Accessible Requires Authentication Published by De Gruyter March 7, 2015

Age at menarche and diet among adolescents in slums of Nashik, India

Sushama Khopkar, Sangita Kulathinal, Suvi M. Virtanen and Minna Säävälä

Abstract

Background and aim: The role of dietary patterns in determining age at menarche is insufficiently understood in low-income countries. The relationship between dietary patterns, particularly the consumption of oil, and age at menarche in a slum-dwelling adolescent population in India is examined.

Methods: Data were derived from a cross-sectional baseline survey and anthropometric measurements among 10- to 19-year-old adolescents (n=545, female respondents 272, of whom 160 were post-menarcheal) and a household survey in two slums in the city of Nashik, Western India. By using mixed effects linear regression models, the association between age at menarche and household-wise use of sources of animal protein and oil and fat is examined.

Results: Age at menarche (mean 13.7 years) in the slums studied was relatively high according to Indian standards. Age at menarche and the consumption of dairy products, meat, fish and eggs were not associated. The household per capita consumption of vegetable oil had an inverse association with a girl’s age at menarche, and there was an indication of a positive association between use of ghee (clarified butter) and age at menarche. These associations did not disappear when controlling for anthropometric status and socio-economic characteristics.

Conclusion: Intake of fats and foods that are important sources of protein among underprivileged households in India is low and reflected in the relatively late age at menarche. The potential differences in the association between various types of fatty acids, energy intake and age at menarche in conditions of undernutrition requires further prospective study.


Corresponding author: Minna Säävälä, PhD, Adjunct Professor, Population Research Institute, University of Helsinki, Vaestoliitto, PO Box 849, 00101 Helsinki, Finland, Phone: +358-40-573 6557, E-mail:

Acknowledgments

This study was made possible by Khopkar’s scholarship from the International Postgraduate Program in Epidemiology and Public Health (IPPE) at the School of Health Sciences, University of Tampere, Finland, and by Kulathinal’s and Säävälä’s scholarship from Kone Foundation. We thank the funding agencies for their support.

Potential conflicts of interest, real or perceived: None.

References

1. Sloboda DM, Hickey M, Hart R. Reproduction in females: the role of the early life environment. Hum Reprod Update 2011;17:210–27. Search in Google Scholar

2. Parent A-S, Teilmann G, Juul A, Skakkebaek NE, Toppari J, et al. The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev 2003;24:668–93. Search in Google Scholar

3. Karlberg J. Secular trends in pubertal development. Horm Res 2002;57(Suppl 2):19–30. Search in Google Scholar

4. Rao S, Joshi S, Kanade A. Height velocity, body fat and menarcheal age of Indian girls. Indian Pediatr 1998;35:619–28. Search in Google Scholar

5. Thomas F, Renaud F, Benefice E, de Meeüs T, Guegan JF. International variability of ages at menarche and menopause: patterns and main determinants. Hum Biol 2001;73:271–90. Search in Google Scholar

6. Rogers IS, Northstone K, Dunger DB, Cooper AR, Ness AR, et al. Diet throughout childhood and age at menarche in a contemporary cohort of British girls. Public Health Nutr 2010;13:2052–63. Search in Google Scholar

7. Wiley AS. Milk intake and total dairy consumption: associations with early menarche in NHANES 1999–2004. PLoS One 2011;6:e14685. Search in Google Scholar

8. Berkey CS, Gardner JD, Frazier AL, Colditz GA. Relation of childhood diet and body size to menarche and adolescent growth in girls. Am J Epidemiol 2000;152:446–52. Search in Google Scholar

9. Kralj-Čerček L. The influence of food, body fluid and social origin on the age at menarche. Hum Biol 1956;28:393–406. Search in Google Scholar

10. Günther ALB, Karaolis-Danckert N, Kroke A, Remer T, Buyken AE. Dietary protein intake throughout childhood is associated with the timing of puberty. J Nutr 2010;140:565–71. Search in Google Scholar

11. Maclure M, Travis LB, Willett WC, MacMahon B. A prospective cohort study of nutrient intake and age at menarche. Am J Clin Nutr 1991;54:649–56. Search in Google Scholar

