ABSTRACT. Objective. To assess secular trends in menarcheal age between 1973 and 1994 and to determine whether childhood levels of height, weight, and skinfold thicknesses can account for racial (white/black) differences in menarcheal age.Methods. Data from 7 cross-sectional examinations of school-aged children, with menarcheal age obtained through interviews, were used for both cross-sectional (11 218 observations) and longitudinal (n ؍ 2058) analyses. In the latter analyses, the baseline examination was performed between ages 5.0 and 9.9 years, and the mean follow-up was 6 years.Results. Black girls experienced menarche, on average, 3 months earlier than did white girls (12.3 vs 12.6 years), and during the 20-year study period, the median menarcheal age decreased by approximately 9.5 months among black girls versus approximately 2 months among white girls. As compared with 5-to 9-year-old white girls, black girls were taller and weighed more, characteristics that were predictive of a relatively early (before age 11.0 years) menarche. However, even after adjustment for weight, height, and other characteristics, the rate of early menarche remained 1.4-fold higher among black girls than among white girls.Conclusions. Additional study of the determinants of menarcheal age is needed, as the timing of pubertal maturation may influence the risk of various diseases in adulthood. Pediatrics 2002;110(4). URL: http://www. pediatrics.org/cgi/content/full/110/4/e43; menarche, obesity, blacks, height, secular trend.ABBREVIATIONS. BMI, body mass index; RR, rate ratio. B lack girls in the United States undergo sexual development at younger ages than do white girls. [1][2][3][4][5] In a study of 17 000 girls, for example, mean menarcheal ages were 12.2 years (blacks) and 12.9 years (whites), 4 a racial difference consistent with those that have been observed in the development of breast and pubic hair. 2,3 The timing of these events may influence the risk of various diseases in adulthood, and an early menarche has been associated with an increased risk for breast cancer, 6 obesity, 7-9 and spontaneous abortion. 10 The reasons for these racial differences in menarcheal age are uncertain, but several characteristics, such as obesity, 11-14 height, 3,8,13-15 and skeletal maturation, 16 -18 are known to influence sexual development. Furthermore, the dramatic decrease in menarcheal age between the mid-1800s and the mid-1900s 19 may be related to the changes in childhood heights and weights that occurred during this period as a result of improved nutritional status. As compared with similarly aged white girls, black girls are more advanced skeletally (after age 9 years), 20 are taller, 3,21 and are heavier. 3 It is uncertain, however, whether these characteristics account for the earlier sexual development of black girls in the United States.The objectives of the current study were to examine changes in the menarcheal ages of girls between 1973 and 1994 and to determine whether differences between black and white girls are attri...