There’s lots going on in the lives of four-year-old boys, including how to regulate their emotions. Let’s not blame their hormones.    

The idea that four-year-old boys have a spurt of testosterone is often used to explain challenging behaviour at this age.

But how did this idea come about? Is there any truth in it? And if not, what else could explain their behaviour?

Psychologist and author Stephen Biddulph is often credited with being the source of the idea that four-year-old boys have a testosterone spurt.

Although he mentioned it in his bestselling book Raising Boys, he was writing about someone else's work:

"According to Professor Mitchell Harman in the US Department of Aging, boys undergo a testosterone burst at age four … Not all researchers have agreed with this finding though, so it remains controversial."

Biddulph said Professor Harman wrote about this for an article in the men's magazine Esquire in 1999 and "stood by these findings" when contacted in 2015.

So, what does the evidence say?

As a researcher and adolescent endocrinologist, who specialises in puberty hormones, I can say there is no evidence this testosterone spurt exists. Many studies of hormones in boys in peer-reviewed journals confirm this.

Raised levels of testosterone are not possible when testes (where testosterone is made) are small and levels of the hormone that stimulates testosterone production is low.

The only time when a four-year-old's testosterone level is high is in a serious and uncommon condition called precocious puberty, where boys enter puberty and their testicles enlarge much earlier than usual.

Yes, testosterone rises, but not at this age

There are rises in testosterone during a boy's development, which coincide with major brain development. But these don't happen at the age of four.

Testosterone first increases to puberty-like levels in boys during the first two trimesters of pregnancy. This testosterone is responsible for the development of the penis and scrotum, a process known as the masculinisation of external genitalia.

The second testosterone increase occurs in the first six months or so of life. This mini-puberty results in boys' genitalia briefly looking more prominent, which many parents notice.

Puberty is the third and final rise in testosterone, with levels increasing 10- to 20-fold over two to three years. Puberty is a time of major physical growth accompanied by significant behaviour changes, clearly influenced by brain development.

Yes, there are hormone changes, but not testosterone

There are hormone changes starting at around five to six years in both sexes in a period known as adrenarche. Perhaps this has also contributed to the confusion.

Adrenarche is the maturation of part of the adrenal glands where hormones similar to, but much weaker than, testosterone are made. Their most common effect is body odour. However, researchers don't know why exactly boys and girls have this phase. And no-one has yet seen any clear effects on childhood behaviour.

No, testosterone doesn't spurt

Use of the word "spurt" to describe testosterone production is also incorrect.

Testosterone does not spurt at any time of life. The word "spurt" creates a sense of rapidity and urgency, giving testosterone a reputation in childhood it does not deserve. Instead, when testosterone levels rise in puberty, it increases gradually at first, then accelerates in mid to late puberty.

So, what else can explain behaviour?

So is there an alternative explanation for boys' behaviour at this age, which parents regularly report?

We see differences in boys' and girls' brains and behaviour well before puberty. Rises in testosterone in the womb and during the mini-puberty in the first six months of life likely explain these.

Studies that look at behaviour in four to five-year-olds tend to focus on play and social interactions, because these are what children this age do most of the time.

Such studies show boys and girls this age generally have different ways of playing and communicating. Boys' play is generally more physical, engaging with mobile toys or building structures. Girls generally have more socially interactive play, and are more articulate.

Interestingly, girls with congenital adrenal hyperplasia, when they are exposed to high levels of testosterone in the womb, tend to have more "rough and tumble" play styles, consistent with a testosterone effect on early brain development.

So, how might being four or five change boys' behaviour?

At this age, children learn how to interact with others, understand another's needs, share, and to deal with new and unfamiliar situations.

So, children must learn to regulate their own emotions, like fear, concern, upset and anger.

When children don't do this, we see the emotional outbursts, which can be explosive. Children can struggle to either understand or articulate why they lost control of their emotions. Boys may respond more physically and be less able to articulate what happened.

Learning how to regulate their emotions is an important skill for children to develop. Parents can model good emotional regulation, make sure children have regular daily routines, enough time to practice play and enough sleep. Praising positive behaviour and not overreacting to minor attention-seeking misbehaviour also helps.

We shouldn't blame hormones for children's behaviour. Instead, we need to better understand those behaviours.

For instance, persistent and distressing behaviours in a child may signal underlying anxieties, reaction to family stresses, which are felt but not understood, or be a result of adversities when they were younger. So, if you are concerned, seek professional advice.

For all children, we need to prioritise time to play. That could mean space, action and permission to be noisy and boisterous.

For more information about behaviour in preschoolers see the Raising Children Network. If you are concerned about your preschooler's behaviour and want support, see beyondblue.

