The regulation of human growth includes an understanding of competitive growth strategies and community effects on height

2021

HBPH

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Background There is a recurring and seamless interaction between the biology of human development and the social-economic-political-emotional (SEPE) environment. The SEPE environment influences the quality of the material conditions for human biology and, simultaneously, human growth in height and other dimensions provide social and moral signals that provide information to community networks. Objectives This article reviews the role of SEPE factors in human growth, especially skeletal growth. Sample and Methods The meaning of SEPE is defined and shown to be related to individual and group prestige, to social identity, and to ego and task motivation. These influence dominance or subordination of communities and the material and moral conditions of societies. Historical and contemporary examples of SEPE effects on skeletal size are presented. Results Membership in a SEPE community impacts skeletal size in height and breadth. Higher SEPE classes are taller, lower SEPE classes are broader. In elite level sport the winners have more growth stimulation via the hormone IGF-1 even before the contest. These findings are explained in terms of dominance versus subordination and the Community Effect in Height hypothesis. Conclusions SEPE factor regulation of human growth is shown to be a more comprehensive explanation for plasticity in height than traditional concepts such as socioeconomic status and simple-minded genetic determinism. People belonging to upper SEPE class communities, the elites, know that they are superior and are treated as such by the non-elites. The material and moral condition for life operating through these community social networks provide positive stimulation for the elites and negative stimulation for the lower SEPE classes. These differences maintain the gradients in height between SEPE communities in human societies.

Section: Sepe Factorsmentioning

confidence: 99%

Social-Economic-Political-Emotional (SEPE) factors regulate human growth

2021

HBPH

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“…Harmful exposures during parents’ early-life, reflected in their adult height, can negatively affect child growth via various pathways, such as maternal health, biomechanical and biological mechanisms (eg, intrauterine growth restrictions and prematurity), as well as SES 1 , 11 , 12 and other social-economic-political-emotional (SEPE) factors. 13 , 14 The intergenerational effects of harmful exposures on child health may even stretch beyond two generations. 10 Genetic (including epigenetic) and hormonal factors may also link parental height and offspring growth.…”

Section: Introductionmentioning

confidence: 99%

Maternal Height-standardized Prevalence of Stunting in 67 Low- and Middle-income Countries

Karlsson

Kim

Journal of Epidemiology

et al. 2022

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Background Prevalence of stunting is frequently used as a marker of population-level child undernutrition. Parental height varies widely in low- and middle-income countries (LMIC) and is also a major determinant of stunting. While stunting is a useful measure of child health, with multiple causal components, removing the component attributable to parental height may in some cases be helpful to identify shortcoming in current environments. Methods We estimated maternal height-standardized prevalence of stunting (SPS) in 67 LMICs and parental height-SPS in 20 LMICs and compared with crude prevalence of stunting (CPS) using data on 575,767 children under-five from 67 Demographic and Health Surveys (DHS). We supplemented the DHS with population-level measures of other child health outcomes from the World Health Organization’s (WHO) Global Health Observatory and the United Nations’ Inter-Agency Group for Child Mortality Estimation. Prevalence of stunting was defined as percentage of children with height-for-age falling below −2 z-scores from the median of the 2006 WHO growth standard. Results The average CPS across countries was 27.8% (95% confidence interval [CI], 27.5–28.1%) and the average SPS was 23.3% (95% CI, 23.0–23.6%). The rank of countries according to SPS differed substantially from the rank according to CPS. Guatemala, Bangladesh, and Nepal had the biggest improvement in ranking according to SPS compared to CPS, while Gambia, Mali, and Senegal had the biggest decline in ranking. Guatemala had the largest difference between CPS and SPS with a CPS of 45.2 (95% CI, 43.7–46.9%) and SPS of 14.1 (95% CI, 12.6–15.8%). Senegal had the largest increase in the prevalence after standardizing maternal height, with a CPS of 28.0% (95% CI, 25.8–30.2%) and SPS of 31.6% (95% CI, 29.5–33.8%). SPS correlated better than CPS with other population-level measures of child health. Conclusion Our study suggests that CPS is sensitive to adjustment for maternal height. Maternal height, while a strong predictor of child stunting, is not amenable to policy interventions. We showed the plausibility of SPS in capturing current exposures to undernutrition and infections in children.

“…Building on these fundamental clinical observation, we have proposed that much of the current short stature/stunting observed in infants and children from impoverished families of low-and middle-income countries has causes due more to emotional/psychological stress and insecurity rather than undernutrition per Se (39)(40)(41) .…”

Section: Discussionmentioning

confidence: 99%

“…We consider education and social-economic-politicalemotional factors being most significantly involved in the Table 2 Height increments of children of a boarding school, Brno, school year 1903/1904, during 10 months of school attendance and during interposed 2 months of summer holiday at the end of each school year* high prevalence of child stunting in these countries. More and better-quality education and a higher quality of a broad range of social-economic-political-emotional factors have long been associated with better maternal health, higher birth weight, healthier physical growth, more successful schooling and greater earnings in adult employment (39)(40)(41)46) . In view of the ease to perform repetitive daily or short-term (e.g.…”

Section: A Way Forward In Nutritional Epidemiologymentioning

confidence: 99%

Catch-up growth is a better indicator of undernutrition than thresholds for stunting

Hermanussen

Hermanussen

2020

Public Health Nutr.

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Objective: Stunting (height-for-age < −2 sd) is one of the forms of undernutrition and is frequent among children of low- and middle-income countries. But stunting per s e is not a synonym of undernutrition. We investigated association between body height and indicators of energetic undernutrition at three critical thresholds for thinness used in public health: (1) BMI SDS < −2; (2) mid-upper arm circumference divided by height (MUAC (mm) × 10/height (cm) < 1·36) and (3) mean skinfold thickness (SF) < 7 mm and to question the reliability of thresholds as indicators of undernutrition. Design: Cross-sectional study; breakpoint analysis. Setting: Rural and urban regions of Indonesia and Guatemala – different socio-economic status (SES). Participants: 1716 Indonesian children (6·0–13·2 years) and 3838 Guatemalan children (4·0–18·9 years) with up to 50 % stunted children. Results: When separating the regression of BMI, MUAC or SF, on height into distinguishable segments (breakpoint analysis), we failed to detect relevant associations between height, and BMI, MUAC or SF, even in the thinnest and shortest children. For BMI and SF, the breakpoint analysis either failed to reach statistical significance or distinguished at breakpoints above critical thresholds. For MUAC, the breakpoint analysis yielded negative associations between MUAC/h and height in thin individuals. Only in high SES Guatemalan children, SF and height appeared mildly associated with R2 = 0·017. Conclusions: Currently used lower thresholds of height-for-age (stunting) do not show relevant associations with anthropometric indicators of energetic undernutrition. We recommend using the catch-up growth spurt during early re-feeding instead as immediate and sensitive indicator of past undernourishment. We discuss the primacy of education and social-economic-political-emotional circumstances as responsible factors for stunting.