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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 1  |  Issue : 2  |  Page : 113-119

A study of the diurnal height changes among sample of adults aged 30 years and above in Ghana


Department of Nutrition and Food Science, School of Biological Sciences College of Basic and Applied Sciences, University of , P. O. Box LG 134, Legon, Accra, Ghana

Date of Web Publication23-Nov-2017

Correspondence Address:
Frederick Vuvor
Department of Nutrition and Food Science, School of Biological Sciences College of Basic and Applied Sciences, University of Ghana, P. O. Box LG 134, Legon, Accra
Ghana
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_97_17

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  Abstract 


Background: The diurnal variations in stature significantly affect the reliability of height data. Diurnal variation in stature affects the reliability of any data that involves height measurement without a correction factor at different times of the day. The aim of this study was to determine the diurnal height loss of adults aged ≥30 years in the Greater Accra Region of Ghana. Methods: A total of 90 individuals were randomly sampled. Weight and height measurements were taken twice a day between 5.30–7.30 am and 5–7 pm. The WHO Stepwise questionnaires were used to gather all information on subjects. Results: The maximum height loss between 7 am and 7 pm from the study was 2.7 cm whereas mean was 1.61 cm. There was a greater mean height loss in males (1.63 cm) than in females (1.59 cm), greater mean body mass index (BMI) difference between morning and evening BMI was observed for females (1.21 kg/m2) than in males (1.02 kg/m2). There was a significant association between height loss and occupational activities (P < 0.001). Conclusion: The height of the individuals significantly reduced from 7 am to 7 pm and increased from 7 pm to 7 am. The major factor that contributes to diurnal height variations is the level of occupational activity performed in a day. No significant relationships were established between age, sex, total caloric intake, and diurnal height loss.

Keywords: Anthropometry, body mass index, diurnal height variations, intervertebral disc


How to cite this article:
Vuvor F, Harrison O. A study of the diurnal height changes among sample of adults aged 30 years and above in Ghana. Biomed Biotechnol Res J 2017;1:113-9

How to cite this URL:
Vuvor F, Harrison O. A study of the diurnal height changes among sample of adults aged 30 years and above in Ghana. Biomed Biotechnol Res J [serial online] 2017 [cited 2018 May 27];1:113-9. Available from: http://www.bmbtrj.org/text.asp?2017/1/2/113/219118




  Introduction Top


Height of a person can be defined as the distance from the base of the foot (sole) to the top of the head. Anatomically, it is the composite of linear dimension of the roof or the maximum protuberance of the skull, vertebral column, pelvis, and the end of the lower limbs. It is the most predominantly used anthropometric indices. It has been employed in various fields of study and professions including, medicine in the study of height loss due to aging and many disorders such as scoliosis, knock-knees, hyperextended knees, bowlegs, and knee flexures in osteoporotic, spinal fracture studies, and in anthropometry. It is important in ergonomics concerned with fitting people, their technological tools, and environments.[1],[2],[3],[4]

It is usually assumed that any measurement at any time of height gives people sufficient information for whichever purpose it is taken for. However, there is systematic change in height with respect to time of the day which introduces errors usually considered by many as so small that can be safely ignored. On the contrary, diurnal variations in stature significantly affect the reliability of its use in different fields of discipline. There is a need to minimize measurement error of height in the assessment. Within the course of a day the types of activity may affect decline in height of an individual.[1],[5]

A study reported percentages pertaining to length of the body that is dominated by the spinal column as 33.33% and of this, 30% comprises of the intervertebral discs.[6] The greatest loss in height has been isolated to the region of the lumbar vertebra which possesses the thickest intervertebral discs in the spine.[7] Collagen and proteoglycans are the major macromolecular constituents of the nucleus pulposus of the intervertebral discs, which consists of a network of collagen fibers embedded in a proteoglycans gel.[8] The nucleus pulposus gel consists of 80%–90% water. It is variable and represents equilibrium between the mechanical pressure which dehydrates the gel, and the swelling pressure of the hydrophilic proteoglycans, which causes the gel to absorb fluid. The mechanical pressure occurs during the day due to factors such as the body mass index (BMI) of the individual, gravitational force, occupational exposures, and activity which introduce forms of load on the body.[9],[10] Fluid is expelled from the nucleus pulposus of the intervertebral discs, which leads to the decrease in stature.[11] This was confirmed that the amount of height loss is proportional to the amount of fluid loss and degree of compressive loads on the spine.[12] The swelling pressure, on the other hand, occurs during recumbence of sleep or when one is in a supine position, where the loading of intervertebral discs are significantly reduced, resulting in them absorbing fluid, increasing in volume and subsequently, increasing the total stature of an individual.[11] The diurnal variations in the discs indicate water can be squeezed out under pressure and compressive load when it exceeds the osmotic pressure of the discal tissue leading to the expulsion of fluid, respectively.[13],[14]

