Tall Toddlers and Teens Have Lower Cholesterol as Adults

NORWICH, England, March 1 -- The way that toddlers and teens grow may protect them against high cholesterol levels in adulthood, researchers here found.

Every standard deviation greater height at age two years was associated with 0.119 mmol/L lower total cholesterol level at age 53, according to a longitudinal cohort study in the March 1 issue of the Journal of Epidemiology & Community Health.

Each standard deviation greater height velocity in the teenage years was linked to 0.073 mmol/L lower total cholesterol in adulthood, reported Paula M. L. Skidmore, Ph.D., of the University of East Anglia here, and colleagues.

However, rapid increase in body mass index (BMI) had the opposite effect.

Greater BMI increases from ages 15 to 36 and from 36 to 53 were associated with higher total cholesterol and LDL levels and lower HDLs.

The study included 2,311 men and women born in a single week in 1946 in England, Scotland, and Wales followed to age 53. Their heights and weights were measured at age two, four, seven, 11, 15, 36, 43 and 53, and a non-fasting blood sample to evaluate lipid levels was collected at age 53.

The 3.9% of men and 1.7% of women taking cholesterol-lowering drugs were excluded, which "essentially made no difference to any of the analyses."

Among the sex-adjusted findings, the researchers reported:

• Lower total cholesterol with greater height at every age (P?0.01 in all cases).
• A trend for lower total cholesterol with each standard deviation higher height velocity between ages seven and 15 (-0.063 mmol/l, 95% confidence interval -0.132 to 0.006, P=0.07) and from age 15 to 36 (-0.073 mmol/l, 95% CI -0.145 to -0.001, P=0.05).
• Significantly increased cholesterol at age 53 for each standard deviation greater growth in BMI between ages 15 to 36 (0.097 mmol/l, 95% CI 0.037 to 0.156, P=0.001) and 36 to 53 (0.156 mmol/l, 95% CI 0.099 to 0.214, P<0.001).
• Higher BMI from age 11 through 53 was associated with lower HDL cholesterol (P=0.02 at age 11 and P<0.001 thereafter).

Similar, but generally insignificant associations were seen for LDL cholesterol, possibly due to the use of nonfasting blood samples, the researchers said. The effects of growth were not explained by birth weight or lifetime socioeconomic status since adjusting for these factors "hardly changed" the findings.

Therefore, the researchers concluded:

"In those with poor early height growth who have higher total and LDL cholesterol levels, it may be particularly important to prevent fast BMI increases during adulthood which have a detrimental impact on HDL as well as total and LDL cholesterol levels."

Of the two components of height--leg height and trunk length--the researchers found that leg length at age 53 was most strongly related to cardiovascular risk factors.

Longer legs were related to significantly lower total cholesterol and LDL cholesterol (P<0.001 for both) whereas trunk length was not related to either (P=0.09 and P=0.96, respectively).

Leg length is influenced by environmental factors early in life, such as nutrition, infection and stress; whereas trunk length is more likely to reflect growth during puberty, Dr. Skidmore and colleagues said.

"Early life exposures, which restrict height growth in infancy, resulting in shorter adult leg length, may influence lipid levels in adult life," they wrote.

"Prevention of early life exposures, such as stress, infection and poor nutrition, are vital to ensure that infants reach their optimal height potential," they concluded. "Therefore it is vital that parents are aware of the importance of nutrition in babies and children."