© Kamla-Raj 2016 Anthropologist, 24(3): 737-745 (2016)

Body Height and its Estimation Utilizing Arm Span Measurements in Macedonian Adults

Stevo Popovic1, Dusko Bjelica2, Georgi Georgiev3, Dragan Krivokapic4 and Rajko Milasinovic5

1,2,4,5Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro 3Faculty of Physical Education, Ss. Cyril and Methodius University, ,

KEYWORDS Prediction. Measurement. Stature. Arm Span. Macedonia

ABSTRACT The purpose of this study is to examine body height in Macedonian adults as well as its relationship with arm span, as an alternative to estimating body height. A total of 239 students (114 men and 125 women) participated in this study. The anthropometric measurements were taken according to the protocol of ISAK. The relationships between body height and arm span were determined using simple correlation coefficients at a ninety- five percent confidence interval. Then a linear regression analysis was performed to examine extent to which arm span can reliably predict body height. Results displayed that male Macedonians are 178.10±6.79cm tall and have an arm span of 178.78±7.71cm, while female Macedonians are 164.58±5.40cm tall and have an arm span of 164.41±6.42cm. The results have shown that both genders made Macedonians a tall nation but not even close to be in top tallest nations. Moreover, the arm span reliably predicts body height in both genders.

INTRODUCTION tains and . However, it is interesting to highlight that it belongs to two different moun- The Republic of Macedonia is an indepen- tain ranges, namely, the Shar Mountains that dent, democratic state with a multiparty parlia- continues to the west of Vardar/ group mentary system. The governmental system is of mountains, also well known as the Dinaric based on the division of power into legislative, range, as well as the Osogovo- moun- executive and judiciary. This country is one of tain chain, also well known as the Rhodope range. the successor states of the former , Total population of the Republic of Mace- from which it declared independence in 1991. It donia, according to the 2002 census, was became a member of the United Nations in 1993. 2,022,547 inhabitants (State Statistical Office However, it was admitted under the provisional 2005). Moreover, the ethnic population of the reference of the Former Yugoslav Republic of Republic of Macedonia is very diverse because Macedonia (FYROM), due to the dispute with of the country’s turbulent past. According to the over its name (United Nations 1993). To- 2002 census, the largest ethnic group in the coun- day, the Republic of Macedonia covers the area try is the Macedonian ethic group, representing of 25,713 square kilometers. It is located in the 64.18 percent of the total population, while the central Balkan Peninsula in southeast Europe and second largest are the Albanians, who dominat- it is landlocked and borders Kosovo (as defined ed much more in the northwestern part of the under UNSCR 1244/99) in the northwest, Serbia country and represent 25.17 percent of the total to the north, to the east, Greece to the population. It is also very important to analyze south, and Albania to the west. The Republic of the number of Roma in the country, mostly due Macedonia is a landlocked country that is geo- to the reason the official estimations from the graphically clearly defined by a central valley 2002 census registered just 53,879 persons from formed by the Vardar River and framed along its this ethnic group, while some unofficial estima- borders by mountain ranges of the Shar Moun- tion indicate that there are up to 260,000 Roma in Address for correspondence: the Republic of Macedonia (United Nations De- Dr. Stevo Popovic, velopment Program 2006). Assistant Professor The tallness of the nations in the Dinaric Alps University of Montenegro was recognized by European anthropologists Faculty for Sport and Physical Education Narodne omladine bb, 81400 Niksic, Montenegro more than 100 years ago (Pineau et al. 2005). As Telephone: 00382 (40) 235 207 the modern Macedonians, like the rest of the Fax: 00382 (40) 235 200 nations from former Yugoslavia, fall into the Di- E-mail: [email protected] naric racial classification, it is assumed by the 738 STEVO POPOVIC, DUSKO BJELICA, GEORGI GEORGIEV ET AL. researchers of this study that Macedonian adults timate body height, are very important in pre- might be