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From the Townsend Letter
February/March 2008


Increasing Human Body Size and Its Physical and Environmental Ramifications
by Thomas T. Samaras, and Jonn Desnoes, OMD, MD, PhD

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Reasons Larger Mass Promotes a Shorter Lifetime
There are several reasons why a larger body size (exempting the known risks of overweight) reduces the expected lifetime of an individual. One reason is that a larger body uses more fuel and produces more free radicals as a by-product of metabolic processes. More free radicals mean more opportunity for a harmful mutation or creation of cancerous cells. Since a 182.9 cm, 86.4 kg (72", 190 lb) person has about 40 trillion more cells than a 152.4 cm, 50 kg (60", 110 lb) person, this could significantly increase the cancer incidence as was found by Gunnell's review of 300 height-cancer studies.2(p.67) While free radical scavengers, such as the enzymes superoxide dismutase and catalase, probably increase in proportion to body mass, the net result is that the relative percentage of free radicals would be the same. However, the absolute number is greater for the taller person. In addition, rapid growth and early maturity may increase free radical concentration beyond that expected simply from greater body weight. Thus, a taller or rapidly growing person has more cells that can evolve into malignant tumors.

Blood volume is proportional to body mass. Thus, a person who is 20% heavier would have 20% more blood in his body. Although the heart's size is also proportional to body size, it must work harder, because the blood must be pumped a longer distance, e.g., 20% farther for a 182.9 cm person vs. a 154.4 cm person. However, if a tall person is light for his/her height, the workload on the heart could be less than that for a shorter, heavier person. As Astrand1 and others have pointed out, maximum cardiac output (ml/sec) increases as the square of height or in proportion to surface area and not in proportion to body weight, which increases as the cube of height. Thus, a taller, bigger person's heart cannot provide oxygenated and waste-cleansed blood to his or her muscles as rapidly as a shorter person's heart. This limitation can place the larger body under greater stress when involved in sustained rigorous work or athletic activities, which push the cardiac output to its limits.

When doing physical work or walking or running, larger bodies have more difficulty getting rid of body heat generated because they have less surface area in proportion to body mass. For example, a 183 cm-long body has only 44% more surface area in comparison to its 73% greater mass than to a 152 cm-long body. Some studies have found smaller women maintain body temperature better than men in endurance type activities. Also many champion marathon runners, such as German Silva, 160 cm and 50 kg (5'3", 110 lb), tend to be short and light.

Lung performance is also affected by size. As Astrand6 has pointed out, lung surface area increases as the square of the height and not in proportion to body mass, which increases as the cube of height. While biological adaptation may develop a surface area greater than the square of height for athletes, tall people of the same build type should be at a disadvantage in terms of maximum oxygen uptake (liters per kg/minute). Whether this would have some effect on the rate of aging is presently unknown. In addition, the large person has a lower maximum respiration rate.

Another disadvantage of taller height may be related to the fact that brain size increases with body size at a decreasing rate. Studies have found that brain size increases at the 2/3 or 3/4 power of body mass. Sacher1 found a smaller brain weight in relation to body size reduced longevity within a species. Perhaps this explains part of the difference in male-female longevity, since women have heavier brains in relation to their body weight. Because of their smaller bodies, women's brains are on average ten percent smaller compared to men, but their body weight is ~ 20% less. The reason for the advantage of a higher brain-to-body weight ratio is not certain but may result from better neural supervision of the body's functions.

The Tarahumara Indians of Northern Mexico are great endurance runners with virtually no heart disease. They are short and light in weight with low resting heart rates, normal blood pressure, optimal cholesterol and triglyceride levels, and no evidence of diabetes. In spite of being active, they consume only 1500 calories per day and live on a diet far below what is considered to be an adequate nutritional intake for calories, protein, and vitamins. Rene Dubos also found that the short, frail-looking Guatemalan natives were very strong, healthy, and long-lived.13 They were also grossly underfed by US nutritional standards.

A WHO panel of 11 international nutritional scientists supports the observations of these researchers. They reviewed the literature and 150 background papers and concluded that radical changes in our food supply have been at the root of our modern epidemic of chronic diseases.1 The affluent diet of developed countries was characterized as one with high consumption of energy-dense foods of animal origin and of foods processed or prepared with added fat, sugar, and salt. The panel recommended a BMI of 20-22, a value much lower than the US's 26+. The panel concluded its report with the following caveat: "...chronic diseases are, to a large extent, manifestations of nutrient excesses and imbalances in the diet and are thus largely preventable. An epidemic of cancer, heart disease, and other chronic ills need not be the inevitable price paid for the privilege of socioeconomic progress." Today, with our epidemic of obesity, insulin resistance, and diabetes we are seeing the end results of a 60-year-old experiment of over-consumption, which is still continuing, particularly in the now economically developing countries of China and India, which are continuing to make the same mistakes of over-consumption that those in the West have made.