This article was originally published on The Conversation. Read the original article.

Provided by The Conversation

"Do boys really have a testosterone spurt at age four?" October 23, 2017 https://medicalxpress.com/news/2017-10-boys-testosterone-spurt-age.html

Isla Bonita, a Spanish food company, has created Avocado Light – a “diet avocado.”

This new product will have 30 percent less fat than original avocados and will oxidize at slower rates, meaning your avocado will keep its green color longer.

The company says their product will taste like an original avocado but will be slightly milder in flavor and will have a “juicier and lighter pulp.” Because Avocado Light is human-engineered, it will be available all year.

However, don’t expect to be picking up one of these diet avocados anytime soon, as Isla Bonita says their product will only be available in Spain for now.

Do we want these diet avocados to make their way to US grocery stores?

While it’s true avocados do have lots of fat, Dr. Jacqueline Ivey-Brown, an internal medicine physician at Advocate Christ Medical Center in Oak Lawn, Ill., says avocado fat is actually good for us.

“Avocados contain monounsaturated fat,” says Dr. Ivey-Brown. “This fat is known to help lower cholesterol and can keep you fuller longer.”

While avocado fat is healthy, Dr. Ivey-Brown says, “Like any food, avocados should be eaten in healthy serving sizes. Most people don’t realize that a serving size of avocado is only one-fifth of the fruit.”

That being said, diet avocados will have the potential to last longer and will allow us to eat more than a typical serving. Conversely, cutting out the fat also has the potential of making avocados less healthy and perhaps less satisfying.

Regardless if you’re pro- or anti- diet avocado, Dr. Ivey-Brown says that outside of its fat, avocados are healthy in other ways, as well. For example:

•    Avocados have many vitamins and minerals, some which promote eye health and repair damaged cells

•    They contain B vitamins, including folic acid, which can help fight off illness and is important during pregnancy

•    Avocados are low in sugar, unlike many other fruits 

Is all of this talk about avocados making you hungry?

Researchers conducted a review of previous research to determine the effects of dragon fruit in diabetes management.

Prediabetes and type 2 diabetes are diagnosed using blood sugar levels. A fasting plasma glucose (FPG) test measures blood sugar levels after approximately eight hours without eating. The two hours post-prandial glucose (2HPP) test measures blood sugar levels two hours after ingestion of a standardized glucose sample. The results of these tests are measured against a standard to determine diagnosis and next steps in the treatment plan.

Prediabetes is a precursor of type 2 diabetes. A person with prediabetes has high blood sugar levels but does not meet the threshold for a type 2 diabetes diagnosis. Management of these medical conditions includes a healthy diet, physical activity, weight management, medications, and natural health products.

Dragon fruit is high in antioxidants and animal studies have found that it may have blood-sugar lowering properties. In particular, the red flesh dragon fruit has been found to have higher antioxidants than the white flesh dragon fruit.

The objective of this study, conducted in Thailand and recently published in PLoS, was to review the available published data to assess the possible role of dragon fruit in diabetes, particularly prediabetes and type 2 diabetes. Data from four randomized controlled clinical trials were analyzed. All four trials had a control group, and the outcomes measured were the fasting plasma glucose (FPG) and two-hour post-prandial glucose (2HPP) levels. Patients with other diseases were excluded from the review.

In one study, researchers gave the participants between 60g and 600g of red flesh dragon fruit. One of the trials had pre-diabetic patients only. The prediabetes trial measured FPG with a sample size of 36 and the duration of treatment was four weeks. Three other trials comprised of type 2 diabetic patients only. The outcome measured in two of these studies was FPG, while the last study measured 2HPP. The sample sizes ranged from 28 to 51 participants and the duration of treatment was ten days, fifteen days, and four weeks. There were no adverse events documented by the studies.

The analysis of the results showed a significant decrease in FPG in the prediabetes study, but no significant reduction in FPG and 2HPP in the type 2 diabetes groups. Thus, so far in studies of dragon fruit in diabetes management, the results are mixed. Although dragon fruit has shown potential benefit in rat studies, more clinical trials are required to better understand whether dragon fruit can be used in the management of diabetes.

The sample sizes of the trials included in this analysis were small, the length of treatment in each trial was short and long-term safety was not measured. Another limitation mentioned by the article is the possibility that studies with negative results may not have been published. Until more information is available, dragon fruit may be considered as part of a healthy diet in managing prediabetes and type 2 diabetes.

Written by Anuolu Bank-Oni, Pharm.D,CDE
https://www.medicalnewsbulletin.com/dragon-fruit-help-diabetes-management/