Parents should monitor their child's height to ensure optimal growth. — Photos: 123rf
FOR decades, it was an accepted truth that Asians are shorter than Americans and Europeans.
But in 2016, a study produced a global height database and showed how the world population has grown in the last century. Interestingly, countries have different growth rates, proving that genetics isn’t a singular factor that determines height.
Published in the journal eLife, the study was coordinated by researchers from Imperial College London in Britain, measuring the heights of men and women from different countries since 1914 with data collected from 18.6 million people.
It found that, among others, that people in Japan have grown enormously, more quickly than any other country in Asia.
In the 1950s, for instance, the average height of Japanese men was 1.5m and women, 1.49m. But by 2021, this grew to 1.72m for men and 1.58m for women. This was, among others reasons, the result of the country taking nutrition seriously, with a nutritional intake standard and a food safety management standard for school diets.
Paediatric endocrinologist Dr Azriyanti Anuar Zaini says over the last 100 years however, the average height of Malaysians has increased by only 10cm and if this trend continues, Malaysian children will not grow up to be tall adults.
Being tall isn’t just about stature. The aforementioned 2016 study lead researcher Majid Ezzati said being taller is associated with longer life expectancy, lower risk of premature death, and a lower risk of dying of cardiovascular disease.
“We therefore, need to empower parents to make informed decisions about their kids’ nutrition,” Dr Azriyanti says.
Dr Azriyanti says nutrition, exercise and sleep are at play in a child's growth. — Photos: Danone Malaysia
Treating stunting
Being tall starts from childhood and this means putting in place, effective intervention for stunting – or being too short for one’s age – which currently affects about 30% of Malaysian children aged between zero and five years old.
Some cases, Dr Azriyanti says, are presented to her late.
“I had a male patient who came to me when he was 17, at only 151cm tall. He was already towards the end of puberty and there was nothing I could do to help him be taller,” she says.
The shortest patient she had was 144cm, also at 17 years old. “Parents should seek medical opinion early if they think that their child is short for age, or if he or she is the shortest in class,” she says.
“If the patient comes early – around six to eight years old – then we can map something and the outcome will be better,” she says, adding that she also has a female patient who, at 12 years old, is 131cm tall and the shortest in her class.
“The awareness (about stunting) is better now, but some parents are still reluctant to bring their child to see a doctor, thinking that the child will eventually catch-up on growth,”
Dr Azriyanti says between the age of zero and five years old, a child’s growth is all about nutrition. “After that, parents might want to check for thyroid or growth hormone and during puberty, hormones like testosterone and oestrogen play their role for boys and girls, respectively,” she says.
She adds the first five years of a Malaysian child’s life is monitored through vaccination records, but after that, their growth monitoring “falls off the radar” so parents need to continue to monitor growth and get medical advice if they are worried about their child’s height.
“Compare your child’s height with his or her classmates and bring them in if you are worried. Trust your instincts and check the World Health Organisation (WHO)’s standard reference of children’s height and weight and compare the reading with your child’s,”
“If your child is within an ideal weight range, maintain this otherwise his or her height will falter,” she says.
Growth hormone is released during sleep, which is why children should sleep early and have regular bedtime.
Achieving optimal growth
Three factors – nutrition, exercise and sleep – are at play in a child’s growth, Dr Azriyanti says. “These are modifiable factors that affect growth that parents can change.”
“It’s important for a child to have regular bedtime because it is during sleep that the growth hormone is released. If a child sleeps long, that means he or she enjoys that multiple growth hormone surge that’s important for growth,” she adds.
“Exercise is another important factor for growth. It helps the child sleep better at night and doubles the hormone surge peak.”
Contrary to traditional belief, swinging on a monkey bar does not make a child taller. “But gravitational exercises like running, walking or skipping might help,” she says.
When it comes to nutrition, eating right is as important as eating regularly. She suggests parents to take eating seriously. “Instead of feeding a child while he or she is playing, parents need to educate them to sit down at the dining table and eat with the family. When a child eats while the eyes are glued to the screen, he or she is not mindful of eating,” she says.
“Feeding a child with adequate protein both from animal and plant sources helps kids grow too. Make sure the ratio of protein to carbohydrate is proportionate,” she adds.
Danone global nutrition manager Dr Yvonne Yee Siang Tee says it is important to retrain children who are picky eaters, to increase the variety of food they eat.
“Most importantly, parents should be good role models because kids copy what they see,” she says. “Parents should also encourage kids to be involved with food and don’t kick up a fuss if kids mess up the dining table. Focus on the long-term goal, which is introducing kids to a variety of food,” she says.
“At the end of the day, we all need to go back to basic nutrition with a balanced and a variety of food on the plate,” she says.
“And when it comes to children’s growth, parents should know that genes play a role, but nutrition plays a bigger role,” Dr Azriyanti concludes.