A number of previous studies over the years have reported greater longevity for shorter men vs. taller men. These include baseball players, football players, basketball players, veterans, Harvard graduates, Finnish athletes, and famous people.2(p.95-103) The most recent data show that populations with the longest life expectancies are substantially shorter than Northern Europeans, such as the Dutch, Scandinavians, and Germans. The six populations with the highest life expectancy in the world are listed in Figure 1.14

Figure 1: Top Life Expectancy Ranking
(projected for 2007) (In order of decreasing life expectancy)
Andorra (a state between Spain and France)
Macua (Island near Hong Kong)
San Marino (a state in Italy)
Hong Kong

Heights for people in Andorra and San Marino were not available and are assumed to be similar to Spain, Southern France, and Italy. In addition, the people used to determine projected life expectancy for ages beyond 70 years were substantially shorter than the youth of today. It should be pointed out that many populations of tall people have excellent life expectancies. These include Sweden, Norway, Holland, and Iceland.

Body Size and CVD
Over 20 studies show that taller people have lower mortality from CVD.2(p.78) As a result, most researchers believe that shorter people suffer from increased deaths from coronary heart disease and stroke. For example, McCarron and associates found that taller men had lower CVD compared to shorter men based on a long-term study involving 338 deaths. However, Song and associates2(p.93) found no significant difference in CHD based on a study of over 386,000 South Korean men, which involved 653 deaths. They concluded that other factors in addition to short height are needed to increase the risk of CHD for shorter people. However, many more examples of short populations with low to non-existent CVD exist. A few of those examples are presented below.

Based on the deaths of over one-quarter million California men and women, Wild and associates found Whites and Blacks had twice the mortality from CHD, compared to Chinese and Japanese cohorts.2(p.83) While heights were not given, other sources indicate that the Asians average a few inches shorter than the Whites and Blacks. Another study, involving 11 Western European countries, found that the Scandinavians had about twice the mortality from CHD as shorter Portuguese and Spanish populations.2(p.82,83)

Lindeberg and associates15 reported that a 70-year study in Papua New Guinea (PNG) found no evidence of CVD in these short people, a population in which men average about 5'4". Sawari and Bradley2(p.164) also reported that traditional (or developing) populations have very little CVD, diabetes, and cancer. Eveleth and Tanner have reported that most of these populations are quite short and light.16

Shorter females have lower CVD compared to men in virtually all developed populations. Some exceptions exist in a few developing countries. While female hormones play a role in the West, they don't seem to be important in traditional societies that are relatively free of Westernization, such as Kitava (an island near PNG), where both sexes are free of CVD.2(p.91) Six populations in the developed world with the lowest CHD are listed in Figure 2.17

Figure 2: Populations (Men) with Lowest CHD Mortality Ranking
Japan (lowest CHD)
Hong Kong
Italy (highest CHD)

As in the populations with the longest life expectancies, all six populations are relatively short compared to Northern Europe. It should be noted that the southern French are shorter than the French in the North and also have substantially lower CVD mortality, as illustrated by Toulouse. The pattern of stroke mortality is not as clear, and Portugal has almost three times the death rate as Spain. However, France and Switzerland have the lowest stroke mortality in all of Europe, and their heights fall between Northern and Southern Europe.

Body Size and Cancer
Gunnell and associates conducted a review of 300 studies and found taller people had a moderately higher incidence of cancer.2(p.67) Other studies have found the incidence of the four major cancers – lung, breast, prostate, and colorectal cancer – are related to greater height. In addition, the incidence of skin cancer for tall people is about two times that of short people. However, relatively few people die from skin cancer, which represents about 50% of all cancers.

Reducing Body Size
Increased body size due to obesity is a worldwide problem and, for those of us who have reached maturity, requires constant vigilance and control of our food intake. Whether tall or short, weight loss is an important strategy for achieving optimum health and longevity. Of course, keeping physically active is also important. James2(p.148) reported that CVD, diabetes, and gallstones increase with rising BMI from a baseline of 19-20 kg/m2. For most Westerners, this is difficult to achieve. However, the closer one gets to a BMI of 21 to 23 points, the better, assuming that a well-balanced diet and regular exercise are the foundation for this lean body configuration. Dr Desnoes has outlined a life-long plan for weight loss and maintenance of good health in his book Fat Loss Quick Safe and Simple.18 He correctly warns against fad or quick weight-loss diets. These won't work for most people. Instead, a permanent lifestyle change in activity levels and nutritional practices is needed.

