Secular trends and pubertal growth spurts in body height among Tibetan children and adolescents living at high altitudes in Lhasa (China) from 1965 to 2019

Astratt

Abstract Height is an anthropometric measure of nutritional levels and health status during childhood and adolescence and can strongly predict health and developmental outcomes across the lifespan. There is little evidence on the growth trends of Chinese children and adolescents living at high altitudes. This paper aimed to examine the secular trends and pubertal growth spurts in height among Tibetan children and adolescents in Lhasa from 1965 to 2019. Height data among Tibetan children and adolescents aged 7–17 years were obtained from ten cross-sectional surveys (1965, 1975, 1985, 1991, 1995, 2000, 2005, 2010, 2014, and 2019). Sample-weighted regressions (linear or quadratic or cubic regressions) were performed to estimate trends in height by sex and age. A population-weighting procedure was used to calculate the changes for boys and girls. The SuperImposition by Translation and Rotation model was used to separately fit height–distance and height–velocity curves for boys and girls, yielding sex- and wave-specific peak height velocity (PHV) and age at PHV (APHV). The results showed that population-based height increased by 17.8 cm or 2.28 effect size (ES) for boys and by 14.1 cm or 1.98 ES for girls from 1965 to 2019. Among boys, there was a moderate increase per decade (0.76 ES) from 1965 to 1970, followed by a gradual deceleration in this trend. For girls, there was a largest increase per decade (0.74 ES) in 1960s. Then, the trend slowed and remained stable in the last decades. From 1965 to 2019, the PHV for boys increased from 6.53 cm/year to 7.36 cm/year ( P = 0.007), whereas the APHV decreased from 15.84 years to 13.39 years ( P < 0.001). Girls showed no significant trend in PHV, but APHV decreased from 12.85 years to 10.00 years. In sum, this study reveals a secular trend in height among Tibetan children and adolescents in Lhasa over the past five decades, with a recent deceleration in trends. Puberty development has advanced in both sexes. More public health policies are needed to promote the growth and development of Tibetan children and adolescents and prevent negative impacts from sustained growth and early puberty.