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Association of Traditional dietary pattern with early and precocious puberty: a population-based cross-sectional study

Pediatric Research (2024)Cite this article

Abstract

Background

Precocious puberty is an endocrine disease that is diagnosed by sex, age, and Tanner stage of puberty. This study aimed to investigate the association between various dietary patterns and early or precocious puberty, especially Traditional dietary patterns, which have been rarely investigated.

Methods

A total of 4085 primary school students in grades 1–3 (6–9 years) completed individual characteristic surveys, health examinations, and food frequency questionnaires (FFQs). Physical examinations were also conducted to assess obesity and pubertal onset. Traditional, Westernized, and Protein dietary patterns were determined by factor analysis, and their associations with pubertal onset were analyzed by multiple logistic regression analysis.

Results

Compared to the other two patterns, children who predominant the Traditional dietary pattern were protectively associated with precocious puberty (OR = 0.72, 95% CI = 0.55, 0.94), even after adjusting the confounders (OR = 0.66, 95% CI = 0.48, 0.89). Neither the Westernized nor Protein dietary pattern demonstrated an association with pubertal onset. The Traditional dietary pattern was negatively associated with children’s weight status, classified by body mass index (BMI), and was positively associated with parental education. The maternal education and the Protein dietary pattern were negatively related.

Conclusions

Traditional dietary patterns were protective associated with early and precocious puberty among Chinese children.

Impact

  • The Traditional dietary pattern was protective associated with early puberty or precocious puberty in children, as found in large-scale population-based public health research.

  • Current research primarily focuses on Westernized dietary patterns, and we studied Traditional dietary patterns to further explore the influence of food on children’s puberty development.

  • We discovered that children’s preference for Traditional dietary patterns is protective of pubertal development, which implies that society and parents can benefit from diet guidance to protect children’s natural development during adolescence.

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Data availability

The data underlying this article cannot be shared publicly due to the privacy of individuals who participated as children in the study. The data will be shared upon reasonable request with the corresponding author.

References

  1. Nathan, B. M. & Palmert, M. R. Regulation and disorders of pubertal timing. Endocrinol. Metab. Clin. North Am. 34, 617–641 (2005).

  2. Jansen, E. C. et al. Vegetables and lean proteins-based and processed meats and refined grains -based dietary patterns in early childhood are associated with pubertal timing in a sex-specific manner: a prospective study of children from Mexico City. Nutr. Res. 56, 41–50 (2018).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Jansen, E. C., Marin, C., Mora-Plazas, M. & Villamor, E. Higher childhood red meat intake frequency is associated with earlier age at menarche. J. Nutr. 146, 792–798 (2015).

    Article  PubMed  Google Scholar 

  4. Li, S. J., Paik, H. Y. & Joung, H. Dietary patterns are associated with sexual maturation in Korean children. Br. J. Nutr. 95, 817–823 (2006).

    Article  CAS  PubMed  Google Scholar 

  5. Rogers, I. S. et al. Diet throughout childhood and age at menarche in a contemporary cohort of British girls. Public Health Nutr. 13, 2052–2063 (2010).

    Article  PubMed  Google Scholar 

  6. Kerver, J. M., Gardiner, J. C., Dorgan, J. F., Rosen, C. J. & Velie, E. M. Dietary predictors of the insulin-like growth factor system in adolescent females: results from the Dietary Intervention Study in Children (Disc). Am. J. Clin. Nutr. 91, 643–650 (2010).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Thankamony, A. et al. Higher Levels of Igf-I and adrenal androgens at age 8 years are associated with earlier age at menarche in girls. J. Clin. Endocrinol. Metab. 97, E786–E790 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Mueller, N. T. et al. Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche. Am. J. Clin. Nutr. 102, 648–654 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Chen, C. et al. Association between dietary patterns and precocious puberty in children: a population-based study. Int J. Endocrinol. 2018, 4528704 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gunther, A. L., Karaolis-Danckert, N., Kroke, A., Remer, T. & Buyken, A. E. Dietary protein intake throughout childhood is associated with the timing of puberty. J. Nutr. 140, 565–571 (2010).

    Article  PubMed  Google Scholar 

  11. Xie, L. et al. Effect of decaffeinated green tea polyphenols on body fat and precocious puberty in obese girls: a randomized controlled trial. Front. Endocrinol. (Lausanne) 12, 736724 (2021).

    Article  PubMed  Google Scholar 

  12. Moslehi, N., Asghari, G., Mirmiran, P. & Azizi, F. Longitudinal association of dietary sources of animal and plant protein throughout childhood with menarche. BMC Pediatr. 21, 206 (2021).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. DG, K. & A, S. The association of dietary factors with the age of menarche.nutrition research. Nutr. Res. 7, 471–479 (1987).

    Article  Google Scholar 

  14. Villamor, E. & Jansen, E. C. Nutritional determinants of the timing of puberty. Annu. Rev. Public Health 37, 33–46 (2016).

    Article  PubMed  Google Scholar 

  15. Marshall, W. A. & Tanner, J. M. Variations in the pattern of pubertal changes in boys. Arch. Dis. Child. 45, 13–23 (1970).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Marshall, W. A. & Tanner, J. M. Variations in pattern of pubertal changes in girls. Arch. Dis. Child. 44, 291–303 (1969).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Yu, T. et al. Effects of childhood obesity and related genetic factors on precocious puberty: protocol for a multi-center prospective cohort study. BMC Pediatr. 22, 310 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lebrethon, M. C. & Bourguignon, J. P. Management of Central Isosexual Precocity: Diagnosis, Treatment, Outcome. Curr. Opin. Pediatr. 12, 394–399 (2000).

