Early menarche is associated with disordered eating-results from a National Youth Survey

Sharon Iron-Segev; Chen Namimi-Halevi; Chen Dor; Rita Dichtiar; Aliza H Stark; Lital Keinan-Boker; Tali Sinai

doi:10.1038/s41390-025-03852-1

Early menarche is associated with disordered eating-results from a National Youth Survey

Pediatr Res. 2025 Jan 16. doi: 10.1038/s41390-025-03852-1. Online ahead of print.

Authors

Sharon Iron-Segev^{1

2}, Chen Namimi-Halevi¹, Chen Dor¹, Rita Dichtiar¹, Aliza H Stark², Lital Keinan-Boker^{1

3}, Tali Sinai^{4

5}

Affiliations

¹ Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel.
² School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
³ The Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
⁴ Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel. [email protected].
⁵ School of Nutritional Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel. [email protected].

PMID: 39821134
DOI: 10.1038/s41390-025-03852-1

Abstract

Background: Disordered eating (DE) is highly prevalent among adolescents, though its definition varies. The association between DE and early pubertal maturation (EPM) remains underexplored in Israel, and has not been sufficiently examined using the widely-used SCOFF questionnaire. This study examines these associations in adolescents.

Methods: Participants (n = 2415 girls, 2095 boys; ages 12-18 years) in a nationally-representative, cross-sectional Youth Health and Nutrition Survey (2015-2016) completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. EPM was determined by menarcheal age <11.5 years in girls, and facial hair appearance <12.5 years in boys. Respondents affirming ≥2 SCOFF items were classified as DE cases. Multivariable logistic regression analyses examined the associations between EPM and DE.

Results: Among the participants, 12.7% of the girls and 20.4% of the boys met EPM criteria; 55.5% and 33.7%, respectively, were categorized as having DE. Following adjustment for age, socioeconomic status, ethnic background, and weight status, EPM was significantly associated with DE in girls (OR 1.47, 95%CI: 1.12-1.93) and with 3/5 SCOFF items. No such association was found in boys (OR 1.00, 95%CI: 0.77-1.28).

Conclusion: EPM in girls was associated with DE. Identifying high risk groups for DE in adolescents is crucial for early intervention and prevention.

Impact: This study included a large, nationally representative sample of Israeli adolescents and utilized the SCOFF questionnaire, a widely used screening measure for disordered eating (DE). Following comprehensive analyses, a significant association between early pubertal maturation (EPM), defined as early menarche, and DE was documented in Israeli adolescent girls. Identifying girls with EPM and screening for disordered eating will allow for early interventions, potentially improving physical and mental health, and preventing progression to eating disorders.