Why are obese children more prone to early puberty?

Why Are Obese children Prone to Early Puberty? How Can Obesity-Related Early Puberty in Children Be Prevented and Treated?

Childhood obesity has evolved into a pressing societal concern, significantly impacting the physical and mental well-being of children. Adding to parental worries, a portion of obese children experience premature development and early puberty. This phenomenon may stem from:

(1) Obese children tend to overeat compared to their non-obese counterparts, exhibiting an improper diet preference for snacks, fast food, various meats, and fried foods. A significant portion of these choices includes junk foods, characterized by high calories and fat content, some even containing hormones. Frequent consumption not only leads to obesity but also accelerates premature sexual gland development in children.

(2) A study published in the American journal "Pediatrics" revealed that childhood obesity contributes to early puberty in girls. Adipose tissue encourages the production of certain hormones that trigger early adolescence, amplifying the risk of early puberty. The prevalence of early puberty in children is on the rise, particularly among girls. Premature puberty leads to an early onset of adolescence and growth stages, potentially causing premature closure of growth plates in bones, ultimately hindering optimal height development. In China, the incidence of early puberty in children is approximately 1%, rising to about 3% in economically developed cities. Early puberty often arises as a consequence of poor dietary habits.

We recommend diverse food choices for children, avoiding selective eating and finicky habits. Overuse of supplements like caterpillar fungus, ginseng, and longan should be avoided. Poultry, especially products like duck neck, are often fed with fast growth agents, contributing to early maturation in marketed poultry. Out-of-season vegetables and fruits, such as winter strawberries, watermelons, tomatoes, and early-ripening pears, apples, and peaches, are often ripened artificially with "ripening agents." Consumption of such products should be minimized for children. Deep-fried foods, notably fried chicken and French fries, carry excessive calories that transform into surplus fat within children, causing endocrine disruption and triggering early puberty. Certain oral liquids promoted as height and strength enhancers for children might contain hormone components that cause abnormal growth patterns, leading children to appear taller and more robust at the age of five or six, with bone age reaching eight or ten years. However, as children enter normal developmental stages, their growth might stall.

According to the 2010 "Guidelines for the Diagnosis and Treatment of Early Puberty (Trial)" released by the Ministry of Health, early puberty is defined as "the presentation of secondary sexual characteristics before the age of 9 in boys and before the age of 8 in girls." The strategy to prevent early puberty in obese children involves weight loss to mitigate early puberty risk. However, weight loss should not solely rely on dieting or weight loss medications. Unlike adults, children are still in their growing stages and require comprehensive and ample nutrient supplementation. When children resort to dieting, not only do they lose fat, but they also lose muscle, which negatively impacts organ function and may lead to malnutrition. Weight loss medications may also have adverse effects on a child's growth and development.

Excessive dieting should be avoided for children. A balanced diet is the cornerstone of healthy weight loss. Physical activity is crucial for childhood weight loss, but the timing and intensity of exercise should be scientifically gradual and logical. Early puberty in children is not insurmountable. With proactive prevention and rational weight management, parents can avert early puberty in their children.

It's important to differentiate between childhood early puberty and isolated breast development. Isolated breast development in childhood is a specific form of early puberty, caused by a transient elevation of internal and external estrogen levels. It's a benign, non-progressive condition characterized by the early development of bilateral breasts, occasionally starting on one side before the other. However, this development lacks nipple and areolar growth. Apart from breast development, no other secondary sexual characteristics develop, and both uterus and ovaries appear normal during ultrasound examination. Generally, treatment isn't necessary for isolated breast development, but the use of hormone-containing cosmetics should be minimized, and consumption of junk food and nutritional supplements should be limited.

Childhood early puberty can be classified into central and peripheral types. In the former, the premature release of gonadotropin-releasing hormone causes early hormonal release, which is physiologically normal. The latter relies on gonadotropin-releasing hormone or sex steroids for stimulation. Treatment using gonadotropin-releasing hormone agonists for central childhood early puberty requires meticulous clinical and trial monitoring. Effective treatment can halt or regress secondary sexual characteristic development and slow bone maturation, eventually leading to the anticipated height. However, insufficient dosage might promote, rather than inhibit, adolescent development, thus diminishing expected final height.