How to improve children’s height

04/05/2023

Genetic factors only determine 60 – 70% of a child’s adult height while the rest is determined by nutrition, exercise and daily sleep.

According to the results of the 2019 – 2020 National Nutrition Investigation, the average height of Vietnamese young adults has had a remarkable change.

The average height of women reached 156.2 cm (2010: 154.8cm) and the average height of men reached 168.1 cm (an increase of 3.7cm compared to 2010: 164.4cm)1. This is the result of continuous efforts through national strategies to improve people’s nutritional regime, bringing the average height of Vietnamese people to 4th place in Southeast Asia, behind Singapore. (men: 171 cm, women: 160 cm), Thailand (men: 170.3 cm, women: 159 cm), Malaysia (men: 168.4 cm, women: 157.7 cm). Among countries in Asia, South Korea is currently leading in height (men: 173.9 cm, women: 161.1), followed by India (men: 173 cm, women 165 cm) and Japan (men: 172 cm, women: 158 cm).

The average height of Vietnamese children has improved significantly (Photo: Shutterstock)

The average height of Vietnamese children has improved significantly (Photo: Shutterstock)

With the current growth momentum, the height of Vietnamese people can absolutely be improved. Scientists estimate that about 60 – 70% of an individual’s height is determined by the DNA sequence combinations they inherit2, with the rest determined by other environmental factors such as nutrition, level of exercise, sleep… Thus, the height of Vietnamese children still has the potential to grow further if nutrition and lifestyle continue to improve.

However, one of the Government’s top concerns in the new National Nutrition Strategy is the large difference in nutritional status between regions, especially between urban areas, delta areas, and mountainous areas.

The results of the 2019-2020 National Nutrition Investigation show that the stunting rate in mountainous areas is 38%, which is still very high in terms of public health significance. Nationwide, there are still 7 provinces with a stunting malnutrition rate of over 30%, which is a very high level of public health significance according to the WHO standard in 2018. According to the World Bank and the Institute of Nutrition, ethnic minorities in Vietnam often face malnutrition. Although the national malnutrition rate has decreased, the rate of stunting among ethnic minority children is still 2 times higher than that of Kinh ethnic children (31.4% compared to 15.0%. %). Furthermore, up to 60% of children with stunting malnutrition in the 10 provinces with the highest stunting malnutrition rates in the country are ethnic minorities.

The decision approval of National Nutrition Strategy for the period 2021-2030 and vision to 2045 points out that many important nutritional interventions would determine the development of children’s stature and physical strength, such as nutritional care for children in the first 1000 days of life. The research “Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development” published by Datta Meghe Institute of Medical Sciences (India) also shows the important role of proper nutrition in the first 1,000 days of a child’s life.

Rational nutritional regime

Proper nutrition is especially important for children’s height development. Many studies have proven that the first 1,000 days of a child’s life are the most important period to lay the foundation for healthy growth and development in children3. Without proper nutritional care, children will face the risk of malnutrition and stunting during this period, thereby affecting their adult height4. In the next stages of development, providing a comprehensive and balanced diet is also the key for children to develop well.

Nutrition in the first 1000 days of life is important for the healthy growth and development of children later on. (Photo: Viamclinic)

Nutrition in the first 1000 days of life is important for the healthy growth and development of children later on. (Photo: Viamclinic)

So what is rational nutrition? A rational nutritional diet is a diet that meets the energy and nutritional needs for each stage of a child’s development, with all nutrient groups (Protein, Carbohydrate, Lipid, Vitamins and Minerals). To achieve this, children need to eat a rational amount of a variety of foods such as starch, animal protein (meat, fish, seafood) and vegetable protein (beans and nuts), cooking oil and animal fats in appropriate proportions, vegetables, milk and dairy products, and use iodized salt.

In addition, caregivers can supplement a combination of vitamins and minerals that support bone development such as Calcium, Vitamin D3 and Vitamin K2.

So what is rational nutrition? A rational nutritional diet is a diet that meets the energy and nutritional needs for each stage of a child’s development, with all nutrient groups (Protein, Carbohydrate, Lipid, Vitamins and Minerals). To achieve this, children need to eat a rational amount of a variety of foods such as starch, animal protein (meat, fish, seafood) and vegetable protein (beans and nuts), cooking oil and animal fats in appropriate proportions, vegetables, milk and dairy products, and use iodized salt.

In addition, caregivers can supplement a combination of vitamins and minerals that support bone development such as Calcium, Vitamin D3 and Vitamin K2.

