Human ReproductionDietary Patterns and Age at Menarche in a Prospective Study of Girls in the USA

This prospective cohort study from the Growing Up Today Study (GUTS) investigates how dietary patterns—specifically the Alternative Healthy Eating Index (AHEI) and the Empirical Dietary Inflammatory Pattern (EDIP)—relate to age at menarche. Associations were evaluated using Cox proportional hazards models, adjusting for BMI-for-age (BMIz) and height to isolate dietary effects.

⚕️ Key Clinical Considerations ⚕️

• Healthier Diet Delays Menarche: Girls in the highest AHEI quintile were 8% less likely to reach menarche in the next month (HR = 0.93; 95% CI = 0.86–1.00).
• Pro-inflammatory Diet Accelerates Menarche: Those in the highest EDIP quintile were 15% more likely to reach menarche (HR = 1.15; 95% CI = 1.06–1.25).
• Adjustment for Growth Metrics: Associations remained significant after controlling for BMIz and height, suggesting an independent dietary effect.
• Timing of Dietary Assessment: Baseline dietary data were collected on average 1.75 years before menarche, strengthening temporal inference.
• Study Cohort: Analysis included 7,530 participants from two GUTS cohorts, with 93% reporting menarche during follow-up.

🎯 Clinical Practice Impact 🎯

• Patient Communication: Clinicians can counsel families on how dietary quality may influence pubertal timing, independent of weight.
• Practice Integration: Pediatricians and dietitians may consider incorporating anti-inflammatory dietary guidance into anticipatory guidance.
• Risk Management: Early menarche is linked to long-term health risks; dietary interventions may offer a modifiable preventive strategy.
• Action Items: Screen for dietary patterns in preadolescents and promote AHEI-aligned eating habits.
• Resource Implications: May inform public health nutrition programs targeting early puberty prevention.

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