Foot Length Growth as a Novel Marker of Early Puberty

Association of height, foot length, and pubertal development in children aged 3-18: a cross-sectional survey in China

Objective

This study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3-18 and examine their associations with puberty development.

Methods

A cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed.

Results

From an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3.

Conclusion

Boys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

Assessing the role of adolescent hormonal contraceptive use on risk for depression: a 3-year longitudinal study protocol

BACKGROUND

The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females' risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning.

METHODS

Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels.

DISCUSSION

In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.

Relationship of the Use of Short Footwear with the Development of Hallux Valgus in a Sample of Andalusian Schoolchildren

Background: Several studies have shown the relationship between poor footwear fit and the risk of feet deformities. The available evidence seems to show that the development of hallux valgus deformity in the feet of schoolchildren may be related to the use of shoes that are poorly fitting in length. The objective of this cross-sectional study was to analyze the relationship between poor footwear fit in length and risk of developing hallux valgus. Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length was obtained and compared to the inner length of the shoe in 187 schoolchildren. Hallux valgus angle (HVA) was measured on weight-bearing podogram image obtained from the longest foot in 188 schoolchildren. Results: By default, the footwear was poorly fitting in length (too short or close-fitting) in 38.5% of the schoolchildren, with boys having the worst footwear fit; though no significant differences stood out. (p = 0.276). Regarding the HVA, no significant differences were recorded according to age or gender (p = 0.573). A strong correlation was observed between too-short footwear and the increase in HVA in 10-year-old boys (r = 0.817; p = 0.025) and in 9-year-old girls (r = 0.705; p = 0.005). Conclusions: Inadequate footwear fit in length may be a predisposing extrinsic risk factor for the development of hallux valgus in schoolchildren of both sexes. Results of the present study demonstrate the need to adapt the sizes of footwear to the rapid increase in foot-length that occur at puberty to avoid the risk of developing hallux valgus, especially at the ages of onset pubertal foot growth.

A Cross-Sectional Study of Foot Growth and Its Correlation with Anthropometric Parameters in a Representative Cohort of Schoolchildren from Southern Spain

Background: The relationship between growth of the foot and other anthropometric parameters during body development until puberty has been scarcely studied. Some studies propose that growth of the foot in length may be an early index of puberty. The objective of this cross-sectional study was to analyze the relationship between the growth of the foot in length and width with other anthropometric parameters, in prepubertal and early pubertal schoolchildren (Tanner stage II). Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length, width and height were obtained in 1005 schoolchildren. Results: The findings indicate that the age of onset of pubertal foot growth spur was 7–8 years in girls, and 8–9 years in boys. Growth in foot length stabilized in both sexes after 12 years of age. In boys, a strong correlation was found between height and foot length (r = 0.884; p < 0.047), and between body mass index (BMI) and forefoot width at 12 years of age (r = 0.935; p < 0.020). A strong correlation was found between height and forefoot width at 6 years in girls (r = 0.719; p < 0.001), as well as between BMI and metatarsal width in 10 years-old girls (r = 0.812; p <0.001). Conclusions: The average increase in foot length and width that precedes the onset of Tanner’s stage II in both girls and boys can be considered as a useful biological indicator of the onset of puberty.