Childhood leg length and adult mortality: follow up of the Carnegie (Boyd Orr) Survey of Diet and Health in Pre-war Britain

Abstract

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...

Ulna length to predict height in English and Portuguese patient populations

“…(Auyeung et al, 2009). It is also thought that poor nutrition in utero (Elia et al, 2007) and childhood (Tanner et al, 1982;Gunnell et al, 1998;Jantz and Jantz, 1999;Bogin et al, 2001Bogin et al, , 2002 reduces leg length relative to trunk length and/or trunk plus head length, and this will affect the prediction of height from lower limb measurements. The extent to which these considerations apply to upper limb measurements, especially distal limb lengths (for example, ulna length), is unclear.…”

Childhood economic conditions and length of life: Evidence from the UK Boyd Orr cohort, 1937–2005

“…Some of the studies have focused on the links between anthropometric or medical indicators observed in 1937-39, and the onset of a variety of medical conditions later in life. One example is the link between childhood leg length and cancer risk (Gunnell et al, 1998a;Gunnell et al, 1998b); another is between childhood body mass index, cancer risk and cardiovascular mortality (Gunnell et al, 1998c;Jeffreys et al, 2005). Other studies have focused on the connection between food intake and its dietary constituents and life course outcomes (see Frankel et al, 1998;Ness et al, 2005).…”

Body mass index in early and mid-adulthood, and subsequent mortality: a historical cohort study

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