Birth and early life influences on the timing of puberty onset: results from the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) Study

Background: Early age at puberty onset may predispose an individual to many currently prevalent diseases, including cancer and adiposity. Objective: The objective was to investigate whether early life exposures influence the timing of puberty, as defined by both early and late markers, in healthy German girls and boys. Design: Term participants (n = 215; 49.8% female) of the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) Study, with sufficient repeated anthropometric measurements between 6 and 13 y to allow estimation of age at take-off of the pubertal growth spurt (ATO) and information on a variety of early life exposures, including birth weight, breastfeeding status, velocity of weight gain, and parental characteristics, were studied. Age at peak height velocity (APHV) and menarche were also considered. Results: Children who weighed between 2500 and <3000 g at birth were approximate to 7 mo younger at ATO than were the other children (beta +/- SE: -0.56 +/- 0.20 y; P = 0.006). Children who had gained weight rapidly between birth and 24 mo (increase in weight SD score >0.67) experienced ATO 4 mo earlier than those who had gained weight normally (-0.34 +/- 0.15 y; P = 0.02). Rapid weight gain was also associated with an earlier APHV (P = 0.0006) and, in girls, with an earlier menarche (P = 0.002). Adjustment for body mass index SD score or body fat percentage 1, 2, or 3 y before ATO did not account for these effects. Conclusion: In both boys and girls, intrauterine and early postnatal growth factors appear to influence both early and later markers of puberty onset independently of prepubertal body composition. Am J Clin Nutr 2009; 90: 1559-65.