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Growing up too fast: early puberty and mental illness

Puberty has long been recognised as a transition point in which many emotional and behavioural problems emerge. These include depression and anxiety, substance use and abuse, self-harm and eating disorders…

Children who go through puberty early have poorer mental health than their peers. But it’s not a simple case of cause and effect. Image from shutterstock.com

Puberty has long been recognised as a transition point in which many emotional and behavioural problems emerge. These include depression and anxiety, substance use and abuse, self-harm and eating disorders.

We previously thought that children who entered puberty earlier than their peers were at greater risk of these problems because they were less equipped to cope with the transition. This may be part of the story.

But we’re increasingly realising that social and emotional disadvantages and stresses in childhood may trigger early puberty. This possibility was explored in a study published today in the Journal of Adolescent Health, which found children who go through puberty early showed signs of poorer mental health in early childhood.

We studied a cohort of 3,491 children and families from the Longitudinal Study of Australian Children. Parents reported behavioural difficulties and emotional, social and school functioning in four surveys between ages four and 11. Around 16% of girls and 6% of boys had begun puberty by age eight to nine.

We found that boys with an earlier onset of puberty had greater behavioural difficulties and poorer emotional and social adjustment. These difficulties began as early as four to five years of age and continued to early adolescence.

Girls who reached puberty early also had more difficulties in emotional and social adjustment from early childhood. But these girls did not have the increased behavioural problems found in boys.

When does puberty start?

Puberty is the stage of development in which a child’s body matures to enable reproduction. This includes the development of breast tissue and the first period in girls, and maturation of the testes in boys. The hormonal changes that lead to sexual maturation during puberty are accompanied by major physical growth and maturation of the brain.

Puberty typically begins in late childhood. On average, girls begin puberty at ages ten to 11; boys start at 11 to 12. But the timing of puberty varies by four to five years among healthy children. This reflects the effects of nutrition, psychological status and socioeconomic conditions. Studies also suggest that genes play a role.

The age of first menstruation has dropped significantly since the 1840s, when the average age in Western European girls was around 16. Since the 1960s this trend has ceased in most developed countries and the average age is now 12 to 13.

Within countries, differences in pubertal age may be found according to socioeconomic status and racial origin. Data from the United States, for example, found that black American girls begin puberty earlier than white or Mexican-American girls.

Boys typically start puberty at age 11 or 12. Image from shutterstock.com

Emotional and behavioural problems

We know that adversity in life – such as stressful family circumstances or a lack of care and warmth – can affect the rate and course of a child’s development. Early psychosocial stress can be a cue for environmental risk and trigger earlier reproductive development. From this perspective, emotional and behavioural problems would be expected to occur even before early puberty is evident.

Puberty is a time of increasing stresses and challenges, as children adapt to their changing social roles. For this reason, mental health issues often first emerge in adolescence. Younger children and those with fewer social and emotional resources may find this phase more difficult, which increases their risk of subsequent mental health difficulties.

These changes interplay with prenatal factors. We know, for instance, that children who had a low birth weight are more likely to have early puberty.

Social determinants and health-related behaviours are also highly influential. The families, peers and communities children grow up with can provide “social scaffolds” for their mental health. Equally, negative influences in children’s environments can be risk factors for mental health difficulties in adolescence.

Our research supports a “life course” hypothesis. This suggests that differences in pubertal timing and childhood adjustment may, in part, result from adversity early in life. In other words, early puberty may be part of an accelerated transition to adult development which begins early in life. This, in turn, heightens the risks for emotional and behavioural problems.

Reducing the risk

The early life factors that may be influencing children’s development and leading to early puberty are not yet fully understood. Finding out what lies behind early puberty may help us to understand the origins of emotional and behavioural problems of children and adolescents.

We hope to find preventive ways to avoid some of the mental health difficulties which can emerge in adolescence. Promoting healthy environments and behaviours from early in childhood may help children develop social and emotional resources. Whether these resources will then protect children’s mental health during puberty is an important question.

We need to be aware of the social and emotional stresses during puberty, particularly for children who reach puberty earlier than their peers. It is crucial that there are positive frameworks in place to support these children at this phase of their lives. These may include supportive families, peers and communities, as well education, counselling and health services.

Join the conversation

42 Comments sorted by

  1. Ron Chinchen
    Ron Chinchen is a Friend of The Conversation.

    Retired (ex Probation and Parole Officer)

    I've often wondered if the effect of living in what is a domesticated city based or agrarian societal structure, with all its related characteristics, has brought about a significant increase in overall human dysfunctions.

