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BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Age at menarche and its relationship to body mass index among adolescent girls in Kuwait

Authors: Nora Al-Awadhi, Nouf Al-Kandari, Teebah Al-Hasan, Daliah AlMurjan, Salhah Ali, Abdullah Al-Taiar

Published in: BMC Public Health | Issue 1/2013

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Abstract

Background

Despite the increasing rates of childhood obesity and rapid change in socio-economic status, the mean age at menarche remains mostly unknown among contemporary girls in Kuwait and other countries in the Gulf region. This study aimed to estimate the mean age at menarche among schoolgirls in Kuwait and investigate the association between age at menarche and obesity.

Methods

A cross-sectional study was conducted on 1,273 randomly selected female high school students from all governorates in Kuwait. Overweight was defined as higher than or equal to the 85th percentile and obesity as higher than or equal to the 95th percentile using growth charts provided by the Centres for Disease Control and Prevention (CDC, 2000). Data on menarche, socio-demographic status, physical activity and diet were collected using confidential self-administered questionnaire.

Results

Out of 1,273 students, 23 (1.8%) were absent or refused to participate. The mean age at menarche was 12.41 years (95% CI: 12.35-12.48). The prevalence of early menarche, defined as less than 11 years of age, was 8.5% (95% CI: 7.0-10.2%). The prevalence of obesity and overweight was 18.3% (95% CI: 16.2-20.6%) and 25.8% (95% CI: 23.42-28.30%), respectively. Age at menarche was inversely and significantly associated with odds of overweight and obesity after adjusting for potential confounders, odds ratio 0.84 (0.77-0.93); (p = 0.001).

