1. bookVolume 59 (2020): Issue 3 (September 2020)
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1854-2476
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29 Jul 2010
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Changes in the Growth and Development of Adolescents in a Country in Socio-Economic Transition 1993–2013

Published Online: 25 Jun 2020
Volume & Issue: Volume 59 (2020) - Issue 3 (September 2020)
Page range: 164 - 171
Received: 19 Nov 2019
Accepted: 02 Jun 2020
Journal Details
License
Format
Journal
eISSN
1854-2476
First Published
29 Jul 2010
Publication timeframe
4 times per year
Languages
English
INTRODUCTION

The growth and development of the human body from birth and through childhood and adolescence are reflected in body size and the proportions of body parts in adulthood (1). Different secular trends in human growth and development, e.g. changes in childhood growth patterns and earlier sexual maturation, have been observed in many countries over the last century (2). Important factors underlying the secular growth changes are environmental factors such as industrialisation (2) and an increase in general economic status (3). By monitoring changes of growth in children and adolescents of the same age from different generations who had been affected by such factors, it should be possible to determine the impact of these changes on the pattern, velocity and duration of an individual’s growth.

During childhood, different regions of the body experience different growth patterns (4). Distal parts of the limbs approach adult size sooner than their proximal parts (5): thus, in the lower extremities, the feet fully develop earlier than the tibia and the tibia grows faster (to an almost adult size) than the femur. The same pattern of growth is also observed in the upper extremities (6).

Childhood ends with puberty and adolescence. Puberty is the process of physical changes by which adolescents reach sexual maturity, i.e. become capable of reproduction, while adolescence can be described as a dynamic period characterised by rapid changes in body height, shape, and body structure, and by morphological gender differences (7). One of the characteristics of adolescence is the growth spurt, which is a period of accelerated leg growth that can be observed prior to accelerated trunk growth. In an interval during early adolescence, an individual will therefore have relatively long legs; this appearance will, however, disappear with the consequent increase in trunk length (8). Since females enter adolescence on average two years earlier than males, they have, on average, longer legs for a shorter period than males during early adolescence (9).

During their growth spurt, adolescents experience their peak height velocity (PHV), which is the fastest growth in body height (10). In females, PHV occurs between the ages of ten and 14 on average, which is approximately two years sooner than in males (11); this corresponds to the period of earlier entrance into adolescence in females compared to males (9). The age at PHV is the most commonly used indicator of biological maturity in longitudinal studies of puberty (1, 12), as data on age and corresponding body height is relatively easy and inexpensive to collect. By referring to PHV, we can accurately determine maximum growth during puberty and compare it between individuals (13). It has been reported that contemporary adolescents experience PHV (10) and final body height at a lower chronological age (2) than their peers in previous generations.

The aim of the present study is to assess whether the change in environmental factors over a 20-year period (when Slovenia experienced significant socio-economic transition) was influential enough to be reflected in altered growth and the age at which adolescents achieved sexual maturity. The twin objectives of the study were therefore to determine whether the ratio between leg and trunk length changed among 14-year-old adolescents between 1993 and 2013, and whether adolescents experienced PHV earlier in 2013 than did adolescents of the same age two decades earlier. An earlier beginning of sexual maturity could be reflected in an earlier start to trunk growth (and consequently a smaller leg-to-body height ratio and leg-to-trunk ratio in adolescents of the same age from different generations). We hypothesised that this should be primarily evident in females, as they enter puberty earlier than males.

METHODS
Observed Population

To achieve the aims of this study, basic anthropometric data was obtained from three samples of 14-year-old subjects in Slovenia: from a sample measured in 1993, from a second sample measured in 2003 and from a third sample measured in 2013.

Sampling Procedure

The present study is a part of the longitudinal ACDSi project (Analysis of Children’s Development in Slovenia), led by the Faculty of Sport of the University of Ljubljana, Slovenia and conducted in cooperation with other faculties. The project has been under way since 1970 (14). Measurements at primary schools take place every ten years in the same 11 locations all over Slovenia. The locations are selected to reflect four types of settlement (rural, rural-industrial, industrial-rural and industrial) and spread across the regions in order to be representative of the population as a whole (14). The project examines selected physical and developmental characteristics of children between the ages of 6 and 15. The measurements are pre-arranged with the administrators of the participating primary schools, with parental consent for participation being obtained in advance. In order to fulfil our research goals, we planned to include 200 children in each age- and sex-group, with an estimated drop-out rate of 15% (14).

Study Instruments and Measurements

Body height and leg length were measured. Body height was measured using a portable anthropometer (GPM, Switzerland). During this measurement, the subjects were barefoot, their back was straight, their hands were relaxed alongside the body, their feet and knees were together, their heels touched the anthropometer, and their head was held in the Frankfurt horizontal (15).

