Socio-demographic Factors Associated with Body Mass Index of Female Adolescent Students in Semnan City, Iran

Malnutrition among adolescents is not only an important health problem but also an economic development problem in Iran and other developing countries. The home environment is found to be related to the development of malnutrition in children. Information on this relationship is important to identify the target risk groups for nutritional intervention. The objective of this study was to determine the association between socio-demographics with BMI status in high school adolescent girls in Semnan. In a cross- sectional study, using two-stage random sampling, 256 girl students aged 14-18 years were randomly selected from eight Semnan high schools. Weight and height were measured and BMI was calculated. Weight status was determined based on the CDC 2000 reference for BMI-for-age. Data on socio-demographic factors like age, age at menarche, family size, parental education, parental job and economic status was collected through a questionnaire. Age at menarche and mother's literacy had significant association with weight status (P =0.031, P =0.001 respectively). Logistic regression analyses showed mother's literacy and age at menarche were strong predictors for overweight but not for under weight. Increasing maternal nutritional knowledge is necessary to initiate changes in nutritional conduct. In addition, a longitudinal study of adolescent nutrition and its associated factors is suggested.     

The factors affecting the relation between the menarcheal age of mother and daughter

BACKGROUND: Menarche is one of the most important biologic signals in the life of a woman. Menarche is a biological variable which has a significant genotypic component in girls. In recent years, many studies reporting the earlier onset of menarche owing to the improvement of socio-economic conditions have been published. DESIGN: We asked some questions about menarche to 1017 female students studying in the high schools of Manisa region in order to determine the menarcheal age and the correlation of menarcheal age between the mothers and daughters in our region. RESULTS: The mean age at menarche for the girls was 12.82+/-1.07 years and for the mothers was 13.6+/-1.39 years. The mean menarcheal age of the mothers was higher than the mean menarcheal age of the girls (P<0.001). This difference persisted independent of the socio-economic status, nutritional state and physical activity of the girls. There was a significant correlation between the menarcheal age of the girls and their mothers (r=0.262, P<0.001). This correlation existed in all the girls with different socio-economic status, nutritional state and physical activity. However, this correlation disappeared in girls with body mass index (BMI)>25 (r=0.04, P=0.813). In girls with BMI<25, there was a correlation between the menarcheal age of the girls and mothers (r=0.282, P<0.001). CONCLUSION: These results suggest that the menarche occurs earlier in the daughters than their mothers. The correlation between the menarcheal age of the girls and their mothers persists under all circumstances except in obesity. The mother's menarcheal age is a good predictor of the daughter's menarcheal age in non-obese girls and the BMI is an important factor.     

Correlation of body mass index levels with menarche in adolescent girls in Shaanxi,China: a cross sectional study

Background

Menarche is a milestone for adolescent girls. The timing of menarche is influenced by genetics, social status and nutritional status (e.g., height, weight and body mass index [BMI]) and impacts future health (e.g., obesity and breast cancer). There have been many studies on trends in age at menarche among adolescent girls in China, but few have investigated associations between growth status and the timing of menarche. This study examined the association between age at menarche and growth status among adolescent girls in Western China.

Methods

The participants in this cross sectional study came from three geographical regions of Shaanxi Province. A total of 533 adolescent girls from urban and rural areas were randomly selected. Trained investigators administered a standard questionnaire to each participant during a face-to-face interview and carried out anthropometric measurements.

Results

The average age at menarche was 13.3 years. There were statistically significant differences in BMI z-scores between pre-menarcheal and post-menarcheal girls of the same age and these differences were related to socioeconomic factors. Girls who had reached menarche, in particular those aged 13–14 years, were significantly taller (P?<?0.01) and had higher BMI (P?<?0.01) than girls in the same age group who had not reached menarche.

Conclusions

BMI is associated with the timing of menarche but socioeconomic factors are also important.

