Background & Aim: Puberty is a period of rapid physical maturation, often anecdotally accompanied by rises in appetite/food intake. Presumably, intake increases to match growth-related energy requirements. However, little high-quality evidence exists to support this, as research to date has largely been cross-sectional. Variable methods for describing puberty also limit the interpretability of study outcomes. A systematic review was therefore undertaken to summarise supporting evidence on this research area.
Methods: The search was conducted across five databases. Eligible studies included validated measures of pubertal development, e.g. Tanner staging (TS) or hormones, as well as resting energy expenditure (REE), total daily EE (TDEE) and/or energy intake (EI) in healthy, non-obese adolescents. Standardised mean differences (SMD) between prepubertal (TS1) and pubertal (TS≥2) adolescents were quantified.
Results: The search netted 6,213 articles with 12 (nine cross-sectional, three longitudinal) included for review. Eleven studies measured EE (one EI). Eight included both genders, one males only and three females only. Pubertal status was most commonly assessed via TS (n=11). From 11 studies where SMDs for EE or EI could be calculated, all but two favoured significantly lower REE in prepubertal adolescents (SMD range: -5.93 to -0.60), and all studies measuring TDEE showed significantly lower levels in prepuberty. Results were equivocal when data were adjusted for fat free mass. Three studies favoured lower adjusted-REE (SMD: -0.56 to -0.16; one significant) in prepuberty, whereas three showed significantly higher levels (SMD: 0.53 to 1.71).
Conclusions: There is reasonably convincing evidence to support lower absolute REE and TDEE in prepubertal versus pubertal adolescents, independent of gender. This can largely be accounted for by changes in fat free mass, among other potential factors. Research is required to understand EE/EI alterations and appetite regulation during specific pubertal stages, as this may help to uncover risk periods for excess weight gain.