Cancer Causes & Control

, Volume 16, Issue 10, pp 1245–1252 | Cite as

Effects of a School-based Obesity-prevention Intervention on Menarche (United States)

  • Jorge E.  Chavarro
  • Karen E. Peterson
  • Arthur M Sobol
  • Jean L. Wiecha
  • Steven L. Gortmaker
Article

Abstract

Objective: Early menarche is a risk factor for breast cancer. Since body composition influences age at menarche we decided to estimate the effects of a school-based intervention for the prevention of obesity on the initiation of menses in young girls.

Methods: Ten schools were randomized to a modified curriculum or no curricular changes for 2 school-years. Data of 508 pre-menarcheal girls at baseline (age range: 10–13 years) were analyzed.

Results: Girls attending an intervention school experienced menarche less frequently than girls attending control schools during the intervention period (intervention schools = 54%, control schools = 59%; RR = 0.76; 95% CI [0.66, 0.87]). Attending an intervention school was also associated with lower increase in BMI (−0.3 kg/m2; p = 0.003), lower gains in triceps skinfold thickness (−1.5 mm; p = 0.007), decreased television viewing (−0.6 h/day; p<0.0001) and increased physical activity (3.1 MET-h/week; p = 0.032). Including these changes as predictors of menarche incidence attenuated the intervention effect (RR = 0.94; 95% CI [0.80, 1.10]).

Conclusions: The intervention delayed menarche in this group of girls. The delay was produced by increased physical activity, reduced television viewing and changes in BMI and fat distribution. These findings may have implications for the primary prevention of breast cancer.

