Pondering Puberty: How Diet Impacts Pubertal Timing

Authored by Aprile Bertomo, Human Biology, Health, and Society '22

Art by Flavia Scott, Human Biology, Health, and Society '24

When one reflects upon the commencement of “puberty,” several engaging experiences may come to mind. Whether it is discovering how intense body hair can evolve, or realizing what a particular cramp signals each month, people experience puberty in different manners, and at varying times. Yet, the determiners of the timing of pubertal onset remain unknown. However, recent speculation has concluded that diet may influence pubertal timing.

Pubertal onset timing is crucial for girls, for it may point to the development of future medical issues. In fact, menarche (the occurrence of one’s first menstrual period) can indicate future development of PCOS, or polycystic ovary syndrome [1]. Similarly, premature thelarche, or PT, can be another indicator [2]. PCOS is a common disorder in premenopausal females, having the capacity to bring about fertility issues [3]. In addition, individuals with PCOS often experience other issues, such as irregular menstrual cycles, hirsutism comparable to male processes, and a greater risk of obesity [4]. Interestingly, diet plays a relatively significant role in menarche, so further research could help predict the risk of PCOS development in the future [5].

The Mediterranean diet is one that has been found to be promising in the prevention of future reproductive health issues. The Mediterranean diet typically includes extensive vegetable, fruit, nut, legume, and seafood intake, while stressing the avoidance of red meat [6]. Interestingly, the Mediterranean diet has been found to lower the risk of health issues such as type 2 diabetes, and cancer [7]. Consequently, researchers have studied how the adherence to the Mediterranean diet influences pubertal milestone timing. Szamreta et al., 2020 discovered that greater adherence to a Mediterranean diet was associated with a longer time to menarche and thelarche [8]. The researchers noted that the results of the study seemed to be most influenced by a fusion of the vegetable, fish, and nonfat and low-fat dairy elements of the Mediterranean diet [8].

Consuming foods higher in fat prior to the onset of puberty may lead to earlier puberty. In a 2014 study, girls who consumed foods that were higher in fat underwent puberty earlier, as a result of modifications in hormones and genes [9]. In this study, indicators of puberty were analyzed based on the evaluation of hormones secreted and expression facilitated in the HPG (hypothalamus-pituitary-gonadal) axis [9]. In a separate research study conducted by Patel et al., 2018, the researchers found that subjecting rats to a diet high in fat prior to puberty brought about symptoms in the rats that were indicative of early PCOS development [10]. Specifically, the expression of luteinizing hormone receptors occurred more in rats with the high-fat diet [10]. Though this research is significant, rats and humans differ metabolically and physiologically, so the applicability of the study must be considered. However, another study conducted by Atoum et al., 2022 similarly noted that participants with PCOS had notably higher luteinizing hormone levels [11].

The compilation of research regarding this topic is notable as it shows that one’s diet earlier in life can have significant implications for one’s health later in life. The results of these studies can thus also be noteworthy in developing public health policy. Healthier foods, like those in a Mediterranean diet, are commonly not as affordable as their counterparts–foods higher in fat, for example [12]. It is thus imperative to consider how to make this research applicable for all of its benefits. More research may be necessary to convince policymakers to invest in advocacy and action for greater accessibility and affordability of healthier food options. This way, the benefits indicated in the research compiled may become a more widespread reality. It may take time for the implementation of significant changes in public health policy. However, consistency and dedication to such research could bring forth substantial differences beyond the timing of pubertal milestones–changes that could, ultimately, improve human health as a whole.

Works Cited

1. Lacroix, A. E., & Langaker, M. D. (2019, April 25). Physiology, Menarche. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470216/

2. Seymen Karabulut, G., Atar, M., Çizmecioğlu Jones, F. M., & Hatun, Ş. (2020). Girls with Premature Thelarche Younger than 3 Years of Age May Have Stimulated Luteinizing Hormone Greater than 10 IU/L. Journal of Clinical Research in Pediatric Endocrinology, 12(4), 377–382. https://doi.org/10.4274/jcrpe.galenos.2020.2019.0202

3. Escobar-Morreale, H. F. (2018). Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology, 14(5), 270–284. https://doi.org/10.1038/nrendo.2018.24

4. Lentscher J.A., & DeCherney, A. (2020). Clinical Presentation and Diagnosis of Polycystic Ovarian Syndrome. Clinical Obstetrics & Gynecology, Publish Ahead of Print. https://doi.org/10.1097/grf.0000000000000563

5. Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review. (2021). Maedica - a Journal of Clinical Medicine, 16(3). https://doi.org/10.26574/maedica.2020.16.3.516

6. Schwingshackl, L., Morze, J., & Hoffmann, G. (2019). Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. British Journal of Pharmacology, 177(6), 1241–1257. https://doi.org/10.1111/bph.14778

7. Martini, D. (2019). Health Benefits of Mediterranean Diet. Nutrients, 11(8), 1802. https://doi.org/10.3390/nu11081802

8. Szamreta, E. A., Qin, B., Rivera-Núñez, Z., Parekh, N., Barrett, E. S., Ferrante, J., Lin, Y., & Bandera, E. V. (2020). Greater adherence to a Mediterranean-like diet is associated with later breast development and menarche in peripubertal girls. Public Health Nutrition, 23(6), 1020–1030. https://doi.org/10.1017/S1368980019002349

9. Zhuo, Y., Zhou, D., Che, L., Fang, Z., Lin, Y., & Wu, D. (2014). Feeding prepubescent gilts a high-fat diet induces molecular changes in the hypothalamus-pituitary-gonadal axis and predicts early timing of puberty. Nutrition, 30(7-8), 890–896. https://doi.org/10.1016/j.nut.2013.12.019

10. Patel, R., & Shah, G. (2018). High-fat diet exposure from pre-pubertal age induces polycystic ovary syndrome (PCOS) in rats. Reproduction, 155(2), 139–149. https://doi.org/10.1530/rep-17-0584

11. Atoum, M. F., Alajlouni, M. M., & Alzoughool, F. (2022). A Case-Control Study of the Luteinizing Hormone Level in Luteinizing Hormone Receptor Gene (rs2293275) Polymorphism in Polycystic Ovarian Syndrome Females. Public Health Genomics, 1–9. https://doi.org/10.1159/000521971

12. Daniel, C. (2020). Is healthy eating too expensive?: How low-income parents evaluate the cost of food. Social Science & Medicine, 248, 112823. https://doi.org/10.1016/j.socscimed.2020.112823