GENERAL

HEIGHT ASSESMENT

სიმაღლეში ზრდის შეფასება

Sort stature as a medical terminology describes the state of persons whose height is less than the height of people who are the same age, sex and ethnicity. In practice it's mostly used for evaluation of children's development.

What can the short stature indicate in clinical practice

A child with a short stature may be completely healthy. It's especially common when parents also have a short stature, because genetic is the main factor which determines the natural potential height.

Also must be considered that growth rate is very individual. Some children grow faster at an early age and others have active growth period later.

Sometimes growth may be affected by different diseases. In some cases the natural potential height can be achieved with treatment and in others treatment doesn't help and permanent short stature lasts.

Diseases that affect the growth

  • endocrine diseases:
    • growth hormone deficiency
    • Hypothyroidism (underactive thyroid gland)
    • diabetes
    • Cushing's disease
  • chronic illnesses:
    • heart diseases
    • bronchial asthma
    • inflammatory bowel diseases
    • kidney diseases
    • juvenile idiopathic arthritis
  • genetic disorders:
    • Down's syndrome
    • Turner's syndrome
    • Williams syndrome
  • bone and skeletal disorders:
    • rickets
    • achondroplasia
  • malnutrition - food deficiency

Standardized growth charts

The child's height must be measured accurately by pediatrician or pediatric endocrinologist. Then this data must be analyzed with so called standardized growth charts.

These charts are developed according to sex, age and the geographic region.

An important thing to consider is that the key point is how child's growth progresses over time, not how much height he or she has at a given time. It means that growth assessment must be dynamic process beginning from the birth.

The image below includes low normal, median and high normal numbers of height for Georgian boys and girls.

Remark: This information has just a general character for parents who are interested in comparison their child's height to others and doesn't have exact medical meaning.

The exact assessment and interpretation of any abnormal finding must be done only by physicians.

სიმაღლეში ზრდის შეფასება

How to interpret these numbers: For example, if the height of 10 years old boy is 123sm (low normal level), it means that 3% of Georgian boys with the same age are shorter. If 10 years old boy's height is 137sm (normal level), it means that 50% of the boys with same age are with the same height and if 10 years old boy's height is 150sm, it says that 97% of boys with the same age are shorter.

Growth dynamic in numbers

  1. Birth length:
    1. Average birth length is 50sm
    2. This length is doubled for 4 years age
    3. And triples for 13 years age
  2. Growing during the first year: 23-27sm
  3. Second year: 10-14sm
  4. Third year: 7,5-10sm
  5. Growing yearly before puberty: 6-7sm
  6. Growth during puberty:
    1. For boys: 10-14sm
    2. For girls: 8-12 sm

Calculate of natural height potential

Useful information is what is the person's natural height potential.

There are some different formulas to calculate this number. One of them is here:

  1. Make sum of mother's and father's heights in santimeters
  2. Substract 13sm from this number for girls and add 13sm to this number for boys
  3. Received number must be divided by 2.

The second method is: doubling 2 years old height for boys and doubling 18 months old height for girls.

When does the human's body stop growing

The growth rate is very intensive and rapid during the first 2 years. Then the rate is declined and the second pick presents after puberty starts.

This pick coincides with beginning of puberty for girls and in case of boys with the end of the puberty.

After the second pick the growth rate in declining to zero. This age is 16 years for girls and 18 years for boys.

Sometimes in the middle years the body height starts to reduce and this process becomes even more active in older ages. These changes are caused by thinning of spinal discs and also by other degenerative processes in the body.

An interesting fact is that the body height may decrease slightly (approximately 1,5sm) to the end of the day. It can be caused by decompression of spinal discs due to daily physical activities. This change is minor and usually stays undetected and it's fully recovered during the sleep at night.

Bone age assessment

Bone age assessment is the best way to get information if the growth potential is remained or not.

Children's bones have so called growth plates at the both end, where bone tissue is being made from the cartilage and as a result bone grows. When the all cartilage is replaced with bone tissue it means that growth plates are closed and body growing is ended.

After starting puberty, influence of gonadal hormones accelerates closure of growth plates.

Bone age is assessed exactly by checking the state of growth plates. Radiography of dominant hand (includes wrist, palm and fingers) is done for this purpose. Received image is compared with the images in standard bone age atlas and bone age is established.

Bone age is mostly matched to chronologic age. If there is any difference, medical assessment should be done to rule out any disease which can affect the growth.

General recommendations about how to promote physical growth ზოგადი რჩევები

Besides genetic, different environmental factors influence human's growth. Some of them can be affected by us during childhood and adolescent age.

  • Healthy eating: unprocessed food (fruits, vegetables), whole grain products, proteins, dairy products must be used mostly. Sugar, saturated fats, trans fats, salt usage must be restricted.
  • Sleeping hygiene: in children and adolescents proper amount of sleep is essential for growth. Full information about how much sleep is enough is given in the following article: SLEEP AND HORMONE BALANCE
  • Regular exercise for bone and muscular strength
  • Paying attention to good posture: it makes body to look higher. For maintenance of good posture it's good to play basketball, to swim, to do some stretching exercises such as Pilates and yoga. Such movements promote decompressing spinal discs. This recommendation is also useful for adults, when growth plates are already closed.

"Magic" pills to become higher is available neither for children nor for adults.

Growth hormone and other medications aren't used in healthy persons.

Written by: Elga Giorgadze, MD