Studies have shown that about 1 cm to 3 cm loss in stature of an individual is due to 9.9%–20% decrease in vertebral column height. Stature loss is also thought to occur in the joints of the pelvis, knee and ankle. Height is expected to be at its maximum after rising from bed. Diurnal variations in stature may substantially affect the reliability of height data at different times of the day.[1],[8],[15],[16]

Due to the increasing use of height in the estimation of nutritional, health status, ergonomic, and medico-legal quantitative measures of individuals, there is the need to standardize the height measurement and BMI of an individual taking into account the diurnal changes in height. This study considered diurnal loss in heights for effective analysis, interpretation, and use.


  Methods Top


Study design and population

The experimental sample consisted of randomly selected individuals of both genders classes from the six different districts in the Greater Accra Region. The weight and height of each individual were measured in the morning (5.30 am to 7.30 am) and also in the evening (5 pm to 7 pm). The measurements were taken in triplicates using the standard techniques. Interview-administered questionnaires were used to gather all information on the individuals.

The eligible individuals were apparently healthy, free from any ailment and deformity; aged 30 years and above; not pregnant or lactating and willing to take part in the experimental study at those times (5.30 am–7.30 am and 5 pm–7 pm) of the day. The height of an individual rapidly begins to decrease within the first 2 h after rising from bed.[1] The average Ghanaian is usually awake and ready by 6 am and is usually closed from work by 5 pm. These made it a convenient time for the willing individuals to participate in the study.


  Results Top


Background information

The results showed majority of the respondents were in the age group of 30–50 years (66.8%). The least proportion of respondents was in the 66–70 years age group. Of the 90 respondents interviewed, 57.8% comprised of males [Table 1].
Table 1: Background Information on age and sex

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Diet and eating habits

An assessment of the total caloric intake per day revealed that the majority of the subjects (51.1%) had caloric intakes between 2000–2999 kcal during the day of data collection [Figure 1].
Figure 1: Distribution of Subjects by their total caloric intake (kcal)/day

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Anthropometric data

The BMI classification used was as employed.[17] Nearly 44.4% of the respondents were observed to be overweight, whereas 28.9% of the respondents were obese. Only 1.1% of the individuals were found to be underweight [Figure 2].
Figure 2: Body mass index profile of subjects

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The most height loss by the individuals after the morning and evening measurements of stature was between the values of 1.4 cm and 1.5 cm (14.4%). The least proportion of height loss (3.3%) was recorded for 2.2 cm–2.3 cm [Figure 3].
Figure 3: Height loss by subjects between morning and evening

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The mean morning and evening heights of the males were 174.68 cm and 176.31 cm, respectively, and resulted in a mean height loss of 1.63 cm. The morning and evening heights ranged from 149.80 cm to 192.10 cm and 152.10 cm to 194.00 cm, respectively while the losses in height ranged from 0.70 cm to 2.60 cm. The weight gain ranged from 1.00 to 3.00 kg. The calculated BMI for males in the morning differed from that of the evening by values that ranged from 0.56 to 1.79 kg/m2. The females however recorded mean morning and evening heights of 166.60 cm and 165.01 cm, respectively, and that resulted in a mean height loss of 1.59 cm. While the morning height ranged from 151.20 cm to 184.1 cm, the evening height ranged from 152.10 cm to 185.60 cm. The losses in height ranged from 0.70 cm to 2.70 cm. The calculated BMI for the morning differed from that of the evening by values that ranged from 0.56 to 1.95 kg/m2.

The graph shows an inverse relationship between BMI and Height loss [Figure 4].
Figure 4: A graph of body mass index against height loss

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The graph shows an inverse relationship between age and height loss [Figure 5].
Figure 5: A graph of age against height loss

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The graph shows an inverse relationship between total caloric intake and height loss [Figure 6].
Figure 6: A graph of total caloric intake against height loss

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On analysis of correlation, it was revealed that parameters such as age, BMI, and total caloric intake showed a negative correlation with height loss. The correlation coefficients also showed a poor fit between all parameters and height loss. The analysis further revealed that, the relationships between age, BMI, and total caloric intake were not significant (Sig. 2 tailed > 0.05).