Reasons for Conflicts in Findings
Several reasons for conflicting findings exist. In recent years, researchers have recognized that promoting rapid growth in lower BW infants promotes chronic disease in adulthood, such as CVD and diabetes (Singhal et al.2[p.165]). In trying to have smaller children conform to standard growth charts, excessive nutrition is provided to accelerate growth, and this process can create health problems later on in life. Since small infants usually do not attain the same stature in adulthood as normal-weight peers, studies can erroneously attribute shorter height to higher mortality when catch-up or accelerated growth may be the true problem.

Another problem that can confound the results of studies is childhood or adolescent infections or other pathological conditions that can both reduce growth and increase the risk for morbidity or mortality in adulthood. There are over 50 diseases that can impact growth, such as H. pylori stomach infection, rheumatic fever, chronic diarrhea, asthma, and congenital heart disease.

Socioeconomic (SES) class can have a major impact on study results. For example, some studies have found that the lowest social class has four times the mortality rate of the highest. Since people with higher SES average a few inches taller than the lowest class, this difference can provide misleading results if not accurately adjusted. Most studies do adjust for various risk factors, and this adjustment tends to reduce the mortality rates of shorter cohorts by five percent to 20%. However, Wannamethee and associates and other researchers have noted that adjustment for risk factors is a crude and inexact process.2(p.71)

Studies usually compare short and tall people with about the same BMIs. This procedure can provide erroneous results, since the studies should compare taller people with higher BMIs compared to shorter ones. The reason for comparing taller people with higher BMIs is that tall and short people should be compared with the same body proportions since body type affects mortality. Adjusting the BMIs of taller people upward assures a more valid comparison of short and tall cohorts in a study. For example, if the average height is ten-percent greater for the tall cohort, then the BMI for this cohort should be ten-percent higher, as explained in detail in Human Body Size and the Laws of Scaling.2(p.9-31) Since mortality increases roughly linearly with increasing BMI, failure to adjust for BMI can provide a substantially lower mortality for taller people; e.g., a ten-percent lower BMI decreases mortality by ten percent.2(p.28)

Biological Mechanisms in Relation to Longevity
Taller people have certain biological advantages compared to shorter people. These include lower resting metabolic rate, lower arterial peripheral resistance, and lower resting heart rate. These factors have been found to be beneficial for reducing mortality risk.

In view of the preceding advantages of taller people, why should shorter people have longer longevity compared to taller people? The key biological disadvantages of taller bodies of the same proportions follow. However, keep in mind that differences in body proportions or obesity between tall and short people can modify these disadvantages:

1. Taller people require more cell replications from birth to attain full body size. Since many types of cells have a limited number of cell replications (Hayflick limit) before extinction, taller people have fewer potential cell replications to replace defective or dead cells at older ages.

2. Since taller people have more cells than shorter people, these extra cells provide increased opportunity for cancer development. (A six-foot tall person may have 40 trillion more cells than a five-foot tall person of the same body type.)

3. The greater number of cells in taller people increases maintenance costs by using more cell replication potential to replace lost or damage cells during their lifetimes. Thus, fewer cell replications are available for taller persons at older ages.

4. Based on data provided by Giovannelli and associates,2(p.169) it was found that an 19% taller person had an 85% higher rate of DNA damage. Thus, the potential for cancer and reduced cellular and organ function is greater in taller people.

5. Rapid growth in height and weight and early sexual maturity diverts energy or resources from body maintenance functions that promote longevity (Rollo2[p.243,266]). This could include reduced cellular repair and organ growth/maintenance due to increased free radical generation during childhood. Rapid growth may also reduce the rate of cellular garbage removal that tends to gradually accumulate over a lifetime with undesirable effects.

6. With the exception of the heart, spleen, and lungs, the relative size of most organs is smaller in taller people.2(p.136) As a result, reduced organ functional capability exists, especially at greater ages.

7. Taller people have greater blood pressure, left ventricular mass, and hypertrophy compared to shorter people. These conditions are independent risk factors for heart disease. In addition, taller people have more atrial fibrillation (Hanna2[p.83]).

