Longitudinal association of dietary sources of animal and plant protein throughout childhood with menarche.

BACKGROUND

Inconsistent findings have been reported for associations between protein intake and age at menarche. We aimed to investigate the association between intake of protein and protein-containing food groups during childhood with menarche among Iranian girls.

METHODS

Girls aged 6-18 years who did not experience menarche in the third or fourth examination cycles of the Tehran Lipid and Glucose Study were selected and were followed to the fifth examination cycle. Daily intakes of protein from different animal/plant sources and ten protein-containing food groups were assessed using a food frequency questionnaire at baseline (the third or fourth examination cycles). Occurrence of menarche and its onset age were asked during each examination cycle. Cox proportional hazards regression was used to estimating hazard ratios (HRs) and 95% confidence interval (95%CI) for the occurrence of menarche per one standard deviation (SD) of dietary intakes. Logistic regression was also used to estimate the odds of reaching menarche ≤12 years.

RESULTS

During the study, 147(61%) of girls reached menarche, the median age at menarche was 12 years. The adjusted HRs (95% CI) for the occurrence of menarche per one-SD of dietary intakes were 0.68 (0.48, 0.98; p = 0.040) for plant protein and 1.36 (1.01, 1.84; p = 0.042) for animal protein after adjusting for baseline age, BMI Z-score, energy intake, and mother's early menarche and education. Substituting 10-g animal protein with plant protein was associated with a 16% (95%CI: 5-25%; p = 0.006) lower risk of menarche. Dietary intakes of poultry (adjusted HR: 1.35; 95% CIs: 1.00-1.82; p = 0.049) and low-fat dairy (adjusted HR: 1.20; 95%CIs: 0.99-1.46; p = 0.064) were marginally associated with the increased risk of menarche. However, the odds of early menarche was significant only for plant protein (adjusted odds ratio = 0.39; 95% CI: 0.16-0.96; p = 0.040).

CONCLUSIONS

Our findings indicate that the risk of menarche increases by higher intakes of animal protein and decreases by plant protein. Intakes of poultry and low-fat dairy associate with a higher risk of menarche. The odds of menarche occurrence ≤12 years reduces by higher intakes of plant protein.