Age at puberty and the emerging obesity epidemic

Abstract

Background: Recent studies have shown that puberty starts at younger ages than previously. It has been hypothesized that the increasing prevalence of childhood obesity is contributing to this trend. The purpose of this study was to analyze the association between prepubertal body mass index (BMI) and pubertal timing, as assessed by age at onset of pubertal growth spurt (OGS) and at peak height velocity (PHV), and the secular trend of pubertal timing given the prepubertal BMI.

Methodology/principal findings: Annual measurements of height and weight were available in all children born from 1930 to 1969 who attended primary school in the Copenhagen municipality; 156,835 children fulfilled the criteria for determining age at OGS and PHV. The effect of prepubertal BMI at age seven on these markers of pubertal development within and between birth cohorts was analyzed. BMI at seven years was significantly inversely associated with age at OGS and PHV. Dividing the children into five levels of prepubertal BMI, we found a similar secular trend toward earlier maturation in all BMI groups.

Conclusion/significance: The heavier both boys and girls were at age seven, the earlier they entered puberty. Irrespective of level of BMI at age seven, there was a downward trend in the age at attaining puberty in both boys and girls, which suggests that the obesity epidemic is not solely responsible for the trend.

Figure 1. Age at OGS and PHV according to BMI.

Age at OGS (upper panel) and at PHV (lower panel) according to BMI category 1–5 divided by birth cohort. BMI category 1, 2, 3, 4 and 5 = BMI SDS: <−0.75, −0.75 to −0.25, −0.25 to +0.25, +0.25 to +0.75 and >+0.75, respectively. Note data in boys only shown from birth year 1940–69 due to a small number of samples before that time.

Figure 2. Age at OGS and PHV according to birth year.

Age at OGS (upper panel) and at PHV (lower panel) according to year of birth. Wide lines represent data on the whole cohort including confidence intervals, whereas the slimmer lines represent data on children according to BMI category 1–5. BMI category 1, 2, 3, 4 and 5 = BMI SDS: <−0.75, −0.75 to −0.25, −0.25 to +0.25, +0.25 to +0.75 and >+0.75, respectively. Note data in boys only shown from birth year 1940–69 due to a small number of samples before that time.