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Objective-To investigate the relation between childhood height, its componentsleg length and trunk length-and mortality in adulthood. Design-Cohort study based on the Carnegie (Boyd Orr) Survey of diet and health in pre-war Britain, 1937-9. Subjects-2990 boys and girls aged between 2 years and 14 years 9 months when they were examined in 1937-9. These children were drawn from 1134 families who underwent a one week assessment of family diet and home circumstances. Of these, 2547 (85%) have been traced and flagged using the NHS Central Register. Main outcome measures-Age adjusted overall, coronary heart disease, and cancer mortality in men and women in relation to age and sex specific z scores for height, leg length, and trunk length. All analyses were adjusted for the possible confounding eVects of childhood and adult socioeconomic circumstances and childhood diet. Results-Leg length was the component of childhood height most strongly associated with socioeconomic and dietary exposures. There was no significant relation between childhood height and overall mortality. Height-mortality relations were observed in relation to both coronary heart disease (CHD) and cancer. Leg length was the component of height most strongly related to cause specific mortality. In men and women CHD mortality increased with decreasing childhood leg length. Men in the lowest leg length quintile had a relative risk (RR) of 2.5 (95% CI 1.0 to 6.2) compared to those with the longest legs (linear trend p=0.14). Similarly, women in the lowest leg length quintile had a RR of 3.9 (95% CI 0.8 to 19.0; linear trend p<0.01). Adjustment for childhood and adult socioeconomic circumstances had little eVect on these trends. In men, but not women, those who as children had long legs experienced increased cancer mortality. The significant relations between anthropometry and both CHD and cancer mortality were restricted to those aged < 8 years when measured. Conclusions-These findings suggest that adverse diet and living conditions in childhood, for which leg length seems to be a particularly sensitive indicator, are associated with increased risk of CHD in adulthood and possibly reduced cancer risk. It is likely that these influences operate after birth, during the first few years of life. (J Epidemiol Community Health 1998;52:142-152) For many centuries it has been recognised that a child's environment and diet are important in determining its rate of growth, timing of maturation, and final stature. Setting-The 14 centres in England and1 In the past 60 years epidemiological analyses have shown that poverty, undernutrition, and disease exposure in childhood may also have important long term eVects on adult health and life expectancy.2 Adult height reflects a child's nutrition and health throughout its growing years and, although final height is limited by a child's genotype, environmental influences also aVect its adult size.3 Exposure to the factors that inhibit or promote growth-nutrition, disease, psychological stress, overcrowding, and ot...

A large national cohort of children studied from birth to 36 years was used to test the predictive value of childhood obesity for obesity in adult life. Only 21% (39) of obese 36 year olds had been obese at age 11 years, and even when associated social factors were taken into account the correctly predicted percentage was much lower than the prediction rate achieved using body mass data from age 26 years. The comparatively poor predictive value of childhood obesity and the associations of adult obesity with educational achievements and socioeconomic circumstances of family of origin emphasise the need for encouraging good nutritional and exercise habits ratherthan placingundue emphasis on the control of childhood obesity.

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