Project HEALTH: Stages of Secondary Sexual Characteristics and Nutrition Related Correlates

Project HEALTH (Helping Encourage African Americans to Lean Toward Health) was launched to investigate the relationships between nutrition and nutrition-related health risks and increase community awareness about health risks, such as early development of secondary sexual characteristics. The consequences of early sexual development have been investigated by researchers and the consensus is that they extend not only to the individual but also have an extensive impact on the society at large. The incidence of early development of secondary sexual characteristics, that is, the enlargement of breasts and the growth of pubic hair, has been associated with negative psychosocial consequences. Psychosocial consequences. Researchers contend that there is increasing research evidence of psychiatric risks associated with girls that enter sexual maturation at an early age (Hayward et al., 1997). Hayward et al. (1997) indicated that early sexual maturation is associated with a disturbed body image, scholastic underachievement, and high-risk behaviors, such as smoking, drinking, and sexual intercourse at an earlier age. Graham and Erum (2005) found that sixth-grade AA early-maturing boys and girls who were viewed as victims by their peers reported depressed mood, psychosomatic symptoms, and low self-worth. The moderating role of early puberty was based on peer report measures of victimization instead of self-report measures, indicating the social consequences of early maturation. Studies have also identified the association of early development of secondary sexual characteristics with the onset of schizophrenia (Cohen, Seeman, Gotowiec, & Kopala, 1999). Kaltiala-Heino, Kosunen, and Rimpela (2003) confirmed that there is a relationship between pubertal timing, sexual activity and self-reported depression. Among girls, self-reported depression was associated with early sexual maturation and intimate sexual relationships. Pinto (2007) conducted qualitative analyses of the attitudes of girls experiencing early sexual maturation. She found that difference from same-sex peers' pubertal status led to shame, while peers' envy was also a source of pride. The author also found that early maturation took on varied meanings in the context of the developmental demands of childhood stress. Early development of secondary sexual characteristics also has societal implications from the public health viewpoint. For example, early development has also been associated with an increased risk of breast cancer (Herman-Giddens et al.,1997), teenage pregnancies among AA girls reported by the Alan Guttmacher Institute, 1999, (http://www.cdc.gov/mmwr/preview/mmwrhtml/00021930.htm), sexual activity (Dixon, Schoonmaker, & Philliber, 2000), and birthrate. The National Vital Statistics Reports, 2005 data, indicate that births to AA females under the age of 15 years were 55% of all black mothers, at the live birth rate of 1.7 in contrast to 11% births of all white mothers. (http://www.cdc.gov/nchs/data/ nvsr/nvsr56/nvsr56 06.pdf). Deardorff (2004) studied a sample of women from four ethnic groups (AA, Caucasian, Latino, & American Indian) who had experienced a pregnancy in their teens or early twenties. Results indicated that across all groups, the relationship between early sexual maturation and early pregnancy was mediated by the age at first intercourse and age at first substance abuse. Thus, early sexual maturation was associated with early pregnancy if the females engaged in sexual intercourse and substance abuse at an early age. Disturbingly, research also indicates that sexually abused adolescent girls were more likely than non-abused girls to have experienced early sexual maturation and to feel older than their peers (Turner, Runtz, & Galambos, 1999). Thus, from a public health point of view and in light of the psychosocial consequences, early development of secondary sexual characteristics is a domain that needs to be investigated. …