult to resolve.

METHODS

A nation-wide record-linkage cohort study of over 950 000 Swedish men born 1950-75 followed with respect to attained education for up to 27 years after measurement of height at age 18 (baseline). The association between height and attained education in later life was investigated by logistic regression modelling with adjustment for age, geography, parental socioeconomic position, and cognitive ability. Shared family factors were accounted for in analyses of full-brother-pairs using conditional logistic regression.

RESULTS

The odds ratio (OR) for attaining higher education 7-27 years after baseline was 1.10 [95% confidence interval (95% CI) 1.09-1.10] in fully adjusted models per 5 cm increase in height. Men taller than 194 cm were two to three times more likely to obtain a higher education as compared with men shorter than 165 cm. The association remained within brother-pairs, OR 1.08 (95% CI 1.07-1.10), suggesting that non-familial factors contribute to the association between height and education attainment. A significant interaction (P < 0.0001) was found between year of birth, height, and attained education, showing slightly weaker associations among later birth cohorts.

CONCLUSIONS

The strong positive association between height and educational achievement remaining after adjustment for year of birth, parental socioeconomic position, other shared family factors, and cognitive ability may reflect educational discrimination based on height although residual confounding cannot be ruled out.

Menarcheal age and socio-economic factors in Poland

BACKGROUND

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

OBJECTIVE

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

SUBJECTS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

Growth of Estonian seventeen-year-old boys during the last two centuries

Between 1811 and 2003, the mean height of 17-year-old Estonian boys increased 18.4 cm (0.97 cm per decade). The increase was 5.2 cm (0.7 cm per decade) between 1811 and 1886, 12.3 cm (2.2 cm per decade) between 1922 and 1978, and 0.5 cm per decade between 1978 and 2003. Between 1922 and 2003, mean height increased 8.2% and mean weight increased 27.2%. Between 1956 and 2003, biacromial (shoulder) breadth increased more than bicristal (hip) breadth; relative chest depth diminished; chest circumference and upper thigh circumference both increased. A multidimensional body structure model is constructed from 1998 to 2003 data.

Overweight in Southeastern Pennsylvania children: 2002 household health survey data

OBJECTIVE

The authors sought to estimate the prevalence of overweight and risk for overweight and to examine relationships between body mass index (BMI) and socioeconomic and demographic characteristics among children in Philadelphia and four neighboring counties.

METHODS

Data from the 2002 Philadelphia Health Management Corporation Household Health Survey was examined.

RESULTS

Of 2,621 children aged 2 to 17 years, 36% were overweight or at risk for overweight and 23% were overweight. Prevalences of overweight and at risk for overweight were higher among younger children than among older children and adolescents. African American, Hispanic, and Asian children had higher prevalences than non-Hispanic white children. Childhood overweight was positively associated with household poverty, lower educational status, and higher BMI in the adult survey respondents.

CONCLUSIONS

The observed inverse relationship between age and the prevalence of overweight among Southeastern Pennsylvania children and adolescents differs from previous reports of the prevalence of overweight in samples of U.S. children and adolescents. The high prevalence of overweight among children aged 2 to 9 years should focus attention on improving nutrition and increasing opportunities for physical activity and exercise among preschool and early school-age children.

Age at menarche in relation to adult height: the EPIC study

In the last two centuries, age at menarche has decreased in several European populations, whereas adult height has increased. It is unclear whether these trends have ceased in recent years or how age at menarche and height are related in individuals. In this study, the authors first investigated trends in age at menarche and adult height among 286,205 women from nine European countries by computing the mean age at menarche and height in 5-year birth cohorts, adjusted for differences in socioeconomic status. Second, the relation between age at menarche and height was estimated by linear regression models, adjusted for age at enrollment between 1992 and 1998 and socioeconomic status. Mean age at menarche decreased by 44 days per 5-year birth cohort (beta = -0.12, standard error = 0.002), varying from 18 days in the United Kingdom to 58 days in Spain and Germany. Women grew 0.29 cm taller per 5-year birth cohort (standard error = 0.007), varying from 0.42 cm in Italy to 0.98 cm in Denmark. Furthermore, women grew approximately 0.31 cm taller when menarche occurred 1 year later (range by country: 0.13-0.50 cm). Based on time trends, more recent birth cohorts have their menarche earlier and grow taller. However, women with earlier menarche reach a shorter adult height compared with women who have menarche at a later age.

