CHILDHOOD LEG LENGTH AND ADULT MORTALITY - FOLLOW-UP OF THE CARNEGIE (BOYD-ORR) SURVEY OF DIET AND HEALTH IN PREWAR BRITAIN

Objective-To investigate the relation between childhood height, its co mponents-leg length and trunk length-and mortality in adulthood. Desig n-Cohort study based on the Carnegie (Boyd Orr) Survey of diet and hea lth in pre-war Britain, 1937-9. Setting-The 14 centres in England and Scotland that participated in the Carnegie Survey and where children w ere examined. Scottish centres: Aberdeen, Dundee, West Wemyss, Coaltow n of Wemyss, Hopeman, Methlick, Tarves, Barthol Chapel. English Centre s: Liverpool, Yorkshire, Barrow in Furness, Wisbech, Fulham, and Bethn al Green. Subjects-2990 boys and girls aged between 2 years and 14 yea rs 9 months when they were examined in 1937-9. These children were dra wn from 1134 families who underwent a one week assessment of family di et and home circumstances. Of these, 2547 (85%) have been traced and f lagged using the NHS Central Register. Main outcome measures-Age adjus ted overall, coronary heart disease, and cancer mortality in men and w omen in relation to age and sex specific z scores for height, leg leng th, and trunk length. All analyses were adjusted for the possible conf ounding effects of childhood and adult socioeconomic circumstances and childhood diet. Results-Leg length was the component of childhood hei ght most strongly associated with socioeconomic and dietary exposures. There was no significant relation between childhood height and overal l mortality. Height-mortality relations were observed in relation to b oth coronary heart disease (CHD) and cancer. Leg length was the compon ent of height most strongly related to cause specific mortality. In me n and women CHD mortality increased with decreasing childhood leg leng th. Men in the lowest leg length quintile had a relative risk (RR) of 2.5 (95% CI 1.0 to 6.2) compared to those with the longest legs (linea r trend p=0.14). Similarly, women in the lowest leg length quintile ha d a RR of 3.9 (95% CI 0.8 to 19.0; linear trend p<0.01). Adjustment fo r childhood and adult socioeconomic circumstances had little effect on these trends. In men, but not women, those who as children had long l egs experienced increased cancer mortality. The significant relations between anthropometry and both CHD and cancer mortality were restricte d to those aged < 8 years when measured. Conclusions-These findings su ggest that adverse diet and living conditions in childhood, for which leg length seems to be a particularly sensitive indicator, are associa ted with increased risk of CHD in adulthood and possibly reduced cance r risk. It is Likely that these influences operate after birth, during the first few years of life.