     

Update on Age at Menarche in Italy: Toward the Leveling Off of the Secular Trend

PurposeTo update the information on age at menarche in the Italian population and to verify the influence of genetic, nutritional, and socioeconomic factors on menarcheal age. Recent studies suggest that the magnitude of the secular trend toward an earlier age at menarche is slackening in industrialized countries.MethodsThis multicenter study was conducted on a large, population-based sample of Italian high school girls (n = 3,783), using a self-administered questionnaire. The questionnaire was used to gather information on the girls, including demography, anthropometry, menarcheal date, regularity of menses, behavioral habits, and physical activity. The questionnaire was also used to gather information on parents, including demography and mothers' and sisters' menarcheal ages. The median age at menarche and its 95% confidence interval were estimated by means of Kaplan-Meier survival analysis. To identify the independent predictive factors of age at menarche, multivariate mixed-effects models were applied.ResultsThe median age at menarche of the subjects was 12.4 years (95% confidence interval: 12.34–12.46). The girls had their first menses approximately one-quarter of a year (median–0.13) earlier than did their mothers (p < .0001). Among all variables, parents' birth area, body mass index, family size, and the mother's menarcheal age were significantly and independently associated with age at menarche.ConclusionsThis study confirmed the reduction in the trend toward earlier menarche in Italy. The results also confirmed that genetic and nutritional factors are strong markers for early menarche. Currently, socioeconomic factors do not seem to play as significant a role as in the past.     

A nested case-control study of the correlates of early menarche

Age at menarche, an early determinant of breast cancer risk, shows both a downward secular trend and marked differences by socioeconomic status, both presumably the reflection of dietary variations. A cohort study is being conducted in the Quebec City, Canada, area to assess the relation between diet, physical activities, and menarche. In the fall of 1986, 3,022 fifth-grade girls (mean age, 10.7 years) agreed to participate in the study. All of the girls' parents provided information on health, familial, and socioeconomic variables. A 3-day dietary record and a 7-day physical activity recall were provided by 95.8% of the girls. All dietary information was verified with each girl by a dietician. Body weight and height and two skinfold thickness measurements were also recorded for 98% of the subjects. At the beginning of the study, 107 girls had already experienced menarche. In the fall of 1987, letters were sent to the mothers of the remaining 2,915 girls; 2,854 (97.9%) responded. In the preceding year, 352 girls had reached menarche. Of these, 333 (94.6%) had provided baseline dietary data. A case-control analysis was conducted in which these 333 girls were compared with 333 age-matched premenarcheal girls. There was a weak association between energy intake, energy expenditure, and early menarche. Weight, height, skinfold thickness, mother's age at menarche, and participation in a dance, ballet, gymnastics, or figure skating club were also associated with the early onset of menstruation.     

Socioeconomic status and age at menarche: an examination of multiple indicators in an ethnically diverse cohort

PurposeEthnic disparities exist in US girls' ages at menarche. Overweight and low socioeconomic status (SES) may contribute to these disparities but past research has been equivocal. We sought to determine which SES indicators were associated uniquely with menarche, for which ethnic groups, and whether associations operated through overweight.MethodsUsing National Longitudinal Study of Youth data, we examined associations between SES indicators and age at menarche. Participants were 4851 girls and their mothers. We used survival analyses to examine whether SES, at various time points, was associated with menarche, whether body mass index mediated associations, and whether race/ethnicity modified associations.ResultsBlack and Hispanic girls experienced menarche earlier than whites. After adjusting for SES, there was a 50% reduction in the effect estimate for “being Hispanic” and 40% reduction for “being black” versus “being white” on menarche. SES indicators were associated uniquely with earlier menarche, including mother's unmarried status and lower family income. Associations varied by race/ethnicity. Body mass index did not mediate associations.ConclusionsRacial differences in menarche may in large part be due to SES differences. Future experimental or quasiexperimental studies should examine whether intervening on SES factors could have benefits for delaying menarche among blacks and Hispanics.     

