Girls who have a healthy diet during childhood are more likely to begin their menstrual periods at a later age than girls with poor diets, new research has found.
The link between diet and age at menarche was observed irrespective of body size and could have implications for long-term health outcomes, since early menarche is a risk factor for type 2 diabetes, obesity, cardiovascular disease and breast cancer.
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The US-based study of more than 7,500 girls is published in Human Reproduction and the authors say this is the first to link dietary patterns and the timing of a girl’s first period.
The team devised a prospective cohort study of girls enrolled in The Growing Up Today Study (GUTS). Participants were between the ages of nine and 14, and the researchers followed the girls between 2001 and 2008, beginning at each girl’s entry point to the study and then at 1-3-year intervals over the study period.
Each girl completed surveys about their diet when they joined the study, before their periods started, and then every 1-3 years thereafter; they also recorded the date of their first menstrual cycle. The researchers used the Alternative Healthy Eating Index (AHEI) and the Empirical Dietary Inflammatory Pattern (EDIP) to assess how healthy each child’s diet was.
Ninety-three per cent of the girls who participated in the research had their first period during the study.
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Girls with the top 20th percentile of AHEI scores (those with the healthiest diets) were found to be 8% less likely to experience menarche in the next month compared with those in the bottom 20th percentile (those with the least healthy diet). This was true even after adjustment for age, race/ethnicity, maternal education, total energy intake, body mass index (BMI) and height.
The girls in the top 20% of EDIP measurements (those with the most inflammatory diet) were 15% more likely to begin menstruating in the next month than peers with the lowest EDIP scores, again independently of variable factors such as BMI and height.
The researchers say their analysis indicates that a healthier diet delays the onset of menstrual periods; they believe that the type of food eaten by girls during childhood and adolescence, and its impact on inflammation, may influence the time of menarche.
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Lead author, Dr Holly Harris, from the Fred Hutchinson Cancer Centre, Seattle, Washington, said: ‘These results were independent of BMI and height, demonstrating the importance of a healthy diet regardless of body size. As earlier age at menarche is associated with multiple later‑life outcomes – including higher risks of diabetes, obesity, cardiovascular disease and breast cancer – this may be an important period for trying to reduce the risk of these chronic diseases.’
Dr Harris emphasised the need for nutritional guidelines in schools. She added: ‘I think our findings highlight the need for all children and adolescents to have access to healthy meal options, and the importance of school-based breakfasts and lunches being based on evidence-based guidelines.’
