Overweight/Obesity in Childhood and the Risk of Early Puberty: A Systematic Review and Meta-Analysis

Abstract

PurposeTo determine the relationship between childhood overweight/obesity and early puberty in both boys and girls. Specifically, this is the first time to conduct a meta-analysis of the relationship between childhood overweight/obesity and early puberty in boys.MethodsRelevant studies were identified from PubMed, Web of Science, and EMBASE searches. The exposure of interest was overweight/obesity in childhood. Childhood was defined internationally as the age range of 0–18 years. The overall risk estimates were pooled using random effects models. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity and to assess the robustness of the results.ResultsA total of 10 studies involving 13,338 girls and 12,796 boys were included. Results showed that childhood overweight/obesity were associated with a significantly higher risk of early puberty in girls [odds ratio (OR): 2.22, 95% CI: 1.65–2.99]. Although without statistical significance, a higher risk of early puberty was also found in boys who were overweight/obese in childhood (OR: 1.29, 95% CI: 0.98–1.70). Heterogeneity in the risk estimates of early puberty was partially explained by study design, sample size, follow-up duration, definitions of early puberty and confounders controlled. Sensitivity analyses validated the robustness of the findings.ConclusionsOur findings showed that for girls the associate between overweight/obesity and early puberty is definite or strong whereas for males, such an association is possible, prompting that future studies need to further explore the possible relationship between overweight/obesity and early puberty in boys.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021264649, PROSPERO CRD42021264649.

Phenotyping children and adolescents with obesity using behavioral, psychological, and familial data

“…Children with obesity experience accelerated growth [52] and, particularly in girls, earlier puberty [53, 54]. A meta‐analysis and systematic review showed that girls with overweight and obesity are at increased risk of early puberty (4.67‐fold and 2.22‐fold, respectively) compared with those with normal weight [55]. This relationship was not statistically significant among boys.…”

Neurobehavioral phenotypes of delay discounting and cognitive control in child attention‐deficit/hyperactivity disorder and obesity: Shared or distinct?

“…Studies of obesity have produced more mixed results, with substantial variation in findings by developmental stage, sample characteristics (e.g., ADHD symptoms, pubertal stage, IQ), and task type (e.g., real vs. hypothetical) 17,25 . Pubertal status may be a particularly important confounder to consider given the impact of puberty on body weight, 26 eating behavior, 27 and brain development 28 …”

“…23,24 Studies of obesity have produced more mixed results, with substantial variation in findings by developmental stage, sample characteristics (e.g., ADHD symptoms, pubertal stage, IQ), and task type (e.g., real vs. hypothetical). 17,25 Pubertal status may be a particularly important confounder to consider given the impact of puberty on body weight, 26 eating behavior, 27 and brain development. 28 As far as we are aware, no published studies have examined whether experiential DD using a salient, concrete non-food reward varies by body weight in either TD children or children with ADHD.…”

“…Critically, TD children had ADHD symptom scores that were substantially below clinical cutoffs on all parent/teacher rating scales, allowing us to identify dimensions of CC and DD specific to obesity in the absence of other co-morbidities, and supplementary analyses controlled for stimulant use, which could obscure relationships with weight 29 due to appetite suppression and potentially via improved self-control. The sample was predominantly pre-pubertal, important both to avoid confounding from hormonal effects on body weight, eating behavior and brain development, [26][27][28] and because characterizing prepubertal neurobehavioral risk factors for later obesity or ADHD [30][31][32] could inform early life prevention and intervention approaches. We hypothesized that ADHD and higher BMIz would both be associated with greater DD (reflecting a shared phenotype), with greatest DD in children with both higher BMIz and ADHD, and greater effects for the game time DD than the money DD task.…”

Variability in Pubertal Timing Among Asian American, Native Hawaiian, and Pacific Islander Subgroups

“…Obesity is associated with earlier pubertal timing in girls and possibly boys. 5 The average body mass index (BMI) of each subgroup throughout the study was not reported, but Kubo et al 3 addressed obesity as a potential confounder by performing a sensitivity analysis including only those individuals who had a prepubertal BMI between the 5th and 85th percentiles. The differences in pubertal timing among subgroups persisted after removing individuals with a BMI that fell outside…”