Psychosocial risk and correlates of early menarche in Mexican-American girls

Mexican-American girls have one of the fastest rates of decline in age at menarche. To date, no study has addressed the role of psychosocial factors on age at menarche in this population. Using data from a longitudinal cohort of Mexican-American girls from the Houston, Texas, metropolitan area recruited in 2005, the authors investigated associations between family life and socioeconomic environment and age at menarche in 523 girls. After adjusting for maternal age at menarche, daughter's age, and body mass index at baseline, perception of family life environment as conflict-prone was significantly associated with an earlier age at menarche (< 11 years). Additionally, there was a 2-fold higher risk (odds ratio = 2.22, 95% confidence interval: 1.12, 4.40) of early menarche among daughters of mothers who were single parents compared with those who were not. Furthermore, girls who matured early had a 2.5-fold increased risk (odds ratio = 2.69, 95% confidence interval: 1.04, 6.96) of experimenting with cigarettes compared with those who had an average-to-late age at menarche (≥ 11 years). This study provides important information regarding the role of family life environment and single parenting on age at menarche in Mexican Americans. Awareness of the impact of the family life environment and fathers' absence during the early years should be emphasized when addressing early age at menarche across cultures.     

Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate

Summary. General health, growth and sexual development were evaluated in 74 teenage boys and 98 girls who had been exposed to medroxyprogesterone acetate (MPA) in utero , and 385 boys and 448 girls not exposed. In this 17-year prospective study, the ascertainment of the end points was 'double blind' in that neither the interviewer nor the subject was aware of our interest in MPA. On average, girls exposed to MPA reported reaching the menarche 4 months earlier than the comparison group. This difference disappeared, however, in a multiple regression analysis taking into account social class, the mother's age at menarche and height of the girl's mother and father. Boys exposed to MPA reported their growth spurt to have occurred an average of 6 months earlier and voices to have broken 5 months earlier than unexposed boys. Again, the differences between them and the comparison group disappeared after controlling for confounding variables. There were no significant differences between the MPA-exposed and comparison groups in a wide variety of indices of health reported by the teenagers' mothers. These findings are consistent with the hypothesis that intrauterine exposure to MPA, in the doses used for pregnancy maintenance or for contraception, poses no threat to the long-term health and development of the progeny.     

Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate

General health, growth and sexual development were evaluated in 74 teenage boys and 98 girls who had been exposed to medroxyprogesterone acetate (MPA) in utero, and 385 boys and 448 girls not exposed. In this 17-year prospective study, the ascertainment of the end points was 'double blind' in that neither the interviewer nor the subject was aware of our interest in MPA. On average, girls exposed to MPA reported reaching the menarche 4 months earlier than the comparison group. This difference disappeared, however, in a multiple regression analysis taking into account social class, the mother's age at menarche and height of the girl's mother and father. Boys exposed to MPA reported their growth spurt to have occurred an average of 6 months earlier and voices to have broken 5 months earlier than unexposed boys. Again, the differences between them and the comparison group disappeared after controlling for confounding variables. There were no significant differences between the MPA-exposed and comparison groups in a wide variety of indices of health reported by the teenagers' mothers. These findings are consistent with the hypothesis that intrauterine exposure to MPA, in the doses used for pregnancy maintenance or for contraception, poses no threat to the long-term health and development of the progeny.     

Age at menarche and first pregnancy among psychosocially at-risk adolescents

We sought to determine which factors influence the association between menarche and conception among adolescent study participants (n = 1030), who demonstrated an earlier age of menarche than did national samples. Age at first sexual intercourse (coitarche) mediated the relationship between age at menarche and first pregnancy among White girls, whereas gynecologic age at coitarche (age at coitarche minus age at menarche) and age at menarche explained the timing of the first pregnancy among Black and Hispanic girls. Pregnancy prevention interventions to delay coitarche should also include reproductive education and contraception.     