equally tall or at least very close to the dicting age-related loss in body height. Also, in tallest nations in the Europe, in line with the identifying individuals with disproportionate Dutch (male: 183.8 centimeters; female: 170.7 cen- growth abnormalities and skeletal dysplasia or timeters), Montenegrins (male: 183.21 centime- body height loss during surgical procedures on ters; female: 168.37 centimeters) and Serbians the spine (Mohanty et al. 2001), as well as pre- (male: 182.0 centimeters; female: 166.8 centime- dicting body height in many older people as it is ters). Unlike the most other countries through very difficult to measure it precisely, and some- Western Europe, Macedonia keeps poor records, times impossible because of mobility problems and an update of average body heights among and kyphosis (Hickson and Frost 2003). Macedonian populations is so beneficial as well According to all mentioned above, the re- as its estimation utilizing arm span measurements, searchers believed it would be reasonable to find mostly due to the reason that measurement of the effectiveness of using various body indica- body height is important in many settings (Pop- tors in estimating body height in the Macedonian ovic et al. 2015). population. Furthermore, several studies have It is already well known in scientific literature reported the effectiveness of using various body that the measurement of body height is an indis- parameters in predicting body height and arm pensable variable when assessing nutritional span was found to be the most reliable one (Hick- status (cited in Datta Banik 2011), as well as de- son and Frost 2003; Jalzem and Gledhill 1993; termination of basic energy requirements, stan- Mohanty et al. 2001; Ter Goon et al. 2011). How- dardization of measures of physical capacity and ever, the associations of arm span and body adjusting drug dosage, and evaluation of chil- height was found to vary in different ethnic and dren’s growth, prediction and standardization of racial groups (Bjelica et al. 2012; Brown, Feng physiological variables such as lung volumes, and Knapp 2002; Reeves et al. 1996; Popovic et muscle strength, glomerular filtration and meta- al. 2013; Steele and Chenier 1990; Popovic et al. bolic rate (Golshan et al. 2003; Golshan et al. 2007; 2015), while the study conducted by Quanjer et Mohanty et al. 2001; Ter Goon et al. 2011). How- al. (2014) has reported that the arm span to height ever, there are many conditions in which the ex- ratio changes non-linearly with age and differs act body height cannot always be determined between males and females. Even though sever- the usual way, for example, due to paralysis, frac- al studies of this nature are available on Western tures, amputation, scoliosis and pain (Quanjer et populations, very limited data is available on al. 2014). In such circumstances, an estimate of Macedonian subjects. In the light of rather scarce body height has to be derived from other reliable recent scientific literature, the purpose of this anthropometric indicators such as hand and foot study was to examine the body height in both lengths (Agnihotri et al. 2008; Agnihotri et al. genders of Macedonian adults and the relation- 2007; Kanchan et al. 2008; Rastogi et al. 2008; ship between arm span and body height. Sanliet al. 2005; Uhrova et al. 2015), knee height (Fatmah 2005; Fogal et al. 2015; Hickson and Frost METHODOLOGY 2003; Karadag et al. 2012), length of the forearm (Ilayperuma et al. 2010), length of the sternum The nature and scope of this study qualifies (Menezes et al. 2009; Menezes et al. 2011), verte- 239 students (114 men and 125 women) from the bral column length (Nagesh and Pradeep 2006), Ss. Cyril and Methodius University to be sub- sitting height (Fatmah 2005), length of scapula jects. This group was chosen because the growth (Campobasso et al. 1998), arm span (Aggrawal et of an individual ceases by this age and there is al. 2000; Bjelica et al. 2012; Bubanja et al. 2015; no age-related loss in body height at this age. Datta Banik 2011; Fatmah 2005; Hickson and Frost Although university-educated persons, accord- 2003; Jalzem and Gledhill 1993; Mohanty et al. ing to Bjelica et al. (2012) have been taller than 2001; Popovic et al. 2015; Ter Goon et al. 2011; the general population in Poland (Kulaga et al. Vujovic et al. 2015) as well as cranial sutures (Rao 2011; Wronka and