Childhood Obesity Again Tied to Earlier Puberty in Girls

Study compared onset age of breast development in 1997 and now

By Amy Norton

HealthDay Reporter

MONDAY, Nov. 4 (HealthDay News) -- U.S. girls are developing breasts at a younger age compared to years past, and obesity appears to explain a large share of the shift, a new study suggests.

Researchers found that between 2004 and 2011, American girls typically started developing breasts around the age of 9. And those who were overweight or obese started sooner -- usually when they were about 8 years old.

The numbers are concerning, the researchers said -- especially since the typical age at breast development is younger now than it was in a similar study from 1997. The main reason: Girls are heavier now than they were in the '90s.

"This is another manifestation of America's high body-mass index," said lead researcher Dr. Frank Biro, of Cincinnati Children's Hospital Medical Center. Body-mass index (BMI) is a measure of body fat based on a ratio of height to weight.

The findings, reported online Nov. 4 and in the December print issue of the journal Pediatrics, add to evidence that American children are hitting puberty earlier than in decades past. The rising tide of childhood obesity has been suspected as a major cause, but the new study gives more hard data to support the idea.

Biro said, however, that excess pounds do not seem to be the full explanation. And it's possible that other factors -- such as diet or chemicals in the environment -- play a role.

Why should people worry that puberty is coming sooner now than in years past? There is a concern when young kids look older than they are, and are possibly treated that way, Biro said.

Studies have found that girls who mature early are more likely to be influenced by older friends, start having sex sooner and have more problems with low self-esteem and depression. "Just because you're developing more quickly physically doesn't mean you're maturing emotionally or socially," Biro said.

Plus, early puberty has been tied to long-term health risks. For women, an earlier start to menstruation has been linked to a heightened risk of breast cancer. It's not clear why, but some researchers suspect that greater lifetime exposure to estrogen might be one reason.

Biro said earlier puberty also has been tied to increased risks of high blood pressure, heart disease and diabetes in adulthood. It's hard, though, to know whether earlier puberty is to blame since obese kids tend to start puberty earlier, and obese children often become obese adults, he said.

Dr. Patricia Vuguin, a pediatric endocrinologist at the Steven and Alexandra Cohen Children's Medical Center in New Hyde Park, N.Y., said it's not known if it's the earlier development or the obesity itself that causes the increased risk of those conditions.

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Childhood Arthritis: Aggressive Treatment Better?

Nov. 4,  2013 (San Diego) -- Treating children with juvenile arthritis with multiple medications soon after the disease appears is more likely to make symptoms go away than treating them later or with fewer medications at the start, according to new research.

"Remission is achievable if you treat early and aggressively," says study researcher Carol Wallace, MD. She is a pediatric rheumatologist at Seattle Children's Hospital.

She presented the findings at the annual meeting of the American College of Rheumatology.

About 294,000 children under the age of 18 have childhood arthritis and other related conditions, according to the Arthritis Foundation. Juvenile RA is an umbrella term for several types of arthritis. The common thread: chronic, long-term joint inflammation along with fevers, rash, or eye inflammation.

Wallace and her team compared two treatment strategies for a kind of childhood arthritis known as polyarticular JIA. It affects five or more joints soon after the disease appears.

The study included 85 children ages 2 to 17. The researchers focused on which treatment could produce what doctors call ''clinically inactive disease'' within 6 months. For children, that means they have no arthritis, fever, rash, or other symptoms of JIA. After 6 months of no symptoms on JIA medication they are considered in remission.

The children either received:

Wallace followed the children for a year. Among the trends she notes from her research:

Children on the more aggressive therapy with three drugs got to remission a full month earlier than the others.Children in the aggressive group were symptom-free for close to 5 months, about 2 months longer than those on methotrexate alone.Children who received either treatment within 3 months after the disease started had fewer clinic visits compared to those treated later.Children who responded to either treatment within 4 months were more likely to go into remission.

Timothy Beukelman, MD, calls the study “important and impactful.” He is an associate professor of pediatrics in the division of rheumatology at the University of Alabama at Birmingham. He reviewed the findings.

"A clear result from this study is, it's best to treat juvenile arthritis as early as possible," he says. "This study only looked at 1-year outcome. The results may be ongoing."

Wallace's team is continuing to look at results.

Beukelman and Wallace report doing consulting for or receiving research grants from several pharmaceutical companies.

The study was funded by the National Institute for Arthritis and Musculoskeletal and Skin Diseases and the Howe Endowment for Juvenile Idiopathic Arthritis Research.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the ''peer review'' process, in which outside experts scrutinize the data prior to publication in a medical journal.

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