In a comprehensive prospective cohort study, researchers have identified significant associations between dietary patterns and the timing of menarche in adolescent girls, independent of body mass index and height.
The study, conducted by researchers from Fred Hutchinson Cancer Center and Harvard T.H. Chan School of Public Health, found that girls who consumed diets aligned with the Alternative Healthy Eating Index (AHEI) experienced later onset of menarche, while those who followed the Empirical Dietary Inflammatory Pattern (EDIP) reached menarche earlier.
Key Findings
Investigators analyzed data from 7,530 premenarchal participants in the Growing Up Today Study (GUTS) who completed food frequency questionnaires. The median age of menarche in the study population was 13.1 years.
Participants in the highest quintile of AHEI scores (indicating healthier diets) were 8% less likely to attain menarche within the next month compared with those in the lowest quintile. This association persisted after adjustment for body mass index (BMI)-for-age (BMIz) and height.
Conversely, girls in the highest quintile of EDIP scores (most inflammatory diet) were 15% more likely to attain menarche in the next month compared with those in the lowest quintile. This association also remained after controlling for BMIz and height.
Importance of Dietary Quality
"Our findings of an association between both the AHEI and EDIP and age at menarche indicate that diet quality may play a role in age at menarche independent of BMI or height," the authors noted in their conclusion.
While stratified analyses showed that the AHEI association was most pronounced among girls with lower BMIz scores, the EDIP association with earlier menarche was consistent across BMIz groups.
Study Design and Methodology
The study utilized data from GUTS, which enrolled children aged 9 to 14 years in two waves (1996 and 2004). On average, participants completed baseline food frequency questionnaires 1.75 years prior to menarche.
"The AHEI awards points for healthier foods, including vegetables, legumes, and whole grains and deducts points for foods such as red meat and trans fats," the study authors described. The EDIP identifies dietary patterns that are predictive of inflammatory biomarkers.
Cox proportional hazard models were employed to calculate hazard ratios for menarche by quintile of dietary pattern score, with adjustments for physical activity, inactivity, family dinner frequency, birthweight, maternal age at menarche, BMIz, and height.
Public Health Implications
Earlier age at menarche has been associated with an increased risk of diabetes, obesity, cardiovascular disease, and breast cancer. The researchers noted that their findings underscore dietary patterns as modifiable factors that may influence the timing of menarche.
They concluded, “This may be an important period for the reduction in chronic disease risk.”
This study was supported by the Breast Cancer Research Foundation and the National Institutes of Health. The authors reported no competing interests.
Source: Human Reproduction