Pawliñska-Chmara 2009), and et al. 2009), skull (Bidmos 2006; Bidmos and Asa- Hungary (Bodzsár and Zsákai 2008; Eiben and la 2005), facial measurements (Sahni et al. 2010) Tóth 2000; Szöllõsi 1998), but not in Montene- et cetera. Therefore, all these anthropometric in- gro (Bjelica et al. 2012; Popovic et al. 2014), the dicators, which are used as an alternative to es- researchers also believe that this sample could PREDICTION OF BODY HEIGHT BY ARM SPAN IN MACEDONIANS 739 fairly represent the whole population of Mace- erwise the respondents had to raise or lower their donia, as students were admitted into the Ss. chin until it was in the Frankfort horizontal plane Cyril and Methodius University regardless of to align their head properly. geographical residence and socioeconomic sta- The arm span is the anthropometric measure- tus, as well as ethnicity. The average age of the ment of the length from the tip of the middle fin- male subject was 19.25±1.23 years old (range 18- gers of the left and right hands when raised 24 years), while the average age of the female parallel to the ground at shoulder height at a one subject was 20.19±2.56 years old (range 18-28 hundred and eighty degree angle. It was mea- years). It is also important to emphasize that the sured using a calibrated steel tape to the nearest researchers could not accept students with phys- 0.1 centimeters bare feet on a level concrete floor ical deformities that could affect body height or with their upper backs, buttocks and heels arm span, and without informed consent were ex- against the wall, which provide support. The cluded from the study. The exclusion criterion was participant’s head was also in the Frankfort hor- also being non-Macedonian. Accordingly, the re- izontal plane and the arms were outstretched at searchers have purposely selected (deliberate right angles to the body with palms facing for- sampling) the students from the Faculty of Phys- wards. The measurements were taken from one ical Education at Ss. Cyril and Methodius Univer- middle fingertip to the other middle fingertip, sity, as they believed that most of them could be with the tape passing in front of the clavicles eligible to participate in the study, as well as this while two fieldworkers supported the elbows. is one of the highly ranked faculties of Physical The measurements were taken twice, and an av- Education in Macedonia, which brings together erage of the two readings was calculated. When students from all parts of Macedonia. the two measurements agreed within 0.4 centi- Although photogrammetric anthropometry is meters, their average was taken as the best esti- an accurate way nowadays, this is not valid for mate for the true value. When the two initial mea- arm span measurement (Penders et al. 2015) and sures did not satisfy the 0.4 centimeters criteri- the anthropometric measurements, including on, two additional determinations were made and body height and arm span, were taken according the mean of the closest records was used as the to the protocol of the International Society for best score. the Advancement of Kinanthropometry - ISAK The analysis was carried out using the Sta- (Marfell-Jones et al. 2006). The trained anthro- tistical Package for Social Sciences (SPSS) ver- sion 20.0. Means and standard deviations (SD) pometrist (the same one for each measure) whose were obtained for both anthropometric variables. quality of performance was evaluated against the A comparison of means of body heights and arm prescribed “ISAK Manual” prior to the study spans within each gender group and between performed these measurements. The age of the genders was carried out using a t-test. The rela- individuals was determined directly from their tionships between body height and arm span reported date of birth. were determined using simple correlation coeffi- The body height presents the perpendicular cients at ninety-five percent confidence inter- distance between the top of the head (the ver- val. Then a linear regression analysis was per- tex) and the bottom of the feet. It was measured formed to examine the extent to which the arm using a stadiometer to the nearest 0.1 centime- span can reliably predict body height. Finally, ters in bare feet with the participants standing these relationships were plotted as scatter dia- upright against a stadiometer. The respondents grams. Statistical significance