8. Taller children have earlier adiposity rebound and higher risk for obesity in adulthood.

9. Assuming similar activity levels, larger bodies experience accelerated increase in entropy (disorder) with the passage of time due the synergy of increased cell number and greater energy intake. While this implies less activity and associated energy expenditure is desirable, a minimum amount of physical activity is needed to maintain optimum functioning of the brain and body.

Closing Observations and Conclusions
Many years ago, Dr. Desnoes asked some of his octogenarian patients who were concentration camp survivors about what factors helped with survival under the extreme conditions of starvation and overwork by manual labor. All the survivors – both men and women – were small and thin people with the tallest being 5'3". They replied that the smaller, thinner, and muscular people like themselves were the ones that survived. The obese they said died the fastest, normally lasting less than a week, at the most two weeks. (This is a paradox since you would think that during periods of starvation they could live off their fat reserves.) The next group who died quickly were tall people who also didn't last much longer than a few weeks. After the fall of Germany, many of the camp guards took off their uniforms, shaved their heads, and donned the camp pajamas and tried to disguise themselves as survivors. However, the Americans noticed them right away because they were fatter and taller than all the survivors, even the ones who had newly arrived.

Body height by itself is not the only factor in increasing chronic disease and reducing longevity. For example, John Kenneth Galbraith at 6'8" lived 98 years. However, body mass and BMI tend to be strongly associated with height, and these factors are also strongly correlated with longevity-reducing factors such as increased cholesterol, triglycerides, blood pressure, glucose, insulin, insulin-like growth factor, and lower HDL. Whether people are tall or short, the following recommendations are far more important than height in promoting longevity: (1) weight control, (2) regular exercise, (3) a diet with relatively low animal protein and increased emphasis on fruits, legumes, nuts, and vegetables, and (4) active participation in improving oneself and society. That said, we feel that we need to drastically alter our thinking regarding the benefits of a taller, heavier population and begin to implement societal, political, and corporate changes in attitude to stem the illogical belief that leads to heightism regarding our societal and corporate preferences for increased height.

Additionally, a larger population requires far more resources, which puts a greater strain on the environment. Taller and heavier people require more cloth and leather for their clothing. They require more space for their bodies, larger houses and seats, more leg room in automobiles and airplanes, etc. If we do not change our attitude for preferring bigger everything – bigger people, bigger food portions, bigger houses, etc. – we may all grow ourselves into extinction. The best we can do is to begin by making changes within ourselves by consuming less food and lowering our weight. Although we cannot alter our height, the act of consuming less and feeding our children less will end up decreasing our body mass over generations and will result in our personal positive impact on the environment and the planet.

For the survival of the planet and humanity, we must begin to favor a restricted diet and smaller people, because supplying high-energy diets to large segments of the population will become increasingly difficult. For example, the world has lost over 30% of its arable land in the last 40 years due to farming and other human activities. At this rate, we will not be able to use farmland to feed cattle for human consumption, since this is a very inefficient way to grow food. The reduction in our annual fish catch also adds pressure to reduce human size. The heavy dependence on animal flesh and products is a questionable luxury that the world will not be able to afford in as little as 30 to 50 years from now, and we will be forced to move to a low-fat, plant-based diet to feed the anticipated population of 12 billion people. Under these conditions, smaller people will help reduce farmland and water needs and will help preserve some of the rainforests, which are rapidly becoming depleted at 25 to 40 million acres per year.

The entropy theory of aging appears to be useful in predicting reduced longevity on the basis of human size and energy needs. Animal studies and a variety of human studies suggest that reduced food intake from childhood can create smaller bodies that are healthier, live longer, and are just as intelligent as larger ones,2(p.301-316) and the findings support the basic premise of the entropy theory that morbidity and mortality can be reduced through smaller mass and height.

The problem with the preceding findings is that they go against our society's deeply held belief that bigger is better. Changing this belief among scientists as well as the public is the main obstacle to decreasing our ecological burden to the planet and improving the health and longevity of the human population for future generations.

Note: The relation of increasing body size on cognitive ability, the environment, and fiscal costs were not discussed here. For a further discussion of the impact of body size on resources, physical performance, intelligence, and evolutionary considerations refer to Human Body Size and the Laws of Scaling.2

Thomas T. Samaras
Reventropy Associates
11487 Madera Rosa Way
San Diego, California 92124

Dr. Jonn Desnoes OMD, PhD
TRM International
15947 N. Florida Ave.
Lutz, Florida 33549

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