Running Head: CHILDHOOD OBESITY AND PREMATURE ADOLESCENCE

Relation of Obesity in Childhood to Premature Adolescence Alyssa F. McCall William Carey University

CHILDHOOD OBESITY AND PREMATURE ADOLESCENCE

Abstract It has been suggested that early puberty in children is leading to an increase in certain diseases and illnesses in adulthood. In order to try to prevent early onset of adolescence in children, the cause of early maturation must be determined. Many studies have been conducted to try to prove the relation of the increased percentage of obese children in our country today. Children with a higher fat percentage do indeed undergo puberty before more athletic, lean children. The production of the protein leptin in adipose tissue has been identified as a possible link between obese children and timing of puberty. The following studies discussed suggest there is a causal relationship between increasing obesity and decreasing age of menarche.

Keywords: premature adolescence, childhood obesity, leptin

CHILDHOOD OBESITY AND PREMATURE ADOLESCENCE Relation of Obesity in Childhood to Premature Adolescence

In our country and all over the world today, children are experiencing puberty at lower ages. However, it is more prevalent in the United States than in other countries. This could be largely due to the increased weight gain in children of this generation. The eating habits and health of our nation has declined greatly over the years. Data from nationally representative surveys of United States children shows that obesity increased dramatically from 1976-1980 to 1999-2004. The number of overweight children has doubled or tripled between the early 1970s and the late 1990s. (Cheng et al., 2012) Recent data shows that the average age at menarche dropped from 12.75 to 12.54 years. At the same time, the percentage of girls who were 10 to 15 years of age and had a BMI >85th percentile increased from 16% to 27%. (Kaplowitz, 2008) In order to study the age at which a child undergoes puberty, there has to be a universal marker of the onset of sexual maturity. In girls, this marker tends to be menarche, but in boys it is harder to choose a distinct universal marker. Therefore, there is less data available about boys and obesity affecting age of puberty. It is assumed that the same results would occur in studies about boys. (Kaplowitz, 2008) Figuring out what causes a child to begin sexually maturing is very important as well in studying what could be causing them to undergo premature onset. There is a protein called Leptin produced by fat cells. This protein is responsible for controlling the release of gonadotropins. Gonadotropins must be released in order for a child to undergo puberty. Current evidence suggests that a threshold level of leptin may be required for initiation of puberty. (Kaplowitz et al., 2001) This protein provides the link between body fat stores and the timing of puberty. Children with more fat stores are going to have leptin being produced, and the children with very low fat percentages are only going to have trace amounts. Naturally the childs body will gain weight and begin menarche, but overeating and becoming obese as a child can accelerate this process. After reviewing longitudinal growth data for 181 normal girls, Frisch and Revelle3 observed that the mean weight at menarche was constant at 48 kg for girls who reached menarche before age 12, between 12 and 13, between 13 and 14, and after age 14. (Kaplowitz, 2008) This led him to believe that a certain fat percentage was required for the onset of menarche. There is no threshold level of weight or fatness that is critical for the onset of menarche, but children that are athletic will mature much later than those with higher levels of fat. (Kaplowitz, 2008) There have been several studies over the years to prove the relation of obesity to premature adolescence. One of these studies was conducted by the National Heart, Lung, and Blood Institute. They examined a group of 2,379 equally white and black girls that were recruited at age 9. Every year, they examined their height, weight, skinfold thickness and stage of pubertal maturation. Recent analysis from this study showed that the mean age was 12.7 years in white girls, and 12.0 years in black girls for menarche. The earlier maturing girls had consistently higher BMIs than the midonset girls, who had higher BMIs than late onset girls. (Kaplowitz, 2008) Both the age of onset of breast development, and age of menarche are related to obesity in girls.

CHILDHOOD OBESITY AND PREMATURE ADOLESCENCE

Evidence from the Girls Health Enrichment Multi-site studies also shows a relationship between high BMI and the age of menarche. The reason that they measure the BMI of the young girls in order to determine fat percentage of the body is because it is easy and effective. Other methods of determining body fat can be expensive and harder to conduct on a large group of subjects. In this study, they examined 147 black girls between the ages 8 and 10. Increasing stages of breast development were positively related to BMI and waist circumference. Children with BMIs that are in the 95th percentile and higher are considered to be obese. Pubertal girls were 8 times more likely to have a BMI in the 95th percentile or higher. (Kaplowitz, 2008) One more study called the Bogalusa Heart Study examined 5-17 year old girls. Over a 20 year period the median menarcheal age decreased by about 9.5 months in blacks and about 2 months in whites. Early menarche (before age 11) was 1.79 fold greater for girls at the 75th percentile for BMI versus the girls in the 25th percentile. (Kaplowitz et al., 2001) This analysis suggests there is a causal relationship between increasing obesity and the decline in average age at menarche. All of these studies show a relation to early puberty and increased BMIs in young girls. What they dont address, is the alternative question of whether the early puberty is triggering the weight gain. There is less evidence out there supporting this theory, but it should not be overlooked. When a young girl undergoes the onset of puberty, her body will start to produce more estrogen and other hormones that cause their body to start storing more fat. The relation of higher BMIs in the pubertal girls could very well be because of these hormones increasing. The problem with this theory is there is no evidence confirming it. (Kaplowitz et al., 2001) In conclusion, it is not completely a proven fact that obesity in childhood is the cause of early adolescence. One thing that is indeed true is that there is a relationship between higher BMI in children and the age at which they begin sexual maturation. The relationship seems to be a causal relationship, according the mentioned studies, but it is not proven. Much more in depth studies of all the hormones released at the time of puberty need to be conducted.

CHILDHOOD OBESITY AND PREMATURE ADOLESCENCE References Cheng, G., Buyken, A., Shi, L., Karaolis-Danckert, N., Kroke, A., Wudy, S., & ... Remer, T. (2012). Beyond overweight: nutrition as an important lifestyle factor influencing timing of puberty. Nutrition Reviews, 70(3), 133-152. doi:10.1111/j.1753-4887.2011.00461.x. Kaplowitz, P., Slora, E., Wasserman, R., Pedlow, S., & Herman-Giddens, M. (2001). Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics, 108(2), 347-353. Kaplowitz, P. (2008). Link between body fat and the timing of puberty. Pediatrics, 121 Suppl 3S208-S217.