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| ORIGINAL ARTICLE |
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| Year : 2014 | Volume
: 2
| Issue : 1 | Page : 29-32 |
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Does obesity cause precocious pubertal voice changes in adolescent boys: Evaluating the critical weight hypothesis in the Indian adolescents
Radish Kumar Balasubramanium, Kuriacose Joseph, Jayashree S Bhat
Department of Audiology and Speech Language Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
| Date of Web Publication | 25-Jul-2014 |
Correspondence Address:
Radish Kumar Balasubramanium
Associate Professor, Department of Audiology and Speech Language Pathology, Kasturba Medical College, Manipal University, Mangalore-575 001, Karnataka
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2347-2618.137597
Objectives: The present study was taken up with the aim of investigating the effect of obesity and underweight on the occurrence of vocal mutation in adolescent boys. Materials and Methods: The study followed a cross-sectional study design. Ninety male participants in the age range of 14-17 years were classified into three groups based on the body mass index (BMI) which include underweight, normal weight, overweight/obese. Praat software (version 5.1.43) was used for the analysis of voice samples and speaking fundamental frequency was extracted from all the samples. Results: The results of the present study revealed significant main effect of the group (F = 5.732; P < 0.05). Results of post hoc analysis revealed that there was a significant difference between all the three groups at P < 0.05. Conclusion: The present study investigated the effect of BMI values on the occurrence of vocal mutation in the age range of 14-17 years in adolescent boys. The results revealed that obesity and underweight caused delay in the attainment of vocal mutation in the male adolescents. Hence, the present study does not favor the critical weight hypothesis at least in the vocal mutation in the Indian male adolescents. Keywords: Critical weight hypothesis, fundamental frequency, obesity, underweight, vocal mutation
How to cite this article:
Balasubramanium RK, Joseph K, Bhat JS. Does obesity cause precocious pubertal voice changes in adolescent boys: Evaluating the critical weight hypothesis in the Indian adolescents. Saudi J Obesity 2014;2:29-32 |
How to cite this URL:
Balasubramanium RK, Joseph K, Bhat JS. Does obesity cause precocious pubertal voice changes in adolescent boys: Evaluating the critical weight hypothesis in the Indian adolescents. Saudi J Obesity [serial online] 2014 [cited 2023 Jun 2];2:29-32. Available from: https://www.saudijobesity.com/text.asp?2014/2/1/29/137597 |
| Introduction | |  |
Overweight and obesity are defined as an abnormal or excessive fat accretion that presents as a risk to health of that individual. Overweight and obesity pose a major risk to humans causing many chronic conditions like cardiovascular disease, and cancer. These were once observed only in high-income countries and dramatically increasing now in developing as well as the underdeveloped countries, especially in urban areas. Obesity and overweight are usually measured using body mass index (BMI). It is calculated by an individual's weight (in kilograms) over the square of his or her height (in metres). A BMI greater than 25 kg/m 2 is considered as overweight, BMI greater than 30 kg/m 2 as obese, and a BMI below 18.5 kg/m 2 as underweight. [1] India, being a developing country, has the following prevalence rate for obesity and overweight in the age range of 15-19 years. [1] Prevalence of underweight, normal weight, overweight, and obesity in 15-19 year old Indian adolescents were 28.8%, 40.2%, 1.4%, 0.2%, respectively in males and 25.9%, 50.8%, 2.1%, and 0.2% in females, respectively.
Role of obesity in individuals with precocious puberty has attracted the interest of researchers from 1970 onwards. It is commonly agreed that puberty is precocious when secondary sexual characteristics appear before the age of 8 in girls and before the age of 9 in boys. [2] According to the traditional studies of Kennedy and Mitra [3] and the work of Frisch et al.[4] critical body weight or fat mass must be achieved before the onset of puberty. Accordingly, Frisch and Revelle in the early 1970s proposed a hypothesis called "critical weight" hypothesis which suggests that a minimum weight of 48 kg or 22% body fat is required for the puberty to start. [4] The current trends in pubertal maturation also seem to be related to the increasing prevalence of overweight and obesity in girls and have raised significant discussion as to whether the early occurrence of puberty is due to obesity.
A relationship between early pubertal maturation and obesity is widely accepted in girls [3],[4],[5],[6],[7] although the cause and effect relationship has not been established. However, most of these data are based on cross-sectional studies, and the exact cause effect relationship between BMI and sexual maturation is not clearly understood. Hence, longitudinal studies were carried out to elucidate the relationship between BMI and pubertal maturation and results did support advanced pubertal maturation in girls with higher BMI during their childhood. [8],[9],[10],[11]
In contrast, data on the relation between body weight and timing of puberty in boys are very few in the literature. One such study is by Wang who reported that thinner boys were maturing earlier than boys with increased BMI based on the Tanners genitalia stages. [12] In contrast, Aksglaed et al. reported advanced pubertal changes in obese males based on the critical weight hypothesis. [2] Also, there have been very few studies on the effect of obesity on voice and its characteristics. One such study was by Cunha et al. who reported that obese individuals exhibit vocal instability, hoarseness, increased jitter and shimmer, and reduced maximum phonation duration as well as the presence of vocal strain at the end of sentence, when compared to a non-obese control group. [13] However, this study did not emphasize relationship between fundamental frequency (F0) changes and pubertal maturation in detail.
