Submitted to: Journal of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/21/2004
Publication Date: 9/28/2005
Citation: Must, A., Naumova, E., Phillips, S., Blum, M., Dawson-Hughes, B., Rand, W. 2005. Childhood overweight and maturational timing in the development of adult overweight and fatness: the newton girls study and its follow-up. Journal of Pediatrics. 116(3):620-7. Interpretive Summary: Several studies have suggested that an early puberty is associated with the development of adult obesity. We examined this question in 307 women, now age 42 years, who had been followed for 30 years. Their weights in childhood and pubertal stages were documented periodically, starting at age 10. We found that girls who were overweight before the onset of their menstrual periods were 7.7 times more likely to be overweight as adults whereas an early onset of menstrual periods did not increase risk of being overweight as an adult. Interventions to prevent and treat obesity should focus on girls before they begin puberty.
Technical Abstract: Although several studies have suggested that early menarche is associated with the development of adult overweight, few have accounted for childhood overweight prior to menarche. This study was a 30-year follow-up of the original participants in the Newton Girls Study, a prospective study of development in a cohort of girls followed through menarche, provided data on premenarcheal relative weight and overweight (BMI >85th percentile), prospectively obtained age at menarche, as well as self-reported adult BMI, overweight (BMI>25), obesity (BMI>30) and, for a subset of participants, percentage body fat by dual-photon absorptiometry. The results of the 448 women who participated in the adult follow-up at mean (SD) age 42.06 (0.76) y, 307 had childhood data with which to characterize premenarcheal and menarcheal weight status, and age at menarche. After a follow-up of 30.1 (1.4) y, reported BMI was 23.43 (4.82), 28% were overweight and 9% were obese. In multivariate linear and logistic regression analysis, almost all of the influence on adult weight status was due to premenarcheal weight status (model R2 = 0.199). Inclusion of a variable to reflect menarcheal timing provided very little information (model R2 = 0.208). Girls who were overweight before menarche were 7.7 times more likely to be overweight as adults (95% CI 2.3, 25.8) whereas early menarche (<age 12) did not elevate risk (odds ratio = 1.3, 95% CI 0.66, 2.43). A similar pattern of results was observed when percentage body fat in adulthood was evaluated. It was concluded that the apparent influence of early maturation on adult female overweight is due largely to the influence of elevated relative weight on early maturation. Interventions to prevent and treat overweight should focus on girls before they begin puberty.