Leg length was measured as the iliospinal height (i.e. the vertical distance between the iliac spine and the floor) (16). A shortened portable anthropometer (GPM, Switzerland) was used for this purpose. During the measurements, the subjects stood with their knees and feet together, and the examiner positioned the top of the anthropometer at the anterior superior iliac spine of the pelvis. Trunk length was calculated by subtracting leg length from body height. The leg-to-body height ratio (i.e. leg length as a proportion of the height of the whole body) was calculated by dividing leg length by body height. The leg-to-trunk ratio was calculated by dividing leg length by trunk length.

In addition, body height data for adolescents who were 14 years old in either 1993 or 2013 was obtained over four consecutive years from ages 10 to 14 from the national surveillance system of somatic and motor development (SLOfit). The SLOfit measurements take place every year in April and cover children and adolescents from all Slovenian primary and secondary schools from ages 6 to 18. Annual increments in body height (cm/year) were calculated for each individual as the differences in their body height between two consecutive years. The largest annual increment in body height was adopted as the PHV, while the lower margin of an annual interval in which the PHV was observed was adopted as the age at PHV.

Methods of Analysis

Descriptive statistics (means and standard deviation (SD)) were obtained for subjects’ age, body height, leg and trunk length, as well as for both ratios. The values of the three generations were compared with a one-way analysis of variance (ANOVA) and Tukey’s HSD post-hoc test. A student’s t-test was used to compare PHV and age at PHV between the generations of 1993 and 2013. The level of statistical significance was set at p<0.05.

RESULTS
Description of the Study Group

Anthropometric data was obtained from a total of 1,221 adolescents (674 males and 551 females) measured in 1993, 2003 and 2013. Response rate was approximately 82%, which represents around 2% of the entire population of children in primary schools in Slovenia (14). Their mean age, body height, leg and trunk length, leg-to-body height ratio, and leg-to-trunk ratio, as well as the corresponding p-values for the comparisons between the three generations are presented in Table 1.

Typical values of body measurements (mean and standard deviation (SD)) in 14-year-old males and females in Slovenia in 1993, 2003 and 2013. ANOVA – one-way analysis of variance, HSD – honestly significant difference.

Year of measurementOne-way ANOVA (p)Tukey’s HSD test (p)
1993200320131993 vs. 20032003 vs. 20131993 vs. 2013
Males
Subject number [N]222236216
Age [years]14.1 (0.4)14.0 (0.3)14.2 (0.3)<0.001<0.001<0.0010.004
Body height [cm]167.6 (8.7)165.1 (8.3)169.0 (7.7)<0.0010.001<0.0010.089
Leg length [cm]96.4 (6.1)95.7 (5.8)98.9 (5.5)<0.0010.234<0.001<0.001
Trunk length [cm]71.3 (4.5)69.4 (4.5)70.1 (5.2)<0.001<0.0010.1030.012
Leg-to-body height ratio [%]57.5 (1.8)58.0 (1.8)58.5 (2.2)0.0170.0030.004<0.001
Leg-to-trunk ratio1.36 (0.10)1.38 (0.09)1.42 (0.16)<0.0010.0020.004<0.001
Females
Subject number [N]179209163
Age [years]14.0 (0.5)14.0 (0.3)14.2 (0.3)<0.0010.788<0.0010.002
Body height [cm]162.6 (6.8)161.2 (5.9)163.2 (5.9)0.0040.0280.0010.345
Leg length [cm]92.8 (4.8)92.1 (4.5)92.5 (4.6)0.3140.1290.4570.473
Trunk length [cm]69.8 (3.7)69.1 (3.8)70.8 (3.5)<0.0010.067<0.0010.009
Leg-to-body height ratio [%]57.1 (1.6)57.1 (1.9)56.6 (1.7)0.0110.7190.0060.009
Leg-to-trunk ratio1.33 (0.09)1.34 (0.12)1.31 (0.09)0.0160.6160.0100.011
Body Height

No significant differences in body height were detected in 14-year-old females between 1993 and 2013, although there was a trend (p=0.089) towards increasing body height in 14-year-old males. However, in comparison to the previous generation, males from the contemporary generation were taller at the age of 10 to 12 years. There was a noticeable difference in the body height of males and females between 1993 and 2003, and between the years 2003 and 2013. In both 1993 and 2013, males were on average 2.5 and 3.9 cm taller respectively, than their peers in 2003. Females in 2013 were on average 2 cm taller than their peers in 2003.

Leg and Trunk Length

In males, a significant difference in leg length and trunk length was observed between 1993 and 2013. Between 1993 and 2013, the leg length of males increased by an average of 2.5 cm, while their trunk length decreased by an average of 1.2 cm. In females, while leg length did not change significantly in the same 20-year period, trunk length did increase by an average of 1 cm between 1993 and 2013.

