Davis C P, Fest S, Cushing-Haugen K, Kensler T W, Chavarro J E, Harris H R
Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.
Hum Reprod. 2025 Jun 1;40(6):1087-1093. doi: 10.1093/humrep/deaf072.
Are dietary patterns associated with age at menarche after accounting for BMI-for-age (BMIz) and height?
We observed associations between both the Alternative Healthy Eating Index (AHEI) and the Empirical Dietary Inflammatory Pattern (EDIP) and age at menarche.
Dietary patterns have been sparsely examined in relation to age at menarche and no studies have examined the association between the AHEI, a healthier diet, and EDIP, a pro-inflammatory diet, and menarche.
STUDY DESIGN, SIZE, DURATION: The Growing Up Today Study (GUTS) is a prospective cohort of children ages 9-14 years at study enrollment. GUTS enrolled in two waves with enrollment beginning in 1996 (GUTS1) and 2004 (GUTS2). For this analysis, GUTS1 and GUTS2 participants were followed through 2001 and 2008, respectively.
PARTICIPANTS/MATERIALS, SETTING, METHODS: We included 7530 participants who completed food frequency questionnaire(s) (FFQ) prior to menarche who then self-reported age at menarche during study follow-up. Cox proportional hazard models were used to calculate multivariable hazard ratios (HRs) and 95% CIs for the associations between two dietary patterns, the AHEI and EDIP, and age at menarche, with and without adjustment for time-varying BMIz and height.
Six thousand nine hundred ninety-two participants (93%) reported menarche during the study period. On average, participants completed the baseline FFQ 1.75 years prior to menarche. Participants in the highest quintile of AHEI diet score (indicating a healthier diet) were 8% less likely to attain menarche within the next month compared to those in the lowest quintile (95% CI = 0.85-0.99; Ptrend = 0.03). This association remained after adjustment for BMIz and height (corresponding HR = 0.93; 95% CI = 0.86-1.00; Ptrend = 0.04). Participants in the highest quintile of the EDIP score (i.e. most inflammatory diet), were 15% more likely to attain menarche in the next month relative to those in the lowest quintile (95% CI = 1.06-1.25; Ptrend = 0.0004), and the association remained following adjustment for BMIz and height (corresponding HR = 1.15; 95% CI = 1.06-1.25; Ptrend = 0.0004).
LIMITATIONS, REASONS FOR CAUTION: Self-reported questionnaires are subject to some error; however, given our prospective study design it is likely this error is non-differential with respect to the outcome.
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.
STUDY FUNDING/COMPETING INTEREST(S): This work was supported by the Breast Cancer Research Foundation. The GUTS is supported by the National Institutes of Health U01 HL145386. C.P.D. was supported by National Institutes of Health T32 CA094880. The authors have no conflicts of interest to disclose.
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在考虑年龄别体重指数（BMIz）和身高后，饮食模式与初潮年龄是否相关？
我们观察到替代健康饮食指数（AHEI）和经验性饮食炎症模式（EDIP）与初潮年龄之间均存在关联。
关于饮食模式与初潮年龄的关系研究较少，尚无研究探讨更健康的饮食模式AHEI和促炎饮食模式EDIP与初潮之间的关联。
研究设计、规模、持续时间：“今日成长研究”（GUTS）是一项针对入组时年龄在9至14岁儿童的前瞻性队列研究。GUTS分两批招募，始于1996年（GUTS1）和2004年（GUTS2）。本次分析中，GUTS1和GUTS2的参与者分别随访至2001年和2008年。
参与者/材料、研究环境、方法：我们纳入了7530名在初潮前完成食物频率问卷（FFQ）且在研究随访期间自行报告初潮年龄的参与者。使用Cox比例风险模型计算两种饮食模式（AHEI和EDIP）与初潮年龄之间关联的多变量风险比（HR）和95%置信区间（CI），并对时变BMIz和身高进行了调整与未调整分析。
6992名参与者（93%）在研究期间报告了初潮情况。平均而言，参与者在初潮前1.75年完成了基线FFQ。AHEI饮食评分最高五分位数的参与者（表明饮食更健康）与最低五分位数的参与者相比，在下个月初潮的可能性低8%（95%CI = 0.85 - 0.99；P趋势 = 0.03）。在对BMIz和身高进行调整后，这种关联仍然存在（相应HR = 0.93；95%CI = 0.86 - 1.00；P趋势 = 0.04）。EDIP评分最高五分位数的参与者（即炎症性最强的饮食）与最低五分位数的参与者相比，在下个月初潮的可能性高15%（95%CI = 1.06 - 1.25；P趋势 = 0.0004），在对BMIz和身高进行调整后，这种关联仍然存在（相应HR = 1.15；95%CI = 1.06 - 1.25；P趋势 = 0.0004）。
局限性、谨慎的原因：自我报告的问卷存在一定误差；然而，鉴于我们的前瞻性研究设计，这种误差可能与结果无关。
我们发现AHEI和EDIP与初潮年龄之间均存在关联，这表明饮食质量可能在初潮年龄中发挥作用，且独立于BMI或身高。
研究资金/竞争利益：这项工作得到了乳腺癌研究基金会的支持。GUTS由美国国立卫生研究院U01 HL145386资助。C.P.D.由美国国立卫生研究院T32 CA094880资助。作者没有利益冲突需要披露。
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