title: Childhood overweight and maturational timing in the development of adult overweight and fatness: the Newton Girls Study and its follow-up.
abstract: 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.
  
  
  METHODS
  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 < or = 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.
authors.affiliation: Department of Public Health and Family Medicine, School of Medicine, Tufts University, Boston, Massachusetts 02111, USA. aviva.must@tufts.edu
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
authors.forename: Elena N
authors.initials: EN
authors.lastname: Naumova
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Phillips
authors.forename: Miriam
authors.initials: M
authors.lastname: Blum
authors.forename: Bess
authors.initials: B
authors.lastname: Dawson-Hughes
authors.forename: William M
authors.initials: WM
authors.lastname: Rand
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008572:Menarche; D009765:Obesity / Q000175:diagnosis*; D050177:Overweight; D046468:Sexual Development