Detailed cross tabulations are shown in [Table 1], [Table 2], [Table 3], [Table 4]
Table 2: Descriptive statistics for weight, height, and body mass index

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Table 3: Association between other variables and height loss

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Table 4: Correlation between total caloric intake (kcal) and height loss (cm)

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The analysis of variance revealed the existence of an association between the variables and height loss [Table 2]. However, the associations between type of physical exercise performed and height loss was not significant while that between the level of activity/occupational exposure, condition/mode of activity, and height loss showed a strong association (P < 0.001) [Figure 7] and [Figure 8].
Figure 7: Distribution of different levels of activity

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Figure 8: Distribution of different types of physical activities

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The t-test analysis also revealed that sex, back pain, and marital status did not have any significant association with height loss. Knee joint pain, however, showed a strong association with height loss.


  Discussion Top


The male respondents recorded a mean evening and morning height of 174.68 cm and 176.31 cm, respectively, whereas the females recorded 165.01 cm and 166.60 cm for the mean evening and morning heights, respectively. Now, it is evident from the results that, the stature of an individual shows a variation at different times of the day (morning and evening). The variations which were observed to be losses in height were found to be a mean loss of 1.63 cm for males and 1.59 cm for females. These variations ranged from 0.70 cm to 2.70 cm. Buckler in 1978, also recorded a similar range from 0.80 cm to 2.80 cm in his study and further explained that the decline in height was not always continuous throughout the day nor are measurements necessarily identical at similar times on consecutive days. This may imply that the pattern of activity during the day, affects diurnal height to some extent.

Since the height of an individual rapidly begins to decrease within the first two hours after rising[1] and is said to stop 6 to 7 h after rising,[15] comparable time periods of 6 am–8 am and 5 pm–7 pm were chosen to adhere, to a certain degree, the earlier statement by Buckler in 1978. For quality assurance purposes, any individual not measured within this time range was ruled out. In general, taller subjects recorded greater variations in stature than shorter subjects. This find is in conformity with the outcomes from previous studies and in general agreement with the statement given by Krishan and Vij.[1]

[Table 4] also shows a clear difference in the height loss among the sexes. Males recorded greater losses than females. The comparatively small diurnal variation in stature among the female subjects could not be properly explained by Krishan and Vij;[1] however, they gave a probable reason in relation to genetics and with an example stated that females were more canalized than their male counterparts. In relation to the weights of the subjects, males are generally heavier set since they have more body muscles than fat compared to the females.[18] Thus, males will show will show greater variations in height due to the body's compressive force under the influence of gravity. The t-test Analysis in [Table 4] indicates that sex played no significant role in height loss (P = 0.720). Majority of the individuals (49.9%) recorded height losses between 1.0 cm and 1.9 cm.

Repeat measurements on individual adults were to be made not only with the same instrument but also by the same observer and assistant to ensure accuracy and consistency in the height measurements. Voss et al.[19] opined that the ideal adult to measure would be rigid, but a living subject is of no fixed height. He further explained that independent of diurnal variation, the posture can vary from one moment to the next, and the aim of measurement can only be to estimate an adult's mean height by making several separate observations.

The loss in height and gain in weight as indicated in [Table 4] by the individuals from morning to evening resulted in a mean evening BMI of 28.49 kg/m2 and mean morning BMI of 27.39 kg/m2. Their mean gain in BMI from the morning to evening was 1.10 kg/m2 and ranged from 0.56 kg/m2 to 1.95 kg/m2. These values clearly show how significant diurnal height losses affect the reliability of height data and this should give rise for concern, whether in the communities, clinics, and research departments. In the year 1997 and 2007,[1],[15] respectively made general statements that complied strongly with the latter statement.

A rather intriguing find was the association between BMI and height loss which according to[20],[21] was positively correlated and significant. The graph of BMI against height loss indicated an inverse relationship, where an increase in BMI gave a corresponding lower decrease in stature [Figure 4]. In logical terms, on the other hand, the weight of the body which acts as a compressive load on the spine due to gravity should lead to a corresponding increase in height loss with increasing BMI. The findings of this study, however, showed no significant relationship between these two [Table 3]. A possible explanation to this may be as a result of the activities one performs during the day. This acts as a confounder since other studies that have proven the existence of this positive relationship were performed based solely on BMI and height loss under controlled laboratory conditions.

The age distribution showed that the age group of 30–50 had the highest proportion of respondents (15.6%). The least proportion was found in the 66–70 years age group (3.3%). There were more males (57.8%) than females (42.2%) in the study with the highest male proportion being in the 30–40 years age group whereas the highest female proportion was found to be among the 41–45 years age group. The maximum height loss was found to be more prominent among subjects of the 41–50 years age group.

