Published online August 11, 2005
PEDIATRICS Vol. 116 No. 3 September 2005, pp. 620-627 (doi:10.1542/peds.2004-1604)
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Childhood Overweight and Maturational Timing in the Development of Adult Overweight and Fatness: The Newton Girls Study and Its Follow-up

Aviva Must, PhD*,{ddagger}, Elena N. Naumova, PhD*, Sarah M. Phillips, MS, MPH*, Miriam Blum, MD§, Bess Dawson-Hughes, MD§ and William M. Rand, PhD*

* Department of Public Health and Family Medicine, School of Medicine, Tufts University, Boston, Massachusetts
{ddagger} Epidemiology Program
§ Bone Metabolism Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts

Objective. Although several studies have suggested that early menarche is associated with the development of adult overweight, few have accounted for childhood overweight before menarche.

Study Design. 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, self-reported adult BMI, overweight (BMI > 25), obesity (BMI > 30) and, for a subset of participants, percentage body fat by dual-energy x-ray absorptiometry.

Results. Of the 448 women who participated in the adult follow-up at a mean age of 42.1 years (SD: 0.76 years), 307 had childhood data with which to characterize premenarcheal and menarcheal weight status and age at menarche. After a follow-up of 30.1 years (SD: 1.4 years), reported BMI was 23.4 (4.8), 28% were overweight, and 9% were obese. In multivariate linear and logistic-regression analyses, almost all of the influence on adult weight status was a result of premenarcheal weight status (model R2 = 0.199). Inclusion of a variable to reflect menarcheal timing provided very little additional information (model R2 = 0.208). Girls who were overweight before menarche were 7.7 times more likely to be overweight as adults (95% confidence interval: 2.3, 25.8), whereas early menarche (at ≤12 years of age) did not elevate risk (odds ratio: 1.3, 95% confidence interval: 0.66, 2.43). A similar pattern of results was observed when percentage body fat in adulthood was evaluated.

Conclusions. The apparent influence of early maturation on adult female overweight is largely a result of the influence of elevated relative weight on early maturation. Interventions to prevent and treat overweight should focus on girls before they begin puberty.

Key Words: overweight • obesity • menarche • puberty • maturation • adolescence

Abbreviations: NGS, Newton Girls Study • DXA, dual-energy x-ray absorptiometry

Accepted Dec 21, 2004.


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