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Premature adulthood in boys: persistent

exposure to high energy food, adult societies and sexualized media

Ghulam Nabi, Muhammad Amin, Yousaf Khan, Sardar Ali, Nigar Gul

Abstract— Puberty is a temporal and a sequential process. The pubertal stage today’s still persisting but its timing is changed due to changes in nutrition, body weight, social stress, and exposure to adult societies. The objectives of this study were to investigate the effects of persistent exposure to adult socie- ties, media, cattle rearing and meat in male children for pubertal timing. Five groups were made, each group contained 20 children. All children were exam- ined by a physicians and morning serum total testosterone were measured in their blood by using Bio-check (USA) kit. Total serum testosterone was signifi- cantly (P**** ˂0.0001) higher in butcher children (102.3± 21.15 ng/dL), workshop children (98.20± 23.53 ng/dL), media exposed children (101.9± 18.38 ng/dL) and shepherd children (90.70± 13.64 ng/dL) as compared to age matched control group (45.10± 9.25 ng/dL). It is concluded that persistent exposure of children to adult societies, Medias, cattles and eating meat for a long time positively affects pubertal timing, propelling the children to premature adult- hood abruptly as compared to age matched control group.

Index terms- Puberty, Temporal, and Testosterone

.

1 INTRODUCTION

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uberty in physiology is defined as, the appearance of secondary sex characters. In boy the first mani- festation sign of normal puberty is pubic hairs and tes- ticular enlargement, which increases from 1-3mL be- fore puberty up to 15-25 mL in adulthood [1], [2]. In endocrinology an increase release of GnRH (Gonado- tropin Releasing Hormone) from the hypothalamus leads to puberty onset [3] because at puberty, release of increase pulsatile GnRH causes secretion of the LH (Leutinizing Hormone) and FSH (Follicle Stimulating Hormone). These LH and FSH then elevate the level of testosterone hormone, which in combination with
FSH starts spermatogenesis [4].

————————————————

Ghulam Nabi, M.Phil scholar, Department: Animal sciences, Lab: Reproduc- tive neuro-endocrinology, Quaid-i-Azam University, Islamabad, Pakistan. PH-

+92 345 8112741 E-mail: ghulamnabiqau@gmail.com

Muhammad Amin, M.Phil scholar, Department: Zoology, University of Kara- chi, Pakistan.E-mail: aminmuhammad013@yahoo.com

Yousaf Khan, , MSc. Hematology, Zia Udin medical University, Karachi, Pakistan. E-mail: somiyousaf@hotmail.com

Sardar Ali,BS (Hon) Microbiology, KUST, Pakistan. E-mail:

sa.kustmicro@gmail.com

Nigar Gul, MBBS, PG, FCPS trainee in gynaecology and obstetrics, KTH, Peshawar, Pakistan

This has been confirmed by Wildt et al., 1980 [5];
Loose and Terasawa, 1985 [3] and Plant, 2001[6] that precocious puberty in sexually immature monkeys
(both male and female) and guinea pigs (female) can be induced by pulsatile infusion of GnRH.
Precocious puberty can be defined as the earlier pro- duction of sex hormones or exposure than the norms
for gender and racial or ethnic background [7]. On the basis of etiologies, there are two types of precocious
puberty i.e. Central Precocious Puberty (CCP) and Pe- ripheral Precocious Puberty (PPP). A variety of Cen-
tral Nervous System (CNS) abnormalities like CNS
trauma, CNS infections, CNS irradiation, hydrocepha-
lus, brain tumor and gain of function mutation of kis- speptin/ kisspeptin receptor activate the hypothalamic- pituitary-gonadal axis and ultimately result CPP. Ge- netic, environmental factors and increased adiposity in adopted children after nutritional deprivation also causes CPP. PPP in boys are caused by the primary hypothyroidism, congenital adrenal hyperplasia, exog- enous testosterone exposure, Leydig cell tumor, hCG- secreting tumor, androgen-secreting adrenal tumor etc. [8], [9].
Sex, nutrition and environment, affects the timing of sexual maturation [10]. The incidence of precocious puberty is higher in girls as compared to boys i.e. 15–
20 females for each male with the disorder because, of
having a hypothetical greater number of kisspeptin fibers [11], [12], [13]. Precocious puberty is positively correlated with obesity [14]. In all ethnicities, rates of