    Humanity is in reality and Ice Age creature, having even before modern humans emerged, moulded for a hunter/gatherer mode in small community groups ia a colder, drier environment for at least 90% of its existence. It seems best adapted physically and psychologically to that…

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  2. Tom Hennessy

    Retired

    There is a theory , in children , as in adults , the metal iron speeds ageing , precocious puberty , which is why meat eating children reach puberty on average two years earlier than vegetarian girls and evidenced by Metformin , which reduces iron strores , affecting puberty.
    "Metformin Slows Early-onset Puberty In Girls, Study Shows"
    http://www.sciencedaily.com/releases/2008/06/080616163450.htm

    "Reduction in body iron stores with metformin"
    http://care.diabetesjournals.org/content/30/9/2309.full

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    1. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Tom Hennessy

      Tom

      That is a pretty long bow that you draw..

      Earlier puberty of children eating meat, possibly proves that iron on its own has nothing to do with it the onset of puberty. Might even mean that metformin is so toxic that it delays natural development. Which in turn could mean that people feeding no meat to developing children are unwise.

      That is what started all this off - we live in a desperately micro-nutrient deficient world and meat is a source of those nutrients. Shallow rooted plants are not rich in m-n.

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  3. Terry J Wall
    Terry J Wall is a Friend of The Conversation.

    Still Learning at University of Life

    We seem to have forgotten something or chosen to ignore it. Humanity has been warned about this likelihood and it has been in the public domain for nearly 20 years. Pseudo-estrogen chemicals (BPA from plastics), estrogen in SOY is doing exactly what science said it would: Add to the levels of estrogen in our diets. You know; female hormones, you know; early maturity; limp dicks, delayed puberty in boys and lord knows what other mischief.

    So why are we surprised that men are less male and girls are cycling at the age of 8. And we are doing this at a time when micro-nutrients which are the keys to most or our biological functions are as low as ever recorded in history.

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    1. Tom Hennessy

      Retired

      In reply to Terry J Wall

      Oh comeon , plants are bad for you ?

      "Cell proliferation is significantly inhibited by potential
      phytoestrogens isolated from rye, green and yellow pea seeds"

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    2. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Terry J Wall

      My thoughts exactly Terry. While debate rages about sugar, oils etc etc on human health & development there is little if any debate on the basics eg Australia's iodine deficiency issues which affects metabolism, brain development etc etc. True the Australian government is now supplementing us with compulsory iodised salt in bread products but this is barely enough to cover our daily needs let alone recover a deficiency.

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    3. Tom Hennessy

      Retired

      In reply to Karen Tough

      Iodine is the problem causing low hormones ?

      "During iodide administration there was a significant decrease
      in thyroid hormone concentrations which remained within normal levels, and a significant increase in TSH concentrations which in 14 out of 25 (56%) patients reached the hypothyroid level."
      http://www.ncbi.nlm.nih.gov/pubmed/11022172

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    4. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Tom Hennessy

      http://www.ncbi.nlm.nih.gov/pubmed/11916284

      "Thyroid failure is a rather rare endocrine complication in patients with beta-thalassemic from Greece. In our series, no case of central hypothyroidism was observed. No correlation was found between thyroid functional status and ferritin plasma levels"

      CONSIDERATION OF MANDATORY FORTIFICATION WITH IODINE FOR AUSTRALIA AND NEW ZEALAND SAFETY ASSESSMENT AND RISK CHARACTERISATION REPORT
      December 2007

      .http://www.foodstandards.gov.au/_srcfiles/P1003%20SD9%20-%20Safety%20Assessment.pdf

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    5. Tom Hennessy

      Retired

      In reply to Karen Tough

      Yours says "rather rare endocrine complication" .. ?
      This says , "Patients with beta-thalassemia frequently develop primary hypothyroidism and other endocrine disorders due to iron overload".

      The question would be then , in Greece , do they receive iodide supplementation ?
      "Patients with beta-thalassemia should not be exposed to excess iodide"

      And then , how much iron AND iodine is too much as per the mandatory fortification ?

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    6. Sue Ieraci

      Public hospital clinician

      In reply to Terry J Wall

      "micro-nutrients which are the keys to most or our biological functions are as low as ever recorded in history."

      Any evidence for this, Terry Wall?

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    7. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Mr Hennessy, you conveniently missed out the fact that this was in "in patients with beta-thalassemia major and iron overload".

