The relationship between pubertal timing and under-nutrition in rural Pakistan

Relationships between Age at Menarche and Risk of Cardiovascular Disease Mortality among Japanese Women: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study

AIM

In this study, we aimed to evaluate the association between age at menarche and risk of cardiovascular disease mortality.

METHODS

In total, 54,937 women aged 40-79 years old between 1988 and 1990 without a history of cardiovascular disease were eligible for analysis and were followed through December 2009. We used the Cox proportional hazards models to examine the association between age at menarche and risk of cardiovascular disease.

RESULTS

Compared with women with age at menarche of 15 years, the hazard ratios (95% confidence intervals) of stroke were 1.22 (0.85-1.75) for women with age at menarche of 9-12 years, 1.08 (0.85-1.36) for those of 13 years, 1.23 (1.02-1.47) for those of 14 years, 1.27 (1.07-1.50) for those of 16 years, 1.16 (0.95-1.41) for those of 17 years, and 1.39(1.16-1.68) for those of 18-20 years (P for trend=0.045). A similar pattern was observed for hemorrhagic stroke, ischemic stroke, and total cardiovascular disease. No such association was found for coronary heart disease. When stratified by age, for women aged 40-59 at baseline, the similar U-shaped association was observed. In contrast, for women aged 60-79 years at baseline, a significantly high hazard ratio was noted in the group of late age at menarche, but not in the group of early age at menarche.

CONCLUSIONS

Both women with early and late age at menarche were determined to have higher risk of death from stroke and cardiovascular disease.

Age at menarche and its association with blood pressure in adult women of developing countries: a systematic review and meta-analysis

CONTEXT

Evidence about the effect of age at menarche (AAM) on blood pressure (BP) has largely been drawn from studies in developed countries. Studies in developing countries are expanding recently but have not been summarised.

OBJECTIVE

To systematically explore the association between AAM and BP and the potential modifiers in developing countries.

METHODS

We searched PubMed, Embase, and Web of Science for publications until March 2022. A random-effects model was used to calculate the pooled relative risk (RR) with 95% confidence interval (CI).

RESULTS

Twenty studies were eligible. In studies with participants' mean age at BP assessment <55 years, women in the oldest group as compared with the middle or the youngest group of AAM had a higher risk of hypertension in those studies without adjustment for confounders (RR 1.79, 95% CI 1.41-2.28, I²=97.0%), those with adjustment for confounders excluding adiposity (1.25,1.04-1.51, I²=84.8%), and those with adjustment for confounders including adiposity (1.38,1.03-1.86, I²=91.8%). In studies with participants' mean age at BP assessment ≥55 years, no significant differences were found for studies without adjustment for confounders (RR 1.07, 95% CI 0.78-1.47, I²=90.3%), studies with adjustment for confounders excluding adiposity (0.85, 0.78-0.92, I²=12.3%), or studies with adjustment for confounders including adiposity (0.95, 0.80-1.11, I²=45.5%). A similar association was observed between AAM and baseline systolic BP and diabolic BP.

CONCLUSION

Late menarche was associated with a higher risk of BP and this association was modified by age and adiposity in developing countries.

Psychosocial and energetic factors on human female pubertal timing: a systematized review

Childhood psychosocial stressors have been proposed to favour fast life history strategies promoting earlier puberty in females. However, studies demonstrating this association often do not elucidate causal mechanisms, nor account for greater childhood energetic availability - also known to promote rapid growth and earlier puberty. To assess the extent to which such confounding has been considered, we conducted a systematized review to identify studies examining measures of both prepubertal growth (e.g. weight, height) and psychosocial stressors (e.g. adversity, father absence) in relation to female pubertal timing. A total of 1069 non-duplicated studies were identified across five databases. Twenty studies met selection criteria for critical review following independent screening of titles, abstracts and manuscripts. Within these studies, measures indicative of rapid childhood growth were more consistently associated with earlier pubertal timing than were measures of psychosocial stress. We discuss future research directions to investigate the impact of psychosocial stress on pubertal timing more robustly, including methodological and mechanistic considerations, and contextualization of findings by socioecological environments.

Trends in growth and nutritional status of high school graduates in Hangzhou, China, 2011-2020

Background

During past decades, there was a positive trend in growth and nutrition status of adolescents in China, but there was significant regional disparity. The purpose of this study is to investigate the trends in growth and nutritional status of high school graduates in Hangzhou between 2011 and 2020.

