Examining the Relationship between Age at Menarche and Body Mass Index in Adolescent Girls
===
Age at menarche (AAM) is the age when a girl experiences her first menstrual bleeding. It is an important indicator of female reproductive health and development. AAM varies widely among individuals and populations, depending on genetic, environmental, nutritional, and socio-economic factors. AAM has been declining globally over the past century, especially in developing countries, due to improved nutrition, sanitation, and health care [1].
Body mass index (BMI) is a measure of body fatness based on weight and height. It is commonly used to assess obesity and overweight, which are major risk factors for many chronic diseases, such as diabetes, cardiovascular disease, and cancer. BMI also influences female reproductive function and outcomes, such as fertility, menstrual cycle regularity, and pregnancy complications [2].
Several studies have reported an association between AAM and BMI in adolescent girls. Generally, earlier AAM is associated with higher BMI, and vice versa [3]. This association may be explained by several mechanisms. First, adipose tissue produces estrogen, which stimulates the maturation of the hypothalamic-pituitary-ovarian axis and the onset of puberty [4]. Second, leptin, a hormone secreted by fat cells, also plays a role in regulating puberty onset by signaling the energy status to the brain [5]. Third, insulin resistance, which is often associated with obesity, may impair ovarian function and delay menarche [6].
However, the association between AAM and BMI may vary by population characteristics, such as ethnicity, socio-economic status, living area, and region. For example, a study in Indonesia found that AAM declined from 14.4 years in the 1940s to 13.4 years in the 1990s, while BMI increased from 19.9 kg/m2 to 21.6 kg/m2 over the same period [7]. However, AAM was not associated with BMI or NCD prevalence in later life in this population. Another study in China found that earlier AAM was associated with higher child BMI in both boys and girls, and that maternal BMI mediated this association [8].
Therefore, it is important to examine the relationship between AAM and BMI in adolescent girls in different settings and contexts, as it may have implications for their current and future health and well-being. In this blog post, we will review some of the recent studies on this topic and discuss their findings and implications.
Recent Studies on AAM and BMI in Adolescent Girls
—
One of the recent studies on this topic was conducted by Asrullah et al. [7], who used secondary data of 15,744 women aged 15–65 years from the Indonesian Family Life Survey (IFLS) conducted in the period 1993 to 2015. They applied multiple linear regression to determine the association of AAM with BMI, and Poisson regression to investigate the association of AAM with NCD prevalence ratios. They found that AAM declined from 14.4 years in the 1940s to 13.4 years in the 1990s,
while BMI increased from 19.9 kg/m2 to 21.6 kg/m2 over the same period. They also found that AAM was inversely associated with BMI (β: −0.30 kg/m2 per year older AAM) and body weight (β: −0.67 kg per year older AAM), but not with height or NCD prevalence.
Another recent study was conducted by Wang et al. [8], who recruited 17,571 children aged 6–13 years from 26 primary schools using cluster random probability sampling in Shanghai, China, in 2014. They used multiple linear regression models to estimate the adjusted associations of maternal age of menarche (MAM) with offspring BMI. They also used mediation analysis to examine the contribution of maternal BMI and gestational diabetes to offspring BMI. They found that earlier MAM was associated with higher child BMI in boys (−0.05 z-score per year older MAM) and girls (−0.05 z-score per year older MAM). They also found that maternal BMI positively mediated the association of MAM with offspring BMI in both sexes,
with mediation effects of 37.7% for boys and 19.4% for girls.
A third recent study was conducted by Singh et al. [3], who studied the correlation between AAM and BMI in adolescent girls aged 10–18 years from a rural area of Uttar Pradesh, India. They measured the weight, height, and AAM of 300 girls using standard methods and calculated their BMI using WHO criteria. They used Pearson’s correlation coefficient and ANOVA to analyze the data. They found that the mean AAM was 12.75 ± 1.06 years and the mean BMI was 21.6 ± 3.64 kg/m2. They also found that high BMI girls had earlier menarche, compared to normal BMI and underweight girls (P = 0.02).
Implications and Recommendations
—
The studies reviewed above suggest that there is a negative association between AAM and BMI in adolescent girls, meaning that earlier menarche is associated with higher BMI, and vice versa. This association may have implications for the current and future health and well-being of adolescent girls, as both early menarche and high BMI are associated with increased risks of chronic diseases, such as diabetes, cardiovascular disease, and cancer [2]. Moreover, the association may have intergenerational effects, as maternal menarche and BMI may influence the offspring’s BMI and health [8].
Therefore, it is important to monitor and promote healthy growth and development of adolescent girls, especially in developing countries where AAM is declining and BMI is increasing. Some of the possible interventions include:
– Providing adequate nutrition and physical activity for adolescent girls to prevent obesity and overweight, as well as undernutrition and stunting.
– Educating adolescent girls and their families about the importance of reproductive health and hygiene, as well as the prevention and management of menstrual disorders.
– Providing access to quality health care services for adolescent girls, including screening and treatment of NCD risk factors, such as hypertension, diabetes, and dyslipidemia.
– Supporting adolescent girls to cope with the psychosocial challenges of puberty and adolescence, such as body image, self-esteem, peer pressure, and sexual behavior.
– Empowering adolescent girls to make informed decisions about their education, career, marriage, and fertility.
Conclusion
—
Age at menarche and body mass index are two important indicators of female reproductive health and development. They are influenced by genetic, environmental, nutritional, and socio-economic factors. They are also associated with each other, as well as with the risk of chronic diseases in later life. Therefore, it is important to examine the relationship between AAM and BMI in adolescent girls in different settings and contexts, as it may have implications for their current and future health and well-being.
References
—
[1] Gluckman PD, Hanson MA. Evolutionary origins of health and disease: developmental perspectives on life-course transitions. In: Kuh D, Hardy R (eds). A life course approach to women’s health. Oxford University Press; 2002: 15–34.
[2] Rich-Edwards JW, Manson JE, Michels KB et al. Research paper writing help. Adverse outcomes of underweight and overweight among young women using oral contraceptives. Am J Obstet Gynecol 2005; 192: 330–337.
[3] Singh S, Singh S K , Singh S K et al. Study of correlation between age of menarche and body mass index in adolescent girls from a rural area of Uttar Pradesh India. Int J Reprod Contracept Obstet Gynecol 2020; 9: 11853–11857.
[4] Frisch RE. The right weight: body fat, menarche and fertility. Proc Nutr Soc 1994; 53: 113–129.
[5] Mantzoros CS. The role of leptin in human obesity and disease: a review of current evidence. Ann Intern Med 1999; 130: 671–680.
[6] Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev 2012; 33: 981–1030.
[7] Asrullah M , L’Hoir M , Feskens EJM et al. Trend in age at menarche and its association with body weight, body mass index and non-communicable disease prevalence in Indonesia: evidence from the Indonesian Family Life Survey (IFLS). BMC Public Health 2022; 22: 628.
[8] Wang H , Zhang Y , Tian Y et al. Maternal age at menarche and offspring body mass index in childhood. BMC Pediatr 2019; 19: 312.
