The Relationship Between Stature, Growth, and Short-term Changes in Height and Weight in Normal Prepubertal Children

Abstract

Human growth is a nonlinear process with marked variation in growth rate during the short-term. It is not known how long-term height gain or stature is influenced by short-term changes in height and weight. This study has addressed these issues by using thrice weekly height and weight measurements during 1 year in 43 normal prepubertal children (aged 5.7-7.7 y) to construct individual height and weight velocity curves by regression analysis. The former were comprised of 3 to 6 growth spurts separated by stasis, whereas the latter were characterized by 2 to 5 periods of weight gain separated by periods of weight loss. Stepwise regression analysis to determine characteristics of these curves that influence stature and growth showed that height SD score was correlated to the mean absolute weight velocity amplitude (+), the mean length of height velocity peaks (-), and the number of periods of weight gain (-) (r2 = 38%). In contrast, change in height SD score (delta height SD score) was correlated to the number (+) and mean amplitude (+) of the periods of weight gain and the mean height velocity peak amplitude (+) (r2 = 44%). Examination of changes in height relative to weight during the year in the whole group revealed that height increased relative to weight in autumn and spring, whereas the reverse occurred during the winter months. We conclude that 1) both height and weight velocities during 1 year show a biphasic pattern, 2) there is seasonal variation in the short-term change in height relative to weight, and 3) prepubertal stature and the amount grown through the year are related to short-term changes in height and weight. Our data indicate that large but infrequent changes in weight with growth spurts of short duration are found in tall children. Good growth during the year was related to large but frequent gains in weight and large individual spurts in height.

Seasonal variations in growth and body composition of 8–11-y-old Danish children

“…A higher level of physical activity during spring than during winter may be a likely explanation for the changes in gains in body weight and body composition during winter and spring (22). Two newer studies are comparable with our study regarding latitude and population characteristics (11,12). Gelander et al found a peak in height velocity during spring among 50 Swedish 7-11-y olds measured in 1992-1993 (11); no data were available on weight or body composition.…”

“…Based on data from prepubertal British children, Tillmann et al concluded that in addition to a strong seasonal trend (height and body weight gains both highest during spring), linear growth was comprised of three to six yearly growth spurts separated by stasis, whereas weight gain was characterized by two to five periods of weight gain separated by periods of weight loss (12). Their study setup differed from ours by having fewer study subjects (n = 43), but more frequent measurements (biweekly for 1 y) and reporting average number, length and amplitude of height velocity peaks, and periods with growth stasis, weight gain, and weight loss based on averages of smooth estimates from individual height and weight velocity profiles (12). Most of the previous studies on seasonal variation in growth are not contemporary and results may reflect seasonal variations in food availability (1,9), impacts of infectious diseases (7), or other factors which are less relevant in contemporary cohort of school-aged children in highincome countries.…”

“…Among Japanese children, the seasonal variation in height and weight gains was attenuated from 1959-1963 to 1971-1975 (9), and no seasonal variation was detectable in 1982-1984 (10). However, two small studies from the 1990s from the United Kingdom and Sweden reported seasonal variations in height (11,12) and body weight (12) gains, and seasonal variation in circulating insulin-like growth factor 1 levels that were consistent with short-term variations in body weight and BMI and also consistent with long-term variations in height velocity (13). Furthermore, children treated for growth hormone deficiency showed the largest height velocity responses during spring and early summer (14) or when experiencing the largest sunlight exposure (15), despite equal doses of growth hormone throughout the year.…”

Sex Differences in the Relationships Among Weight Gain, Subcutaneous Skinfold Tissue and Saltatory Length Growth Spurts in Infancy

“…These observations may be relevant to previous conflicting reports regarding simultaneity versus. lag in the relationships between the timing of weight and height growth (37,38), suggesting effect modification by sex differences and accompanying environmental sensitivities. Males' reliance on fat stores for growth has been reported to be greater than females in late gestation (10), and phase shifts in weight and length growth have been reported to characterize the male fetus by contrast with copulsatility, more common among females (39).…”

Seasonality of growth response to GH therapy in prepubertal children with idiopathic growth hormone deficiency

“…who reported that in healthy prepubertal English children, growth starts to decrease in August, reaches a nadir in January, and exhibits a marked spurt from March to July (15,16). Since there are no major climatic and geographic differences between England and Germany (temperate climate, degree of latitude 58 8 249 8 and 55 8 247.5 8 respectively), the same subdivision was used even though it resulted in time intervals of different lengths (5 vs 7 months)…”