Leg-to-Body Height Ratio and Leg-to-Trunk Ratio

A comparison of leg-to-body height ratio and leg-to-trunk ratio between the generations of males from 1993, 2003 and 2013 demonstrates that relative leg length (i.e. in comparison with the rest of the body) increased significantly with each decade. The leg-to-body height ratio increased by 0.5 percentage points, i.e. from 57.5% to 58.5% in the period observed. In females, leg-to-body height ratio remained unchanged between 1993 and 2003 (57.1%), falling significantly to 56.6% in 2013. The leg-to-trunk ratio increased by approximately 0.03, i.e. from 1.36 to 1.42 in the period observed. In females, the legto-trunk ratio remained unchanged between 1993 and 2003 (at approx. 1.33) and fell significantly to 1.31 in 2013. This means that leg length accounted for a lower percentage of total body height and trunk with head for a larger percentage of total body height in females in 2013 in comparison to females from previous generations.

Peak Height Velocity (PHV)

For the calculation of PHV and age at PHV, data was successfully obtained from 236 14-year-old adolescents from 1993 and 311 14-year-old adolescents from 2013. The mean (SD) age at PHV determined for males of the 1993 and 2013 generations was 12.9 (1.0) and 12.7 (1.0) years respectively. The observed difference was close to the level of statistical significance (p=0.077). Females of the 1993 and 2013 generations were, on average, 11.4 (1.1) and 11.2 (1.0) years old at PHV, i.e. a trend similar to that in males was observed (p=0.071). Table 2 presents the number of adolescents of the 1993 and 2013 generations, who reached PHV at a particular age, values of their mean PHV for a particular age, as well as the corresponding p-values for the comparisons between the two generations.

Mean (standard deviation (SD)) peak height velocity (PHV) of males and females in the 1993 and 2013 generations. Height increments for the calculation of PHV were obtained for each subject of the two generations from the annual anthropometric measurements performed nationally at schools. Any presented age is the lower margin of an annual interval in which the PHV was observed. The t-test relates to a difference in PHV between 1993 and 2013. NA – not applicable.

Year of measurementNo of subjects [N {%}]PHV [cm/year (SD)]T-test [p]
19932013199320131993 vs. 2013
Males
Age at PHV [years]
  104 {3}2 {1}6.8 (2.3)10.2 (5.4)NA
  115 {5}33 {16}11.0 (0.4)8.6 (1.9)0.003
  1234 {29}33 {16}10.1 (2.2)9.2 (1.8)0.037
  1340 {33}97 {46}9.4 (2.0)9.9 (1.5)0.048
  1436 {30}44 {21}9.5 (1.5)9.2 (2.1)0.237
Total119 {100}209 {100}9.6 (2.0)9.4 (1.9)0.203
Females
Age at PHV [years]
  1030 {26}32 {31}8.4 (1.8)8.0 (1.7)0.220
  1132 {27}34 {33}8.5 (1.7)7.8 (1.2)0.042
  1244 {38}25 {25}8.4 (1.4)8.1 (2.2)0.282
  136 {5}10 {10}8.1 (1.9)8.2 (2.5)0.413
  145 {4}1 {1}7.2 (0.8)7.0 (NA)NA
Total117 {100}102 {100}8.3 (1.6)8.0 (1.7)0.066
DISCUSSION
The Most Important Results of the Study

The results of the present study demonstrate that contemporary generations experience PHV at a younger age. This is true for both genders, even in adolescents born no more than two decades (1993, 2013) apart. As expected, females in both generations experienced PHV sooner than their male peers. The comparison between the 1993, 2003 and 2013 generations demonstrates that males have longer legs and females longer trunks in the latest generation compared to the two previous generations. At the same time, it appears that contemporary females and males experience somewhat different pubertal growth patterns in terms of intensity. While both experience earlier PHV, females experience a growth intensity that is similar to that of previous generations (of females), resulting in earlier conclusion of pubertal growth, while males experience earlier PHV than in previous generations, but also lower intensity. This results in their slower (although longer) pubertal growth. Related to the above, leg-to-body height ratio and leg-to-trunk ratio increased significantly in males and decreased significantly in females over the time period observed.

Comparison of the Results to the Results of Similar Studies

It has been reported that adolescence in females starts at least two years earlier than in males: females enter adolescence at the age of around 11 years on average and males at the age of 13 years on average (17, 18). Females also reach PHV earlier than males, as was confirmed in the study by Malina et al. (8) performed in North America and Europe between 1988 and 1998. In this study, females reached PHV between the ages of 11.3 (11 years and 4 months) and 12.2 years (12 years and 2 months), and males between the ages of 13.3 (13 years and 4 months) and 14.4 (14 years and 5 months). The study by Malina et al. (8) therefore observed a difference in age at PHV between the genders of approx. two years. This observation can be confirmed by the results of the present study, with females in the 1993 and 2013 generations reaching PHV approximately 1.5 years sooner than their male peers.

