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Are children today really going through puberty earlier?

In 1977, hundreds of young Italian boys and girls attending a school near Milan suddenly began growing breasts. A subsequent investigation published in the Lancet suggested that contaminated beef and poultry were the likely cause. A decade earlier, another outbreak of early puberty in seven young kids in California had been traced to a tuberculosis drug that was accidently laced with estrogen-like compounds. In a 2006 piece for the New York Times—which, incidentally, was embellished for an episode of House —I described the case of a brother and sister who began growing pubic hair before reaching kindergarten. It turned out their father was secretly applying a high-potency testosterone cream purchased from an Internet pharmacy, for supposed cosmetic and sexual performance benefits, and the cream was rubbing off onto his kids from normal daily contact.

As with infections or chemical spills, early puberty can occur in small outbreaks. But can it also happen on a larger, population-wide scale? Recently, a drumbeat of scientific publications have speculated that children today undergo puberty earlier than in decades past, spurring worry about pervasive environmental triggers like bisphenol-A (BPA), phthalates, and obesity.

But a closer look at the data suggests that fears about early puberty may be misplaced.

The concerns about widespread early puberty began in the 1990s, when a North Carolina physician assistant named Marcia Herman-Giddens wondered why many 7- and 8-year old girls appeared to be developing breasts. She organized a study in which 225 pediatricians graded the maturity of young girls’ breasts and pubic areas. In a controversial 1997 Pediatrics paper, she concluded that puberty occurred earlier than in previously reported federal health studies from the 1960s.

Last year, Danish researchers compared data taken from girls from 2006 to 2008 to another cohort from 1991 to 1993 and also found the breast and pubic hair development was now occurring earlier by about one year. And in a well-publicized study released earlier this month, a team led by Frank Biro of Cincinnati Children’s Hospital reported that American girls examined between 2004 and 2006 appeared to undergo puberty even earlier than reported by Herman-Giddens, prompting fears that the trend was accelerating.

Is it really possible that the process of human maturation could be changing rapidly? Identifying the start of puberty is very subjective and many studies showing earlier puberty, particularly those that focus on breast development, can be flawed and misleading. The key is to find a more reliable marker of puberty.

Thankfully, there is one.

The precise trigger for sexual maturation is unknown, but sometime during childhood, a grape-sized area of the brain called the hypothalamus decides one night that it’s time to grow up. Beginning that night, the hypothalamus periodically drops a bit of a hormone called GnRH just onto the pea-sized pituitary gland, rousing it from its lifelong slumber.

The pituitary then secretes its own hormones into the circulation, ultimately activating the adrenal glands and ovaries (which make lots of estrogen) or testes (which make lots of testosterone). In girls, the first sign of puberty is typically a slight budding of the breast; in boys, it’s a mild enlargement of the testicles. Over the next years, other changes arrive: pubic and underarm hair, voice deepening, the adolescent growth spurt, acne, menstruation or semen production, and so on.

With no objective blood test or scan, most experts consider breast budding and testicular growth the hallmarks of puberty’s beginning. Unfortunately, those measures are very subjective—particularly for male children. Pediatricians guess the size of a boy’s testicles by touch and comparison to a rosary-like string of balls called an orchidometer, which is not very accurate.

As a result, most studies of early puberty focus on girls—but those assessments aren’t much better. Herman-Giddens’ 1997 study relied only on visual inspection by hundreds of different pediatricians trained in different programs, and not on actually feeling systematically for the small, firm masses that typify breast buds. That might lead obese kids to be prematurely termed pubertal.

There is a much clearer and defined marker of puberty: the age of a girl’s first period, or menarche. If puberty is occurring earlier, one would think menarche should also, since the process responds to the same cascade of hormones. But in the past 40 years, there hasn’t been any real change in age of menarche, which remains at just over 12 years. Additionally, no researcher has shown any objective change in the timing of adolescent growth spurts. In 2008, an international group of endocrinologists and other experts led by the U.S. Environmental Protection Agency found little agreement that puberty was happening much earlier.

Perhaps researchers seeing widespread precocious puberty are just noticing breast development earlier—looking harder at normal bodies. It would follow that today’s puberty would seem to take longer than in previous decades. That’s precisely the case. (Epidemiologists call this “lead-time bias.”)

It’s possible that obesity might correlate with earlier puberty in some girls (oddly, fat boys appear to have later puberty than other boys), though the population-wide effect is still imperceptible by objective measures. And there are plenty of other reasons to worry about toxins like BPA or phthalates.

But in the end, the epidemic of earlier and earlier puberty is a myth that the media love and certain researchers continue to propagate. The tale’s promotion doesn’t always depend on data. Instead, worries about earlier physical maturation in girls sublimate and propel concerns about society’s sexualization of young girls, whether by provocative dance routines or revealing clothing. Those topics certainly get people talking. Unfortunately, any solutions are unlikely to come from the labs of our nation’s endocrinologists.


The phenomenon of women bringing home the bacon is nothing new. But a new study shows that women are now the leading – or only — breadwinners in 40 percent of American households.

Women earn more than men in almost a quarter of U.S. households, a huge leap from 50 years ago, when only a handful of women brought home more income, according to a study released Wednesday by the Pew Research Center.

Women are now the leading or solo breadwinners in 40 percent of households, compared with just 11 percent in 1960, according to Census Bureau data analyzed by Pew.

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That’s both good and bad, depending which part of the ladder you’re on: At the top, educated women are catching up with men in the workforce, but on the bottom rungs are more single moms than ever—most of them living near the poverty line.

“It’s a long-term trend since the ’60s that the breadwinner moms have gone up,” said Wendy Wang, a Pew research associate and the lead author of the report.

Seventy-one percent of husbands are working in households where women make more money than their spouses, and they have a median family income of $80,000, according to 2011 data.

In 1960, only 4 percent of women made more than their husbands; it’s now 23 percent. That translates into 5.1 million married “breadwinner moms.” Of those making more than their husbands, 49 percent have at least a college degree, 65 percent are white and 67 percent are between the ages of 30 and 50.

Women, who for generations were not in the workforce in the same numbers as men, are still catching up. The Pew study noted that despite the fact that women are now equally or better educated than their husbands, most men still earn more than their spouses.

While Oprah Winfrey and Marissa Meyer are often mentioned as high-profile examples of that trend, the other end of the economic spectrum is driving the numbers.

The other part of the female breadwinner equation focuses on the steep rise in unwed mothers. In 1960, only 5 percent of women with children were unmarried. In 2010, that number had increased to 41 percent, according to research from the National Center for Health Statistics cited in the Pew report. The median income for a single mother who has never been married was $17,400 as of 2011. That can include income from a job, child support and government assistance.

In 1960, only 4 percent of women made more than their husbands; it’s now 23 percent. That translates into 5.1 million married “breadwinner moms.”

Of the never-married mothers, 49 percent have a high school education or less, and 46 percent are 30 or younger; 40 percent were black, 24 percent Hispanic and 32 percent white.

The Pew survey also gauged opinion on more women becoming the primary breadwinner.”The public is really conflicted about the trend,” Wang said.

Overall, survey respondents liked the economic benefits to their families but also worried that work might take a toll on their children and marriages. About 67 percent said the change made it easier for families to earn enough money to live comfortably; about 28 percent said it was harder for families to earn enough, and 2 percent said it made no difference, according to Pew.

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