It has been hard to miss Hussain Bisad this week. The papers have been full of the 27-year-old asylum seeker who has come to north London from Somalia, and who is also a contender for the title of world's tallest man. Bisad is 7ft 7in and growing. He weighs 33 stone, sleeps in a 9ft bed, and takes size 26 shoes which have to be made for him in Thailand, at the tidy sum of £600 a pair. In an average day he consumes 5lb of pasta, half a loaf of bread, three tins of tuna, two tins of baked beans, and 24 pints of water.
Though Bisad professes to be happy with his height, being excessively tall is usually a sign of one of a number of conditions, most of which lead to greatly shortened life expectancy. Doctors are concerned that Bisad may be suffering from gigantism. His symptoms suggest that a tumour in his pituitary gland has prevented him from experiencing normal puberty, and he has simply continued growing. It is a condition which could prove fatal if left untreated.
Height is an inherited characteristic. Most children grow at a rate of around two or three inches a year, from the age of four until they reach puberty. More than 5ft 8in is considered tall for women, and more than 5ft 11in is tall for men. Generally, people who are taller than average can be expected to live longer. They are also less likely to develop chronic diseases and strokes, though they are prone to knee and back injuries, muscular pain, and non-smoking related cancers, such as cancer of the colon, breast, stomach, bowel, skin and prostate.
Excessive height can be attributed to a number of medical conditions, with a variety of different causes. Gigantism, such as may be the case with Bisad, results from an over- secretion of growth hormones by the pituitary gland, leading to excessive growth of all the body tissue. It is a condition which can affect children, adolescents and adults. If it strikes before the end of puberty, the person will grow to be unusually tall, with large feet and hands, and large facial features. The tallest man ever was the American, Robert Wadlow, whose gigantism took him to 8ft 11in. He died in 1940, aged just 22.
If the pituitary gland only goes haywire once an individual has reached adulthood, the effect is somewhat different. When we stop growing, our bones fuse at the ends. If the pituitary becomes overactive after this has occurred, the adult develops what is known as acromegaly. Because the bones cannot actually grow longer, they begin to thicken instead. It is predominantly the bones of the hands, feet and skull which are affected, with the fingers and toes growing spadelike, and the bones of the cheek and jaw becoming more prominent. The voice may also grow deeper, as a result of cartilage growth in the Adam's apple. The soft tissues, such as the tongue and the liver, will also become enlarged. Both gigantism and acromegaly are usually caused by a tumour of the pituitary, and treatment involves either removal or irradiation.
The metabolic rate of someone with gigantism or acromegaly is at least 20% higher than that of a normal person, and they are also likely to suffer hyperglycaemia, owing to over-activity of the cells which manufacture insulin in the pancreas, eventually leading to diabetes. It is these metabolic abnormalities which result in the life expectancy of a giant being shorter than normal.
Gigantism, although very rare, is the most common reason for abnormal growth. However, it is not the only condition in which excessive height is often a symptom. Other conditions include Marfan syndrome and Sotos syndrome. In 75% of cases, Marfan syndrome is an inherited disorder of the connective tissue. The sufferer is characteristically tall, thin, and pigeon-chested with long limbs and, often, a spinal curvature. Sotos syndrome is a rare disorder, with only 100 families known to the Sotos Group in the UK. Characteristics include accelerated growth, large hands and feet and poor coordination. Sotos syndrome is thought to be genetic, though this has yet to be confirmed.
Klinefelter syndrome occurs in 1.3 per 1,000 male births, and is caused by an extra X chromosome. At birth, the baby may be smaller than average, but growth, especially of the legs, is rapid in childhood. After puberty, someone with Klinefelter syndrome is approximately four inches taller than average. Although characteristically gangly, those with the disorder sometimes develop obesity. They often experience learning difficulties. The syndrome also results in infertility.
But not all very tall people have a health problem. Indeed, 30% of people under 25 are now over 6ft. The Tall Persons Club cites well over 1,000 members in the UK, with the average female member 6ft 1in, and the average male standing 6ft 6in tall. The group provides support for tall people throughout the country, supplying a directory of where to buy clothing, footwear and furniture, and lobbying high-street stores to take extra length into account. It's a battle they may not have to fight for too much longer. Thanks to improved nutrition, the height of the average Briton has increased 0.75 inches with each generation. At this rate, in a couple of generations, the average British man will be 6ft tall, and the average woman, 5ft 7in. The only way, it seems, is up.