The comparison of PHV attainment between the 1993 and 2013 generations demonstrates that PHV was experienced earlier in the 2013 generation, suggesting an earlier onset of puberty in the most recent generation. In both genders, the age at PHV decreased for 3 months over a twenty-year period on average. This is consistent with findings from other studies from Denmark (18), Sweden (19), Japan (20), and Portugal (21), covering a longer period of 50 years or more, during which time these countries underwent an economic transition similar to Slovenia’s, albeit at a slower pace. There is a lack of data on age at PHV across Eastern and Southern Europe, as most of the studies have focused on age at menarche (e.g. Croatia (22), Poland (23)).

In terms of the growth of various parts of the body in human beings, legs are a part of the body, that grow faster than other segments from birth to puberty (5). The leg length of males and females from our study was quite similar to the situation reported for a wider region, e.g. in Croatia in 1997, where leg length at the age of 14 years was 99.0 cm in males (N=225) and 93.8 cm in females (N=209) (24). In most other studies of Eastern Europe (e.g. 25) leg length was obtained by subtracting sitting height from body height, which prevents a direct comparison of results. In our study, the leg-to-body height ratio and leg-to-trunk ratio – the proportion of leg length to trunk length – increased significantly in males over the three generations observed. By contrast, both ratios diminished in females over the course of the same 20-year period. According to the results of the present study, we can reasonably assume that females from the 2013 generation entered puberty sooner than females of previous generations. Moreover, it is most likely that girls from the 2013 generation had already been experiencing the trunk growth stage at the time the measurements were taken, in contrast to previous generations. This is supported by the leg-to-trunk ratio data, which indicates that in the most recent generation of females leg length accounted for a lower percentage of total body height then was the case with females from previous generations. In contrast, the leg length of males from the 2013 generation accounted for a larger percentage of total body height in comparison with males from previous generations. This indicates that, despite their earlier PHV timing, males from the 2013 generation were at an earlier phase of trunk growth than their peers from previous generations, which indicates that pubertal growth intensity was lower than in previous generations.

Our results regarding gender-specific changes in trunk and leg growth between adolescents of the same age between 1993 and 2013 (i.e. longer legs in males and longer trunks in females than in previous generations) are consistent with the study conducted by Bowles (26), where sitting height and leg length were compared at the same age between sons and fathers, as well as daughters and mothers, enrolled at Harvard University between 1840 and 1930 (all subjects had a high social status). In this study, sons were taller and heavier, and had a greater legto-body height ratio than their fathers, suggesting that, on a relative basis, the greatest change in the length of body segments between the generations appeared in the legs. Daughters were taller and heavier than their mothers, but had a greater trunk-to-body height ratio, suggesting that they had already entered the trunk growth stage. No data on PHV timing was reported for the participants (27).

Keyfitz (28) and Meredith and Meredith (29) reported that the mean height of ten-year-old children in 1892, 1923, 1930 and 1939 increased by 1.5 cm per decade. The observed secular trend in body height was caused by several factors. Although healthier diet was a strong factor, it could not be the sole responsible factor, as the same trend has been observed in various societies irrespective of the economic or social status of their individuals (30). In the present study, we did not detect significant differences in body height between the 14-year-old adolescents of the 1993 and 2013 generations. This was true for both genders. Interestingly, the body height of 14-year-old adolescents of the 2003 generation was less than that of the 1993 or 2013 generations. It is possible that the increase in body height in 1993 was superficial and influenced by the large number of child refugees from Bosnia and Herzegovina (31) who attended Slovenian schools in 1993, but who left Slovenia after 1995 (existing evidence shows that the population of Bosnia and Herzegovina is among the tallest in Europe (32)). The overall increase in mean body height between 2003 and 2013 may partly be explained by the process of economic transition, with Slovenia being one of a group of European countries in which significant social and economic changes have taken place in recent decades (33). The transition began in Slovenia in 1991 with the disintegration of the former Yugoslavia, the introduction of consumerism, increased nutritional intake from increased sale of highly processed food, and an increase in sedentary lifestyles resulting from increased use of screen technology. Entry into the European Union in 2004 and the subsequent closing of the gap with wealthier countries resulted in a significant change in GDP: from EUR 11 billion in 1993 to EUR 26 billion in 2003 to EUR 36 billion in 2013 (34). Significant (albeit less drastic) socioeconomic changes were also observable in the decades prior to Slovenia gaining independence (34).

In many societies, improved environmental conditions have enabled children to reach their genetic maximum growth potential (7), which is the ability of an individual to reach their theoretical maximum height with proper development, training and nutrition. It has also been reported that puberty begins earlier in children who live in developed countries (35) and whose parents have a good social position (which is determined by good economic status, social power and reputation) (2). Despite the lack of evidence regarding the influence of socio-economic transition on pubertal growth in Eastern Europe, there is evidence that, with economic growth and consequently improved living conditions, the share of children from the region who are short for their age has decreased (36) and their BMI increased (37). Once the conditions for achieving maximum growth potential are established, full body height is probably attained first and earlier development established later. In our study on a sample from Slovenia, a country that is still undergoing economic transition, no significant differences in body height were observed between 14-year-old adolescents born 20 years apart. However, we did observe a trend towards PHV timing in the most recent generation.