12. Moisan J, Meyer F, Gingras S. Diet and age at menarche. Cancer Causes Control 1990;1:149–54. Search in Google Scholar

13. Petridou E, Syrigou E, Toupadaki N, Zavitsanos X, Willett W, et al. Determinants of age at menarche as early life predictors of breast cancer risk. Int J Cancer 1996;68:193–8. Search in Google Scholar

14. Bagga A, Kulkarni S. Age at menarche and secular trend in Maharashtrian (Indian) girls. Acta Biol Szege 2000;44:53–7. Search in Google Scholar

15. Rokade S, Mane A. A study of age at menarche, the secular trend and factors associated with it. Internet J Biol Anthropol 2008;3:2. Available at: http://ispub.com/IJBA/3/2/7469#. Accessed 19 June 2014. Search in Google Scholar

16. Atay Z, Turan S, Guran T, Furman A, Bereket A. Puberty and influencing factors in schoolgirls living in Istanbul: end of the secular trend? Pediatrics 2011;128:e40. DOI: 10.1542/peds.2010–2267. Search in Google Scholar

17. Zhu K, Zhang Q, Foo LH, Trube A, Ma G, et al. Growth, bone mass, and vitamin D status of Chinese adolescent girls 3 y after withdrawal of milk supplementation. Am J Clin Nutr 2006;83:714–21. Search in Google Scholar

18. Kwok MK, Leung GM, Lam TH, Schooling CM. Breastfeeding, childhood milk consumption, and onset of puberty. Pediatrics 2012;130;e631. Search in Google Scholar

19. Ramezani Tehrani F, Moslehi N, Asghari G, Gholami R, Mirmiran P, et al. Intake of dairy products, calcium, magnesium, and phosphorus in childhood and age at menarche in the Tehran Lipid and Glucose Study. PLoS One 2013;8:e57696. Search in Google Scholar

20. International Institute for Population Sciences (IIPS) & Macro International. National Family Health Survey (NFHS-3), 2005–06: India: Volume I. International Institute for Population Sciences, Mumbai, 2007. Search in Google Scholar

21. Moral R, Escrich R, Solanas M, Vela E, Costa I, et al. Diets high in corn oil or extra-virgin olive oil provided from weaning advance sexual maturation and differentially modify susceptibility to mammary carcinogenesis in female rats. Nutr Cancer 2011;63:410–20. Search in Google Scholar

22. R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Available at: http://www.R-project.org/. Accessed 13 August 2014. Search in Google Scholar

23. Bates D, Maechler M, Bolker B, Walker S. lme4: Linear mixed-effects models using Eigen and S4. R package version 1.1-7. Available at: http://CRAN.R-project.org/package=lme4. Accessed 13 August 2014a. Search in Google Scholar

24. Bates D, Maechler M, Bolker BM, Walker S. lme4: Linear mixed-effects models using Eigen and S4. ArXiv e-print; submitted to Journal of Statistical Software. Available at: http://arxiv.org/abs/1406.5823. Accessed 13 August 2014b. Search in Google Scholar

25. Government of India, Press Information Bureau. Planning commission, poverty estimates for 2009–10. Available at: http://pib.nic.in/newsite/erelease.aspx?relid=81151. Accessed 30 July 2014. Search in Google Scholar

26. Dhambare DG, Wagh SV, Dudhe JY. Age at menarche and menstrual cycle pattern among school adolescent girls in central India. Glob J Health Sci 2012;4:105–11. Search in Google Scholar

27. International Institute for Population Sciences (IIPS) and Population Council. Youth in India: situation and needs 2006–2007. Mumbai: IIPS, 2010. Search in Google Scholar

28. Bosch AM, Willekens FJ, Baqui AH, Van Ginneken JK, Hutter I. Association between age at menarche and early-life nutritional status in rural Bangladesh. J Biosoc Sci 2008;40: 223–37. Search in Google Scholar

29. Rah JH, Abu AS, Ummeh TA, Labrique AB, Rashid M, et al. Age of onset, nutritional determinants, and seasonal variations in menarche in rural Bangladesh. J Health Popul Nutr 2009;27:802–7. