The Role of Pediatric Nutrition as a Modifiable Risk Factor for Precocious Puberty.

Valeria Calcaterra,Virginia Rossi,Arianna Sangiorgio,Martina Chiara Pascuzzi,Chiara Mameli,Alessandra Bosetti,Gianvincenzo Zuccotti,Vittoria Carlotta Magenes,Elvira Verduci

doi:10.3390/life11121353

Abstract

Puberty is a critical phase of growth and development characterized by a complex process regulated by the neuroendocrine system. Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The timing of puberty has important public health, clinical, and social implications. In fact, it is crucial in psychological and physical development and can impact future health. Nutritional status is considered as one of the most important factors modulating pubertal development. This narrative review presents an overview on the role of nutritional factors as determinants of the timing of sexual maturation, focusing on early-life and childhood nutrition. As reported, breast milk seems to have an important protective role against early puberty onset, mainly due to its positive influence on infant growth rate and childhood overweight prevention. The energy imbalance, macro/micronutrient food content, and dietary patterns may modulate the premature activation of the hypothalamic–pituitary–gonadal axis, inducing precocious activation of puberty. An increase in knowledge on the mechanism whereby nutrients may influence puberty will be useful in providing adequate nutritional recommendations to prevent PP and related complications.

Highlights

Puberty, a critical phase of growth and development, is a complex process that starts with a growth spurt and the development of secondary sex characteristics and culminates in the acquisition of psychophysical maturity and reproductive capacity [1,2].Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal
gonadotropinreleasing hormone (GnRH) stimulates the pulsatile release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary, inducing the production of sex hormones that are responsible for the physical manifestations of puberty [3]
Even though a major limitation of pubertal timing studies is that they are conducted cross-sectionally, so the possible changes in pubertal progression should be interpreted with caution before being confirmed by longitudinal studies, the literature supports the role of nutritional status and nutrients as determinants of the timing of sexual development

Summary

Introduction

Precocious puberty (PP) is defined as the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. The onset and progression of puberty are regulated by the neuroendocrine system [2]. The onset of puberty follows the disinhibition of the hypothalamic–pituitary–gonadal axis (HPG), resulting in the progressive amplification of the pulsatile secretion of gonadotropinreleasing hormone (GnRH) by hypothalamic neurons. GnRH stimulates the pulsatile release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary, inducing the production of sex hormones that are responsible for the physical manifestations of puberty [3]. The timing of puberty has important public health, clinical, and social implications. The regular timing of puberty is crucial to psychological and physical development and can impact future health [4]. PP has been associated with short adult stature, adverse psychological outcomes, increased risk of obesity, hypertension, type two diabetes, cardiovascular disease, and estrogen-dependent cancer, breast cancer [5]

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