Limitations and Strengths of the Study

Limitations of our study were that we examined just as much particiapants to satisfy the criteria for the recommended sample size, furthermore, we did not ask the participants for ethnicity, also we did not determine the Tanner stages for pubertal development, as this is an invasive approach, which would risk higher refusal rates, and self-report approach by the children or their parents would result in 30-40% error. We did not use the same measuring device over 20 years, but we used device of identical standard, and body height was obtained only once a year and therefore also the observed difference in age at PHV. However, on the other hand our study has important strengths, as it is a longitudinal monitoring of children with a large number of different measurements and highly trained measuring team.

Importance of the Study for Public Health

According to the above, we can conclude that our study is important for public health, as it demonstrates that the socio-economic changes in Slovenia, that included a three-time increase in national GDP over the period of 20 years, were profound enough to result in earlier attainment of PHV in adolescents and, through earlier entrance into the period of the trunk growth, a change in body proportions over the observed two-decade period.

Possibilities for Future Research in the Field

In future research it can be reasonably assumed that the difference in age at PHV between generations would be even more pronounced, if the age at PHV could be determined more accurately for each individual, and measuring of sitting height would give us possibility to calculate leg length as substracting sitting height from body height, which would enable comparison of our results with similar studies in other countries.

CONCLUSION

In 14-year old males, leg-to-body height ratio increased with each decade from 1993 to 2013 due to the increased growth of legs in males and slower overall intensity of pubertal growth despite the earlier PHV timing in the most recent generation. In 14-year-old females, exactly the opposite phenomenon was observed (it was due to trunk growth). The differences in the results between the genders can be explained by the fact that females enter puberty earlier. While they were at the same chronological age as the males, they were, according to the results of this study, already in the trunk growth stage. The present study demonstrates that even when environmental changes occur over a relatively short period of time (20 years in this case), they can affect growth/developmental patterns. The provision of a favourable environment that allows children to achieve their maximum growth potential is therefore of the utmost importance.

Typical values of body measurements (mean and standard deviation (SD)) in 14-year-old males and females in Slovenia in 1993, 2003 and 2013. ANOVA – one-way analysis of variance, HSD – honestly significant difference.

Year of measurementOne-way ANOVA (p)Tukey’s HSD test (p)
1993200320131993 vs. 20032003 vs. 20131993 vs. 2013
Males
Subject number [N]222236216
Age [years]14.1 (0.4)14.0 (0.3)14.2 (0.3)<0.001<0.001<0.0010.004
Body height [cm]167.6 (8.7)165.1 (8.3)169.0 (7.7)<0.0010.001<0.0010.089
Leg length [cm]96.4 (6.1)95.7 (5.8)98.9 (5.5)<0.0010.234<0.001<0.001
Trunk length [cm]71.3 (4.5)69.4 (4.5)70.1 (5.2)<0.001<0.0010.1030.012
Leg-to-body height ratio [%]57.5 (1.8)58.0 (1.8)58.5 (2.2)0.0170.0030.004<0.001
Leg-to-trunk ratio1.36 (0.10)1.38 (0.09)1.42 (0.16)<0.0010.0020.004<0.001
Females
Subject number [N]179209163
Age [years]14.0 (0.5)14.0 (0.3)14.2 (0.3)<0.0010.788<0.0010.002
Body height [cm]162.6 (6.8)161.2 (5.9)163.2 (5.9)0.0040.0280.0010.345
Leg length [cm]92.8 (4.8)92.1 (4.5)92.5 (4.6)0.3140.1290.4570.473
Trunk length [cm]69.8 (3.7)69.1 (3.8)70.8 (3.5)<0.0010.067<0.0010.009
Leg-to-body height ratio [%]57.1 (1.6)57.1 (1.9)56.6 (1.7)0.0110.7190.0060.009
Leg-to-trunk ratio1.33 (0.09)1.34 (0.12)1.31 (0.09)0.0160.6160.0100.011

Mean (standard deviation (SD)) peak height velocity (PHV) of males and females in the 1993 and 2013 generations. Height increments for the calculation of PHV were obtained for each subject of the two generations from the annual anthropometric measurements performed nationally at schools. Any presented age is the lower margin of an annual interval in which the PHV was observed. The t-test relates to a difference in PHV between 1993 and 2013. NA – not applicable.

