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Greek young men grow taller

Article in Acta Paediatrica · May 2008

DOI: 10.1111/j.1651-2227.2008.00855.x · Source: PubMed

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 Acta Pædiatrica ISSN 0803–5253

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Greek young men grow taller

Anastasios Papadimitriou (anpapad@med.uoa.gr), Grigorios Fytanidis, Konstandinos Douros, Dimitrios T Papadimitriou, Polyxeni Nicolaidou,
Andreas Fretzayas
Third Department of Pediatrics, University of Athens School of Medicine, ‘Attikon’ University Hospital, Athens, Greece

Keywords Abstract
Height, Men, Secular trend, Socioeconomic factors
Aim: To examine whether a secular trend for greater height is still observed in young Greek men.
Correspondence Method: Height and weight of 3982 Greek conscripts, aged 18–26 years, were measured and
Anastasios Papadimitriou, M.D., Third Department
of Pediatrics, University of Athens School of correlated with the level of education and place of residence. Our data were collected from May
Medicine, ‘Attikon’ University Hospital, Rimini 1 2006 to May 2007 from pre-selected army camps all over Greece. The data were compared with
Street, Athens 124 64, Greece. those of a similar study performed in 1990.
Tel: +30-210-5832046 |
Fax:+30-210-5832229 | Results: Mean height (±SD) of the conscripts was 178.06 (±7.05) cm. From 1990 until 2006, mean
Email: anpapad@med.uoa.gr height increased from 175.7 cm to 178.06 cm (p < 0.001), corresponding to 1.47 cm/decade.
Received Height was positively correlated with the place of residence (p = 0.007) and the level of education
19 February 2008; revised 10 March 2008; (p < 0.001) of the conscripts.
accepted 14 April 2008.
DOI:10.1111/j.1651-2227.2008.00855.x Conclusion: Our data show a further increase in the stature of young Greek men in the last 16 years. It appears
that the male Greek population has still not exhausted its growth potential.

collected from May 2006 to May 2007 from pre-selected

INTRODUCTION
Secular growth changes are a marker of the socioeconomic
conditions and the health status of a population through
time (1); they also provide insight into the link between
growth and the environment (2). Environmental factors that
influence the growth of the populations include nutrition
and hygienic conditions and in turn these factors are influ-
enced by the socioeconomic conditions of the population.
Positive secular changes in the height of populations in
the industrialized countries, and also in developing ones,
have been well documented for the last two centuries (3–6).
These changes were most prominent in the 20th century, es-
pecially after World War II, and manifested as greater height
of children and adults alike. The improvement in socioeco-
nomic conditions also had a positive influence on pubertal
maturation of children, as clearly shown in girls by the fall of
the age at menarche (7). However, there are studies report-
ing that the acceleration of physical development reached
a plateau in some developed countries. This suggests that
some populations have already achieved their full genetic
growth potential or that the socioeconomic conditions in
these countries ceased to improve (8–10).
The objective of this study was to determine whether there
is still a secular trend towards greater height in young Greek
male adults by comparing the data of this study with those
of a previous similar study conducted in 1990 (11). Further-
more, we examined whether the body height was influenced
by sociodemographic factors, such as level of education and
place of residence.
SUBJECTS AND METHODS
Survey and subjects
The study was based on anthropometric data of 3982 con-
scripts of the Greek Army, aged 18–26 years. The data were
army camps all over Greece, so as to obtain a country repre-
sentative sample. All men enlisted in those camps during that
period were included (participation rate 100%). The study
was approved by the ethics committee of ‘Attikon’ Univer-
sity Hospital.
Measurements
Anthropometric measurements were performed with the
use of calibrated measuring devices and standard meth-
ods of measurement (12). The height of the conscripts was
measured to the nearest millimetre by a Raven Minimeter
portable height gauge and body weight was measured in
kilograms using a Secca weighing scale. Measurements were
performed by the same physician with a substantial measur-
ing experience prior to the study. During measurements the
soldiers were lightly dressed (underwear only) and without
shoes.
Assessment of socioeconomic characteristics
The educational level, which is the most stable and robust
indicator of socioeconomic status (13), and the place of
residence were evaluated using a questionnaire, in which
each conscript had to reply. Conscripts were classified ac-
cording to the schooling years into ≤9 (primary school,
i.e. ninth grade or less), 10–12 (high school – secondary
school) and ≥13 (college, university) years. Also, they were
categorized according to the place of residence, as living
in metropolitan cities (Athens, Thessaloniki), urban (pop-
ulation at least 10 000 people), semi-urban (population be-
tween 2000 to 9999 people) and rural (population less than
2000 people) areas. The population of the place of residence
was based on data from the National Statistical Service of
Greece.


