Menstrual cycle among adolescents: girls' awareness and influence of age at menarche and overweight / Ciclo menstrual em adolescentes: percepção das adolescentes e influência da idade de menarca e excesso de peso

Abstract Objective: To characterize the menstrual cycle (regularity and menstrual flow length), the prevalence of dysmenorrhea and self-monitoring of the cycle in students from Lisbon region, and explore the effect of chronological age, age at menarche and body mass index (BMI) on menstrual disorders. Methods: This is a cross-sectional study with 848 girls aged 12-18 years. A questionnaire about the sociodemographic context and characteristics of the menstrual cycle, and weight and height measures were assessed. BMI was classified according to International Obesity Taskforce criteria. A descriptive analysis of the variables was made, and Odds Ratios (ORs) and 95% confidence intervals (95%CIs) were determined. Results: Mean age at menarche was 12.4 years and mean BMI was 22.0kg/m2. Among adolescents, 59% have regular menstrual cycle, 83% have menstrual flow length of ≤6 days. 88% suffered from dysmenorrhea, among which 8,7% declare absenteeism from school and 49% took pain medication, and 65% self-monitor their menstrual cycle. Higher maternal education was associated with a higher self-monitoring of menstrual cycle among the sample (OR 1.60; 95%CI 1.15-2.17). Girls with menarche <12 years-of-age are more likely to have menstrual flow length of >6 days (OR 1.73; 95%CI 1.19-2.51) and dysmenorrhea (OR 1.87; 95%CI 1.11-3.16) than those with menarche ≥12 years-of-age. No significant association between BMI and menstrual cycle variables was observed. Conclusions: The results suggest that menstrual disorders are frequent and may be associated with early menarche, but not with BMI. It is important to encourage self-monitoring of the menstrual cycle to detect menstrual disorders timely and promote health and well-being.

Resumo Objetivo: Caracterizar o ciclo menstrual (regularidade e duração da menstruação), prevalência de dismenorreia e automonitoramento do ciclo em estudantes da região de Lisboa, e explorar o efeito da idade cronológica, idade de menarca e índice de massa corpórea (IMC) nos distúrbios menstruais. Métodos: Este é um estudo transversal com 848 meninas entre 12 e 18 anos. Foi aplicado um questionário sobre contexto sociodemográfico e características menstruais e feita a medição do peso e altura. O IMC foi classificado pelos critérios da International Obesity Taskforce. Fez-se uma análise descritiva das variáveis e determinaram-se Odds Ratio (p<0,005; IC95%). Resultados: A média da idade de menarca foi 12.4 anos e do IMC foi de 22.0kg/m2. Entre as jovens, 59% afirmaram ter ciclo menstrual regular, 83% menstruação com duração ≤6 dias, 88% sofrem de dismenorreia, entre as quais 8,7% faltaram à escola e 49% consumiram analgésicos, e 65% automonitoram o ciclo menstrual. Uma educação materna elevada está associada a maior monitorização do ciclo menstrual entre as jovens (OR 1,60; IC95% 1,15-2,17). Meninas com idade de menarca <12 anos têm maior chance de ter menstruação com duração >6 dias (OR 1,73; IC95% 1,19-2,51) e dismenorreia (OR 1,87; IC95% 1,11-3,16) do que aquelas com menarca ≥12 anos. Não se observou associação entre o IMC e as características menstruais. Conclusões: Os resultados sugerem que os distúrbios menstruais são frequentes nas adolescentes e podem estar associados com a menarca precoce, mas não com o IMC. É importante incentivar a automonitoramento do ciclo menstrual para detectar adequadamente as perturbações menstruais e promover a saúde e bem-estar.

Patterns of lifestyle-related behaviors and parents'overweight are associated with increased body adiposity in schoolchildren: a cross-sectional study in Portugal

BACKGROUND: This study evaluated the association between lifestyle-related behavior patterns and weight status indicators in schoolchildren. METHODS: Cross-sectional study includes nationally representative sample of Portuguese school children (6­9yearsold;n= 10,258). Weight status was assessed using the body mass index (BMI) and waist circumference (WC). Principal component analysis was used to identify lifestyle-related behavior patterns. Multiple linear regression models were used to estimate the association between behavior patterns, BMI, and WC.RESULTS: Six lifestyle-related behavior patterns were identified: pattern 1: consuming iced tea and soft drinks≥2 times/week, having a television (TV) in the bedroom, watching TV≥2 h/day, and consuming <2 portions of fruits/day; pattern 2: parents and children remaining physically inactive during leisure time; pattern 3: consuming≤1 portion of vegetables and milk/day; pattern 4: having parents with excess weight; pattern 5: consuming≤3daily meals and skipping breakfast; and pattern 6: not participating in physical education classes. After the adjustment, all of the patterns were associated with increased BMIz-score (P≤0.02) and WC (P≤0.03).CONCLUSIONS: Lifestyle-related behavior patterns were associated with an increased risk of excess weight and the central distribution of body fat. Taking a public health perspective toward preventing childhood obesity, special attention should be given to identify subgroups with simultaneous occurrence of multiple risk behaviors, which is useful for planning prevention programs.

Irregular breakfast habits are associated with children's increased adiposity and children's and parents' lifestyle-related behaviors: a population-based cross-sectional study

BACKGROUND: Skipping meals, especially breakfast, is related to an increase in adiposity indicators, and this behavior is related to metabolic changes that predispose to the development of chronic diseases, recognized as major causes of death worldwide. The objective of the present paper was estimated the association between irregular breakfast habits with adiposity indices in schoolchildren and other lifestyle factors. METHODS: A population-based cross-sectional study was conducted in 2009­2010, including schoolchildren (n=10,243) between 6 and 9 years old (51.3 % girls) from 18 districts of mainland Portugal. Breakfast habits were as certained by asking a yes/no question ("Does your child eat breakfast regularly?"). An index estimated by performing principal component analysis was used to assess body adiposity from three different adiposity indicators (body mass index (BMI), waist circumference (WC), and the triceps, subscapular, and supra iliac skinfolds (used to estimate body fat percentage (BFP))). Multivariate logistic regression and multiple linear regression models were used to estimate the association of irregular breakfast habits with anthropometric indicators (BMI, BMI z score, WC, BFP, and adiposity index) and with children's and parents' lifestyle and socioeconomic characteristics. RESULTS: A total of 3.5 % of the children did not have breakfast regularly (girls 3.9 %; boys 3.1 %; P= 0.02). Among boys, irregular breakfast habits were associated with lower fathers' education level, television time≥2 h/day, and soft drink consumption≥2 times/week. For girls, irregular breakfast habits were associated with lower mothers' education level and physical inactivity, soft drink consumption≥2 times/week, and <1 portion of milk/day. Multivariate linear models revealed a positive association between irregular breakfast habits with increased adiposity indicators among boys (BMI (kg/m2):ß= 1.33; BMI z score:ß= 0.48; WC (cm):ß= 2.00; BFP (%):ß= 2.20; adiposity index:ß= 0.37;P< 0.01 for all). No significant association was found for girls. CONCLUSIONS: Irregular breakfast habits were positively associated with boys' increased global adiposity and were significantly affected by children's and parents' lifestyle-related behaviors.