The trio of Calcium, Vitamin D3, and Vitamin K2 plays an important role in children's height development (Photo: Freepik)

The trio of Calcium, Vitamin D3, and Vitamin K2 plays an important role in children’s height development (Photo: Freepik)

Calcium is a key nutrient involved in bone formation and metabolism, with over 99% of total Calcium in the body found as Calcium Hydroxyapatite in bones and teeth5. The active transport of calcium relies on the activity of Calcitriol (the active form of Vitamin D) and Vitamin D receptors in the intestine. In case of lacking the necessary amount of Vitamin D, the body can only absorb 10 – 15% of the amount of Calcium ingested, but if enough Vitamin D is provided, the amount of Calcium absorbed from the intestines and blood will increase from 30 to 40%6. Vitamin D’s main source is synthesis in the skin under the influence of solar ultraviolet B radiation (UV-B) accounting for 80-90% and about 10-20% due to daily diet7. Therefore, every day you should sunbathe for 15-30 minutes before 9 am and after 4 pm, when the sunlight is not too intense; At the same time, increase the use of foods rich in vitamin D such as fish liver, egg yolks, fish, seafood… for daily meals.

Meanwhile, Vitamin K2 is necessary for the process of transporting Calcium from the blood to the bones with the following mechanism: Osteoblasts will produce Osteocalcin, an important compound in the bone formation process with the task of binding Calcium from the blood. into the skeletal system, helping bones become stronger. However, Osteocalcin needs Vitamin K2 to be activated and carry out its mission in the process of bone formation and mineralization. Thus, children should be supplemented with the trio of Calcium, Vitamin D3 and Vitamin K2 in the journey of attaining optimal height development.

Proper exercising program

Besides nutrition, exercise also helps support physical growth by stimulating the secretion of growth hormone and other anabolic hormones. The results of the study “The Effects of Exercise on Growth” by author Borer – University of Michigan (USA) also concluded that the process of exercise is a necessary stimulus for growth through its stimulatory effects on the secretion of growth hormone (GH) and other anabolic hormones10. Physical activity also helps children prevent the risk of obesity, a medical condition that negatively affects children’s growth.

According to the US CDC Preventive Medicine Center, young children should have at least 1 hour of physical activity a day with the following exercises11:

Aerobic exercises: Include activities such as walking, running or any activity that makes the heart beat faster. At least 3 days a week should include vigorous intensity activities.

Muscle-strengthening exercises: Include activities such as climbing or push-ups, at least 3 days per week.

Bone-strengthening exercises: Include activities such as jumping or running, at least 3 days per week.

Physical activity stimulates growth hormone in children (Photo: Freepik)

 Physical activity stimulates growth hormone in children (Photo: Freepik)

Good sleep regime

Human growth hormone is secreted from the pituitary gland during sleep. Growth hormone plays an important role in a child’s longitudinal development, and children with growth hormone deficiency experience problems with short stature and many other quality-of-life problems12.

According to the recommendations of the US CDC Preventive Medicine Center, the recommended sleep time for each age group is as follows:

  • Newborns 0 – 3 months old: 14 – 17 hours/day
  • Newborns 4 – 12 months old: 12 – 16 hours/day
  • Children 1 – 2 years old: 11 – 14 hours/day
  • Preschool children 3 – 5 years old: 10 – 13 hours/day
  • Primary school children 6 – 12 years old: 9 – 12 hours/day
  • Teenagers 13 – 18 years old: 8 – 10 hours/day
  •  Adults 18 – 60 years old: 7 hours or more/day
  • Elderly people 61 years old and older: 7 – 9 hours/day
 Sleep is an important factor to pay attention to so that children's growth hormone has optimal development conditions (Photo: Freepik)

 

REFERENCES:

  1.  Bộ Y tế. “Tổng điều tra dinh dưỡng toàn quốc 2019 – 2020”
  2.  Yang J et al. Genetic variance estimation with imputed variants finds negligible missing heritability for human height and body mass index. Nat Genet. 2015 Oct;47(10):1114-20.
  3.  Likhar A, Patil MS. Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development: A Narrative Review. Cureus. 2022 Oct 8;14(10):e30083.
  4.  Iacona S. Maternal and child undernutrition: consequences for adult health and human capital. [Sep; 2022]. 2008.
  5.  Institute of medicine of the national academies. Dietary Reference Intakes for Calcium and Vitamin D. 2010
  6.  Holick MF. Vitamin D deficiency. N Engl J Med. 2007
  7.  Kim E. Naylor et al. Measurement of Biochemical Markers of Bone Formation. 2006
  8.  Maresz K. Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health. Integr Med (Encinitas). 2015 Feb;14(1):34-9.
  9.  Borer. The effect of exercise on growth. 1995
  10. Centers for Disease Control and Prevention. “How much physical activity do children need?”. 2022
  11.  Heaton AL et al. Mechanism for the Increase in Human Growth Hormone with Administration of a Novel Test Supplement and Results Indicating Improved Physical Fitness and Sleep Efficiency. J Med Food. 2021 Jun;24(6):653-659.
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