Maternal Age at Menarche and Pubertal Timing in Boys and Girls: A Cohort Study From Chongqing,China

PurposeThis study explored the association of maternal age at menarche (AAM) with pubertal timing among girls and boys in Chongqing, China.MethodsPubertal development of 1,237 children (542 girls and 695 boys) were examined half-yearly through inspection and palpation from April 2014 to June 2019. Characteristics of parents and maternal AAM were collected by a parental questionnaire at baseline. Maternal AAM was used both as a continuous and a categorical variable in Cox regression models.ResultsA total of 1,198 children (528 girls and 670 boys) were included in the study. In the simple Cox model, earlier maternal AAM was associated with girls' earlier menarche, breast and pubic hair development, and boys' first ejaculation, testicular development, and genital development. When adjusting for children's body mass index z-scores (BMIz) and socioeconomic covariates, we found that girls whose mothers had early AAM had a higher risk of earlier onset of menarche (hazard ratio [HR]: .922, 95% confidence interval [CI]: .852–.998 for continuous maternal AAM, HR: 1.297, 95% CI: 1.041–1.616 for maternal AAM ≤13 years), and boys whose mother achieved menarche earlier experienced a higher risk of earlier onset of first ejaculation (HR: .896, 95% CI: .830–.968). Children's BMIz were related to all nine pubertal milestones. Parental education and relationship, birth weight, parity, and family type were also associated with pubertal timing.ConclusionsEarlier maternal AAM was related to earlier pubertal timing in both girls and boys in Chongqing, especially girls' age at menarche and boys' first ejaculation. Children's BMIz was the most consistent factor for pubertal timing. Children's BMIz and socioeconomic conditions had greater influence on most pubertal milestones than maternal AAM.     

Nutritional factors affecting the menarcheal state of adolescent school girls in Alexandria

The nutritional status of adolescents plays a dominant role in determining the maturation status. The aim of the present work was to assess the mean age of menarche and the main nutritional factors affecting it. A cross-sectional study of 1606 girls was conducted in primary and preparatory schools in Alexandria. Every girl was subjected to anthropometric assessment including weight, height, mid upper arm circumference (MUAC), waist circumference, hip circumference and triceps skin-fold thickness. BMI and body fat percentage were calculated. A 24 hours diet recall method was used to assess the dietary intake. The mean age of menarche was 11.98+/-0.96 years. The mean MUAC, triceps skin-fold thickness, waist circumference and hip circumference were significantly higher among menstruating girls as compared to non-menstruating. (p<0.01). Only 7.5% of the females less than the 5th percentile of BMI (thinness) were menstruating, while the corresponding figure for those at or more than 85th percentile (overweight) was 65.6% and this was statistically significant (X 2 (2) =102.8, P<0.001). Girls who attained menstruation demonstrated a higher significant mean percent of body fat (43.40+/-10.0) as compared to non menstruating ones (35.41+/-7.87), ( t=17.09, P<0.001). The oldest age at menarche was noted when the protein, iron and caloric intake was less than 80% of the RDAs. However after adjustment of other variables direct relation was detected between age of girls and their age of menarche and those in private school had earlier age of menarche than those in governmental one. The nutritional status of the adolescents had a significant association with the onset of menstruation and the age at menarche.     

Dietary and physical determinants of menarche

Age at menarche shows a downward secular trend and differs according to socioeconomic conditions, presumably the result of dietary variations. We report two studies conducted in Quebec City in which the relation between diet and menarche was evaluated. In 1978-1980, baseline information for these studies was obtained on girls aged 9 through 15 and included body weight, height, fatfold thickness at six sites, percent of body fat (derived from underwater weighing), and a 3-day dietary record. In a cross-sectional study of 207 girls aged 11 through 15, we compared dietary patterns between premenarcheal and menarcheal girls using logistic regression. In a 6-year follow-up study of 109 girls who had not experienced menarche at the baseline data collection, the relation between time of occurrence of menarche and dietary patterns was assessed using proportional hazards models. The results confirm the association between body weight and age at menarche. Body fat, however, was not strongly related to the onset of menstruation. In both studies, a higher dietary energy intake was associated with an earlier age at menarche. Dietary composition, and dietary fat in particular, was not related to menarche.     

