Which of the following is NOT considered a physiological change during growth?

The option indicating physical appearance is not considered a physiological change during growth because it primarily encompasses superficial or external attributes that may change due to various factors, including environment, culture, and personal grooming, rather than purely biological ones. Physiological changes during growth typically refer to internal processes and adaptations that affect the body's functioning, such as increased strength, muscular endurance, and cardio-respiratory endurance. These attributes are directly linked to the body's biological development and fitness capacities, reflecting underlying physiological mechanisms such as muscle development, energy system efficiency, and overall physical capabilities. In contrast, physical appearance can include aspects like height and other external features, which are influenced by growth but do not entail the physiological processes that define functional capacity.