On 2015 May 22, thomas samaras commented:

Researchers should be aware that two earlier reviews were published showing that shorter people are more likely to have lower coronary heart disease (CHD) (1,2). This apparent conflict with the Nuesch, et al. paper is no doubt due to various confounders and failure to recognize the biological mechanisms that underlie the inherently lower risk of CHD for shorter, lighter people. In addition, ecological studies showing short people often have little or no CHD are often ignored because of the belief that ethnic, racial, climatic and geographical factors make the results unreliable. However, Shaper (1) stated that these factors are completely irrelevant to the incidence of CHD unless they are related to social class and economic status.

In my opinion, the facts covered in the two papers cited below (1,2) provide overwhelming evidence that shorter people have the potential for very low CHD. (Unfortunately, Dr. Elrick and Professor Storms have passed away and cannot co-write this response.) A summary of some of our findings follows.

Before the early 1900s, Europeans and Americans were shorter but CHD was rare. As we got taller and heavier, CHD increased due to the Western diet.

Based on 1 million WWI military recruits in the US, Davenport and Love found that taller men had a much higher incidence of heart problems.

In the developed world, the Japanese have ranked within the top three countries in terms of low CHD for a number of decades. Japanese males average a little over 5’7”.

A number of populations that had very low or no CHD during the 20th C now have much higher rates along with their increased height. For example, S. Korea has seen a large jump in heart disease in recent years along with a substantial increase in height.

Western Sicilian centenarians are short and free of CHD risk factors.

Compared to men, shorter women have lower lifetime death rates from CHD.

A US study found that in a low-income cohort, taller people have almost a 40% higher risk of heart attacks. US mortality statistics based on ages ranging from youth to over 85 years of age show that shorter Asians have an almost 80% lower risk of CHD compared to taller Blacks and Whites. Latinos and Native Americans are taller than Asians but shorter than Whites and Blacks and fall between the shortest and tallest ethnic groups in mortality. (Findings based on a 15-year period and about 8 million deaths.)

A study of 350,000 dogs found that smaller dogs have much lower risk of heart failure compared to bigger dogs. For example, the Great Dane has 70 times the risk of heart failure compared to the miniature Dachshund. And the standard Dachshund has 3 times the rate of heart failure as the smaller miniature Dachshund.

I have also identified over 15 biological factors that would explain the advantages of smaller body size and low CHD. These include longer telomeres, smaller left ventricular mass, lower blood pressure, lower HDL, lower homocysteine, higher sex hormone binding globulin, lower C-reactive protein, higher adiponectin and FOXO3, and lower pulse wave velocity. These factors are based on the assumption that we are comparing shorter and taller people who have the same body type or proportions. (Otherwise, comparing a tall, thin person to a short stocky one would change these parameters.)

Many studies have also found that shorter people live longer. These include studies from the Hawaii, Ohio, San Diego, Spain, Sardinia, Okinawa, Bama (China), and Cuba (3). Many animal studies and experimental research support these human findings (4).

Recently, a 40-year longitudinal study based on over 8000 elderly Hawaiian Japanese males found that shorter men live longer (5). It is unlikely that they had more heart problems than the taller men who died younger.

Unfortunately, the findings discussed above have not received much attention because of the widespread belief that taller people are healthier and longer lived. Over 45 papers, books and book chapters on the ramifications of increasing body size are listed in www.humanbodysize.com

References

1 Samaras TT, Elrick H, Storms LH. Is short height really a risk factor for coronary heart disease and stroke mortality? A review. Med Sci Monit 2004; 10(4): RA63-76.

2 Samaras TT. Shorter height is related to lower cardiovascular disease risk—a narrative review. Indian Heart Journal 2013; 65: 66-71.

3 Samaras TT. Evidence from eight different types of studies showing that smaller body size is related to greater longevity. Journal of Scientific Research & Reports 2014; 3 (16): 2150-2160.

4 Bartke A. Healthy aging: Is smaller better? –A mini review. Gerontology 2012; 58: 337-43

5 He Q, Morris BJ, Grove JS, Petrovitch H, Ross, Masaki KH, et al. Shorter men live longer: association of height with longevity and FOXO3 genotype in American men of Japanese ancestry. PLOS One 2014; 9 (5) 1-8.