Obesity, weight status and employability: empirical evidence from a French national survey

We investigate the relationship between employability and obesity, particularly how obesity and overweight are associated with the percentage of working years spent unemployed and the ability to regain employment. Data for adults who responded to the 2003 Decennial Health Survey collected by the French National Institute of Statistics and Economic Studies revealed that the percentage of time spent unemployed during working years is significantly higher for each kg/m2 deviation from the mean body mass index (BMI) attained at age 20 and that the probability of regaining employment after a period of unemployment is much lower.

Height and BMI of Italian immigrants to the USA, 1908-1970

We analyze self-reported anthropometric data pertaining to 2140 adults who emigrated to the United States, mainly from southern Italy, between 1908-1928 and 1960-1970. The mean height of immigrant men was 165.5 cm: they were taller than contemporary southern Italian men by 0.5-7.3 cm in different periods. The mean height of the Italian immigrant women born before 1952 was 157.6 cm, less than the national average. At the end of the 1990s, national women average height was 162 cm, 159.5 cm for southern women. There were age-related increases of weight and BMI: overweight was more prevalent in the 40-49 years age category. In the male sample, the mean values of BMI were within the overweight range in all age classes. The prevalence of obesity was higher in the male sample than among US men, whereas it was virtually identical in the women's sample and much higher than the values reported for several European countries for the period 1970-1980.

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

OBJECTIVE

To determine whether social inequalities in height change across generations.

METHODS

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

RESULTS

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

CONCLUSIONS

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

Socioeconomic determinants of anthropometric trends among Hungarian youth

The increase of physical stature in the developed countries and their socio-economic correlates has been well documented for nearly two centuries. In this study, the secular changes in height, weight and the BMI of Hungarian university students and conscripts are analyzed for the years 1933-1998. During the first half of this period these body measurements changed little, while in the second half the rates of change accelerated rapidly: height increased by 1.7 cm among males and 1.8 cm among female university students per decade, and 1.8 cm among male conscripts. Differences were found according to the place of birth and residence as well as parental occupation and educational level.

Heritability of body height and educational attainment in an international context: Comparison of adult twins in Minnesota and Finland

We studied the effect of genetic and environmental factors on the association between self-reported height and education in Minnesota and Finland. Our data included 1,598 twin pairs in Minnesota and 5,454 twin pairs in Finland born between 1936 and 1955. Correlations between education and height were found in Minnesota (r = 0.09 in men and 0.11 in women) and in Finland (r = 0.17 and 0.14, respectively) after adjustment for age. This trait correlation was mainly because of the correlation between shared environmental factors in Minnesota (r(C) = 0.38 and 0.36, respectively) and in Finland (r(C) = 0.74 and 0.37, respectively). An unshared environmental correlation was found only in Finland (r(E) = 0.13 and 0.06, respectively). Our results indicate that the association between body height and education is overwhelmingly due to the correlation of the shared environmental factors affecting these two traits. The differences between Minnesota and Finland are possibly associated with average higher education in Minnesota, which decreases the effect of the childhood environment on education, seen as a weaker correlation between height and education. Nonfamilial factors affecting education are possibly different in Minnesota than in Finland, since in Finland they are partly associated with the factors affecting height.

Heights, calories and welfare: a new perspective on Italian industrialization, 1854-1913

The height of Italian conscripts was increasing throughout the second half of the 19th century due primarily to an increases in food intake, but also to an improvement in sanitary conditions, and diffusion of primary schooling. The increase in food intake reflects a growth in agricultural production, contrary to the standard series of national accounts. We infer from an improved estimate of agricultural output, and from the increases in physical stature that the timing of the onset of modern economic growth in Italy was substantially different from the conventional Gerschenkronian perspective.