Conclusion

Age at menarche among contemporary girls in Kuwait is similar to that in industrialized countries. There is an inverse association between age at menarche and obesity or overweight. Trends in menarcheal age should be monitored and time of sexual maturation and its related factors should be taken into account in strategies that aim to combat obesity.
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Literature
1.
Herman-Giddens ME, Slora EJ, Wasserman RC, Bourdony CJ, Bhapkar MV, Koch GG, Hasemeier CM: Secondary sexual characteristics and menses in young girls seen in office practice: a study from the pediatric research in office settings network. Pediatrics. 1997, 99 (4): 505-512.PubMed
2.
Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, Bourguignon JP: The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev. 2003, 24 (5): 668-693.PubMed
3.
Striegel-Moore RH, McMahon RP, Biro FM, Schreiber G, Crawford PB, Voorhees C: Exploring the relationship between timing of menarche and eating disorder symptoms in Black and White adolescent girls. Int J Eat Disord. 2001, 30 (4): 421-433.PubMed
4.
Kaltiala-Heino R, Kosunen E, Rimpela M: Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc. 2003, 26 (5): 531-545.PubMed
5.
Dreyfus JG, Lutsey PL, Huxley R, Pankow JS, Selvin E, Fernandez-Rhodes L, Franceschini N, Demerath EW: Age at menarche and risk of type 2 diabetes among African-American and white women in the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia. 2012, 55 (9): 2371-2380.PubMedPubMedCentral
6.
Stockl D, Doring A, Peters A, Thorand B, Heier M, Huth C, Stockl H, Rathmann W, Kowall B, Meisinger C: Age at menarche is associated with prediabetes and diabetes in women (aged 32–81 years) from the general population: the KORA F4 Study. Diabetologia. 2012, 55 (3): 681-688.PubMed
7.
He C, Zhang C, Hunter DJ, Hankinson SE, Buck Louis GM, Hediger ML, Hu FB: Age at menarche and risk of type 2 diabetes: results from 2 large prospective cohort studies. Am J Epidemiol. 2010, 171 (3): 334-344.PubMed
8.
Lakshman R, Forouhi N, Luben R, Bingham S, Khaw K, Wareham N, Ong KK: Association between age at menarche and risk of diabetes in adults: results from the EPIC-Norfolk cohort study. Diabetologia. 2008, 51 (5): 781-786.PubMed
9.
Stockl D, Meisinger C, Peters A, Thorand B, Huth C, Heier M, Rathmann W, Kowall B, Stockl H, Doring A: Age at menarche and its association with the metabolic syndrome and its components: results from the KORA F4 study. PLoS One. 2011, 6 (10): e26076-PubMedPubMedCentral
10.
Trentham-Dietz A, Nichols HB, Remington PL, Yanke L, Hampton JM, Newcomb PA, Love RR: Correlates of age at menarche among sixth grade students in Wisconsin. WMJ: official publication of the State Medical Society of Wisconsin. 2005, 104 (7): 65-69.
11.
Petridou E, Syrigou E, Toupadaki N, Zavitsanos X, Willett W, Trichopoulos D: Determinants of age at menarche as early life predictors of breast cancer risk. International journal of cancer Journal international du cancer. 1996, 68 (2): 193-198.PubMed
12.
Hadjisavvas A, Loizidou MA, Middleton N, Michael T, Papachristoforou R, Kakouri E, Daniel M, Papadopoulos P, Malas S, Marcou Y, et al: An investigation of breast cancer risk factors in Cyprus: a case control study. BMC Cancer. 2010, 10: 447-PubMedPubMedCentral
13.
Jacobsen BK, Heuch I, Kvale G: Association of low age at menarche with increased all-cause mortality: a 37-year follow-up of 61,319 Norwegian women. Am J Epidemiol. 2007, 166 (12): 1431-1437.PubMed
14.
Lakshman R, Forouhi NG, Sharp SJ, Luben R, Bingham SA, Khaw KT, Wareham NJ, Ong KK: Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab. 2009, 94 (12): 4953-4960.PubMed
15.
Jacobsen BK, Oda K, Knutsen SF, Fraser GE: Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976–88. Int J Epidemiol. 2009, 38 (1): 245-252.PubMedPubMedCentral
16.
Diaz A, Laufer MR, Breech LL: Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Pediatrics. 2006, 118 (5): 2245-2250.PubMed
17.
de Muinich Keizer SM, Mul D: Trends in pubertal development in Europe. Hum Reprod Update. 2001, 7 (3): 287-291.PubMed
18.
Whincup PH, Gilg JA, Odoki K, Taylor SJ, Cook DG: Age of menarche in contemporary British teenagers: survey of girls born between 1982 and 1986. BMJ. 2001, 322 (7294): 1095-1096.PubMedPubMedCentral
19.
Herman-Giddens ME: The decline in the age of menarche in the United States: should we be concerned?. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2007, 40 (3): 201-203.
20.
Lehmann A, Scheffler C, Hermanussen M: The variation in age at menarche: an indicator of historic developmental tempo. Anthropologischer Anzeiger; Bericht uber die biologisch-anthropologische Literatur. 2010, 68 (1): 85-99.PubMed