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obesity are significantly higher in boys as compared to girls of pubertal age [15]. Ethnicity as compared to obesity has a significantly higher contribution in pre- cocious puberty [15], [16], [17], [18], [19]. Leptin produced by fat has a role in the onset of puberty be- cause; it is known that leptin-deficient ob/ob mice have arrested puberty and infertility [20], [21].
Endocrine disruptors, psychosocial stress, and early exposure to an increasingly sexualized society also triggers early onset of sexual maturation. Sexual expo- sure is more provocative but, not well supported in the literature. It is thought that, early exposure to sexual images in real life or via media stimulates the complex neuroendocrine pathways that results in puberty [22]. Similarly, excessive music excites the whole nervous system significantly and especially to the imagination that, then leads to the premature awakening of sex drive [23]. Young children adopted dress style and have also idolized pop-singers and rocks portrayed on television. These songs contains adult sexual theme and, for wanting to be cool are memorized by the chil- dren. Through these songs with sexual seductive words, one can observe the media’s duplicity in hurry- ing and exploiting preteen children into adulthood [24]. It was estimated that 45% of the world popula- tion would be less than 24 years of age by the year
2000. This results because, of the exposure of children
to an adult societal context and culture that propel the children towards adult dress, recreation and adult ac- tivities [25].
In ordered to more fully understand about pubertal timing in boys, the present study is designed to find out the effects of rich protein diet, adult society, cattle rearing and media (television, Internet, mobile phone etc.) exposure in early childhood. For this purpose the children of butchers, shepherds, workshop children and media exposed children were recruited in the study.

2 Materials and Methods

Consent

A written informed consent was signed from all the participants fathers/guardians, before starting study. Suitable to the age, enough information were also giv- en to the children about the study. All the children en- ter the study voluntarily. Permission from the local
community leader as well as register medical practi- tioner (Medical specialist) was also obtained for this study.

Study area

This study was carried out in district Dir (lower), Khyber Pakhtunkhwa, Pakistan.

Ethnicity

The children recruited were Pakistani Patthan

Study Design

Five groups were made for the present study. (1) Con- trol group (2) shepherd children (3) Butcher children (4) workshop children and (5) Media exposed chil- dren. Each group contained 20 male children. Their age ranged from 8 to 10 years. Control group children had a normal diet, had no access to media but had ac- cess to normal recreational activities. Shepherd chil- dren spent most of their time with goats and sheep. These children saw the animals mating with one an- other and heard theirs mating sound. They were also trained how to mate the goats and sheep successfully. These children were not school going. Butcher chil- dren were supplied with abundant of meat in their diet but had no access to media. Workshops childrens, spent most of their time in markets, selling ladies gar- ments (including breasers, nighty dresses, under wears cosmetics etc.). They were also exposed to the talk of ladies, talking with one anothers and also with market children about the size and quality of breasers, under wears and varied numbers of cosmetics for special purposes. The last group was exposed to media like mobile phone, internet, TV etc. but their diet was normal.

Physical examination

Physical examinations such as, axillary hairs, pubic hairs and scrotal changes were performed in clinic by a medical specialist to evaluate specific Tanner stage.

Blood sampling

Morning blood samples of 5 mL size were collected aseptically from the cephalic vein of all children by a phlebotomist in a stress proof clinical laboratory. Blood were immediately transferred into glass Vacu- tainer tubes (Becton Dickinson) without anticoagulant or preservative. These blood samples were then trans- ported on dry ice to another laboratory, where the samples were centrifugated at 3000 rpm for 15 minutes at 4 °C. The resulting serums were stored at –
20 °C for latter analysis.

Assay

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Bio check (USA) kit was used according to the manu- facturer instructions and protocol for measuring total serum testosterone concentration.

Exclusion criteria

Children with chronic physical and mental problems were excluded from the study. Participants were not taking known medications (including hormonal) that affect reproductive axis.

Statistical analysis

For data analysis, software Graph Pad Prism, version

6.03 (Graph Pad Software Inc., San Diego, CA, USA)

was used. All the four groups were compared with control group by using un-paired t- test. The results were represented as Mean± SD. A significant differ- ence was acknowledged at P < 0.05

3 Results

The various characteristics of study population are summarized in Table 1.
Table 1: characteristics of study population

Groups

Normal

Shepherd’s

Butcher’s

Workshop’s

Media ex-

posed

Age

(years)

9.07±0.54

9.05± 0.63

8.96±0.64

8.67± 2.02

8.93± 0.6

Weight

(Kg)

27.92±2.53

28.16±1.71

33.63±2.08

28.44±1.56

29.93± 1.99

Tanner

stages

(I- V)

All Tanner

II

15Tanner

II

5 Tanner

III

9 Tanner II

11 Tanner

III

12 Tanner

II

8 Tanner III

11 Tanner

II

9 Tanner III

Economic

status

Poor

Poor

poor

poor

middle

Schooling

Yes

Not

yes

not

yes

Total serum testosterone concentration in study population

The results of study population are summarized in Ta- ble 2. The results showed that meat, cattle rearing, media and adult society exposure in children signifi- cantly (P**** ˂0.0001) increases serum total testos- terone level at 95% confidence interval as compared to
age matched control group. Table 2: Total serum testosterone concentration in study population

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Groups

Parameter

Mean±SD

(ng/dL)