was set at p<0.05. had to put their feet together and move back until their heels touched the bottom of the stadi- RESULTS ometer upright. Their buttocks and upper part of their back have also been touching the stadiom- A summary of the anthropometric measure- eter upright while their head did not have to touch ments in both genders is shown in Table 1. The the stadiometer. The respondent’s head had to mean of the arm span for male subjects was be in the Frankfort horizontal plane. This was 178.78±7.71 centimeters, which was 0.68±4.89 achieved when the lower edge of the eye socket centimeters more than the body height and sta- (the orbitale) is horizontal with the tragion. The tistically significant (t=-1.989, p<0.049), and for vertex was the highest point on their head, oth- female subjects it was 164.41±6.42 centimeters, 740 STEVO POPOVIC, DUSKO BJELICA, GEORGI GEORGIEV ET AL. which was 0.17±5.39 centimeters less than the The relationships between arm span measure- body height and statistically insignificant ments and body height among the above mod- (t=0.562, p<0.575). The gender difference between els is plotted as a scatter diagram (Fig. 1). body height and arm span measurements was sta- tistically significant (body height: t=17.31; p<.000, DISCUSSION and arm span: t=15.71; p<.000). This study contributes to a very important Table 1: Anthropometric measurements of the study update of average body heights among Mace- subjects donian males and females. The results proved Subjects Body height Arm span that Macedonian males with an average tallness range Range of 179.10 centimeters are close to the tallest na- (Mean±SD) (Mean±SD) tions in the Europe (Table 4), given 183.9 centi- Male 156.0 - 195.0 157.0 - 198.0 meters of the Bosnian and Herzegovinian male (178.10 ± 6.79) (178.78 ± 7.71) population (Popovic et al. 2015), 183.21 centime- Female 150.0 - 186.0 148.0 -186.0 ters of the Montenegrin male population mea- (164.58 ± 5.40) (164.41 ± 6.42) sured in 2011 (Bjelica et al. 2012), 182.4 centime- ters of the Dutch male population measured in The simple correlation coefficients and their the lifestyle, preventive screening in 2010-2013 ninety-five percent confidence interval analysis (Statistics Netherland 2015), and 182.0 centime- between the anthropometric measurements are ters of the Serbian male population measured in presented in Table 2. The relationships between 2012 (Popovic et al. 2013), but not close enough. body height and arm span were significant The average height of Macedonian men is still (p<0.000) and high in this sample, regardless of shorter than 181.3 centimeters of the Lithuanians gender (male: 0.879; female: 0.839). (Tutkuviene 2005), 180.6 centimeters of the Ice- landers (Dagbjartsson et al. 2000), 180.5 centi- Table 2: Correlation between body height and arm meters of the Croats (Juresa et al. 2012), 180.4 span of the study subjects centimeters of the Swedes (Werner and Bodin 2006), 180.3 centimeters of the Slovenes (Starc Subjects Correlation 95% confi- significance and Strel 2011), Danes (Statistics Denmark 2011) Coefficient dence p-value interval Table 4: An update of the top 10 tallest male nations on the earth Male 0.879 -1.366 – -0.003 <0.000 Female 0.839 -0.443 – 0.795 <0.000 S. Country Average Source No. body The results of the linear regression analysis height are shown in Table 3. The first of all models were 1. Bosnia and 183.9 Popovic et al. 2015 derived by including age as a covariate. Howev- Herzegovina Statistics 2015 er, it was found that the contribution of age was 2. Netherland 182.4 Netherland insignificant and therefore the age was dropped 3. Montenegro 183.2 Bjelica et al. 2012 4. Serbia 182.0 Popovic et al. 2013 and estimations were derived as a univariate anal- 5. Lithuania 181.3 Tutkuviene 2005 ysis. The high values of the regression coeffi- 6. Estonia 180.9 Kaarma et al. 2008 cient (male: 0.879; female: 0.839) signify that arm 7. Iceland 180.6 Dagbjartsson et al. span significantly predicts body height in both 2000 Macedonian genders (male: t=19.535, p<0.000; 8. Croatia 180.5 Juresa et al. 2012 female: t=17.069, p<0.000), which confirms the R- 9. Sweden 180.4 Werner and Bodin 2006 square (%) for the male (77.3) as well as for the 10. Slovenia 180.3 Starc and Strel 2011 female (70.3) population. Table 3: Results of linear regression analysis where the arm span predicts the body height