The negative slope in [Figure 5] indicates an inverse correlation between age and height loss. Thus, as age increases the height loss of individuals decreases. In an attempt to find whether age did, in fact, influence height loss, Reilly and Freeman (2006) in their findings showed that irrespective of age one loses height based on the compressive loading on the spine. In relation to this statement, the heavier free fat mass found in younger individuals could be the factor or compressive load that makes them gain greater height losses than their older counterparts [Table 2] and [Table 5].{Table 5}

The study revealed that the majority (60.0%) of the respondents performed occupations that were classified under light work such as secretary, bank manager, and cashier. while the least proportion of respondents (12.2%) performed heavy duty work such as digging, masonry, weight lifting, and truck pushing. It was further observed from the study that the work activities involved conditions such as sitting, walking, standing, running, or a combination of any two. The results demonstrated significant occupational activity-related decreases in height (P < 0.001) [Table 4]. This clearly implies that the activity one performs during the day plays a vital role in diurnal height variations. A number of documentation[10],[12],[22],[23] showed similar results and opined that the main cause of height loss was due to the type, condition, and level of activity of any occupation one perform during the day. The degree of shrinkage was related to the magnitude of compressive load or force on the spine.[6] A typical example by Adams et al.[11] explained the time scale and magnitude of diurnal changes, revealing that heavy labor will have a greater effect in less time than sedentary activities.

Thirty percent (30%) of the respondents performed planned physical exercises during the day. The type of physical exercise reduced in intensity from anaerobic, aerobic to flexibility exercises.[24] No significant relationship was observed on analysis of the association between type of physical exercise and height loss [Figure 6]. A high proportion of height is lost within the first 2–3 h of the day after rising from bed.[5] This loss occurs spontaneously due to the effect of gravity on an individual. After further probing of individuals, it was made clear that the planned physical exercises were usually performed during this period (2–3 h after rising), and may have offset to some extent the effect of the exercises on height loss.[25]

Most respondents (51.1%) consumed between 2000 and 2999 kcal during the course of the day whilst only 4.4% of the respondents consumed 4000–4999 kcal. A cross tabulation between height loss and total caloric intake revealed that those who consumed between 2000 and 2999 kcal recorded the most height loss [Appendix 3]. [Figure 6] shows an inverse relationship between caloric intake and height loss. An increase in food consumption, therefore, should have a corresponding decrease in height loss. This relationship was not significant (two-tailed 0.619). However, a very significant association exists between weight gain by the day's end and total caloric intake for that day (<0.001). It may be stipulated that, though eating leads to slight weight gain at the end of the day, it does not necessarily contribute to height loss in any way [Figure 7].

Equal percentages of respondents (30%) were observed to have reported of recent back pain and knee joint pain [Table 3]. These percentages were not however from the same individuals. There was no significant association between height loss and back pain, but a very significant association between height loss and knee joint pain was observed after an independent sample t-test. Ismaila and Charles-Owaba, in 2008[10] found conclusive evidence that state otherwise. They linked spinal shrinkage to back pain and reported that the spine may be prone to injuries if the load or its frequency exceeds the tissue threshold or tolerance. This ideology may be linked to the occurrence of knee joint pain when high biomechanical force promotes thinning of the knee cartilages.[26] A possible explanation may be due to when the biomedical force for supersedes the tolerance level of the knee tissues.

In summary, the maximum height losses (2.6–2.7 cm) were found to be most prominent for subjects within the 41–50 years age group (57.2%), who were males (71.4%), with BMI in the normal and obese ranges (85.8%), who performed heavy work (85.7%) and who consumed 2000–2999 kcal/day (57.1%). Significant associations existed between level and conditions of activity or occupation (<0.001) [Figure 9].
Figure 9: Types of exercise participants engage in

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  Conclusion Top


It has been concluded that intra-individual variation in stature can substantially affect the reliability of height data. The average loss in the height of Ghanaian subjects was 1.61 cm. The maximum permissible shrinkage was 2.7 cm whiles the least was 0.7 cm. The occupational activities performed by the respondents, acts as the major cause of diurnal variation in height, though this occurs in varying degrees due to differences in posture and conditions of the activities. Age, sex, BMI, and total caloric intake influence height loss. The occurrence of knee joint pain showed a statistically significant association with height loss. This investigation alarms scientists in fields of study about the measurement of height and of the accountability and significance of diurnal variations in height.

