title: Age at menarche in the Canadian population: secular trends and relationship to adulthood BMI.
abstract: OBJECTIVE
  Studies from around the world indicate a trend toward younger ages of menarche. The extent of this trend in the Canadian population is unknown, and the relationship to later-life health indicators has not yet been fully elucidated. The objective of this study is to estimate the trend in age at menarche (AAM) in the Canadian population and evaluate the relationship between AAM and adult body mass index (BMI).
  
  
  METHODS
  Our data source was a nationally representative survey (the Canadian Community Health Survey, 2.2), and analyses included 8080 women, aged 15 and older, who self-reported AAM. Height and weight were measured by the interviewers for the calculation of current BMI. We modeled the secular trend in AAM over time, and the relationship between current BMI and AAM.
  
  
  RESULTS
  We found a statistically significant decline in AAM in successive age cohorts, indicating a 0.73-year (8.8-month) decrease in AAM between the oldest and youngest age cohorts in the sample. A 1-year increase in AAM was associated with a decrease in mean BMI of approximately 0.5 kg/m(2), after adjustment for covariates. A current age-AAM interaction term was nonsignificant, indicating that the relationship was stable throughout increasing temporal separation from puberty.
  
  
  CONCLUSIONS
  The observed trend toward earlier menarche could be an indicator of a change in insulin-related metabolism, possibly mediated by behavioral and environmental variables. This study suggests that AAM may be an important clinical and public health indicator of susceptibility to overweight and obesity and attendant morbidity.
authors.affiliation: School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada. aharris7@interchange.ubc.ca
authors.forename: M Anne
authors.initials: MA
authors.lastname: Harris
authors.forename: Jerilynn C
authors.initials: JC
authors.lastname: Prior
authors.forename: Mieke
authors.initials: M
authors.lastname: Koehoorn
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D008572:Menarche; D055815:Young Adult