In the Indian population, it is generally observed that obese boys develop vocal mutation after the age of 17 years. Hence, the present study was attempted to verify the hypothesis that overweight/obesity does affect the vocal mutation in adolescent boys in Indian population. Also, it would be of interest to know if critical weight hypothesis plays a major role in the onset of pubertal voice changes. As there is a current prevalence of under nourishment and an increasing trend of obesity in the Indian population, [14] the present study was planned with the aim of determining whether obesity and underweight affect the vocal mutation by advancing or postponing it in Indian adolescent boys.
| Materials and methods | | |
The study followed a cross-sectional study design.
Participants
Ninety male participants in the age range of 14-17 years were recruited for the study. They were classified into three groups based on the BMI values [1] which included underweight, normal weight, overweight/obese. Each group consisted of 30 participants. Children with normal hearing and normal speech and language development were included in the study. Children with vocal etiologies like vocal abuse/misuse, smoking, and reflux symptoms as ascertained from a detailed case history were excluded from the study. All the participants in the clinical group had normal voice as evaluated through Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) rating scale. [15] All the participants had consented to participate in the study. Institutional ethical committee approval was obtained prior to the conduction of the study.
Instrumentation
The voice samples were recorded through a sensitive dynamic microphone which was connected to Laptop computer (Lenovo G550) and recorded through Praat software (version 5. 1. 43) at 44.1 kHz sampling frequency in a sound-treated room. Praat software was used for analysis of the recorded voice samples.
Procedure
All the voice samples were recorded into the Praat software (version 5.1.43) at 44.1 kHz sampling frequency using a dynamic microphone which was maintained at a distance of around 10 cm from the participant's mouth. Prior to the recording, they were seated in a comfortable chair and were instructed to narrate a topic at their most comfortable pitch and loudness for at least 5 seconds. The recordings were repeated when required. The recordings were also repeated when the subjects felt that they have not phonated in their comfortable pitch and loudness. Fundamental frequency was extracted from the recordings of sustained phonation. Fundamental frequency of 140 Hz or less is considered as the attainment of vocal mutation in males. One-way analysis of variance (ANOVA) was performed to compare the significant difference between the means of all the groups at P < 0.05.
| Results | | |
Descriptive statistics were employed to find out the mean and standard deviation (SD) of the speaking fundamental frequency (F0) measure and the results are shown in the [Table 1].
From the table, it is seen that F0 is greater in the obese and underweight adolescents than the normal BMI group.
The results revealed significant effect among the groups (normal weight, underweight, and overweight/obese groups) (F = 22.550; df = 2; P < 0.05). Results of post hoc analysis revealed that there was a significant difference between the "Normal BMI" group and the "Overweight/Obese" group at P < 0.05. Significant difference was also observed between normal BMI group and the "Underweight" group and underweight and overweight/obese group at P < 0.05 indicating that F0 is greater in underweight and obese group compared to normal weight group.
| Discussion | | |
The present study investigated the effect of overweight/obesity and underweight on the vocal mutation through the speaking fundamental frequency measure. Results revealed that there was a statistically significant difference between all the three groups indicating that overweight/obese and underweight group having higher speaking fundamental frequency than the normal weight group. The results of the present study are in agreement with the results obtained by Cunha et al. that obese individuals exhibit alterations in voice characteristics from those of non-obese individuals. [13] These alterations are characterized by delay in the vocal mutation in adolescent males as evidenced in the present study.
The participants in the normal BMI group showed a mean F0 value of 135.04 Hz indicating that they have achieved the normal adult male fundamental frequency. But in contrast, the individuals that constituted the overweight/obese group showed a mean F0 value of 182.91 Hz, suggesting that there was a delay in the vocal mutation as compared to the individuals with a normal BMI. This clearly indicates an adverse effect of obesity on the vocal mutation in adolescents. This is in agreement with the previous study by Aksglaed et al. who reports that pubertal changes are delayed in obese children. [2] However, Wang reported negative association between pubertal changes and obesity in males based on the critical weight hypothesis. [12] Hence, the present study supports the critical weight hypothesis, at least in the vocal mutation in the Indian obese boys.
Significant difference between the normal BMI group and the "underweight" group was observed though the difference was small, i.e. latter group showed a mean F0 value of 165.21 Hz, indicating that they are on their way towards the achievement of adult fundamental frequency thereby showing the effect of underweight on the pubertal voice changes. Underweight is often associated with poorer child care, poorer nutrition, and poorer medical services which might have induced a change in size, rate of growth, and timing of pubertal development, [16] and hence the results of the present study. This finding contradicts the critical weight hypothesis because underweight children also exhibited delayed vocal mutation. This raises the suspicion over the critical weight hypothesis in the Indian population, and hence, it can be said that critical weight hypothesis does not favor the Indian adolescent boys at least in the vocal mutation.
| Conclusion | | |
The present study revealed that there was a significant difference between the "Normal BMI" group and the "Overweight/Obese" group indicating that there was a delay in the vocal mutation in the overweight/obese group in comparison to the normal BMI group. These findings suggest that obesity and underweight were associated with postponement in the attainment of vocal mutation in adolescent boys, and hence, the critical weight hypothesis is not in favor of the Indian male adolescent population. However, further studies are required to correlate the general physical development, pubertal status, vocal mutation, and obesity among the adolescent Indian.
| Acknowledgment | | |
Authors would like to thank our Dean, Kasturba Medical College (Manipal University), Mangalore for permitting us to carry out the study.
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[Table 1]
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