21.
Cabanes A, Ascunce N, Vidal E, Ederra M, Barcos A, Erdozain N, Lope V, Pollan M: Decline in age at menarche among Spanish women born from 1925 to 1962. BMC Publ Health. 2009, 9: 449-
22.
Currie C, Ahluwalia N, Godeau E, Nic Gabhainn S, Due P, Currie DB: Is obesity at individual and national level associated with lower age at menarche? evidence from 34 countries in the health behaviour in school-aged children study. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2012, 50 (6): 621-626.
23.
Ahmed ML, Ong KK, Dunger DB: Childhood obesity and the timing of puberty. Trends in endocrinology and metabolism: TEM. 2009, 20 (5): 237-242.PubMed
24.
Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman-Giddens ME: Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001, 108 (2): 347-353.PubMed
25.
Walvoord EC: The timing of puberty: is it changing? Does it matter?. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2010, 47 (5): 433-439.
26.
Musaiger AO: Overweight and obesity in eastern mediterranean region: prevalence and possible causes. Journal of obesity. 2011, 2011: 407237-PubMedPubMedCentral
27.
Ng SW, Zaghloul S, Ali HI, Harrison G, Popkin BM: The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obesity reviews: an official journal of the International Association for the Study of Obesity. 2011, 12 (1): 1-13.
28.
Guy W, Nunn V, Thomas E, Bell J: Obesity, diabetes and longevity in the Gulf: Is there a Gulf Metabolic Syndrome?. International Journal of Diabetes Mellitus. 2009, 1 (1): 43-54.
29.
Abdelalim A, Ajaj N, Al-Tmimy A, Alyousefi M, Al-Rashaidan S, Hammoud MS, Al-Taiar A: Childhood obesity and academic achievement among male students in public primary schools in Kuwait. Medical principles and practice: international journal of the Kuwait University, Health Science Centre. 2012, 21 (1): 14-19.
30.
Badrinath P, Ghazal-Aswad S, Parfitt D, Osman N: Cultural and ethnic barriers in conducting research. Factors influencing menarche in the United Arab Emirates. Saudi medical journal. 2004, 25 (11): 1626-1630.PubMed
31.
Babay ZA, Addar MH, Shahid K, Meriki N: Age at menarche and the reproductive performance of Saudi women. Ann Saudi Med. 2004, 24 (5): 354-356.PubMed
32.
Jabbar FA, Wong SS: Age at menarche and reproductive pattern among Saudi women. J R Soc Health. 1988, 108 (3): 94-96.PubMed
33.
Jackson RT, Al-Mousa Z: Iron deficiency is a more important cause of anemia than hemoglobinopathies in Kuwaiti adolescent girls. J Nutr. 2000, 130 (5): 1212-1216.PubMed
34.
Cooper R, Blell M, Hardy R, Black S, Pollard TM, Wadsworth ME, Pearce MS, Kuh D: Validity of age at menarche self-reported in adulthood. J Epidemiol Community Health. 2006, 60 (11): 993-997.PubMedPubMedCentral
35.
Anderson SE, Must A: Interpreting the continued decline in the average age at menarche: results from two nationally representative surveys of U.S. girls studied 10 years apart. J Pediatr. 2005, 147 (6): 753-760.PubMed
36.
Hosokawa M, Imazeki S, Mizunuma H, Kubota T, Hayashi K: Secular trends in age at menarche and time to establish regular menstrual cycling in Japanese women born between 1930 and 1985. BMC Womens Health. 2012, 12 (1): 19-PubMedPubMedCentral
37.
Vecek N, Vecek A, Zajc Petranovic M, Tomas Z, Arch-Vecek B, Skaric-Juric T, Milicic J: Secular trend of menarche in Zagreb (Croatia) adolescents. Eur J Obstet Gynecol Reprod Biol. 2012, 160 (1): 51-54.PubMed
38.
O’Connell A, Gavin A, Kelly C, Molcho M, Nic Gabhainn S: The mean age at menarche of Irish girls in 2006. Ir Med J. 2009, 102 (3): 76-79.PubMed
39.
Rigon F, Bianchin L, Bernasconi S, Bona G, Bozzola M, Buzi F, Cicognani A, De Sanctis C, De Sanctis V, Radetti G, et al: Update on age at menarche in Italy: toward the leveling off of the secular trend. The Journal of adolescent health: official publication of the Society for Adolescent Medicine. 2010, 46 (3): 238-244.
40.
Papadimitriou A, Fytanidis G, Douros K, Bakoula C, Nicolaidou P, Fretzayas A: Age at menarche in contemporary Greek girls: evidence for levelling-off of the secular trend. Acta paediatrica (Oslo, Norway: 1992). 2008, 97 (6): 812-815.
41.
Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS: Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa Heart Study. Pediatrics. 2002, 110 (4): e43-PubMed
42.
Joinson C, Heron J, Lewis G, Croudace T, Araya R: Timing of menarche and depressive symptoms in adolescent girls from a UK cohort. The British journal of psychiatry: the journal of mental science. 2011, 198 (1): 17-23. sup 11–12
43.
Tunau KA, Adamu AN, Hassan MA, Ahmed Y, Ekele BA: Age at menarche among school girls in Sokoto, Northern Nigeria. Ann Afr Med. 2012, 11 (2): 103-107.PubMed
44.
Deb R: Age at menarche in adolescent Khasi girls, Meghalaya. Indian Pediatr. 2011, 48 (1): 69-PubMed
