Published by Oxford University Press on behalf of the International Epidemiological Association
© The Author 2005; all rights reserved. Advance Access publication 14 April 2005
Commentary: Height and intelligence
Catharine Gale
In 1892, WT Porter published a study of 33 500 students entitled
‘The physical basis of precocity and dullness’ in which he
reported that taller students performed better academically than
did shorter students of the same age.1 Since then many studies
in developed and developing countries have shown that children
who are shorter or whose linear growth is retarded tend to gain
lower scores in tests of cognitive function.2,3 Similar associations
have been found in adults.4 Further evidence of this link is
published in the current issue of International Journal of
Epidemiology. Pearce et al. found that in a cohort of children born
in 1947—the Newcastle Thousand Families Study—those who
were taller at the age of 9 or 13 years had a higher IQ at the age
of 11 years, after adjusting for social class.5
The authors say their results ‘suggest a continuing effect of
postnatal growth on childhood cognition beyond the age of
nine years’, but they acknowledge, ‘Other factors may play a
role in this relationship’. There is certainly little evidence that
an increase in height will itself cause a rise in intelligence.
Among 2177 children studied longitudinally in the National
Health Examination Survey of the 1960s, change in relative
height between the ages of 8 and 13 years was not related to
change in score on tests of intelligence or academic
achievement.2 Furthermore, in a randomized controlled trial
into the effects of long-term growth hormone therapy in
children born small for gestational age, most of the treated
children showed a gain in height of 1 SD or more, paralleled by
increases in IQ, but the increase in height did not explain the
improvement in IQ.6 Growth hormone might have a direct
effect on cerebral function, unrelated to its influence on height.
Others have suggested that children’s height might have an
indirect effect on their cognitive development by influencing
the way adults and peers treat them. Years of cumulative
height-biased expectations may explain the association.2
Height and intelligence, in common with other traits that
show a continuous distribution, are likely to have multiple
determinants, both genetic and environmental, many of which
might have only a small individual effect. Secular trends over
the last century clearly demonstrate the sensitivity of both traits
to environmental influences. Numerous countries have
reported continuous and regular increases in height and IQ.
Many of these increases have been sizeable and have occurred
with striking rapidity, far too rapidly to be explained by
genetics. For example, 18-year-olds from the Netherlands tested
in 1982 scored 20 IQ points higher than an equivalent group of
18-year-olds tested in 1952, an increase of more than 1 SD,
similar in magnitude to the increase in height that occurred in
the country over the same period.7
The secular trends suggest that the association found between
height and intelligence may be due to common influences in
MRC Epidemiology Resource Centre, Southampton General Hospital,
Southampton SO16 6YD, UK. E-mail: crg@mrc.sotton.ac.uk
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International Journal of Epidemiology 2005;34:678–679
doi:10.1093/ije/dyi064
the childhood environment. Children’s height and IQ have
frequently been shown to increase with their parents’
socioeconomic status or level of education. But social
background itself does not seem to explain the association. In
the British 1946 cohort, height was associated with cognitive
test scores, after controlling for father’s social class and mother’s
education.8 Evidence from the National Health Examination
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Survey suggests that the link between height and IQ is not due
to family size or income.2 Information on childhood
circumstances in the paper by Pearce and colleagues is limited
to social class, mother’s age and parity, but an earlier report on
the Newcastle Thousand Families Study by FJW Miller and
colleagues suggests that characteristics of the neighbourhood
where the children lived had an influence on their height and
intelligence, independent of social class. The districts with ‘the
oldest and most derelict housing, the most polluted air, the most
depressing appearance’ were consistently at the lower end of
the ranking for both height and intelligence.9
Diet, disease, psychosocial stress and inadequate cognitive
stimulation have all been suggested as factors that might underlie
the association between height and IQ. Evidence that nutrition
and cognitive stimulation are at least partially responsible comes
from a randomized controlled trial of growth-retarded children
aged 9–24 months in Jamaica. Improvements in both growth and
cognitive function were produced after 2 years of nutritional
supplementation and cognitive stimulation. Only those children
who received both interventions caught up with the non-growth
retarded control group. Cognitive stimulation, but not nutritional
supplementation, had a long-lasting effect on intelligence, as
shown by test results at age 11 years.3
Studies in developing countries suggest that whatever
mechanisms underlie the association between height and
intelligence, their effects may be particularly important in very
early childhood as this is a period of rapid growth and cognitive
development. It is a pity that Pearce and colleagues decided to
include only the data on height at ages 9 and 13 years and IQ at
age 11 years in their analyses. In their book on this Newcastle
cohort, FJW Miller and colleagues describe strong associations
between height at age 3 and 5 years and scores on tests of
cognitive function at age 11 and 12 years.9 Miller’s analyses are
not adjusted for potential confounding factors but their findings
and the exclusion of these data from Pearce and colleagues’
paper make it hard to interpret these new results in relation to
height at ages 9 and 13 years.
The Newcastle cohort was born at a time when height may
have been a more powerful indicator of childhood environment
than it is for children growing up in today’s economically deve-
loped countries. In a study of 9-year-olds born in 1992—who
were on average 3 cm taller than the Newcastle 9-year-olds—
height was not a significant predictor of intelligence, though
height was related to IQ in their mothers.10 Evidence from
Denmark suggests that the association between height and IQ

has weakened in successive birth cohorts.11 Perhaps as
standards of living increase and variations in height between
social groups diminish, similar trends will be evident in other
populations.
References
1 Porter WT. The physical basis of precocity and dullness. Transactions of
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2 Wilson DM, Hammer LD, Duncan PM et al. Growth and intellectual
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3 Walker SP, Grantham-McGregor SM, Powell CA, Chang SM. Effects
of growth restriction in early childhood on growth, IQ, and
cognition at age 11 to 12 years and the benefits of nutritional
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4 Tanner JM. Relation of body size, intelligence test scores and social
circumstances. In: Mussen PH, Largen J, Covington M (eds). Trends
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7 Colom R, Lluis-Font JM, Andres-Pueyo A. The generational
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9 Miller FJ, Court SD, Knox EG, Brandon. The School Years in Newcastle
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11 Teasdale TW, Sorensen TI, Owen DR. Fall in association of height with
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