Methods

High school graduates (Grade 12) who finished the physical examination of the national college entrance examination between 2011 and 2020 (n=481,353)were included in this study. Data were obtained from the database of physical examination of the national college entrance exam. Height and weight were measured; body mass index (BMI) was calculated from height and weight. Thinness, overweight and obesity were defined according to the International Obesity Task Force criteria. For the vast majority of the high school graduates were 18 years old or nearly 18 years old, the cutoffs of 18 years were adopted. Those are 18.5, 25 and 30 kg/m², for thinness, overweight and obesity respectively.

Results

There was a significant growth trend in height, weight and BMI in both sexes (P < 0.001). Height increased by 1.80 cm in boys and 1.45 cm in girls. Weight increased by 4.62 kg in boys and 2.51 kg in girls. BMI increased by 1.09 kg/m² in boys and 0.60 kg/m² in girls. An increase trend was found in the prevalence of overweight and obesity in both sexes (P < 0.001). Overweight increased by 7.43% (from 9.05 to 16.48%) among boys and 4.05% (from 4.57 to 8.62%) among girls. Obesity increased by 3.85% (from 2.29 to 6.14%) among boys and 1.76% (from 0.64 to 2.40%) among girls. The prevalence of thinness fluctuated in both boys and girls, 12.42–15.59% among boys and 18.97–23.68% among girls. Boys had higher odds of overweight and obesity and lower odds of thinness than girls (P < 0.001).

Conclusions

There is a positive trend in growth and nutritional status of high school graduates in Hangzhou. However, there is still a considerable prevalence of thinness, it indicates a double burden of undernutrition and overnutrition.

The association between pubertal timing and quality of life among children and adolescents: a cross-sectional study in Chongqing, China

BACKGROUND

To determine the relationship between pubertal timing and quality of life (QOL) in children and adolescents and to provide a basis for QOL intervention in pubertal children in the future to promote good adaptation and healthy physical and mental development of children.

METHODS

The survey was conducted in one county using a stratified cluster sampling method. The five physiological change items of the Puberty Development Scale (PDS) were used to assess the timing of puberty in students. Compared to students of the same age and the same sex, students who scored higher than the mean + standard deviation (SD) of individual developmental scores were defined as an early pubertal timing group. A 39-item QOL Scale for Children in Puberty was used to assess the QOL of the respondents. Multiple linear regression models were fitted separately for boys and girls.

RESULTS

Of the 7223 students, 3754 (51.97%) were boys and 3469 (48.03%) were girls. The prevalence of early pubertal periods was 16.07%. The total QOL score in the early pubertal timing group (137.16 ± 18.67) was significantly lower than in the normal (on time) group (142.02 ± 17.98) and the late group (142.76 ± 18.35) (F = 37.311, P < 0.001). A multiple linear regression model showed that early pubertal timing was a risk factor for QOL (P < 0.0014), compared with normal and late pubertal timing.

CONCLUSIONS

The early pubertal timing was associated with poorer QOL in children and adolescents. More attention should be paid to children with early pubertal timing in intervening children's QOL during pubertal development. Future longitudinal studies are needed to confirm the association between pubertal timing and QOL.

Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial

Nutritional deficiencies are a leading underlying risk factor contributing to the global burden of disease. In Pakistan, late adolescence is considered a nutritionally vulnerable period, as micronutrient requirements are increased to support maturation, and dietary staples are nutrient poor. However, there has been limited evaluation of micronutrient status beyond anemia and its determinants. Using cross-sectional data from late adolescent and young women (15–23 years) at enrolment in the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial, we aimed to describe the prevalence of key micronutrient deficiencies of public health concern, and generate hierarchical models to examine associations with proxies for social determinants of health (SDoH). The prevalence of micronutrient deficiencies was high: 53.6% (95% confidence interval (CI): 53.0–54.3%) had anemia; 38.0% (95% CI: 36.4–39.6%) iron deficiency anemia; 31.8% (95% CI: 30.2–33.3%) vitamin A deficiency; and 81.1% (95% CI: 79.8–82.4%) vitamin D deficiency. At least one deficiency was experienced by 91.0% (95% CI: 90.1–92.0%). Few SDoH were maintained in the final hierarchical models, although those maintained were often related to socioeconomic status (e.g., education, occupation). To improve the micronutrient status of late adolescent and young women in Pakistan, a direct micronutrient intervention is warranted, and should be paired with broader poverty alleviation methods.