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    8. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Sue Ieraci

      JONES: “Soil carbon - can it save agriculture’s bacon?” Agriculture & Greenhouse Emissions Conference, May 2010

      http://www.amazingcarbon.com/PDF/JONES-soilCarbon&Agriculture(18May10).pdf

      "The nutritional status of soils, plants, animals and people has fallen dramatically in the last 50 years, due to losses in soil arbon, the key driver for soil nutrient cycles. Soil health and human
      health are more deeply connected than many people realise. Food is often viewed in terms of quantity available, hence ‘food scarcity’ is not seen as an issue in Australia. However, food
      produced from depleted soils does not contain the essential trace minerals required for the effective functioning of our immune systems. "

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    9. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Tom Hennessy

      sorry Tom no idea whether Greece receives any iodine supplementation. Both the UK & USA were considering it last time I researched the subject & iodine deficency now appears to be a world wide issue. Iodine sensitivities affect a miniscule % of the population according to the Food Standards Asessment. Interestingly the Japenese consume 1000 times western min RDI. of iodine, primarily the organic form , iodine, from seaweed , rather than the inorganic form , iodide, Australians are currently supplemented…

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    10. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Karen Tough

      fyi - seaweed is a source of iodine & perfectly balanced trace minerals in a readily utilised form.

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    11. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Conveniently ? I'm starting to get a little perturbed at your professionalism , to put it lightly. You don't KNOW thalassemia is an iron loading disease ? You don't know iron and iodine react with each other ? What part of the above don't you know , I may take some time to explain the basics to you , to prevent you from hastening the deaths of any MORE of your charges.

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    12. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Sue Ieraci

      Hi Sue
      yes there is lots of evidence and provided by WHO as well as warnings of this situation delivered to the US Senate 70 years ago. I have built the case using evidence gleened from my work with animals and also using the "balance of evidence" tool in my book. You know acid rain, acid fertilizers, food processing etc.
      The latest WHO awareness program can be read here: in-syncminerals.com/cms/Investing_in_the_future_Summary.pdf

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    13. Sue Ieraci

      Public hospital clinician

      In reply to Terry J Wall

      Hi, Terry - can you direct me to the actual evidence - where levels are measured and correlated to health outcomes?

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    14. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Sue Ieraci

      Hi Sue
      for all 80 micro-nutrients? That is the problem and the reason that science has found the issue too difficult and also unprofitable. Why bother with individual micro-nutrients when we have evolved over 5 million years digesting them all? Plus they are available in nature and in natural balance with each other. Plus it is cheaper to supply them all, every day than to separate them out and run the risk of side effects because some might easily get out of balance with others (synergistic).

      Science has picked on iodine because symptoms become embarrassing to the patient, such as iodine (goiter) selenium (suicide) zinc (hair) calcium/magnesium (bones) but in truth some without the others is dangerous.

      You really need to read my book and the E version is free..
      http://www.in-syncminerals.com

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    15. Sue Ieraci

      Public hospital clinician

      In reply to Terry J Wall

      Hi, Terry

      I'm always a bit wary of "too difficult" and unprofitable" as reasons for lack of evidence.

      Does your book cite any studies? Clinical outcomes? Any evidence of measured levels in humans?

      If not, what is the basis of your assertions?

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    16. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Sue Ieraci

      Hi Sue
      yes there are many links to studies in my book. Plus it makes common sense. 300,000 enzymes required by a fully function brain (neurons) and enzymes are to the best of my knowledge about half minerals (trace elements) and the other half saturated fat. Plus I have been taking this micro-nutrient supplement for over 12 years with great success. Customers just keep reordering, which has to say something.

      I do admit that it is virtually impossible to get acknowledgement of any consequence from commercial science; seem to be focusing on just one or two nutrients (maybe 10). What I concentrate on now, is getting to people like you just to try it. That is not hard surely. Promise I wont tell anyone. :)

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    17. Craig Steel

      Miner

      In reply to Karen Tough

      '...Food is often viewed in terms of quantity available, hence ‘food scarcity’ is not seen as an issue in Australia. However, food produced from depleted soils does not contain the essential trace minerals required for the effective functioning of our immune systems. ' -- Exactly. That is my biggest bitch about broadacre farming. It relies on chemicals added to the soil to make the crop grow, chemicals sprayed over the top to kill bugs, chemicals sprayed around to kill disease and some seeds are genetically modified - and sold at a premium, of course - to enhance some trait or make the plant resistant to some bug. This type of farming is all about profit and has nothing whatsoever to do with 'feeding the masses'. I think I'm a lot better off with my small scale permaculture farm.