Year of measurementNo of subjects [N {%}]PHV [cm/year (SD)]T-test [p]
19932013199320131993 vs. 2013
Males
Age at PHV [years]
  104 {3}2 {1}6.8 (2.3)10.2 (5.4)NA
  115 {5}33 {16}11.0 (0.4)8.6 (1.9)0.003
  1234 {29}33 {16}10.1 (2.2)9.2 (1.8)0.037
  1340 {33}97 {46}9.4 (2.0)9.9 (1.5)0.048
  1436 {30}44 {21}9.5 (1.5)9.2 (2.1)0.237
Total119 {100}209 {100}9.6 (2.0)9.4 (1.9)0.203
Females
Age at PHV [years]
  1030 {26}32 {31}8.4 (1.8)8.0 (1.7)0.220
  1132 {27}34 {33}8.5 (1.7)7.8 (1.2)0.042
  1244 {38}25 {25}8.4 (1.4)8.1 (2.2)0.282
  136 {5}10 {10}8.1 (1.9)8.2 (2.5)0.413
  145 {4}1 {1}7.2 (0.8)7.0 (NA)NA
Total117 {100}102 {100}8.3 (1.6)8.0 (1.7)0.066

Molnar S. Human variation: races, types and ethnic groups. 6th ed. New Jersey: Pearson Prentice Hall, 2005.MolnarS.Human variation: races, types and ethnic groups6th edNew JerseyPearson Prentice Hall2005Search in Google Scholar

Amselem S, Carel JC, De Roux N, Issad T, Maccari S, Prevot V, et al. Growth and puberty: secular trends, environmental and genetic factors. Inserm Collective Expert Reports. 2007. Accessed November 19th, 2019 at: https://www.ncbi.nlm.nih.gov/books/NBK10786/.AmselemSCarelJCDe RouxNIssadTMaccariSPrevotVGrowth and puberty: secular trends, environmental and genetic factorsInserm Collective Expert Reports2007Accessed November 19th, 2019 at: https://www.ncbi.nlm.nih.gov/books/NBK10786/.Search in Google Scholar

Spear BA. Adolescent growth and development. In: Rickert VI, editor. Nutrition: assessment and management. New York: Chapman and Hall, 1996;3–24.SpearBA.Adolescent growth and developmentIn:RickertVIeditor.Nutrition: assessment and managementNew YorkChapman and Hall199632410.1016/S0002-8223(02)90418-9Search in Google Scholar

Bogin B, Varela-Silva MI. Leg length, body proportion, and health: a review with a note on beauty. Int J Environ Res Public Health. 2010;7:1047–53. doi: 10.3390/ijerph7031047.BoginBVarela-SilvaMILeg length, body proportion, and health: a review with a note on beautyInt J Environ Res Public Health2010710475310.3390/ijerph7031047287230220617018Open DOISearch in Google Scholar

Hermanussen M. Growth in childhood and puberty. In: Kumanov P, Agarwal A. Puberty: physiology and abnormalities. 2016;65–76. doi: 10.1007/978-3-319-32122-6_5.HermanussenM.Growth in childhood and pubertyIn:KumanovPAgarwalAPuberty: physiology and abnormalities2016657610.1007/978-3-319-32122-6_5Open DOISearch in Google Scholar

Shephard RJ. Body composition in biological anthropology. Cambridge: University Press, 1991.ShephardRJ.Body composition in biological anthropologyCambridgeUniversity Press1991Search in Google Scholar

Rogol AD, Clark PA, Roemmich JN. Growth and pubertal development in children and adolescents: effects of diet and physical activity. Am J Clin Nutr. 2000;72:521S–8S. doi: 10.1093/ajcn/72.2.521S.RogolADClarkPARoemmichJNGrowth and pubertal development in children and adolescents: effects of diet and physical activityAm J Clin Nutr200072521S8S10.1093/ajcn/72.2.521S10919954Open DOISearch in Google Scholar

Malina RM, Bouchard C, Bar-Or O. Growth, maturation, and physical activity. 2nd ed. Illinois: Human Kinetics, 2004.MalinaRMBouchardCBar-OrOGrowth, maturation, and physical activity2nd edIllinoisHuman Kinetics200410.5040/9781492596837Search in Google Scholar

Armstrong N, van Mechelen W. Oxford textbook of children’s sport and exercise medicine. 3rd ed. Oxford: University Press, 2017.ArmstrongNvan MechelenWOxford textbook of children’s sport and exercise medicine3rd edOxfordUniversity Press201710.1093/med/9780198757672.001.0001Search in Google Scholar

Lloyd RS, Oliver JL. The youth physical development model: a new approach to long-term athletic development. J Strength Cond Res. 2012;34:61–72. doi: 10.1519/JSC.0000000000000756.LloydRSOliverJLThe youth physical development model: a new approach to long-term athletic developmentJ Strength Cond Res201234617210.1519/JSC.000000000000075625486295Open DOISearch in Google Scholar

Balyi I, Way R. The role of monitoring growth in long-term athlete development. Canadian Sport for Life, 2005. Accessed November 19th, 2019 at: http://sportforlife.ca/wp-content/uploads/2016/11/the-role-of-monitoring-growth-in-dlta.pdf.BalyiIWayRThe role of monitoring growth in long-term athlete developmentCanadian Sport for Life2005Accessed November 19th, 2019 at: http://sportforlife.ca/wp-content/uploads/2016/11/the-role-of-monitoring-growth-in-dlta.pdf.Search in Google Scholar