Acknowledgments

The authors would like to express their appreciation to the study participants, Nutrition Teaching/Research Assistants, Tepe – Mensah Felix, Prof. Matilda Steiner-Asiedu, and Prof. Emmanuel Ohene Afoakwa, all of the Department of Nutrition and Food Science, University of Ghana for their kind support of this work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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2.
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Berecki-Gisolf J, Spallek M, Hockey R, Dobson A. Height loss in elderly women is preceded by osteoporosis and is associated with digestive problems and urinary incontinence. Osteoporos Int 2010;21:479-85.  Back to cited text no. 4
    
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Buckler JM. Variations in height throughout the day. Arch Dis Child 1978;53:762.  Back to cited text no. 5
    
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Eston R, Reilly T. Kinanthropometry and Exercise Physiology Laboratory Manual: Tests, Procedures and Data. Physiology Vol. 2. London, UK: Routledge, 2007.  Back to cited text no. 6
    
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Karakida O, Ueda H, Ueda M, Miyasaka T. Diurnal T2 value changes in the lumbar intervertebral discs. Clin Radiol 2003;58:389-92.  Back to cited text no. 7
    
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Park CO. Diurnal variation in lumbar MRI. Correlation between signal intensity, disc height, and disc bulge. Yonsei Med J 1997;38:8-18.  Back to cited text no. 8
    
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Rodacki AL, Fowler NE, Provensi CL, Rodacki Cde L, Dezan VH. Body mass as a factor in stature change. Clin Biomech (Bristol, Avon) 2005;20:799-805.  Back to cited text no. 9
    
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Ismaila S, Charles-Owaba O. Determination of the highest permissible spinal shrinkage. Aust J Basic Appl Sci 2008;2:872-5.  Back to cited text no. 10
    
11.
Adams MA, Dolan P, Hutton WC, Porter RW. Diurnal changes in spinal mechanics and their clinical significance. J Bone Joint Surg Br 1990;72:266-70.  Back to cited text no. 11
    
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Kourtis D, Magnusson ML, Smith F, Hadjipavlou A, Pope MH. Spine height and disc height changes as the effect of hyperextension using stadiometry and MRI. Iowa Orthop J 2004;24:65-71.  Back to cited text no. 12
    
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White AA 3rd, Gordon SL. Synopsis: Workshop on idiopathic low-back pain. Spine (Phila Pa 1976) 1982;7:141-9.  Back to cited text no. 13
    
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Dowzer CN, Reilly T, Cable NT. Effects of deep and shallow water running on spinal shrinkage. Br J Sports Med 1998;32:44-8.  Back to cited text no. 14
    
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Voss LD, Bailey BJ. Diurnal variation in stature: Is stretching the answer? Arch Dis Child 1997;77:319-22.  Back to cited text no. 15
    
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Siklar Z, Sanli E, Dallar Y, Tanyer G. Diurnal variation of height in children. Pediatr Int 2005;47:645-8.  Back to cited text no. 16
    
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Barba C, Cavalli-Sforza T, Cutter J, Darnton-Hill I, Deurenberg P, Deurenberg-Yap M, et al. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004;363:157-63.  Back to cited text no. 17
    
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Bowman B, Russell R, International Life Sciences Institute. Present Knowledge in Nutrition. Washington, D.C.: ILSI Press; 2001.  Back to cited text no. 18
    
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Voss LD, Bailey BJ, Cumming K, Wilkin TJ, Betts PR. The reliability of height measurement (the Wessex Growth Study). Arch Dis Child 1990;65:1340-4.  Back to cited text no. 19
    
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Shigeta Y, Ogawa T, Venturin J, Clark GT, Enciso R. The influence of age and BMI on intervertebral disc height and oropharyngeal airway in Japanese men and women. Int J Comput Assist Radiol Surg 2008;3:97-103.  Back to cited text no. 20
    
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Yar T. Using “spinal shrinkage” as a trigger for motivating students to learn about obesity and adopt a healthy lifestyle. Adv Physiol Educ 2008;32:237-41.  Back to cited text no. 21
    
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Leivseth G, Drerup B. Spinal shrinkage during work in a sitting posture compared to work in a standing posture. Occup Health Ind Med 1998;1:32.  Back to cited text no. 22
    
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Bourne ND, Reilly T. Effect of a weightlifting belt on spinal shrinkage. Br J Sports Med 1991;25:209-12.  Back to cited text no. 23
    
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Smith F. Measurement of diurnal variation in intervertebral disc height in normal individuals: A study comparing supine with erect MRI. Radiol Soc N Am 2003;Q13-1315.  Back to cited text no. 25
    
26.
Waterton JC, Solloway S, Foster JE, Keen MC, Gandy S, Middleton BJ, et al. Diurnal variation in the femoral articular cartilage of the knee in young adult humans. Magn Reson Med 2000;43:126-32.  Back to cited text no. 26
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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