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Evol Med Public Health. 2015 Jul 21;2015(1):167-78. doi: 10.1093/emph/eov017.

Why did children grow so well at hard times? The ultimate importance of pathogen control during puberty.

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Department of Zoology, Institute of Ecology and Earth Sciences, Tartu University, Vanemuise 46, 51014, Tartu, Estonia;
Institute of Psychology, Tartu University, Näituse 2, 50409, Tartu, Estonia.



Secular increase in human height and performance occurred in Europe throughout the 20th century despite the temporally worsening access to nutrients during and after World War II. This pattern is paradoxical under the assumption of the major impact of pre- and postnatal growth conditions for determination of adult size and human capital.


We examined the anthropometric parameters of Estonian girls born between 1938 and 1953, and measured around the age of 17 (n = 1475). This period involved two opposite trends in the economic and epidemiological situation: increasing birth-time economic hardships during the war and particularly in the post-war period, and decreasing infant mortality (a proxy of disease burden) after 1947.


Height of girls was negatively affected by the number of siblings and positively by parental socioeconomic position, but these effects were weaker than the secular trend. Leg length (an indicator of pre-pubertal growth conditions) was independent of age and birth date while all other traits, including measures of performance (cranial volume, lung capacity and handgrip strength) showed acceleration. The best predictor of size at age 17 was, in most cases, infant mortality in the year when the girls were aged 11.


Reduction of disease burden during pubertal growth can override effects of resource shortage at birth. Our results also support the idea that increasing efficiency of pathogen control can contribute to the secular increase in cognitive abilities, i.e. the Flynn effect, and that epidemiological transition is the main driver of secular increase in human capital.


Flynn effect; epidemiological transition; height; infant mortality; pubertal growth spurt; secular trend

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