Beunen GP, Rogol AD, Malina RM. Indicators of biological maturation and secular changes in biological maturation. Food Nutr Bull. 2006;27:S244–56.BeunenGPRogolADMalinaRMIndicators of biological maturation and secular changes in biological maturationFood Nutr Bull200627S2445610.1177/15648265060274S50817361661Search in Google Scholar

Mirwald RL, Baxter - Jones AD, Bailey DA, Baunen GP. An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc. 2002;34:689–94.MirwaldRLBaxter - JonesADBaileyDABaunenGPAn assessment of maturity from anthropometric measurementsMed Sci Sports Exerc2002346899410.1249/00005768-200204000-00020Search in Google Scholar

Jurak G, Kovač M, Starc G. The ACDSi 2013: The analysis of children’s development in Slovenia 2013: study protocol. Anthropol Noteb. 2013;19:123–43.JurakGKovačMStarcGThe ACDSi 2013: The analysis of children’s development in Slovenia 2013: study protocolAnthropol Noteb20131912343Search in Google Scholar

Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Illinois: Human Kinetics, 1988.LohmanTGRocheAFMartorellRAnthropometric standardization reference manualIllinoisHuman Kinetics1988Search in Google Scholar

Anon. Oxford Reference. Oxford: University Press, 2015.AnonOxford ReferenceOxfordUniversity Press2015Search in Google Scholar

Tanner JM, Whitehouse RH, Marshall WA, Carter BS. Prediction of adult height from height, bone age, and occurrence of menarche, at ages 4 to 16 with allowance for midparent height. Arch Dis Child. 1975;50:14–26.TannerJMWhitehouseRHMarshallWACarterBSPrediction of adult height from height, bone age, and occurrence of menarche, at ages 4 to 16 with allowance for midparent heightArch Dis Child197550142610.1136/adc.50.1.141544488164838Search in Google Scholar

Aksglaede L, Olsen LW, Sørensen TI, Juul A. Forty years trends in timing of pubertal growth spurt in 157,000 Danish school children. PLoS One. 2008;3:e2728. doi: 10.1371/journal.pone.0002728.AksglaedeLOlsenLWSørensenTIJuulAForty years trends in timing of pubertal growth spurt in 157,000 Danish school childrenPLoS One20083e272810.1371/journal.pone.0002728Open DOISearch in Google Scholar

Karlberg J. secular trends in pubertal development. Horm Res. 2002;57:19–30.KarlbergJ.secular trends in pubertal developmentHorm Res200257193010.1159/000058096Search in Google Scholar

Ali MA, Lestrel PE, Ohtsuki F. Secular trends for takeoff and maximum adolescent growth for eight decades of Japanese cohort data. Am J Hum Biol. 2000;12:702–12.AliMALestrelPEOhtsukiFSecular trends for takeoff and maximum adolescent growth for eight decades of Japanese cohort dataAm J Hum Biol2000127021210.1002/1520-6300(200009/10)12:5<702::AID-AJHB15>3.0.CO;2-WSearch in Google Scholar

Cardoso HF, Padez C. Changes in height, weight, BMI and in the prevalence of obesity among 9- to 11-year-old affluent Portuguese schoolboys, between 1960 and 2000. Ann Hum Biol. 2008;35(6):624–38. doi: 10.1080/03014460802464200.CardosoHFPadezCChanges in height, weight, BMI and in the prevalence of obesity among 9- to 11-year-old affluent Portuguese schoolboys, between 1960 and 2000Ann Hum Biol20083566243810.1080/03014460802464200Open DOISearch in Google Scholar

Prebeg Z. Changes in growth patterns in Zagreb school children related to socio-economic background over the period 1973–1991. Ann Hum Biol. 1998;25(5):425–39.PrebegZ.Changes in growth patterns in Zagreb school children related to socio-economic background over the period 1973–1991Ann Hum Biol19982554253910.1080/03014469800006672Search in Google Scholar

Saczuk J, Wasiluk A, Wilczewski A. Body height and age at menarche of girls from eastern Poland in the period of political transformation. Anthropol Rev. 2018;81(2):130–45.SaczukJWasilukAWilczewskiABody height and age at menarche of girls from eastern Poland in the period of political transformationAnthropol Rev20188121304510.2478/anre-2018-0010Search in Google Scholar

Živičnjak M, Narancic NS, Szirovicza L, Franke D, Hrenovic J, Bisof V. Gender-specific growth patterns for stature, sitting height and limbs length in Croatian children and youth (3 to 18 years of age). Coll Antropol. 2003;27:321–34.ŽivičnjakMNarancicNSSziroviczaLFrankeDHrenovicJBisofVGender-specific growth patterns for stature, sitting height and limbs length in Croatian children and youth (3 to 18 years of age)Coll Antropol20032732134Search in Google Scholar

