Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle-Income Countries

Research output: Contribution to journalArticle


OBJECTIVE: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent.

RESEARCH DESIGN AND METHODS: We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample, major world regions, and individual countries, in addition to stratifying all analyses by sex. We examined heterogeneity by individual-level characteristics.

RESULTS: Our sample included 554,122 individuals across 25 population-based surveys. Average height was 161.7 cm (95% CI 161.2-162.3), and the crude prevalence of diabetes was 7.5% (95% CI 6.9-8.2). We found no relationship between adult height and diabetes across LMICs globally or in most world regions. When stratifying our sample by country and sex, we found an inverse association between adult height and diabetes in 5% of analyses (2 out of 50). Results were robust to alternative model specifications.

CONCLUSIONS: Adult height is not associated with diabetes across LMICs. Environmental factors in early life reflected in attained adult height likely differ from those predisposing individuals for diabetes.


  • Felix Teufel
  • Pascal Geldsetzer
  • Jennifer Manne-Goehler
  • Viola Koncz
  • Andreas Deckert
  • Michaela Theilmann
  • Maja-Emilia Marcus
  • Cara Ebert
  • Jacqueline A Seiglie
  • Kokou Agoudavi
  • Glennis Andall-Brereton
  • Gladwell Gathecha
  • Mongal S Gurung
  • David Guwatudde
  • Corine Houehanou
  • Nahla Hwalla
  • Gibson B Kagaruki
  • Khem B Karki
  • Demetre Labadarios
  • Joao S Martins
  • Mohamed Msaidie
  • Bolormaa Norov
  • Abla M Sibai
  • Lela Sturua
  • Lindiwe Tsabedze
  • Chea S Wesseh
  • Justine Davies
  • Rifat Atun
  • Sebastian Vollmer
  • S V Subramanian
  • Till Bärnighausen
  • Lindsay M Jaacks
  • Jan-Walter De Neve
External organisations
  • Rheinisch-Westfälisches Institut für Wirtschaftsforschung
  • Harvard Medical School
  • Togo Ministry of Health
  • Caribbean Public Health Agency
  • Kenya Ministry of Health
  • Bhutan Ministry of Health
  • Makerere University
  • University of Abomey Calavi (UAC)
  • National Institute for Medical Research, Tanzania.
  • Nepal Health Research Council
  • Ministry of Health, Solidarity, Social Cohesion and Gender, Union of Comoros
  • National Center for Public Health, Mongolia
  • Eswatini Ministry of Health
  • Liberia Ministry of Health
  • Harvard T.H. Chan School of Public Health
  • Africa Health Research Institute, Somkhele, South Africa.
  • Public Health Foundation of India
  • Heidelberg University
  • Stanford University
  • Brigham and Women's Hospital, Boston
  • Massachusetts General Hospital
  • Ludwig-Maximilian University of Munich
  • University of Göttingen
  • University of Birmingham
  • National Center for Disease Control and Public Health of Georgia
  • American University of Beirut
  • National University of East Timor
  • Stellenbosch University
  • University Hospital Heidelberg
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy
Original languageEnglish
Pages (from-to)2403-2410
Number of pages8
JournalDiabetes Care
Issue number10
Early online date2020 Aug 6
Publication statusPublished - 2020 Oct 1
Publication categoryResearch