Wednesday, May 2, 2018

Wisdom Wednesday: Dietary Intake and Age at Natural Menopause

Age at natural menopause is a matter of concern for women of reproductive age as both an early or late menopause may have implications for health outcomes.

Study participants were women aged 40-65 years who had experienced a natural menopause from the UK Women’s Cohort Study between baseline and the first follow-up. Natural menopause was defined as the permanent cessation of menstrual periods for at least 12 consecutive months. A food frequency questionnaire was used to estimate diet at baseline. Reproductive history of participants was also recorded. Regression modeling, adjusting for confounders, was used to assess associations between diet and age at natural menopause.

During the 4-year follow-up period, 914 women experienced a natural menopause. A high intake of oily fish and fresh legumes were associated with delayed onset of natural menopause by 3.3 years per portion/day and 0.9 years per portion/day respectively. Refined pasta and rice was associated with earlier menopause. A higher intake of vitamin B6 and zinc was also associated with later age at menopause. Stratification by age at baseline led to attenuated results.

Our results suggest that some food groups and specific nutrients are individually predictive of age at natural menopause.

My Take:
This is the abstract minus some of the statistical analysis. Several studies had shown an association between early onset of menopause and lower bone density, osteoporosis, depression and premature death. Other studies indicate an increased risk of cardiovascular and coronary diseases. However, late menopause has been associated with a higher risk for breast, ovarian and endometrial cancers.

Obviously, there are many other factors affecting the onset of menopause – genetic, environmental, hormonal and general health issues to list a few. But the link between diet is intriguing.

The epidemiologists hypothesized that intake of healthier food groups such as fruits and vegetables would be associated with an earlier menopause while a high consumption of meat and processed meat would delay the onset of menopause. Although the data does not support their theories, the high hormone levels in processed meats are associated with early onset of puberty.

Food questionnaires can be flawed because they require self-reporting. However, the study went to great lengths to chart food intake. They listed 217 food items and cross-correlated the list against a 4-day food diary was well as fasting blood measures of specific nutrients.

The oily fish and fresh legumes are high in omega fatty acids, of which the omega 3’s and 6’s are essential in the human diet. While we tend to think of the anti-inflammatory properties of these oils, the omega-6 fatty acids are hormone precursors. It follows that a diet rich in these foods might support a women’s reproductive cycle for a longer time.

The refined food diet obviously leads to long-term dietary deficiencies that fail to support continuation of the menstrual cycle.

The Bottom Line:
Despite the health risks and benefits associated with both early and late onset of menopause, I must recommend the diet high in oily fish and fresh legumes. The Mediterranean style diet has broad-based health benefits documented in several studies.

Source: April 30, 2018 Journal of Epidemiology

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