Subjects Regression coefficient Standard error (SE) R-square (%) t-value p-value

Male 0.879 0.040 77.3 19.535 0.000 Female 0.839 0.041 70.3 17.069 0.000 PREDICTION OF BODY HEIGHT BY ARM SPAN IN MACEDONIANS 741

200

190

180

170 Arm span (cm)

160

150

150 160 170 180 190 200 Body height (cm) Fig. 1. Scatter diagram and relationship between arm span measurements and body height among both genders Source: Authors and Czechs (Vignerová et al. 2006) and several Table 5: An update of the top 10 tallest female na- other nations, which made Macedonians the tall tions on the earth nation but not even close to being the top 10 S. Country Average Source tallest male nations on Earth. No. body On the other hand, the average body height height of Macedonian females were 164.58 centimeters 1 Bosnia and 171.8 Popovic et al. on average and this result proved that Mace- Herzegovina 2015 donian females are tall comparing to the rest of 2 Netherland 168.8 Statistics Netherland the countries but not as tall as 168.8 centimeters 2015 of the Netherlands (Statistics Netherland 2015), 3 Montenegro 168.3 Bjelica et al. 2012 4 Germany 167.7 Hesse et al. 1997 168.3 centimeters of the Montenegrins (Bjelica 5 Lithuania 167.5 Tutkuviene 2005 et al. 2012), 167.5 centimeters of the Lithuanians 6 Slovenia 167.4 Starc and Strel 2011 and several other nations ranked in the top 10 7 Iceland 167.2 Dagbjartsson et al. tallest female nations, according to the available 2000 8 Check Republic 167.2 Vignerová et al. record (Table 5). 2006 However, there is a hypothesis that both gen- 9 Latvia 167.1 Gerhards 2005 ders of Macedonia did not reach their full genet- 10 Sweden 167.0 Werner and Bodin ic potential yet, since they have been influenced 2006 by various environmental factors (wars in the former Yugoslavia, poor economic situation that still is the fact) in the last few decades. There- tries, while it is expected that the secular chang- fore, the researchers believe that these circum- es affecting height will go up in the following stances had a negative bearing on the secular two decades, comparing it to developed coun- trend in Macedonia as well as surrounding coun- tries where this trend has already completed. 742 STEVO POPOVIC, DUSKO BJELICA, GEORGI GEORGIEV ET AL.

It is also interesting to mention that the den- al. 2011). However, it must be underlined that the sity of very tall subjects appears not to be char- individual and ethnic variations in respect to acteristic of the Macedonian males, since 2.7 per- body height and its relation with arm span were cent measured 190 centimeters or more in body already observed in European (Reeves et al. height. If 2.7 percent in Macedonia were be com- 1996) and African populations (De Lucia et al. pared to 20.2 percent in the Bosnian and Herze- 2002), while Mohanty et al. (2001) have stated govinians (Popovic et al. 2015), twenty percent that the estimating equation varies from race to in the Netherlands (Pineau et al. 2005), fourteen race, and ethnic group to ethnic group. In Steele percent in Serbia (Popovic et al. 2013), thirteen and Chenier’s study (1990), the arm span was percent in Montenegro (Bjelica et al. 2012) and nearly 8.3 centimeters more than the body height only 1.5 percent in France (Pineau et al. 2005), it for Black population (105.36% body height), would imply that the density of very tall sub- whereas for White population this difference was jects in Macedonian males does not appear fre- only 3.3 centimeters (102.04% body height). quently like in the Dinaric Alps in general and Mohanty et al. (2001) have noted in their study the Netherlands, and it is much closer to the non- that the arm span was nearly 2.5 centimeters more Dianric Alps nations. On the other hand, the den- than the body height in South Indian females sity of very tall subjects does not appear to be (101.4% body height), which is similar to that characteristic of the Macedonian females too, noted in the White population. In Ter Goon et since less than one percent measured 180 centi- al.’s study (2011), arm span was 5.8 centimeters meters or more in body height (Fig. 2). more than body height for Nigerian males (103.3% The estimation of body height using various body height), whereas for Nigerian females this anthropometric measurements is very common difference was only 4 centimeters (102.5% body from the past centuries and it has been attempt- height), which is similar to that noted in the White ed to be studied by many researchers. As it is population, although they are Black. The most already mentioned, all of them estimated body recent studies conducted by Bjelica et al. (2012) height from various anthropometric measure- that showed that arm span was 2.5 centimeters ments, but it is important to emphasize that the more than body height for Montenegrin males arm span has been derived as the most reliable (101.4% body height), whereas for Montenegrin body indicator for predicting the body height of females this difference was only 0.24 centime- an individual (Mohantyet al. 2001; Ter Goon et ters but in favor of body height (99.9% body

30

20 Frequency 10

0

150 160 170 180 190 200 150 160 170 180 190 200 Body height (cm)