On 2015 May 22, thomas samaras commented:

Researchers should be aware that two earlier reviews were published showing that shorter people are more likely to have lower coronary heart disease (CHD) (1,2). This apparent conflict with the Nuesch, et al. paper is no doubt due to various confounders and failure to recognize the biological mechanisms that underlie the inherently lower risk of CHD for shorter, lighter people. In addition, ecological studies showing short people often have little or no CHD are often ignored because of the belief that ethnic, racial, climatic and geographical factors make the results unreliable. However, Shaper (1) stated that these factors are completely irrelevant to the incidence of CHD unless they are related to social class and economic status.

In my opinion, the facts covered in the two papers cited below (1,2) provide overwhelming evidence that shorter people have the potential for very low CHD. (Unfortunately, Dr. Elrick and Professor Storms have passed away and cannot co-write this response.) A summary of some of our findings follows.

Before the early 1900s, Europeans and Americans were shorter but CHD was rare. As we got taller and heavier, CHD increased due to the Western diet.

Based on 1 million WWI military recruits in the US, Davenport and Love found that taller men had a much higher incidence of heart problems.

In the developed world, the Japanese have ranked within the top three countries in terms of low CHD for a number of decades. Japanese males average a little over 5’7”.

A number of populations that had very low or no CHD during the 20th C now have much higher rates along with their increased height. For example, S. Korea has seen a large jump in heart disease in recent years along with a substantial increase in height.

Western Sicilian centenarians are short and free of CHD risk factors.

Compared to men, shorter women have lower lifetime death rates from CHD.

A US study found that in a low-income cohort, taller people have almost a 40% higher risk of heart attacks. US mortality statistics based on ages ranging from youth to over 85 years of age show that shorter Asians have an almost 80% lower risk of CHD compared to taller Blacks and Whites. Latinos and Native Americans are taller than Asians but shorter than Whites and Blacks and fall between the shortest and tallest ethnic groups in mortality. (Findings based on a 15-year period and about 8 million deaths.)

A study of 350,000 dogs found that smaller dogs have much lower risk of heart failure compared to bigger dogs. For example, the Great Dane has 70 times the risk of heart failure compared to the miniature Dachshund. And the standard Dachshund has 3 times the rate of heart failure as the smaller miniature Dachshund.

I have also identified over 15 biological factors that would explain the advantages of smaller body size and low CHD. These include longer telomeres, smaller left ventricular mass, lower blood pressure, lower HDL, lower homocysteine, higher sex hormone binding globulin, lower C-reactive protein, higher adiponectin and FOXO3, and lower pulse wave velocity. These factors are based on the assumption that we are comparing shorter and taller people who have the same body type or proportions. (Otherwise, comparing a tall, thin person to a short stocky one would change these parameters.)

Many studies have also found that shorter people live longer. These include studies from the Hawaii, Ohio, San Diego, Spain, Sardinia, Okinawa, Bama (China), and Cuba (3). Many animal studies and experimental research support these human findings (4).

Recently, a 40-year longitudinal study based on over 8000 elderly Hawaiian Japanese males found that shorter men live longer (5). It is unlikely that they had more heart problems than the taller men who died younger.

Unfortunately, the findings discussed above have not received much attention because of the widespread belief that taller people are healthier and longer lived. Over 45 papers, books and book chapters on the ramifications of increasing body size are listed in www.humanbodysize.com

References

1 Samaras TT, Elrick H, Storms LH. Is short height really a risk factor for coronary heart disease and stroke mortality? A review. Med Sci Monit 2004; 10(4): RA63-76.

2 Samaras TT. Shorter height is related to lower cardiovascular disease risk—a narrative review. Indian Heart Journal 2013; 65: 66-71.

3 Samaras TT. Evidence from eight different types of studies showing that smaller body size is related to greater longevity. Journal of Scientific Research & Reports 2014; 3 (16): 2150-2160.

4 Bartke A. Healthy aging: Is smaller better? –A mini review. Gerontology 2012; 58: 337-43

5 He Q, Morris BJ, Grove JS, Petrovitch H, Ross, Masaki KH, et al. Shorter men live longer: association of height with longevity and FOXO3 genotype in American men of Japanese ancestry. PLOS One 2014; 9 (5) 1-8.