Elsevier

Annals of Epidemiology

Volume 14, Issue 3, March 2004, Pages 179-187
Annals of Epidemiology

Characteristics of pubertal development in a multi-ethnic population of nine-year-old girls

https://doi.org/10.1016/j.annepidem.2002.08.001Get rights and content

Abstract

Purpose

Early age at menarche increases future disease risk. Secular decline in age at menarche has been attributed to body size characteristics, diet, and energy expenditure. Risk factors for puberty have been less frequently explored.

Methods

A cross-sectional study of 186 New York Metropolitan Area, 9-year-old girls (54 African-American, 70 Hispanic, 62 Caucasians) used interviewer-administered questionnaires to assess exposures. Height and weight were measured. Pediatricians assessed pubertal development according to Tanner stages.

Results

African-Americans were more likely than Caucasians to have achieved puberty as determined by breast or hair development (stage 2 or higher) [age-adjusted odds ratios and 95% confidence intervals = 4.91 (2.15–11.19) and 4.25 (1.85–9.77), respectively]. Pubertal development was similar among Hispanics and Caucasians. Adiposity and height were significantly positively associated with breast or hair development. More sedentary activity hours non-significantly increased the likelihood of hair development. Lower energy, but higher polyunsaturated fat, consumption were suggestive of an association with breast development. Vitamin C and hair development were inversely related. No other nutrients or physical activity measures were related to pubertal development.

Conclusions

Results are consistent with height and adiposity being associated with pubertal development. Sedentary activity or diet might possibly influence maturation.

Introduction

Puberty, characterized by the development of secondary sexual characteristics, begins approximately 3 years before menarche. Pubertal onset is modestly correlated with age at menarche 1., 2.. Early maturation has been linked to adverse health outcomes including insulin resistance, breast cancer, and cardiovascular disease 3., 4.. Age at menarche varies by geography (5), has declined secularly (6), and differs by race/ethnicity (7). Similar trends, though not well documented, may exist for age of pubertal onset (8). A recent study of over 17,000 US girls found that African-American girls began menses approximately 8.5 months earlier than white girls; pubertal breast and hair development began on average 1 and 1.5 years, respectively, earlier in African-American girls (7). Mexican-American girls are believed to have similar or slightly later reproductive development than Caucasian girls (9). Yet little published information on maturation in other US Hispanics is available. As reproductive characteristics such as birthweight differ among Hispanic subgroups, it is plausible that reproductive development also varies (10).

Acknowledged disparities in the age at menarche imply that environmental factors influence reproductive development, but determinants of earlier maturation are unclear. Adiposity has been consistently, positively associated with onset of menses 11., 12., 13.. Other factors, including height, diet, and physical activity, have also been linked with menarche, though less consistently 14., 15., 16., 17., 18.. Whether these characteristics affect pubertal development is unknown 13., 15., 19.. We undertook a study of African-American, Hispanics, and Caucasian girls to examine pubertal development in relation to body size, physical activity, and diet.

Section snippets

Methods

A cross-sectional study was undertaken in New York City from Spring 1997 to Fall 1998. Nine-year-old girls of African-American, Hispanic, or Caucasian race/ethnicity, visiting the Mount Sinai Hospital Pediatric Clinic or a nearby pediatric private practice for a wellness visit were eligible. Girls with existing endocrine disorders were ineligible. Of 224 girls invited to participate, 200 (89%) were eligible, agreed to do so, and had either parental or guardian-signed informed consent. Refusal (n

Results

Figure 1 displays the distributions of breast and hair Tanner stage; more girls were considered pubertal for breast (52%) than for pubic hair development (32%). Pubertal girls were slightly older and their mothers were less educated than prepubertal girls (Table 1). Of 186 girls, 54 were African-American, 70 were Hispanic, and 62 were Caucasians. Among mothers of Hispanic girls, 59% were US born, 26% were born in Puerto Rico, 10% were born in the Dominican Republic, and 5% were born in other

Discussion

Our study is among few that have examined early pubertal development, and is the first to do so among African-American, Caucasian, and Hispanic girls. A large percent of our population had Caribbean maternal ancestry, another unique study feature. Indeed, the percent of our girls with ancestry in the Caribbean Islands may be larger, because the only information available on the girls' ancestry was maternal birthplace. Advanced breast and hair pubertal status was more common among older girls as

Acknowledgements

Support by grants from EPA R825816, CDC CCU300860, AICR 97A057 and from the Rubin Shulsky Philanthropic Fund of the Jewish Communal Fund is gratefully acknowledged. We thank Nell Maloney, Nicole Serra, and Danielle Taylor-Thomas for recruiting patients and for assistance in interpretation of the clinical data; Dr. Nathan Kase and Dr. Neil Leleiko for guidance in the study design and in clinical interpretations; and Yannis Jeminai for programming support.

References (49)

  • C.M. de Ridder et al.

    Body fat mass, body fat distribution, and pubertal development: A longitudinal study of physical and hormonal sexual maturation of girls

    J Clin Endocrinol Metab

    (1992)
  • R.H. Largo et al.

    Pubertal development in Swiss girls

    Helv Paediatr Acta

    (1983)
  • J.A. Morrison et al.

    Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study

    J Pediatr

    (1999)
  • J.L. Kelsey et al.