Webb E, Kuh D, Peasey A, Pajak A, Malyutina S, Kubinova R, et al. Childhood socioeconomic circumstances and adult height and leg length in central and eastern Europe. J Epidemiol Community Health. 2008;62(4):351–7. doi: 10.1136/jech.2006.056457.WebbEKuhDPeaseyAPajakAMalyutinaSKubinovaRChildhood socioeconomic circumstances and adult height and leg length in central and eastern EuropeJ Epidemiol Community Health2008624351710.1136/jech.2006.056457Open DOISearch in Google Scholar

Bowles GT. New types of old Americans at Harvard and at eastern women’s colleges. 1st ed. Cambridge: Harvard University Press, 1932.BowlesGT.New types of old Americans at Harvard and at eastern women’s colleges1st edCambridgeHarvard University Press1932Search in Google Scholar

Himes JH. Secular changes in body proportions and composition. In: Roche AF, editor. Secular trends in human growth, maturation, and development. Monographs of the society for research in child development. Chicago: University of Chicago Press, 1979;28–58.HimesJH.Secular changes in body proportions and compositionIn:RocheAFeditor.Secular trends in human growth, maturation, and development. Monographs of the society for research in child developmentChicagoUniversity of Chicago Press1979285810.2307/1165884Search in Google Scholar

Keyfitz NA. A height and weight survey of Toronto elementary school children, 1939. Ottawa: Minister of trade and commerce, 1942.KeyfitzNA.A height and weight survey of Toronto elementary school children, 1939OttawaMinister of trade and commerce1942Search in Google Scholar

Meredith HV, Meredith EM. The stature of Toronto children half a century ago and today. Hum Biol. 1944;16:126–31.MeredithHVMeredithEMThe stature of Toronto children half a century ago and todayHum Biol19441612631Search in Google Scholar

Malina RM. Secular changes in size and maturity: causes and effects. In: Roche AF, editor. Secular trends in human growth, maturation, and development. Monographs of the society for research in child development. Chicago: University of Chicago Press, 1979;59–102.MalinaRM.Secular changes in size and maturity: causes and effectsIn:RocheAFeditor.Secular trends in human growth, maturation, and development. Monographs of the society for research in child developmentChicagoUniversity of Chicago Press19795910210.2307/1165885Search in Google Scholar

Hadžihalilović J, Hadžiselimović R. Growth and development of male children and youth in Tuzla’s region after the war in Bosnia and Herzegovina. Coll Antropol, 2001;25(1):41–58.HadžihalilovićJHadžiselimovićRGrowth and development of male children and youth in Tuzla’s region after the war in Bosnia and HerzegovinaColl Antropol20012514158Search in Google Scholar

Gardasevic J, Rasidagic F, Krivokapic D, Corluka M, Bjelica D. Stature and its estimation utilizing arm span measurements in male adolescents from Federation of Bosnia and Herzegovina Entity in Bosnia and Herzegovina. Monten J Sports Sci Med, 2017;6(1):37.GardasevicJRasidagicFKrivokapicDCorlukaMBjelicaDStature and its estimation utilizing arm span measurements in male adolescents from Federation of Bosnia and Herzegovina Entity in Bosnia and HerzegovinaMonten J Sports Sci Med20176137Search in Google Scholar

Zdešar Kotnik K, Golja P. Changes in body composition of university students in a country in socio-economic transition. Anthropol Anz. 2012;69:261–71. doi: 10.1127/0003-5548/2012/0198.Zdešar KotnikKGoljaPChanges in body composition of university students in a country in socio-economic transitionAnthropol Anz2012692617110.1127/0003-5548/2012/0198Open DOISearch in Google Scholar

Statistical Office of the Republic of Slovenia, 2019. Accessed November 19th, 2019 at: https://www.stat.si/StatWeb/en/Field/Index/1.Statistical Office of the Republic of Slovenia2019Accessed November 19th, 2019 at: https://www.stat.si/StatWeb/en/Field/Index/1.Search in Google Scholar

Gluckman PD, Hanson MA. Evolution, development and timing of puberty. Trends Endocrinol Metab. 2006;17:7–12. doi:10.1016/j.tem.2005.11.006.GluckmanPDHansonMAEvolution, development and timing of pubertyTrends Endocrinol Metab20061771210.1016/j.tem.2005.11.006Open DOISearch in Google Scholar

Skoufias E. Determinants of child health during the economic transition in Romania. World Dev. 1998;26(11):2045–56.SkoufiasE.Determinants of child health during the economic transition in RomaniaWorld Dev1998261120455610.1016/S0305-750X(98)00090-4Search in Google Scholar

Kozieł S, Welon Z, Bielicki T, Szklarska A, Ulijaszek S. The effect of the economic transition on the body mass index of conscripts in Poland. Econ Hum Biol. 2004;2(1):97–106.KoziełSWelonZBielickiTSzklarskaAUlijaszekSThe effect of the economic transition on the body mass index of conscripts in PolandEcon Hum Biol2004219710610.1016/j.ehb.2003.12.00215463996Search in Google Scholar

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