Monthly Archives: November 2010

Adopted Children Experience Early Sexual Maturity


Puberty occurs when areas within the brain awaken beginning a cascade of hormone signals which conclude with the gonads (ovaries and testicles) increasing their production of the female and male sex hormones estrogen and testosterone. Under the influence of these hormones a child begins the transition from childhood to sexual maturity. In boys puberty is associated with a growth spurt, the appearance of facial, axillary (arm pit) and pubic hair, acne, deepening of the voice, growth of the testicles and penis while girls undergo a growth spurt, develop breasts, acne, pubic and axillary hair, and growth of the clitoris.

Historical data shows the average age of puberty today is many years sooner than in previous generations. Most experts attribute earlier puberty to better nutrition. A recent article in metabolism.com reviewed how “over-nutrition” accelerates obese children into puberty sooner (referred to as precocious puberty) than normal weight children. The latest studies on causes of precocious puberty suggests that a child’s social environment also exerts an important influence on the timing of puberty. Researchers in Madrid publishing in The Journal of Clinical Endocrinology and Metabolism 95:4305 2010 analyzed the age of puberty in normal children, adopted children and children whose families immigrated (children not adopted but subject to high levels of personal stress) to Spain. Adopted children were 25 times more likely than other groups of children to undergo precocious puberty (breast development before the age of 8 years in girls, and boys under 9 years of age with testicular growth). Over-all girls were 11 times more likely than boys to demonstrate precocious puberty.

Researchers speculate that socio-emotional stresses early in life of children who are later adopted result in changes in the brain that cause premature maturation of vital nerve pathways. This early brain maturation later results in stimulation of the pituitary gland, turning on the hormone pathways that cause puberty. This seems strange to me because various forms of deprivation in childhood can also delay puberty. For example, girls who have anorexia remain child-like in their body development and may fail to menstruate even into their late teens. A decade ago I studied hormone levels in adults during the stress of illness and surgery and found this lowered the sex hormone levels in their blood. This makes sense from an evolutionary point of view because during stressful conditions nature wisely cuts off the reproductive hormones. Why make babies if the environment is hostile in some way? Why the opposite occurs in children under stress of adoption is an interesting but unanswered question.

Gary Pepper, M.D.,
Editor-in-Chief, metabolism.com

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Dr. Oz’s “Metabolic Makeover” Dishes Empty Calories


I want to help Dr. Oz not criticize him. Criticizing Dr. Oz is like criticizing Mother Theresa. He is uniformly worshiped by the media and his huge audience. He comes across as someone truly wanting to be helpful. So if I come across as being critical of him think of it as constructive criticism.

Yesterday, as I waited in the checkout line at Walmart, I saw a popular woman’s tabloid with a full page photo of Dr. Oz. The headline with the picture was “Dr. Oz’s Metabolic Makeover”. This intrigued me because I can use new information of this kind in my daily office encounters, so I bought the magazine. Imagine my surprise when, reading through the 2 page article, I didn’t find a single word from the great and powerful Oz. Instead a nameless author offered a summary of “Dr. Oz’s body-transforming secrets!”. What were Dr. Oz’s secrets? Take Vitamin D, fish oil, calcium, multivitamins, get enough sleep, and eat food with anti-oxidants low in carbs and sugar. In conclusion a dietitian put together a few simple recipes for meals based on a 1400 calorie per day diet. That’s it folks. That’s all she wrote!! Nothing even remotely new or body transforming. There was not a single original or inspirational thought to be found. Not even a single quote from the medical guru. I doubt whether he even read the article himself.

Dr. Oz was trained as a cardiac surgeon. It takes years of dedication and hard work to achieve that goal. In his mind must have been a desire to save people’s lives by literally taking them to the brink of death and bringing them back healthier than they were before. What this article says to me is that Dr. Oz has allowed himself to become the Kim Kardashian of medicine. A pretty but empty headed celebrity offering nothing of real value. His full page photo in this magazine is the portrait of an almost cynical drive to grab a few dollars from the pockets of adoring fans. What kind of deal do you have, Dr. Oz? Do you get a few pennies for each magazine sold? Do you really need the money, the fame, the glory that this kind of exploitation provides?

Nobody got hurt by this, you might say. That is true if you have time and money to waste. I know that many people would rather get up to date information they could use to get healthy and donate the money they wasted on this article to better causes.

We expect something more from you Dr. Oz. Shake off your advisers and entourage. Stand up for the person you originally sought to be.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Girls Who are Early Developers Have Increased Risk of Obesity as Adults


We have all met children who are considered “physically advanced” for their age. Research now suggests that girls who are unusually large as young children, are more likely to undergo puberty at an early age, and are also significantly more likely to be obese during adulthood. The term used to describe this type of early development is “constitutional advancement of growth” or CAG.

Researchers in Greece publishing in the October 2010 issue of Journal of Clinical Endocrinology and Metabolism, 95:4535 reviewed the world literature and found that between 50 and 70% of obese children develop into obese adults. Obese girls are also much more likely to have precocious or early puberty. Most endocrinologists define precocious puberty in girls as breast development beginning by the age of 7 years. Therefore, the combination of rapid growth as a young child (ages 2 to 4 years) predisposes girls to have early puberty and proceed on to obesity as an adult. Similar associations of rapid childhood development and adult obesity has not been seen in boys.

Although researchers can only speculate about the connection of accelerated early childhood growth and the later development of obesity, a prominent theory is that insulin resistance in the womb and as an infant may set the stage for the onset of CAG in early childhood and adult obesity.

Gary Pepper, M.D., Editor-in-Chief, Metabolism.com

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