Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Menopause. 2022 Jul 1;29(7):861-867. doi: 10.1097/GME.0000000000001985.
To evaluate the association of plant-based diet index (PDI) with early onset of natural menopause in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII).
We conducted a prospective study with a mean follow-up time of 20 years among premenopausal women living across the US. Participants of the NHS (n = 121,701) and NHSII (n = 116,429) were included from 1984 (age mean [standard deviation]; 44.9 [4.3]) and 1991 (age mean [standard deviation]; 36.4 [4.6]), respectively. Early menopause was self-reported and defined as natural menopause before age 45 years. PDI was derived from semiquantitative food frequency questionnaires administered every 4 years. Cox proportional hazards models were used to assess the association between PDI in quintiles and early menopause in NHS and NHSII separately, and fixed-effect models to pool the results from both cohorts.
During follow-up, 715 and 2,185 women experienced early natural menopause in NHS and NHSII, respectively. After adjustment for potential confounders, no association was observed between PDI and incidence of early natural menopause in either cohort, or when pooling the results from both cohorts, with an exception for unhealthy plant-based diet index which was associated with higher risk of early menopause with increasing levels of consumption (P trend = 0.04).
Adherence to PDI was not associated with timing of menopause while unhealthy plant-based diet might be associated with higher risk of experiencing early menopause.
评估植物性饮食指数(PDI)与护士健康研究(NHS)和护士健康研究 II(NHSII)中自然绝经早期发病的相关性。
我们对美国各地的绝经前女性进行了一项前瞻性研究,中位随访时间为 20 年。NHS(n=121701)和 NHSII(n=116429)的参与者分别于 1984 年(年龄均值[标准差];44.9[4.3])和 1991 年(年龄均值[标准差];36.4[4.6])入组。早期绝经通过自我报告定义为 45 岁前自然绝经。PDI 源自每 4 年进行一次的半定量食物频率问卷。使用 Cox 比例风险模型分别评估 NHS 和 NHSII 中 PDI 五分位数与早期绝经之间的关联,并使用固定效应模型汇总两个队列的结果。
随访期间,NHS 和 NHSII 中分别有 715 名和 2185 名女性发生早期自然绝经。在调整了潜在混杂因素后,PDI 与两个队列中早期自然绝经的发生率之间没有关联,当汇总两个队列的结果时也是如此,只有不健康的植物性饮食指数例外,随着摄入量的增加,与更早绝经的风险增加相关(趋势 P=0.04)。
PDI 的依从性与绝经时间无关,而不健康的植物性饮食可能与更早绝经的风险增加相关。