Early life weight gain predicts pubertal onset in girls
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Distinct patterns of early life weight gain predict differential risk for earlier onset of puberty among girls, according to data from a longitudinal analysis published in Journal of the Endocrine Society.
“Study findings showed that higher rates of weight gain between birth and 15 months and ‘high risk’ BMI percentile trajectories between 24 months and grade 1 may be risk factors for earlier pubertal onset,” Maria E. Bleil, PhD, research associate professor in the department of child, family and population health nursing at the University of Washington in Seattle, and colleagues wrote. “This work has important implications for health care providers to increase surveillance in girls who exhibit these patterns and to consider possible interventions to attenuate maladaptive patterns of weight gain beginning as early as infancy.”
Bleil and colleagues analyzed data from 426 girls who participated in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development, a longitudinal birth cohort of children and their families followed between birth and adolescence. Researchers assessed three pubertal onset outcomes: age at menarche and ages at Tanner stage II for dimensions of breast and pubic hair development.
In infancy, defined as birth to 15 months, researchers found greater percent weight gain and higher birth weight predicted earlier pubertal onset for all outcomes (P < .05 for all). In early childhood, defined as 24 months to grade 1, BMI trajectories reflecting BMI values that were persistently high or changed from low to high over time predicted younger ages at menarche and the onset of breast development (P < .05 for all), but not pubic hair development (P > .05 for all) when compared with BMI values that were stable at median or low levels.
Results persisted after adjustment for breastfeeding, maternal age at menarche, age and race.
“Focusing on these patterns for earlier and more targeted intervention may help lessen life course linkages between prepubertal obesity, accelerated pubertal development, and negative post-pubertal outcomes,” the researchers wrote.
Perspective
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Nicole Fearnbach, PhD
Previous research has focused on adiposity rebound, or the acceleration in weight gain or fat mass accrual between ages 3 to 8 years, which has been described as one of the more critical time periods for accelerated weight gain and childhood obesity risk. The current study takes us even earlier in the lifespan — infancy and early childhood — to help us identify the risks for childhood obesity, early onset puberty and all the consequences that come from that even sooner. The study raises some questions. Are these critical periods independent of one another or does early infancy weight gain predict earlier adiposity rebound?
Well child visits continue to be important for surveillance. This is not about putting young children on any type of diet. Rather, it highlights the need for more behavioral support for families around an overall healthy lifestyle. Clinicians must acknowledge the barriers some families may be facing. Family stressors and the home environment can play into this early lifespan weight gain, and the resources families have access to are important. Those resources may not all come from the pediatrician. Dietitians, social workers and other health care professionals (e.g., WIC) should also be supporting the families as a team.
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