Growth and puberty in German children: is there still a positive secular trend?

Abstract

Background: Since the mid-19th century, growth in German children has accelerated and final height increased. Possible causes of this secular trend include improvements in nutrition, hygiene, and health care. While the upward secular trend still continues in some parts of the world, it seems to be slowing in industrialized countries.

Methods: Selective literature review.

Results: Reliable data on growth that have been published since the middle of the 19th century reveal an increase in final height by 1 to 2 cm per decade in most European countries. Recent epidemiological studies, however, suggest that human height may be nearing an upper limit, beyond which it cannot increase even with further improvements in nutrition and health care. In Germany and other northern European countries, the upward trend in final height has slowed significantly over the last 30 years; in Germany, it now stands at less than 1 cm/decade. In the same interval, the age at menarche has remained constant at just under 13 years (currently 12.8).

Conclusions: In Germany, as elsewhere in northern Europe, the upward secular trend in height is slowing (ca. 2 cm/decade up to the mid-20th century, currently less than 1 cm/decade), and the age at menarche has stabilized at just under 13 years. It remains an open question whether the observed slowing will merely be temporary, or whether it indeed represents the near-attainment of an endpoint owing to relatively stable environmental conditions.

Keywords: child health; growth; puberty; quality of life; short stature.

Figure 1

Secular trend of the average height of adult males—an international comparison. The increase in height (in cm) per decade within the bracketed time frame (years) is shown (from [5])

Figure 2

Development of average height in East and West Germany, USA and Japan in dependence on the birth cohort in 1998 (from [11, 12, e3]). a) Height in women b) Height in men

Figure 3

Average height of East and West German recruits at military draft in dependence on birth cohort (from [13])

Figure 4

ST of physical maturation—a European comparison. The mean age at menarche at the time of the cross-sectional study is stated; (from [5, 17, 18, e7]).