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    18. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Craig Steel

      Absolutely right Craig. Here is an extract from Nature's Power book

      China currently produces enough food to supply the needs of 30 people per hectare, and they do it largely using organic techniques. America and other nations naïve enough to join in with their huge commercial farms, taxpayer subsidies, carbon intensive mechanical tools, petro-chemical fertilisers, agricultural chemicals, genetic engineering and now nano technology, produces only enough for fewer than 4.2 people per hectare. Europe is about 10.0 per hectare. On that basis there does not appear to be much benefit in acid created, genetically modified corn based, additive enhanced, trans-fat stiffened, sugar and fat engineered donuts, topped off with sparkly nano particle enhanced icing.

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    19. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Sue Ieraci

      Hi Sue, Pat Coleby has an extensive bibliography (5 pages) . No links i'm afraid - will need to google if you are interested. Her books are available from Vitec,

      Albrecht, W A The Albrecht Papers (available from Acres USA)
      Balfour, E B The Living Soil & The Haughley Experiment
      Biological Institute of Sydney Veterinary Treatment For Sick Animals, 1930
      Cetinkaya,B, Erdogan, H M, & Morgan, K L, "Relationships between the presence of Johne's Disease & Farm & Management Factors in Dairy Cattle…

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  4. Tim Benham

    Student of Statistics

    The Australian seems happy with reverse causation as the explanation: "Early onset puberty causes emotional issues at preschool age" (http://www.theaustralian.com.au/news/health-science/early-onset-puberty-causes-emotional-issues-at-preschool-age/story-e6frg8y6-1226611493370). Thankfully the authors take a less obtuse view: "the association between early-onset puberty and poor mental health appears to result from processes under way well before the onset of puberty".

    What might those processes be? Is the cause genetic or social?

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    1. Tom Hennessy

      Retired

      In reply to Tim Benham

      The behavior problems could be foretelling the effects of excess iron , early puberty.

      "Effect of iron supplementation during pregnancy on the intelligence quotient and behavior of children at 4 y of age: long-term follow-up of a randomized controlled trial"
      http://www.ncbi.nlm.nih.gov/pubmed/16685054
      "The incidence of children with an abnormal teacher-rated peer problems subscale score was higher in the Fe group (eleven of 112 subjects; 8 %) than in the placebo group (three of 113 subjects; 2 %)"
      http://www.ncbi.nlm.nih.gov/pubmed/17967217

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  5. Terry J Wall
    Terry J Wall is a Friend of The Conversation.

    Still Learning at University of Life

    Here we go again. Picking on one of 80 deficient micro-nutrients and then arguing about the various pros and cons discovered when usually synthetic read manufactured, substitutes are given. Never a thought about the synergistic relationships with other extremely deficient micro-nutrients. Until all potential catalysts are also provided, we are all blowing in the wind.

    Plane evidence that our so called health industry is in desperate need of "non industry supervision". Currently there is just no chance that what works ( www.in-syncminerals.com ) will get attention. There is simply no disease involved, so no money!

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    1. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Terry J Wall

      Good point Terry. I adopted Pat Coleby's horse & land care system in 2006 which is based entirely on balancing the minerals in the soil & the feed in the meantime. Much of her information is taken from CSIRO research conducted prior to their GM direction. I agree with you - the results with mineral supplementation are fast & outstanding. So impressive we now apply to ourselves & the results are equally impressive. Feel better at 45 than I did at 30. My friend discarded her antidepressants in 12 short weeks after 5 years of "needing" them. Pat comments that until iodine shortfalls are addressed in the body nothing works properly. She advises that mineral availabilty is complex & a question of ratios of one to the other & the soil PH etc eg iron can not be utilised correctly without adequate copper. Iodine deficiency inhibits copper , excess iron inhibits vitamin E etc etc. Best practice has become best financial gain it seems :(

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Terry J Wall

      Terry - you criticise the involvement of "industry supervision" and yet you are selling mineral supplements, salts and your book? You don't see any irony there?

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  6. Sue Ieraci

    Public hospital clinician

    "The age of first menstruation has dropped significantly since the 1840s, when the average age in Western European girls was around 16. Since the 1960s this trend has ceased in most developed countries and the average age is now 12 to 13."

    Interesting, Fiona and George - I wasn't aware that the trend had stopped. That does seem to lend weight to the nutrition theory.