The relationship between age of menarche and mental distress in Norwegian adolescent girls and girls from different immigrant groups in Norway: results from an urban city cross-sectional survey

Lower age of menarche has been associated with increased mental distress among adolescent girls. The association might be mediated via body image, as girls with early menarche tend to have higher weight than those with late onset menarche. Many of the existing studies of menarche and mental distress are based on samples of white, western girls. The aim of the study was to analyze the association between age of menarche and mental distress among Norwegian girls and girls from different immigrant groups, and to study the effect of body mass index (BMI) and the difference between current and desired weight, on the relationship between age of menarche and mental distress. The study was a cross-sectional population-based self-report survey of all 10th grade pupils in Oslo for two consecutive years. A total of 3694 girls (91%) participated, one quarter of which were first or second generation immigrants. The Hopkins Symptom Checklist-10 was used to measure mental distress. An inverse, linear association between age of menarche and mental distress was found for both Norwegian girls and girls from all the immigrant groups. Regardless of immigrant status, girls with early onset menarche had higher BMI and higher difference in current and desired weight than those with late onset menarche. In linear regression, the difference in current and desired weight was more strongly associated with mental distress both among the Norwegian girls and girls from immigrant groups than age of menarche and BMI when controlling for social and behavioral factors. Early age of menarche might serve as a predictor for psychopathology in Norwegians girls as well as in girls from different immigrant groups. The association between age of menarche and mental distress might be mediated via differences in current and desired weight.     

Teenage smoking and antecedent parentalcharacteristics: A prospective study

The smoking habits of 1445 white adolescents aged 15 to 17 years were examined in relation to 16 characteristics of the family prevailing at the time the mother was pregnant with the child. Five characteristics were independently associated with teenage smoking, either for boys or girls or both: parental smoking, mother's education and age, father's education and occupation.Multiple regression showed that father's occupation was redundant for both boys andgirls, and that mother's education was redundant for boys' smoking. Parental smoking, father's education and mother's age each had predictive power for boys' smoking. For the girls, mother's education also had predictive power. In general, the major family characteristics associated at birth with later teenage smoking are parental smoking habits and socioeconomic status. The sex differences between associations of family characteristics and teenage smoking suggest that the like-sexed parents' smoking and education have the greater effect on teenage smoking, particularly for the boys. For girls, present smoking status of mother was of more importance than mother's smoking status at birth if the mother had given up smoking.     

特发性中枢性性早熟女童乳房发育年龄与母亲初潮年龄及身高相关性研究

【目的】 探讨特发性中枢性性早熟(idiopathic central precocious puberty, ICPP)女童乳房发育年龄与母亲初潮年龄及母亲身高间的关系。 【方法】 采用回顾性调查方法,并测查身高、体重第二性征、子宫卵巢、B超及促性腺激素释放激素刺激实验,对ICPP组、单纯性乳房早发育(simple premature thelarche, SPT)组及正常对照组进行研究,并进行相关性分析。 【结果】 1)ICPP女童的母亲月经初潮年龄(11.66±1.35)岁显著低于SPT组(12.93±1.66)岁和正常对照组(14.03±0.58)岁(P＜0.01);2)ICPP女童母亲身高(154.13±3.61)cm显著低于SPT组(159.80±4.71)cm及正常对照组(159.50±2.33)cm(P＜0.01);SPT组与正常对照组比较差异无统计学意义;3)ICPP组女童的乳房开始发育年龄与母亲月经初潮年龄、母亲身高均具有显著直线正相关(P＜0.01)。 【结论】 特发性中枢性性早熟女童乳房发育年龄与母亲初潮年龄及身高关联性大;特发性中枢性性早熟女童及母亲的身材矮小与性早熟或青春期提前有关。     

