What Raises the Risk for Early Puberty in Girls?

TOPLINE:

Combinations of overweight/obesity, low physical activity, and excessive screen time increase the risk for early pubertal development (EPD) in girls, with overweight/obesity being the most significant and the highest risk in girls with all three factors.

METHODOLOGY:

EPD has become a global public health concern, especially in girls, highlighting a need for preventive strategies worldwide.Researchers conducted a case-control study between October 2019 and August 2022 to assess potential EPD risk factors related to electronic screen time, moderate to vigorous physical activity, and overweight/obesity in 177 girls newly diagnosed with EPD (mean age, 7.72 years) at Tianjin Women and Children’s Health Center in China and 354 girls (mean age, 7.60 years) with normal pubertal development.Participant data, including dietary and behavioral (focused on electronic screen usage and physical activity) details, were collected by interviews with children and their guardians using a questionnaire, as well as physical examinations of the children.Childhood overweight/obesity was a combined score for statistical power and was defined as a body mass index ≥ 85th percentile for age and sex.To examine the joint associations of three risk factors (overweight/obesity, high electronic screen time, and low physical activity), the girls were categorized into eight groups, with those lacking all three risk factors serving as the reference group.

TAKEAWAY:

The risk for EPD was the highest among those with all three risk factors (odds ratio [OR], 26.10; 95% CI, 6.40-106.45).A combination of any two of the three risk factors was associated with increased EPD risk:High electronic screen time and low physical activity (OR, 13.08; 95% CI, 3.77-45.40)High electronic screen time and overweight/obesity (OR, 6.45; 95% CI, 1.33-31.27)Low physical activity and overweight/obesity (OR, 6.21; 95% CI, 1.68-23.00)Girls with overweight/obesity alone had higher EPD risk (OR, 4.91; 95% CI, 1.01-23.92) than those without any of the three risk factors, but neither high electronic screen time nor low physical activity alone reached statistical significance for EPD risk.

IN PRACTICE:

“We recommend girls do not spend their leisure time watching TV or on other electronic screens, avoid a sedentary lifestyle, which is characterized by both low MVPA [moderate to vigorous physical activity] and high EST [electronic screen time], but instead spend more time exercising for reasons related to obesity and also potential early puberty, even in girls of normal weight,” the authors wrote.

SOURCE:

This study was led by Weiqin Li, Tianjin Women and Children’s Health Center, Tianjin, China. It was published online in Scientific Reports.

LIMITATIONS:

Data on electronic screen time and physical activity were gathered via questionnaires, which may have introduced bias. The study did not distinguish between central and peripheral EPD, as the hormone stimulation test was not performed in all the girls with EPD. Furthermore, the inclusion of participants from a single medical center may have introduced selection bias, restricting the applicability of the results to all populations of Chinese children.