Nutrient Intake through Childhood and Early Menarche Onset in Girls: Systematic Review and Meta-Analysis.

Ngan Thi Kim Nguyen,Shih-Yi Huang,Hsien-Yu Fan,Quynh Thi Vu Huynh,Yang Ching Chen,Meng-Che Tsai,Te-Hsuan Tung

doi:10.3390/nu12092544

Abstract

Among the genetic and environmental risk factors, nutrition plays a crucial role in determining the timing of puberty. Early menarche onset (EMO) is defined as when girls reach menarche onset at an age which is earlier than the mean/median age of menarche, between 12 and 13 years of age, according to individual ethnicity. The present study examined the association between nutrient intake in childhood and EMO risk in healthy girls by performing a systematic review and meta-analysis of prospective studies. We screened EMBASE, Cochrane Library, PubMed/MEDLINE, and Web of Science databases for 16 eligible studies with all medium-to-high quality scores ranging from 3 to 5 of 6 possible points with 10,884 subjects. Higher intakes of energy (risk ratio (RR) = 3.32, 95% confidence interval (CI) = 1.74–6.34, I2 = 97%), and protein (RR = 3.15, 95% CI = 2.87–3.44, I2 = 0%) were associated with EMO risk. For each additional 1 g/day animal protein intake in childhood, the age at menarche was approximately two months earlier (β = −0.13, I2 = 55%), and high iron intake was associated with EMO (RR = 1.20, 95% CI = 1.03–1.40, I2 = 0%). Polyunsaturated fatty acid (PUFAs) intake was associated with EMO risk with a dose-response effect (RR = 1.25, 95% CI = 1.05–1.49, I2 = 44%). Girls with a high intake of fiber and monosaturated fatty acids (MUFAs) in childhood experienced later menarche onset (RR = 0.83, 95% CI = 0.69–1.00, I2 = 31%; RR = 0.66, 95% CI = 0.50–0.86, I2 = 0%, respectively). Thus, adherence to a high intake of animal proteins-, iron- and PUFA-rich food diet makes girls more likely to have EMO, while a high intake of fiber- and MUFA-rich foods may protect girls from EMO. Further studies are expected to investigate the role of specific types of PUFAs and MUFAs on EMO to promote healthy sexual maturity in girls.

Highlights

Since the late 19th century, early puberty onset, defined by a decreased mean age at menarche (AAM), has been noted as a global trend [1]
16 longitudinal studies involving 10,884 girls were selected for systematic review and meta-analysis in the present study (Figure 1)
We found that the dose-response effect of fiber intake in childhood was likely associated with a delayed menarche onset

Summary

Introduction

Since the late 19th century, early puberty onset, defined by a decreased mean age at menarche (AAM), has been noted as a global trend [1]. The first menstrual period, is a widely used variable in epidemiological studies because it is a clear sign, is well-recalled, and occurs relatively late, between 12 and 13 years of age, and after the onset of breast development and the growth spurt in girls [2,3]. Of the genetic and environmental risk factors, nutrition plays a crucial role in determining the timing of puberty [1]. Sexual maturation is sensitive to nutritional regulation that requires the appropriate dietary intake for healthy pubertal growth. Investigations of nutrient intake in association with EMO might provide valuable information for further research on exploring the mechanism

Methods

Discussion

Conclusion