    Article  CAS  PubMed  Google Scholar 

  19. Kaplowitz, P. B. Update on Precocious Puberty: Who Should Be Treated? Adv. Pediatr. 67, 93–104 (2020).

    Article  PubMed  Google Scholar 

  20. Chen, Y. C. et al. Assessing Causality between Childhood Adiposity and Early Puberty: A Bidirectional Mendelian Randomization and Longitudinal Study. Metab. Clin. Exp. 100, 153961 (2019).

    Article  CAS  PubMed  Google Scholar 

  21. Sun, Y. et al. National Estimates of the Pubertal Milestones among Urban and Rural Chinese Girls. J. Adolesc. Health : Off. Publ. Soc. Adolesc. Med. 51, 279–284 (2012).

    Article  Google Scholar 

  22. Cole, T. J., Bellizzi, M. C., Flegal, K. M. & Dietz, W. H. Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey. BMJ (Clin. Res. ed.) 320, 1240–1243 (2000).

    Article  CAS  Google Scholar 

  23. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO consultation. World Health Organ. Tech. Rep. Ser. 894, 1–253 (2000).

    Google Scholar 

  24. Liu, W. et al. Socioeconomic determinants of childhood obesity among primary school children in Guangzhou, China. BMC Public Health 16, 482 (2016).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Liu, D. et al. Dietary patterns and association with obesity of children aged 6–17 years in medium and small cities in China: findings from the CNHS 2010–2012. Nutrients 11, 3 (2018).

  26. McCann, S. E., Marshall, J. R., Brasure, J. R., Graham, S. & Freudenheim, J. L. Analysis of patterns of food intake in nutritional epidemiology: food classification in principal components analysis and the subsequent impact on estimates for endometrial cancer. Public Health Nutr. 4, 989–997 (2001).

    Article  CAS  PubMed  Google Scholar 

  27. Lai, X. et al. Association of obesity and body fat percentage with pubertal state in six- to nine-year-old Chinese females. Child. Obes. (Print.) 17, 525–533 (2021).

    Article  Google Scholar 

  28. Meng, F. S. et al. [Study of relationship between dietary patterns and precocious puberty of school-age girls in shenzhen]. Zhonghua Liu Xing Bing Xue Za Zhi 41, 738–742 (2020).

  29. Ramezani Tehrani, F. et al. Intake of dairy products, calcium, magnesium, and phosphorus in childhood and age at menarche in the Tehran lipid and glucose study. PLoS ONE 8, e57696 (2013).

    Article  ADS  PubMed  PubMed Central  Google Scholar 

  30. Carwile, J. L. et al. Milk consumption after age 9 years does not predict age at menarche. J. Nutr. 145, 1900–1908 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. de Ridder, C. M. et al. Dietary habits, sexual maturation, and plasma hormones in pubertal girls: a longitudinal study. Am. J. Clin. Nutr. 54, 805–813 (1991).

    Article  PubMed  Google Scholar 

  32. de Ridder, C. M. et al. Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturation of girls. J. Clin. Endocrinol. Metab. 75, 442–446 (1992).

    PubMed  Google Scholar 

  33. Valsamakis, G., Arapaki, A., Balafoutas, D., Charmandari, E. & Vlahos, N. F. Diet-induced hypothalamic inflammation, phoenixin, and subsequent precocious puberty. Nutrients 13, 3460 (2021).

  34. Koprowski, C., Ross, R. K., Mack, W. J., Henderson, B. E. & Bernstein, L. Diet, body size and menarche in a multiethnic cohort. Br. J. Cancer 79, 1907–1911 (1999).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Zhao, A. et al. Dietary diversity among Chinese residents during the Covid-19 outbreak and its associated factors. Nutrients 12, 1699 (2020).

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Funding

This study received financial support from various sources, including the National Science Foundation of China (82173534, and 81872637), the Special Program for Women and Children Health (2020YJZX0212), Cultivation Project of Clinical Research from SCMC (LY-SCMC2020-06), Project of “Unveiling the Top” for Sanya Women and Children Hospital [SYFY-JBGS-202201], Major Science and Technology Projects of Fujian Province (2021YZ034011), Zhongshan City Social Welfare Science and Technology Research Project [2023B1049].

Author information

Author notes

  1. These authors contributed equally: Xinlin Chen, Simao Fu.

Authors and Affiliations

  1. The Second School of Clinical Medical, Southern Medical University, Guangzhou, China

    Xinlin Chen

  2. BoAi Hospital of Zhongshan Affiliated to Southern Medical University, Zhongshan, China

    Simao Fu, Yawen Yuan, Zhibin Dai, Ang Chen, Bihong Zhang & Cuilan Lin

  3. Health Care Centre for Primary and Secondary Schools, Zhongshan, China

    Chaojun Chen

  4. Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Shijian Liu

Authors
  1. Xinlin Chen
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  9. Cuilan Lin
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Contributions

X.C., C.L., and S.L. conceptualized and designed this study; S.F. and C.L. organized the investigation; S.F., C.L., C.C., Y.Y., A.C., Z.D., and B.Z. implemented the research and acquired the data; X.C. analyzed the data and drafted this primary manuscript; C.L. and S.L. revised this article for important content. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved its submission.

Corresponding authors

Correspondence to Shijian Liu or Cuilan Lin.

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Each participant and their families signed an informed consent form prior to their participation.

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The authors declare no competing interests.

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Chen, X., Fu, S., Chen, C. et al. Association of Traditional dietary pattern with early and precocious puberty: a population-based cross-sectional study. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03110-w

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  • DOI: https://doi.org/10.1038/s41390-024-03110-w

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