Childhood overweight and obesity and timing of puberty in boys and girls: cohort and sibling-matched analyses

Abstract

Background Early puberty is a risk indicator for adult diseases. Identification of modifiable causes of earlier puberty is, therefore, warranted. We estimate the association between childhood body mass index (BMI) and pubertal timing in a cohort study and in a sibling-matched study to adjust for unobserved time-stable confounders shared within families. Methods For the cohort study, 11 046 of 22 439 (49%) invited children, born 2000–203, from the Danish National Birth Cohort (DNBC) had information on childhood BMI at 7 years and self-reported, half-yearly puberty information from 11 years on Tanner stages, menarche, voice break, first ejaculation, acne, and axillary hair. For the sibling-matched study, 1700 brothers and sisters were included among 86 820 live-born singletons from the DNBC. Results Childhood overweight (85th ≤ BMI < 95th percentile) and obesity (BMI ≥ 95th percentile) were associated with earlier age attaining the pubertal milestones in a dose-dependent manner in boys and girls. When modelling all pubertal milestones simultaneously, the pubertal milestones were attained earlier in: overweight boys: −3.1 [95% confidence interval (CI): −4.5, −1.7] months, overweight girls: −5.5 (95% CI: −7.1, −3.9) months, obese boys: −3.5 (95% CI: −5.1, −2.0) months, obese girls: −5.2 (95% CI: −7.1, −3.4) months compared with normal weight (BMI < 85th percentile) children. In the sibling-matched study, higher BMI was associated with earlier age at attaining most pubertal milestones in girls, but only a tendency toward earlier pubertal timing was observed in boys. Conclusions Childhood overweight and obesity were associated with earlier pubertal timing even after adjustment for unobserved time-stable confounders shared within families.

Ultrasound assessment of pubertal breast development in girls: intra- and interobserver agreement

“…Nevertheless, causality is not established by these studies due to their cross-sectional design. Longitudinal studies have also found associations between a higher weight status in childhood before pubertal onset (down to three years in one study), and younger ages at pubertal timing (15,34,90,(119)(120)(121)(122)(123). These studies suggest that increased body weight, including the presence of overweight and obesity, may lead to the early onset of puberty.…”

Increased incidence of precocious and accelerated puberty in females during and after the Italian lockdown for the coronavirus 2019 (COVID-19) pandemic

“…Our study may help shed light on 3 factors hypothesized in the literature as potentially contributing to the timing and/or tempo of pubertal development: an increased BMI [ 28 , 29 ], the “overuse” of electronic devices [ 21 ] and psychological triggers [ 30 ].…”

Etiology of Increased Referrals for Evaluation of Early Puberty in a Tertiary Care Center in Turkey: True Precocious Puberty, Obesity, or Parental Anxiety and Lack of Knowledge?

“…Increased caloric intake causes faster linear growth, accelerated bone age maturation, and earlier onset of puberty. 2 - 4 The earlier onset of puberty due to obesity does not cause problems that we commonly encounter in true precocious puberty. Usually, these girls do not menstruate before the age of 10 years and the final height stays within the target height since they are typically taller for their age.…”

“… 1 However, the timing of puberty may vary according to the nutritional status of the child. 2 - 4 There has been an increased number of pediatric endocrinology referrals of girls for the concerns of early puberty in most medical centers all over the world, 5 paralleling the increase in childhood obesity in the past 2 decades. 6 However, the reasons behind the increased referrals for the concerns of early puberty is not clear and has not been well studied.…”