45.
Hossain MG, Islam S, Aik S, Zaman TK, Lestrel PE: Age at menarche of university students in Bangladesh: secular trends and association with adult anthropometric measures and socio-demographic factors. J Biosoc Sci. 2010, 42 (5): 677-687.PubMed
46.
Aryeetey R, Ashinyo A, Adjuik M: Age of menarche among basic level school girls in Medina, Accra. Afr J Reprod Health. 2011, 15 (3): 103-110.PubMed
47.
Zegeye DT, Megabiaw B, Mulu A: Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia. BMC Womens Health. 2009, 9: 29-PubMedPubMedCentral
48.
Ekerbicer HC, Celik M, Kiran H, Kiran G: Age at menarche in Turkish adolescents in Kahramanmaras, Eastern Mediterranean region of Turkey. The European journal of contraception & reproductive health care: the official journal of the European Society of Contraception. 2007, 12 (3): 289-293.
49.
Orden AB, Vericat A, Apezteguia MC: Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors. Anthropologischer Anzeiger; Bericht uber die biologisch-anthropologische Literatur. 2011, 68 (3): 309-322.PubMed
50.
Batubara JR, Soesanti F, van de Waal HD: Age at menarche in indonesian girls: a national survey. Acta Med Indones. 2010, 42 (2): 78-81.PubMed
51.
Rebacz E: Age at menarche in schoolgirls from Tanzania in light of socioeconomic and sociodemographic conditioning. Coll Antropol. 2009, 33 (1): 23-29.PubMed
52.
Ghaly I, Hussein FH, Abdelghaffar S, Anwar G, Seirvogel RM: Optimal age of sexual maturation in Egyptian children. Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit. 2008, 14 (6): 1391-1399.
53.
Reagan PB, Salsberry PJ, Fang MZ, Gardner WP, Pajer K: African-American/white differences in the age of menarche: Accounting for the difference. Soc Sci Med. 2012, 75 (7): 1263-1270.PubMedPubMedCentral
54.
Adair LS, Gordon-Larsen P: Maturational timing and overweight prevalence in US adolescent girls. Am J Public Health. 2001, 91 (4): 642-644.PubMedPubMedCentral
55.
Gaudineau A, Ehlinger V, Vayssiere C, Jouret B, Arnaud C, Godeau E: Factors associated with early menarche: results from the French Health Behaviour in School-aged Children (HBSC) study. BMC Publ Health. 2010, 10: 175-
56.
Al-Sahab B, Ardern CI, Hamadeh MJ, Tamim H: Age at menarche in Canada: results from the National Longitudinal Survey of Children & Youth. BMC Publ Health. 2010, 10: 736-
57.
Wronka I: Association between BMI and age at menarche in girls from different socio-economic groups. Anthropologischer Anzeiger; Bericht uber die biologisch-anthropologische Literatur. 2010, 68 (1): 43-52.PubMed
58.
Hernandez MI, Unanue N, Gaete X, Cassorla F, Codner E: [Age of menarche and its relationship with body mass index and socioeconomic status]. Rev Med Chil. 2007, 135 (11): 1429-1436.PubMed
59.
Wang Y: Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics. 2002, 110 (5): 903-910.PubMed
60.
Bralic I, Tahirovic H, Matanic D, Vrdoljak O, Stojanovic-Spehar S, Kovacic V, Blazekovic-Milakovic S: Association of early menarche age and overweight/obesity. Journal of pediatric endocrinology & metabolism: JPEM. 2012, 25 (1–2): 57-62.
61.
Amigo H, Vasquez S, Bustos P, Ortiz G, Lara M: Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents. Cadernos de saude publica / Ministerio da Saude, Fundacao Oswaldo Cruz, Escola Nacional de Saude Publica. 2012, 28 (5): 977-983.
62.
Cheng G, Buyken AE, Shi L, Karaolis-Danckert N, Kroke A, Wudy SA, Degen GH, Remer T: Beyond overweight: nutrition as an important lifestyle factor influencing timing of puberty. Nutr Rev. 2012, 70 (3): 133-152.PubMed
63.
Mamun AA, Hayatbakhsh MR, O’Callaghan M, Williams G, Najman J: Early overweight and pubertal maturation–pathways of association with young adults’ overweight: a longitudinal study. Int J Obes (Lond). 2009, 33 (1): 14-20.
64.
Dvornyk V, Waqar ul H: Genetics of age at menarche: a systematic review. Hum Reprod Update. 2012, 18 (2): 198-210.PubMed
65.
Koprowski C, Coates RJ, Bernstein L: Ability of young women to recall past body size and age at menarche. Obes Res. 2001, 9 (8): 478-485.PubMed
66.
Koo MM, Rohan TE: Accuracy of short-term recall of age at menarche. Ann Hum Biol. 1997, 24 (1): 61-64.PubMed
67.
Must A, Phillips SM, Naumova EN, Blum M, Harris S, Dawson-Hughes B, Rand WM: Recall of early menstrual history and menarcheal body size: after 30 years, how well do women remember?. Am J Epidemiol. 2002, 155 (7): 672-679.PubMed
Metadata
Title
Age at menarche and its relationship to body mass index among adolescent girls in Kuwait
Authors
Nora Al-Awadhi
Nouf Al-Kandari
Teebah Al-Hasan
Daliah AlMurjan
Salhah Ali
Abdullah Al-Taiar
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-29

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