Fig. 2. Density of body height among both genders Source: Authors PREDICTION OF BODY HEIGHT BY ARM SPAN IN MACEDONIANS 743 height) and Popovic at al. (2013) that showed (2012) reported that the correlation was r=0.861 that arm span was 2.8 centimeters more than body for males and r=0.809 for female population, while height for Serbian males (101.5% body height), in Popovic et al.’s study (2013) correlation was whereas for Serbians females this difference was r=0.814 for males and r=0.822 for the female pop- only 0.15 centimeters but in favor of body height ulation. As the correlation between arm span and (98.7% body height) as well as Popovic et al. body height was high and significant in both (2015) that showed that arm span was 0.73 centi- Macedonian genders, the arm span measure meters more than body height for Bosnian and therefore seems to be a reliable indirect anthro- Herzegovinian males (100.3% body height), pometric measurement for estimating body height whereas for Bosnian and Herzegovinian females in Macedonian adults. Even though these rela- this difference was only 1.97 centimeters but in tions are similar, the estimation equations, which favor of body height (98.9% body height), while are obtained in the Macedonian population, are Quanjer et al. (2014) has highlighted the body substantially different from other populations. height estimated from the predicted arm span to height ratio may differ by up to ten percent from CONCLUSION actual stature. All mentioned have confirmed again the necessity for developing separate Although the results of this study confirm height models for each population on account the necessity for developing separate height of ethnic differences, while some of latest stud- models for each population on account of ethnic ies found the regional differences among the differences, it must be emphasized that further same ethnic groups (Bubanja et al. 2015; Vujovic researches should use larger samples for the pre- et al. 2015), which cause the need for additional diction of body height utilizing arm span mea- caution. Therefore, the main goal of the current surement, mostly due to the reason that this study was to find out if these facts are true for study as well as some other studies that has been the Macedonian population, since it is known attempted in the past have used quite small sam- that the estimating equation varies from race to ples. A more precise estimation of the average race, and ethnic group to ethnic group (Mohan- body height and its prediction utilizing arm span measurements in Macedonian adults would re- ty et al. 2001). Hence, in the present study it was quire a large sample with sufficient geographical also observed that the arm span was 0.68 centi- (type of the soil) and social heterogeneity (vari- meters more than the body height in males ous ethnic groups), or a national survey that (100.4% body height), while it was 0.17 centime- measures the whole population. Moreover, next ters less than the body height in Macedonian to the small sample, the obvious limitation of this female population (99.9% body height). The arm research study was the composition of the mea- span to height ratio in Macedonian males is quite sured sample that consisted of university stu- low when compared with other Europeans but it dents. Since university-educated persons have is very close to the data that was reached in the been taller than the general population in Poland measurement of the Montenegrin population and Hungary, but not in Montenegro, the re- (Bjelica et al. 2012), as well as Serbian population searchers cannot exclude the possibility that the (Popovic et al. 2013) and Bosnian and Herzegovin- body height of the students somewhat overesti- ian population (Popovic et al. 2015), while the mates the average body height of contemporary arm span to height ratio in Macedonian females Macedonians. On the other hands, it is also very is a almost equal when compared with Montene- important to highlight that body proportion mea- grin, Serbian, Bosnian and Herzegovinian popu- surement using photogrammetric anthropome- lation and other Europeans. try that is an accurate way nowadays is not valid The results of the previous studies are also for arm span measurement and it is recommend- very similar to the correlation obtained in the ed to keep the old fashion method of measuring present study (men: r=0.879; women: r=0.839). this body proportion. For example, Mohanty et al. (2001) reported that the correlation was r=0.82, while in Hickson and ACKNOWLEDGEMENTS Frost’s study (2003) correlation was r=0.86, and in Zverev’s study (2003) correlation was r=0.87 The researchers are grateful to Damjan Jak- for males and r=0.81 for the female population. In šic from the University of Novi Sad for his con- the most recent studies, Ter Goon et al. (2011) tribution to design of the picture and figures in reported that correlation was r=0.83, Bjelica et al. this manuscript. 744 STEVO POPOVIC, DUSKO BJELICA, GEORGI GEORGIEV ET AL.

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