Negotiating the early developing body: pubertal timing, body weight, and adolescent girls' substance use

Outcomes of pubertal development in girls as a function of pubertal onset age

BACKGROUND

The relationship between pubertal onset and tempo and pubertal growth is controversial. We hypothesized that the age at onset of girls' puberty predicts pubertal tempo and the rate of pubertal progression.

METHODS

We analysed the data of 380 girls from the prospective Study of Early Child Care and Youth Development (SECCYD), who were recruited in the USA from 1991-2006 and followed from birth to age 15.5 years. We used the following indicators: thelarche age (Tanner stage B2), pubarche age (P2), menarche age (M), the age when breast (B5) and pubic hair (P5) became fully mature, pubertal growth, pubertal duration (time from B2 to B5), pubertal progression (time from B2 to M). We clustered the girls according to B2 age into early onset (EO;<9.4 years), intermediate (IO;9.4-10.5 years), late onset (LO;>10.5 years).

RESULTS

All indicators of pubertal onset and conclusion occurred earlier in the EOs than in the LO; yet, the differences in the age at main pubertal milestones lessened as puberty progressed: two years for B2; -1.4 years for M; - one year for B5. In EO, puberty was one year (average) longer than in LO. Although EO grew 7 cm (average) more than LO, their heights at B5 were comparable. There was a significant relationship between the thelarche age and puberty tempo (r=0.23, P<0.0001).

CONCLUSIONS

The study highlights the predictive nature of variation in the onset age of puberty on its progression and duration. These results are reassuring in this context and will add to clinicians' and parental understanding of the expected milestones of puberty.

Growth Trajectories of Health Behaviors from Adolescence through Young Adulthood

Based on nine waves of data collected during a period of 17 years (1990–2007), the present study explored different developmental trajectories of the following unhealthy behaviors: regular smoking, lack of regular exercise, lack of daily fruit intake, and drunkenness. A baseline sample of 1195 13-year-old pupils was from 22 randomly selected schools in the Hordaland County in western Norway. Latent class growth analysis revealed three developmental trajectories. The first trajectory was a conventional trajectory, comprising 36.3% of participants, who showed changes in smoking, physical exercise, fruit intake, and drunkenness consistent with the prevailing age specific norms of these behaviors in the Norwegian society at the time. The second trajectory was a passive trajectory, comprising 25.5% of participants, who reported low levels of both healthy and unhealthy behaviors during the 17-year period. The third trajectory was an unhealthy trajectory, comprising 38.2% of participants, who had high levels of unhealthy behaviors over time. Several covariates were examined, but only sex and mother’s and father’s educational levels were found to be significantly associated with the identified trajectories. While these findings need to be replicated in future studies, the identification of the different trajectories suggests the need to tailor intervention according to specific needs.

Youth Whose Weight Exceeds Healthy Guidelines Are High-Risk Targets for Tobacco Prevention Messaging and Close Monitoring of Cigarette Use

BACKGROUND

Adolescents are long-standing tobacco prevention targets, given that smoking patterns typically originate before adulthood. Pediatric overweight/obesity remains at epidemic levels. Links between these two biobehavioral risks are not well understood, yet of keen public health and pediatric care relevance. The aims of the present study were to examine smoking behaviors and attitudes of overweight (OV), obese (OB), and severely obese (SO) adolescents, compared to healthy weight (HW), utilizing the nationally representative sample, Monitoring the Future.

METHODS

Smoking behavior prevalence (ever, current, or age of initiation), perceived risk of harm, disapproval of others smoking, and peer smoking were determined for a pooled 2008-2009 sample of 19,678 10th graders (Mage=16.09±0.47 years) by CDC-defined BMI percentile-based categories within race/ethnic group (69.5% white, 14.5% African American, and 16.0% Hispanic). Logistic regression examined the impact of excess weight status on smoking behaviors and attitudes relative to HW.