    Epidemiology and prevention of breast cancer

    Annu Rev Public Health

    (1996)
  • W.A. Marshall et al.

    Variations in patterns of pubertal changes in girls

    Arch Dis Child

    (1969)
  • G. Wyshak et al.

    Evidence for a secular trend in age of menarche

    N Engl J Med

    (1982)
  • M.E. Herman-Giddens et al.

    Secondary sexual characteristics and menses in young girls seen in office practice: A study from the Pediatric Research in Office Settings network

    Pediatrics

    (1997)
  • P.B. Eveleth et al.

    Sexual development

  • S.F. Villarreal et al.

    Sexual maturation of Mexican-American adolescents

    Am J Human Biol

    (1989)
  • J.E. Becerra et al.

    Infant mortality among Hispanics. A portrait of heterogeneity

    JAMA

    (1991)
  • R.E. Frisch et al.

    Menstrual cycles: Fatness as a determinant of minimum weight for height necessary for their maintenance or onset

    Science

    (1974)
  • S.M. Garn et al.

    Comparisons of fatness in premenarcheal and postmenarcheal girls of the same age

    J Pediatr

    (1983)
  • P.B. Kaplowitz et al.

    Earlier onset of puberty in girls: Relation to increased body mass index and race

    Pediatrics

    (2001)
  • L. Zacharias et al.

    Age at menarche. Genetic and environmental influences

    N Engl J Med

    (1969)
  • A. Sanchez et al.

    A hypothesis on the etiological role of diet on age of menarche

    Med Hypotheses

    (1981)
  • R.E. Frisch et al.

    Delayed menarche and amenorrhea of college athletes in relation to age of onset of training

    JAMA

    (1981)
  • J. Moisan et al.

    A nested case–control study of the correlates of early menarche

    Am J Epidemiol

    (1990)
  • J. Moisan et al.

    Leisure physical activity and age at menarche

    Med Sci Sports Exerc

    (1991)
  • J.L. Cameron

    Nutritional determinants of puberty

    Nutr Rev

    (1996)
  • N.M. Morris

    Validation of a self-administered instrument to assess stage of adolescent development

    J Youth Adolesc

    (1980)
  • A.C. Hergenroeder et al.

    Validity of self-assessment of pubertal maturation in African American and European American adolescents

    J Adolesc Health

    (1999)
  • W. Willett

    Nutritional Epidemiology

    (1998)
  • A.R. Frisancho

    Anthropometric Standards for the Assessment of Growth and Nutritional Status

    (1990)
  • J.H. Himes et al.

    Guidelines for overweight in adolescent preventive services: Recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services

    Am J Clin Nutr

    (1994)
  • Cited by (32)

    • Exposure to phytoestrogens in utero and age at menarche in a contemporary British cohort

      2017, Environmental Research
      Citation Excerpt :

      This could have affected our findings since socioeconomic status is related to age at menarche (Braithwaite et al., 2009); however, whether socioeconomic status is related to phytoestrogen concentrations is unclear. Although race is related to age at menarche (Biro et al., 2001, 2006; McDowell et al., 2007; Wu et al., 2002; Freedman et al., 2002; Britton et al., 2004) and was associated with maternal lignan concentrations in this study, we were not able to examine the effect of race due to the small number of non-white girls enrolled in ALSPAC. Furthermore, it has been suggested that several genes in Caucasians code for early menarche (Dvornyk and Waqar-ul-Haq, 2012), and since we did not include genetic data in this study, we do not know if our results could be affected.

    • Exposure to polyfluoroalkyl chemicals during pregnancy is not associated with offspring age at menarche in a contemporary British cohort

      2011, Environment International
      Citation Excerpt :

      This could have affected our findings since socio-economic status is related to age at menarche;(Braithwaite et al., 2009) however, there is no evidence that these demographic characteristics are associated with PFC serum concentrations. Although race/ethnicity is also related to age at menarche(Biro et al., 2006b; Freedman et al., 2002; Wu et al., 2002; Britton et al., 2004; McDowell et al., 2007) and was associated with maternal PFC serum concentrations in this study, we were not able to more closely examine the effect of race/ethnicity due to the small number of non-white girls. Finally, due to a relatively small sample size, the study may have been underpowered to detect an association between gestational PFC exposure and age at menarche.

    • The difficult issue of age assessment on pedo-pornographic material

      2009, Forensic Science International
      Citation Excerpt :

      Great interindividual variability in maturation, and in particular in sexual maturation, has been stressed [14–16] due to individual biology, pathological factors, such as obesity, and environmental factors [17]. Numerous publications have tackled the difference between rate of sexual maturation in different populations [18–42]. Another important limitation is that it is impossible to compare photographic staging (on two-dimensional pictures) with a complete medical examination, including inspection and palpation.

    • Higher poultry consumption was associated with an earlier age at menarche

      2021, Acta Paediatrica, International Journal of Paediatrics
    View all citing articles on Scopus

    This work is supported by the US Army Medical Research and Materiel Command under Award Number DAMD 17-99-1-9303. The views, opinions and/or findings contained in this document are those of the author(s) and should not be construed as on official Department of the Army position, policy, or decision unless so designated by other documentation. In the conduct of research where humans are the subjects, the investigator(s) adhered to the policies regarding the protection of human subjects as prescribed by 45 CFR 46 and 32 CFR 219 (Protection of Human Subjects).

    View full text