Key words

adolescence breast cancer menarche prevention randomized trial 

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References

  1. 1.
    Kelsey, JL, Gammon, MD, John, EM 1993Reproductive factors and breast cancerEpidemiol Rev153647PubMedGoogle Scholar
  2. 2.
    Pike, MC, Krailo, MD, Henderson, BE, Casagrande, JT, Hoel, DG 1983“Hormonal” risk factors, “breast tissue age” and the age-incidence of breast cancerNature303767770CrossRefPubMedGoogle Scholar
  3. 3.
    Rosner, B, Colditz, GA, Willett, WC 1994Reproductive risk factors in a prospective study of breast cancer: the Nurses’ Health StudyAm J Epidemiol139819835PubMedGoogle Scholar
  4. 4.
    Rosner, B, Colditz, G 1996Log-incidence mathematical model of breast cancer incidenceJ Natl Cancer Inst88359364PubMedGoogle Scholar
  5. 5.
    Wolff, MS, Collman, GW, Barrett, JC, Huff, J 1996Breast cancer and environmental risk factors: epidemiological and experimental findingsAnnu Rev Pharmacol Toxicol36573596CrossRefPubMedGoogle Scholar
  6. 6.
    Colditz, G, Frazier, A 1995Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focusCancer Epidemiol Biomarkers Prev4567571PubMedGoogle Scholar
  7. 7.
    Colditz, GA 1995Fat, estrogens and the time frame for prevention of breast cancerEpidemiology6209211PubMedGoogle Scholar
  8. 8.
    Meyer, F, Moisan, J, Marcoux, D, Bouchard, C 1990Dietary and physical determinants of menarcheEpidemiology1377381PubMedGoogle Scholar
  9. 9.
    Moisan, J, Meyer, F, Gingras, S 1990Diet and age at menarcheCancer Causes Control1149154CrossRefPubMedGoogle Scholar
  10. 10.
    Moisan, J, Meyer, F, Gingras, S 1990A nested case-control study of the correlates of early menarcheAm J Epidemiol132953961PubMedGoogle Scholar
  11. 11.
    Maclure, M, Travis, LB, Willett, WC, MacMahon, B 1991A prospective cohort study of nutrient intake and age at menarcheAm J Clin Nutr54649656PubMedGoogle Scholar
  12. 12.
    Merzenich, H, Boeing, H, Wahrendorf, J 1993Dietary fat and sports activity as determinants for age at menarcheAm J Epidemiol138217224PubMedGoogle Scholar
  13. 13.
    Berkey, CS, Gardner, JD, Frazier, AL, Colditz, GA 2000Relation of childhood diet and body size to menarche and adolescent growth in girlsAm J Epidemiol152446452CrossRefPubMedGoogle Scholar
  14. 14.
    Tanner, JM 1990Foetus into Man: Physical Growth from Conception to MaturityHarvard University PressCambridgeGoogle Scholar
  15. 15.
    Chavarro, J, Villamor, E, Narvaez, J, Hoyos, A 2004Socio-demographic predictors of age at menarche in a group of Colombian university womenAnn Hum Biol31245257CrossRefPubMedGoogle Scholar
  16. 16.
    Gortmaker, SL, Peterson, K, Wiecha, J,  et al. 1999Reducing obesity via a school-based interdisciplinary intervention among youth. Planet HealthArch Pediatr Adolesc Med153409418PubMedGoogle Scholar
  17. 17.
    Peterson, K, Field, AE, Fox, MK,  et al. 1996Validation of YRBSS Questions of Dietary Behaviors and Physical Activity Among Adolescents in Grades 9–12Division of Adolescent and School Health. Centers for Disease Control and PreventionAtlanta, GAGoogle Scholar
  18. 18.
    Westat,  1988National Health and Nutrition Examination Survey III: Body Measurements (Anthropometry)Westat Inc.Rockville, MDGoogle Scholar
  19. 19.
    Barlow SE, Dietz WH (1998) Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 102: E29.Google Scholar
  20. 20.
    Kuczmarski, RJ, Ogden, CL, Grummer-Strawn, LM,  et al. 2000CDC growth charts: United StatesNational Center for Health StatisticsHyattsville, MDGoogle Scholar
  21. 21.
    Ainsworth, B, Haskell, W, Leon, A,  et al. 1993Compendium of physical activities: classification of energy costs of human physical activitiesMed Sci Sports Exerc257180PubMedGoogle Scholar
  22. 22.
    Binder, DA 1992Fitting Cox’s proportional hazards models from survey dataBiometrika51764776Google Scholar
  23. 23.
    Lin, DJ, Wei, LJ 1989The robust inference for the Cox proportional hazards modelJ Am Stat Assoc8410741078Google Scholar
  24. 24.
    Liang, KY, Zeger, SL 1986Longitudinal data analysis using generalized linear modelsBiometrika731322Google Scholar
  25. 25.
    Woodruff, RS 1971A simple method for approximating the variance of a complicated estimateJ Am Stat Assoc66411414Google Scholar
  26. 26.
    Must, A, Phillips, SM, Naumova, EN,  et al. 2002Recall of early menstrual history and menarcheal body size: after 30 years, how well do women remember?Am J Epidemiol155672679CrossRefPubMedGoogle Scholar
  27. 27.
    Bosetti, C, Tavani, A, Negri, E, Trichopoulos, D, Vecchia, C 2001Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controlsJ Clin Epidemiol54902906CrossRefPubMedGoogle Scholar
  28. 28.
    Koprowski, C, Coates, RJ, Bernstein, L 2001Ability of young women to recall past body size and age at menarcheObes Res9478485PubMedGoogle Scholar
  29. 29.
    Casey, VA, Dwyer, JT, Coleman, KA, Krall, EA, Gardner, J, Valadian, I 1991Accuracy of recall by middle-aged participants in a longitudinal study of their body size and indices of maturation earlier in lifeAnn Hum Biol18155166PubMedGoogle Scholar
  30. 30.
    Bergstein-Brucefors, A 1976A note on accuracy of recalled age at menarcheAnn Hum Biol37173PubMedGoogle Scholar
  31. 31.
    Chumlea, WC, Schubert, CM, Roche, AF,  et al. 2003Age at Menarche and Racial Comparisons in US GirlsPediatrics111110113CrossRefPubMedGoogle Scholar
  32. 32.
    Frisch, RE, McArthur, JW 1974Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenence or onsetScience185949951PubMedGoogle Scholar
  33. 33.
    Frisch, RE 1987Body fat, menarche, fitness and fertilityHum Reprod2521533PubMedGoogle Scholar
  34. 34.
    Matkovic, V, Ilich, JZ, Skugor, M,  et al. 1997Leptin is inversely relate to age at menarche in human femalesJ Clin Endocrinol Metab8232393245CrossRefPubMedGoogle Scholar
  35. 35.
    Garcia-Mayor, RV, Andrade, A, Rios, M, Lage, M, Dieguez, C, Casanueva, FF 1997Serum leptin levels in normal children: ralationship to age, gender, body mass index, pituitary-gonadal hormones and pubertal stageJ Clin Endocrinol Metab8228492855CrossRefPubMedGoogle Scholar
  36. 36.
    Wilson, ME, Fisher, J, Chikazawa, K,  et al. 2003Leptin administration increases nocturnal concentrations of luteinizing hormone and growth hormone in juvenile female rhesus monkeysJ Clin Endocrinol Metab8848744883CrossRefPubMedGoogle Scholar
  37. 37.
    Freedman, DS, Wang, J, Maynard, LM,  et al. 2005Relation of BMI to fat and fat free mass among children and adolescentsInt J Obes2918CrossRefGoogle Scholar
  38. 38.
    Hankinson, SE, Hunter, D 2002

