For decades, it has been accepted as a truth that Asians are shorter than Americans and Europeans.
However, a study done in 2016 created the World Height Database, which showed how the world’s population has grown over the past century. Interestingly, different countries showed different growth rates, proving that genetics is not the only factor that determines height.
The study, published in the journal eLife, was co-ordinated by researchers at Imperial College London and based on data collected from 18.6 million people, measuring the height of men and women from different countries since 1914.
Among other things, the survey found that Japan’s population is growing faster than any other country in Asia.
For example, in the 1950s, the average height of Japanese men was 1.5 meters and women 1.49 meters, but by 2021 it had risen to 1.72 meters for men and 1.58 meters for women. This is also the result of the country taking nutrition seriously, such as through the establishment of nutritional intake guidelines and food safety management standards for school lunches.
However, paediatric endocrinologist Dr Azriyanti Anuar Zaini said the average Malaysian height had only increased by 10cm over the past 100 years and if this trend continued, Malaysian children would not grow up to be tall adults.
Being taller isn’t just about being taller: Being taller is associated with a longer life expectancy, a lower risk of premature death, and a lower risk of dying from cardiovascular disease, said Majid Ezzati, lead researcher of the 2016 study.
“Therefore, we need to empower parents to make informed decisions about their children’s nutrition,” Dr Azriyanti says.
Dr Azriyanti says nutrition, exercise and sleep are key to a child’s development. — Photo: Danone Malaysia
Treatment of growth failure
Height starts in early childhood, which means implementing effective interventions against stunting (low height for age), which currently affects about 30% of children aged 0-5 years in Malaysia.
Dr Azriyanti said some cases are presented to her late.
“I had a male patient who came to see me at 17 and was only 151cm tall. He was already nearing the end of puberty and there was nothing I could do to increase his height,” she says.
Her shortest patient was 17 years old and measured 144cm tall. “If parents feel their child is short for their age or is the shortest in their class, they should take them to the doctor as soon as possible,” she says.
“If patients come in earlier, around age 6 to 8, we can have something planned and the outcomes are better,” she said, adding that one female patient was 12 years old and 131cm tall, the shortest in her class.
“Awareness (about growth stunting) is now higher, but some parents are hesitant to take their children to the doctor, thinking that they will catch up eventually.”
Dr Azriyanti says nutrition is everything when it comes to a child’s development between the ages of zero and five. “After that, parents may want to get thyroid and growth hormone tests done. During puberty, hormones like testosterone for boys and estrogen for girls play a role,” she says.
She added that while the first five years of a Malaysian child’s life are monitored through vaccination records, after that growth monitoring “goes off the radar”, so parents should continue to monitor growth and seek medical advice if they are concerned about their child’s height.
“Compare your child’s height with those of their classmates and bring them in if you’re concerned. Trust your instincts, check the World Health Organization (WHO) child height and weight standards and compare them to your child’s height and weight.”
“If your child’s weight is within the ideal range, make sure they maintain it, otherwise they will stunt their growth,” she says.
Growth hormone is secreted during sleep, so children need to go to bed early and stick to a regular bedtime routine.
Achieving optimal growth
Dr Azriyanti says three factors influence a child’s development: nutrition, exercise and sleep. “These are modifiable factors that affect development and can be changed by parents.”
“It’s important that children go to bed regularly because that’s when growth hormones are secreted. If your child sleeps longer, that means they’ll have more of this hormone released, which is important for their development,” she adds.
“Exercise is another important factor for development. It helps children get a better night’s sleep, doubling their hormone peak.”
Contrary to conventional belief, swinging from a hanging bar won’t make a child taller, “but gravity-based exercises like running, walking and skipping may help,” she says.
When it comes to nutrition, eating right is just as important as eating regularly. She suggests parents to take food seriously. “Instead of feeding their children while they play, parents need to teach their children to sit at the dinner table and eat with the family. If children eat with their eyes glued to a screen, they will not pay attention to what they eat,” she says.
“Feeding your child with enough protein, both animal and plant-based, will also help them grow. Make sure the protein to carbohydrate ratio is right,” she adds.
Dr Yvonne Yee Siang Tee, global nutrition manager at Danone, says it’s important to re-educate picky eaters and increase the variety of foods they eat.
“The most important thing is for parents to set a good example, because children imitate what they see,” she says. “Parents should also encourage their children to be involved in mealtimes, not make a fuss if they make a mess at the table, and focus on the long-term goal of introducing a variety of foods to their children,” she says.
“Ultimately, we all need to get back to basics of nutrition, which is having a balanced and diverse range of foods on the table,” she says.
“Parents should be aware that while genes play a role, nutrition plays a much bigger role when it comes to their child’s development,” Dr Azriyanti concludes.