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  7. Geoffrey Harold Sherrington

    Boss

    Have you examined reverse causation? The possibility that mentally affected children are the primary source of behaviour patterns?
    The classic study for me is by Dr Allen Christophers and Pam da Silva on lead toxicity -
    http://dnacih.com/SILVA.htm
    AFAIK, the reverse causation proposal here was snowed under by heavily funded USA research (Needleman and others) and never resolved finally. It was a factor in lead-free petrol, an enormous cost to society when the premise might be false.

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    1. Karen Tough

      equine learning facilitator with a passion for natural farming & nutrition.

      In reply to Geoffrey Harold Sherrington

      "It has been well known since early this century that pica, defined as abnormal behaviour, is much more common in the mentally retarded; yet, strangely, this fact has not been directly researched and proven until recently. The relationship of pica to mental ability in children of normal intelligence range has never been directly researched." "In this paper, we will accept the association between lead exposure and mental deficit as fact; however, we will argue that, since in all of these studies the…

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    2. George Patton

      Professor of Adolescent Health Research at University of Melbourne

      In reply to Geoffrey Harold Sherrington

      Thanks for the question, Geoffrey.

      We have not explored very many of the possible causal pathways in this paper. We did exclude childhood overweight as an explanation for the association. However we have not looked at factors such as the family social environment in early childhood that might given rise to both emotional problems in children as well as predispose to early puberty.

      Having said that, our hunch is that these kids may be on a different life track from very early on, one that leads to early reproductive maturity and a greater emotional sensitivity to potential hazards in the environment.

      Best

      George

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  8. Jason Only

    Interested Bystander

    Hi Fiona and George
    I remember seeing in an article somewhere there may be a tentative relationship between delayed growth in children and the taking of drugs to treat ADHD. Is this true? If so are there any studies or are you able to comment on the relationship between the taking of these drugs, delayed growth and its impact on mental health good or bad ?

    Note. I am not medically qualified and have no biases regarding the taking of AHDH drugs .

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    1. George Patton

      Professor of Adolescent Health Research at University of Melbourne

      In reply to Jason Only

      Hi Jason

      Thanks for the query.

      There is little doubt that both methylphenidate (Ritalin) and dexamphetamine, both commonly used in the management of ADHD, have the potential to delay the onset of puberty. In part the mechanism is likely to be suppression of diet and weight gain. Generally when the dose of medication is reduced or the medication stopped, these kids proceed into a normal puberty.

      Best

      George

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  9. Fleur Winter

    logged in via Twitter

    Hi Fiona and George, is there somewhere I could read you full article?

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    1. Fiona Mensah

      NHMRC Postdoctoral Research Fellow at Murdoch Childrens Research Institute

      In reply to Fleur Winter

      Hi Fleur,
      the article may be obtained through the Journal of Adolescent Health if you have access to this, this is the link to follow
      http://www.jahonline.org/article/S1054-139X%2813%2900048-7/abstract
      or otherwise please contact Paras Tsiamis, Personal Assistant to
      Professor George Patton who will be able to help
      Tel: 9345 6457, email: Paras.Tsiamis@rch.org.au
      with best wishes, Fiona

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  10. Fleur Winter

    logged in via Twitter

    Thanks for your assistance Fiona

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  11. Helen Barry

    Teacher

    I write this with reservation as my observations are anecdotal not scientific. I have seen many children, through my years teaching, who have reached what may be considered "precocious" puberty. Most of them have been severely overweight. I am no expert, however, body weight does appear to be a factor in triggering puberty. I question if the issues that MAY have caused them to become overweight/overeat are at the root of their mental problems and not early puberty. This is not an attack on overweight children but something that may not have been considered???

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    1. Terry J Wall
      Terry J Wall is a Friend of The Conversation.

      Still Learning at University of Life

      In reply to Helen Barry

      Helen, I agree
      That is what I see as well and generally (in cases like this one must generalise) when one observes what appears to be their parents or care givers, they often exhibit the same condition.
      Their shopping baskets often provides a indication of where the problem lies.

      I go back to my earlier suggestion that we could make a very gentile start by showing the kids at school "Food Inc", "Food Matters" and "Super size me".
      Incidental I know a guy in his 30s who saw "Super Size Me" as a child and has never touched a macca since. Pretty effective I say.

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    2. George Patton

      Professor of Adolescent Health Research at University of Melbourne

      In reply to Helen Barry

      Thanks Helen

      You are right that being overweight as a child is a predictor of early puberty and being overweight is also linked to emotional problems. In the analysis in this paper we did control for childhood weight and although what you say is true it was not the explanation for the higher rate of emotional problems in this children.

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