    Breast Cancer

    Adami, H OHunter, DTrichopoulos, D eds. Textbook of Cancer EpidemiologyOxford University PressNew York
    Google Scholar
  39. 39.
    Hsieh, CC, Trichopoulos, D, Katsouyanni, K, Yuasa, S 1990Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control studyInt J Cancer46796800PubMedGoogle Scholar
  40. 40.
    Shoff, SM, Newcomb, PA, Trentham-Dietz, A,  et al. 2000Early-life physical activity and postmenopausal breast cancer: effect of body size and weight changeCancer Epidemiol Biomarkers Prev9591595PubMedGoogle Scholar
  41. 41.
    Verloop, J, Rookus, MA, Kooy, K, Leeuwen, FE 2000Physical activity and breast cancer risk in women aged 20–54 yearsJ Natl Cancer Inst92128135CrossRefPubMedGoogle Scholar
  42. 42.
    Mittendorf, R, Longnecker, MP, Newcomb, PA,  et al. 1995Strenuous physical activity in young adulthood and risk of breast cancer (United States)Cancer Causes Control6347353CrossRefPubMedGoogle Scholar
  43. 43.
    Friedenreich, CM, Courneya, KS, Bryant, HE 2001Influence of physical activity in different age and life periods on the risk of breast cancerEpidemiology12604612CrossRefPubMedGoogle Scholar
  44. 44.
    Matthews, CE, Shu, XO, Jin, F,  et al. 2001Lifetime physical activity and breast cancer risk in the Shanghai Breast Cancer StudyBr J Cancer849941001CrossRefPubMedGoogle Scholar
  45. 45.
    Marcus, PM, Newman, B, Moorman, PG,  et al. 1999Physical activity at age 12 and adult breast cancer risk (United States)Cancer Causes Control10293302CrossRefPubMedGoogle Scholar
  46. 46.
    Verkasalo, PK, Thomas, HV, Appleby, PN, Davey, GK, Key, TJ 2001Circulating levels of sex hormones and their relation to risk factors for breast cancer in 1092 pre- and postmenopausal women (United Kingdom)Cancer Causes Control124759CrossRefPubMedGoogle Scholar
  47. 47.
    Bernstein, L, Ross, R, Lobo, R, Hanisch, R, Krailo, M, Henderson, B 1987The effects of moderate physical activity on menstrual cycle patterns in adolescence: implications for breast cancer preventionBr J Cancer55681685PubMedGoogle Scholar
  48. 48.
    Kraemer, RR, Durand, RJ, Acevedo, EO,  et al. 2004Rigorous running increases growth hormone and insulin-like growth factor-I without altering ghrelinExp Biol Med229240246Google Scholar
  49. 49.
    Holmes, MD, Pollak, MN, Hankinson, SE 2002Lifestyle correlates of plasma insulin-like growth factor-I and insulin-like growth factor binding protein three concentrationsCancer Epidemiol Biomarkers Prev11862867PubMedGoogle Scholar
  50. 50.
    Lukanova, A, Toniolo, P, Akhmedkhanov, A,  et al. 2001A cross-sectional study of IGF-I determinants in womenEur J Cancer Prev10443452CrossRefPubMedGoogle Scholar
  51. 51.
    Kaaks, R, Lukanova, A 2001Energy balance and cancer: the role of insulin and insulin-like growth factor-IProc Nutr Soc6091106PubMedGoogle Scholar
  52. 52.
    Schett, TP, Mills, PJ, Ziegler, MG, Stoppani, J, Cooper, DM 1999Effect of exercise on cytokines and growth mediators in prepubertal childrenPediatr Res46429434PubMedGoogle Scholar
  53. 53.
    Eliakim, A, Brasel, JA, Mohan, S, Wong, WL, Cooper, DM 1998Increased physical activity and the growth hormone-IGF-I axis in adolescent malesAm J Physiol275R308R314PubMedGoogle Scholar
  54. 54.
    Roy, DK, O’Neill, TW, Finn, JD,  et al. 2003Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS)Osteoporosis Int141926CrossRefGoogle Scholar
  55. 55.
    Chevalley, T, Rizzoli, R, Hans, D, Ferrari, S, Bonjour, J-P 2005Interaction between Calcium Intake and Menarcheal Age on Bone Mass Gain: An Eight-Year Follow-Up Study from Prepuberty to PostmenarcheJ Clin Endocrinol Metab904451CrossRefPubMedGoogle Scholar
  56. 56.
    Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH 1992Long-term morbidity and mortality of overweight adolescents A follow-up of the Harvard Growth Study of 1922 to 1935N Engl J Med32713501355PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Jorge E.  Chavarro
    • 1
    • 2
  • Karen E. Peterson
    • 1
    • 3
  • Arthur M Sobol
    • 3
  • Jean L. Wiecha
    • 3
  • Steven L. Gortmaker
    • 3
  1. 1.Department of NutritionHarvard School of Public HealthBostonUSA
  2. 2.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  3. 3.Department of Society, Human Development and HealthHarvard School of Public HealthBostonUSA

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