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Secular trend of height of Greek conscripts
Statistics
Data are presented as means with standard deviations (SD).
For comparison of height between 1990 and 2006 studies,
we used the t-test. Correlations between variables were ex-
amined with Pearson’s correlation coefficient. A multiple
linear regression model was used to assess the association
between height and the sociodemographic factors of place
of residence and level of education. Levels of independent
variables (educational level and place of residence) were or-
dered and coded from 1 to 3 and from 1 to 4, respectively,
in order to find if a linear relation existed between them and
height. We also searched for interactions between the latter
two variables. As far as it concerns the comparison between
mean heights in the present and the previous study, we con-
ducted an a priori power analysis with significance level 0.05
and effect size 0.15. In order to achieve a power of 0.95, we
needed a sample of about 3500 subjects. The statistical sig-
nificance threshold was set at p < 0.05.
RESULTS
Mean height (SD) of the conscripts was 178.06 (7.05) cm.
Height was positively correlated with the place of residence
(b = 0.27, C.I. of b: 0.07–0.46, p = 0.007) and the level of
education (b = 2.49, C.I. of b: 2.15–2.82, p < 0.001) of the
conscripts. Interactions between place of residence and level
of education were not statistically significant. Although, our
model was statistical significant (p < 0.001), it explained, as
it was expected, only a small part of the total variability of
the height of conscripts (R2 = 0.057). Distribution of height
by place of residence and level of education is shown in
Tables 1 and 2.
Comparing our data with those of the 1990 study we found
that mean height increased from 175.7 cm to 178.04 cm, from
1990 to 2006, corresponding to 1.47 cm per decade (p <
0.001) (Table 3).
There was no correlation between height and body mass
index (BMI) for the whole cohort, or when conscripts were
examined according to place of residence or educational
level.
DISCUSSION
Our data show that young adult Greek males present a sec-
ular trend towards greater height. The data also show that
height is influenced by place of residence and socioeconomic
status (estimated by the level of education).
Growth is dependent upon the interaction between ge-
netic and environmental factors. The influence of each fac-
tor on growth is very difficult to determine. However, in a
population level the influence of environmental factors are
quite strong, as it is shown by the loss of height that chil-
Table 1 Mean height (SD) of conscripts by place of residence
Metropolitan cities
n 1518
Height in cm (Mean ± SD) 179.35 ± 7.21
p = 0.007. It represents the overall p-value for place of residence as produced by the linear regression model.
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Papadimitriou et al.
Table 2 Mean height (SD) of conscripts by years of education
Years of education ≤9 10—12 ≥13
n 334 1729 1919
Height in cm 174.41 ± 6.97 177.10 ± 7.03 179.69 ± 6.64
(Mean ± SD)
p < 0.001. It represents the overall p-value for educational level as produced
by the linear regression model.
Table 3 Mean height (SD) of the conscripts from surveys of 1990 and 2006
1990 2007
n 837 3982
Height in cm (Mean ± SD) 175.7 ± 4.3 178.06 ± 7.02
p < 0.001.
dren presented during the famine of World War II. (14).
Due to the influence of environmental factors on growth,
Tanner suggested that the growth of children is a mirror of
the conditions in the society (15). Bogin proposed that hu-
man growth in height might be used as a cumulative record
of the nutritional and health history of a person or a popu-
lation, as it reflects the economic, social and political envi-
ronment in which people live (16).
Greece spent most part of the 20th century as a developing
country. As late as the 1970s the country managed to become
a developed one and enjoys socioeconomic prosperity since
then. In accordance with the notion that human growth re-
flects the conditions in the society, Greek conscripts’ mean
height increased by almost 8 cm from 1968 to 1990 (17). As
it is evident from our data, this trend continues to exist, even
though the rate seems to decelerate (Fig. 1).
Our finding of conscripts from urban areas being signif-
icantly taller than conscripts from rural areas signifies that
there are still some differences in the socioeconomic factors
related to growth, e.g. nutrition and hygienic conditions, be-
tween urban and rural areas in Greece. This observation
concurs with the results of the 1968 study, but contrasts the
results of the 1990 study, in which conscripts from urban ar-
eas were not taller than those from rural areas. Probably, this
reflects a disproportionate improvement of living conditions
in urban areas.
We also showed that conscripts with a higher educational
level were significantly taller irrespective of the place of res-
idence. This is in line with other studies reporting the same
finding (18).
It is known that childhood overweight, especially if it
is of early onset, is related with increased height during
childhood. Moreover, it has been shown that childhood
Urban areas Semi-urban areas Rural areas
1189 557 718
177.91 ± 6.94 177.58 ± 6.78 176.42 ± 6.77
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Papadimitriou et al.
180
175
170
165
1960 1970
Figure 1 Secular trend of mean height of Greek conscripts from 1968 to 2007.
overweight tracks strongly (around 50–70%) into adulthood,
boys tracking more strongly than girls (19,20). Therefore, a
substantial percentage of overweight conscripts would be ex-
pected to be overweight since childhood. Our finding of no
correlation between height and BMI suggests that childhood
overweight does not affect adult height, neither positively
nor negatively.
In conclusion, in the last 16 years there was a significant
increase in adult stature of young Greek men. The socioe-
conomic status and the place of residence have a significant
influence on body height. These data suggest that the male
Greek population has still not exhausted its genetic growth
potential.
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