Confidence

Interval

Probability

Control

Total serum

Testosterone

45.10±9.25

Shepherd’s

90.70±13.64

-38.14 to -

53.06

˂0.0001

Butcher’s

102.3±21.15

46.70 to

67.60

˂0.0001

Workshop’s

98.20±23.53

41.66 to

64.54

˂0.0001

Media ex-

posed

101.9±18.38

47.43 to

66.07

˂0.0001

4 Discussion

In the present study we investigated the effects of pro- tein diet, media exposure, adult society exposure and cattle rearing in children, to explore whether it induce puberty earlier than the normal timing. We found that all these factors cause early puberty when compared with age matched control group.
Puberty is a very complicated process that is triggered by multiple and very complex neuro-endocrine path- ways, ultimately leadings to the achievement of prima- ry and secondary sex characters. Puberty does not oc- cur abruptly but, is subdivided into five stages called Tanner stages (I-V). It is a temporal process and oc- curs in sequential manner [26].
Kisspeptin one of the most important hormone is a key regulator of puberty. This is supported by the evidence that deletion in kisspeptin or kisspeptin receptor gene can cause delay puberty [27] or precocious puberty in humans [28]. Similar findings are reported in other animal models [29]. Kisspeptin is a very potent GnRH secretagogue, causing the secretion of GnRH into the median eminence that acts on gonadotrops in pituitary gland causing the secretion of LH and FSH. These gonadotropin hormones have a role in gametogenesis and steriodogenesis. During infancy, the ARC kisspep- tin pulsatility is robust, and so is GnRH and gonado- tropins. But during the transition from infancy to ju- venile phase, a neurobiological brake suppresses the pulsatility of kisspeptin and so GnRH and gonadotro- pins, leading to a hypo gonadotropic state. During pu- bertal onset, this neurobiological brake is removed, and the robust pulsatility of kisspeptin and GnRH is restored. Two substrates such as, gamma amino butyr- ic acid (GABA) and NPY is reported for this neuro
Biological brake, but what regulate these is still un- known, thus what exactly triggers puberty is still a Mystery [30]. For pubertal development, attainment of certain percentage of body fats is very crucial. Both fats and leptin concentrations are directly correlated [31]. Leptin is secreted by white adipose tissues and at the hypothalamic level acts as thermo genic and ano- rexigeneic factor [32] providing permissive signals for puberty onset and fertility [33]. Leptin control the ex- pression of kisspeptin neurons, as leptin receptors are present on kisspeptin neurons. In the ARC nucles, de- creased expression of kisspeptin level was found in leptin deficient ob/ob mice. This decreased level was restored by administration of leptin [34]. Diabetic rat models which are hypoleptinemic, leptin administra- tion normalize hypothalamic kisspeptin expression [35]. In patients with leptin mutation have hy- pogonadotropic hypogonadism and are unable to enter puberty. These conditions are reversed by leptin thera- py [36]. All these results strongly agree with our find- ings (butcher children).
Exposure of children to adult culture and societal con- text propels them towards adult dress, recreations and other activities. These adult societal environments hur- ry pubertal maturation leading them to sexual abuse, violence, aggression and anxiety [25]. Preteen chil- dren, two to three decades ago were not allowed for makeup and stockings but, today they uses skirts, hip hugger jeans, spandex pants, halter tops, bikini swim- suits, sunglasses and designed jeans and shoes [25]. These children using adult stuff would act like mini adults [37]. Most of the children have idolized pop singers and hip hop. Their songs are of adult sexual theme and for wanting to be cool; painstakingly these seductive words are memorized propelling children to adulthood [24]. Excessive music leads to premature sexualisation and menstruation by over stimulating the body. Music causes ovulation by enhancing the devel- opment of graffian follicles. It also acts as a stimulant in the genital sense and is therefore one of the most important cause of relative precocity of puberty [38], [39]. Excessive music also excites imaginations and the whole nervous system significantly, leading to premature menstruation and sex drive [23]. Most of

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the children have a decreased time for recreational purposes. Their summer vacations instead of recrea- tions are replaced by dance, computer and language classes. Some children care for themselves at empty home while others have a very young, unemployed and mostly single parent [37], [40]. Children having decrease access to healthful food, physical activities and persistent exposure to chronic and acute stress triggers pubertal onset [41]. Recreational activities such as basketball, tennis court, parks and walking or hiking trails slows pubertal onset [42]. Music videos and images portrayed on television triggers early oc- currence of sexual behaviors [43]. In children psycho- social stresses including sexual abuse, acts as a stress- or and activate puberty onset [44]. Similarly in young girls exposure to an unrelated adult male including step-father causes early pubertal maturation via pher- omones [45]. All these findings support our results.

5 Conclusions

In this study we found that children exposed to adult societies, sexualized media and environment, hurry pubertal timing and stimulate premature sex drive. Similarly children exposed to rich diet evoke suffi- cient adiposity abruptly, that is crucial for pubertal ini- tiation. Premature adulthood has social, physical and psychological implications. Children with early sexual development face remarkable social stigma and so tremendous ill effects on their health and wellbeing. These children should be identified in the societies and special care, educations and guidelines should be giv- en to them about their premature sexual development. Further studies are needed to investigate the exact mo- lecular pathways, of how these societies and environ- ment affects pubertal timing and how premature adulthood should be prevented.

Acknowledgments

We thank to Mr. Sayed Jamalu Din (GHSS, Khanpor) for helping us in writing this manuscript.

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