Abstract
BackgroundDiet has been suggested to play a role in determining the age at natural menopause; however, the evidence is inconsistent. ObjectiveWe systematically reviewed and evaluated published research about associations between diet and onset of natural menopause (ONM). MethodsWe searched 6 databases (Medline, Embase, Cochrane, PubMed, Web of Science and Google Scholar) through January 21,2021 to identify prospective studies assessing the association between diet and ONM. Two independent reviewers extracted data using a predesigned data-collection form. Pooled hazard risks (HRs) were calculated using random effect models. ResultsOf the 6,137 eligible references we reviewed, we included 15 articles in our final analysis. Those 15 articles included 91,554 women out of 298,413 who experienced natural menopause during follow-up. Overall, there were 89 food groups investigated, 38 macronutrients and micronutrients, and 6 dietary patterns. Among the food groups, higher intake of green and yellow vegetables was associated with earlier age of ONM, while high intakes of some dairy products, such as low-fat, skimmed milk, and low intake of alcohol were associated with a later onset. We observed no consistent association between macronutrient and micronutrient intake and ONM. Our results suggests that a vegetarian diet could be associated with early ONM; we did not observe any other consistent effect from other dietary patterns. Limitations included the number of studies, lack of replication studies and the research being of an observational nature; most studies (11/15) were at medium risk of bias. ConclusionAlthough some food items were associated with ONM, the overall evidence about associations between diet and ONM remains controversial.Prospero id: CRD42021232087
Highlights
Menopause represents the end of reproductive years due to the ultimate decrease in follicular activity [1]
It is an unavoidable event of aging and occurs naturally between the ages of 50 and 52, with 95% of women having final menstrual period between ages 44 and 56; due to Abbreviations: AMH, anti-Müllerian hormone; CI, confidence interval; HR, hazard ratio; NHSII, Nurses’ Health Study II; NOS, Nine-star Newcastle-Ottawa Scale; ONM, onset of natural menopause; odds ratio (OR), odd ratio; SD, standard deviation; UKWCS, UK Women’s Cohort Study
High consumption of refined pasta and rice was associated with an earlier age at natural menopause, while high intakes of oily fish, fresh legumes and plant-based proteins was associated with a lower risk of early natural menopause [10]
Summary
Menopause represents the end of reproductive years due to the ultimate decrease in follicular activity [1]. Late menopause (at age 55 years or older) is associated with an increased risk of ovarian, endometrial and breast cancer [4] Understanding factors, such as diet, that can influence the timing of natural menopause has emerged as an important and relevant public health topic in reducing adverse outcomes related to early or late natural menopause, or the impact on family planning. Some studies have reported genetic factors have a relatively small influence on the variation of menopausal timing, yet emerging evidence suggests that modifiable lifestyle factors, such as diet (e.g., food groups or dietary patterns), may play an important role in ovarian aging [6,7,8]. Our results suggests that a vegetarian diet could be associated with early ONM; we did not observe any other consistent effect from other dietary patterns.
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