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Nick Gentle

Earlier maturity linked to rise in living standards
Hong Kong children are maturing physically at a younger age than ever, doctors say.
The  global decline in the age at which children of both sexes begin puberty is manifesting itself, with the average age of onset now 10 for girls and 11 for boys.
Louis Low Chung-kai,  editor-in-chief of the Hong Kong Journal of Paediatrics and a professor in the paediatrics department of the University of Hong Kong, said the phenomenon was most probably caused by improved standards of living.
'It seems to be tracking the increase in people's size,' he said. 'People are eating better, growing faster and maturing earlier.'
He and other paediatricians dismissed as ill-conceived the notion that earlier development was caused by increasing levels of hormones in people's food.
'If we were being exposed to those sorts of doses of hormones, all the boys, and not just girls, would be growing breasts,' he said.
But Professor Low said there were occasional cases of children going through puberty at very young ages - a condition known as 'precocious puberty'.
'When we say someone has precocious puberty, that means that for a girl they have breast development before seven years and start menstruating before 10,' he said.
A mother whose daughter had her first period at nine said that she was  concerned when she became aware of what was happening to her child.
'It was a bit worrying. It  wasn't until after it had happened that I started to hear about it being caused by things like hormones from food and people being big.
'The school was aware of  the issue and they  put on a talk for mums and daughters to hear about it.'
She said while her daughter was big for her age, it had also occurred to her that there could have been a genetic link - the girl's paternal grandmother had experienced the same thing.
The girl had come to accept what was happening to her body.
'She's totally cool with it,' her mother said. 'She realises that she's just got to deal with it.'
Professor Low said he had not noted any particular increase in the number of cases in Hong Kong.
Grace Poon,  another paediatrician, agreed the number of cases was fairly steady. The doctors did sound a warning that children who were experiencing very early puberty should consult a doctor.
'From a doctor's point of view, it's important to find out if the cause is pathological,' Dr Poon said. 'You need to consult a doctor to exclude any sort of central nervous system disorder.'
The importance of the message was underscored by paediatric specialist and chair of the Medical Council's education committee Alvin Chan Yee-shing.
'I have had a patient who had precocious puberty at five years old - that was a boy - and it was because of a brain tumour.'
In other cases, the doctors all agreed precocious puberty could be brought on by a number of other factors, such as obesity or genetics.
'There's just so many things that seem to go on,' Professor Low said.
'It seems to be a very north-south thing,' he said, referring to the way the phenomenon divides roughly between more developed places, where it is happening, and less developed countries, where it does not seem as prevalent.
Recent research, as yet unpublished, from the mainland echoed that observation, the professor revealed.



Girls reaching puberty before the age of 10