RESULTS

Relative to HW of same race/ethnicity, white or African American OV, OB, and SO had higher odds of recent smoking, with the highest prevalence among SO. For white youth, excess weight increased odds of ever smoking, early daily smoking (before grade 9), perceiving low risk of harm, and not disapproving of others smoking. Findings varied for African American or Hispanic youth.

CONCLUSIONS

As we move toward fostering a tobacco-free generation, youth whose weight exceeds healthy guidelines are high-risk targets for tobacco prevention messaging and close monitoring of cigarette use, particularly those who are severely obese as well as white youth of excess weight, starting before adolescence.

Does adolescent weight status predict problematic substance use patterns?

OBJECTIVES

To identify underlying patterns of cigarette smoking, alcohol use, and marijuana use in young adulthood, and ascertain whether adolescent overweight or obesity status predicts problematic substance use patterns.

METHODS

The study included 15,119 participants from the National Longitudinal Study of Adolescent Health (Add Health) at Wave 1 (11-19 years) and Wave 3 (18-26 years). Latent class analysis was conducted.

RESULTS

Participants were classified into a Low Substance Use (35%), Regular Smokers (12%), High-risk Alcohol use (33%), or High Substance Use (20%) class. Overweight/obese adolescents had a greater likelihood of belonging to the Regular Smokers class.

CONCLUSIONS

Overweight/obese adolescents are at higher risk of engaging in regular cigarette smoking without problematic alcohol or marijuana use.

Perceived pubertal timing and recent substance use among adolescents: a longitudinal perspective

AIMS

To determine the longitudinal associations between perceived pubertal timing and recent substance use between the ages of 11 and 17 years.

DESIGN, SETTING AND PARTICIPANTS

A school-based cohort sequential study of adolescents in rural North Carolina, USA (n = 6892, 50% female) in the 6-8th grades at baseline and interviewed across five consecutive semesters.

MEASUREMENTS

Self-administered questionnaires in a group setting measured perceived pubertal development using the Pubertal Development Scale and adolescents reported past 3-month use of cigarettes, alcohol and marijuana. Latent class growth analysis determined the longitudinal relationships between perceived pubertal timing (early, on-time and late) and use of the three substances.

FINDINGS

A negative quadratic model was the best-fitting model for all three substances. Higher proportions of early developers had used cigarettes and marijuana within the past 3 months at age 11 compared with on-time (P < 0.001 and P = 0.013) and late developers (P = 0.010 and P = 0.014) and a higher proportion of early developers had recently used alcohol at age 11 compared with on-time adolescents (P < 0.001). However, the proportion of recent cigarette and marijuana users increased more across adolescence for on-time adolescents compared with early developers (P = 0.020 and P = 0.037). Desistance in the proportion of substance users was similar for all adolescents (all P > 0.050).

CONCLUSIONS

Adolescents who believe they are more advanced in puberty than their peers are more likely to have used cigarettes, alcohol and marijuana recently compared with adolescents who believe they are on-time or late developing; these findings are mainly due to differences in use at age 11.

Individual differences in boys' and girls' timing and tempo of puberty: modeling development with nonlinear growth models

Pubertal development is a nonlinear process progressing from prepubescent beginnings through biological, physical, and psychological changes to full sexual maturity. To tether theoretical concepts of puberty with sophisticated longitudinal, analytical models capable of articulating pubertal development more accurately, we used nonlinear mixed-effects models to describe both the timing and tempo of pubertal development in the sample of 364 White boys and 373 White girls measured across 6 years as part of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Individual differences in timing and tempo were extracted with models of logistic growth. Differential relations emerged for how boys' and girls' timing and tempo of development were related to physical characteristics (body mass index, height, and weight) and psychological outcomes (internalizing problems, externalizing problems, and risky sexual behavior). Timing and tempo are associated in boys but not girls. Pubertal timing and tempo are particularly important for predicting psychological outcomes in girls but only sparsely related to boys' psychological outcomes. Results highlight the importance of considering the nonlinear nature of puberty and expand the repertoire of possibilities for examining important aspects of how and when pubertal processes contribute to development.