广西女性月经初潮年龄相关因素分析

目的分析影响广西地区女性月经初潮年龄的相关因素。方法调查848名年龄在14~16岁之间的女生及母亲的相关因素,用多元线性回归分析这些因素与初潮年龄的关系。结果平均初潮年龄为13.04±1.45岁。母亲初潮年龄,1岁时体块指数(BMI),出生时体重,母亲身高和出生时身长为影响月经初潮年龄的主要因素。结论女孩初潮年龄不仅与遗传因素有关,而且与宫内环境和儿童时期的发育有关。     

Age of Onset, Nutritional Determinants, and Seasonal Variations in Menarche in Rural Bangladesh

Menarche is an important milestone in the development of female adolescents. The study assessed the age at menarche using recall, its seasonality, and association with marital and nutritional status (using midupper arm circumference [MUAC]) among 3,923 female adolescents aged 12–19 years in a rural area of Bangladesh. At the time of assessment, most (88%) adolescents had attained menarche at the mean (standard deviation [SD]) age of 12.8 (1.4) years. Age of onset of menarche among married adolescents (13%) occurred earlier than in those who were unmarried (12.6±1.3 years vs 12.9±1.4 years, p<0.01). Age at menarche was negatively associated with MUAC after adjusting for age and marital status (β=−0.10, p<0.01). More than 50% of the adolescents had an onset of menarche during winter (χ ²=634.97; p<0.001), with peaks in December and January. In this rural population, the current age at menarche was found to be slightly lower than the previous estimates of 13.0 years in Bangladesh. An early onset of menarche was associated with season and better nutritional status of the female adolescents and may be associated with early marriage.Key words: Age at menarche, Marital status, Menarche, Nutritional status, Seasonality, Bangladesh     

Nutritional status and menarche in a rural community in the Philippines

To examine the relationship between nutritional status and onset of menarche, anthropometric measurements and information on age at menarche were obtained from 1844 females aged 6-17 years in a rural community in the Philippines. The mean age at the initiation of the growth spurt in height was 13.5 years, while the spurt in weight occurred at the age of 11.5 years. 25.2% of respondents had attained menarche by age 11.5 years, 43.6% by age 13.5 years, 88.2% by age 14.5 years, and 96.6% by age 15.5 years. This contrasts with data from Bangladesh, where only 3.5% of girls attain menarche by age 13.5 years and only 35.1% reach this point by age 15.5 years. Further analysis indicated that both age and weight are related to the proportion achieving menarche. The effect of height is not as marked as that of body weight. A minimum level of fatness (about 17% of body weight) is associated with the onset of menstruation and its continued maintenance. Malnutrition results in a shorter reproductive span, later age at menarche, and early menopause. Since improvements in nutritional status in developing countries can be expected to result in a pattern of early menarche, late menopause, short birth intervals, and shorter periods of adolescent subfecundity, increasing attention must be given to family planning counseling of adolescents.     

Age at menarche in relation to adult height: the EPIC study

In the last two centuries, age at menarche has decreased in several European populations, whereas adult height has increased. It is unclear whether these trends have ceased in recent years or how age at menarche and height are related in individuals. In this study, the authors first investigated trends in age at menarche and adult height among 286,205 women from nine European countries by computing the mean age at menarche and height in 5-year birth cohorts, adjusted for differences in socioeconomic status. Second, the relation between age at menarche and height was estimated by linear regression models, adjusted for age at enrollment between 1992 and 1998 and socioeconomic status. Mean age at menarche decreased by 44 days per 5-year birth cohort (beta = -0.12, standard error = 0.002), varying from 18 days in the United Kingdom to 58 days in Spain and Germany. Women grew 0.29 cm taller per 5-year birth cohort (standard error = 0.007), varying from 0.42 cm in Italy to 0.98 cm in Denmark. Furthermore, women grew approximately 0.31 cm taller when menarche occurred 1 year later (range by country: 0.13-0.50 cm). Based on time trends, more recent birth cohorts have their menarche earlier and grow taller. However, women with earlier menarche reach a shorter adult height compared with women who have menarche at a later age.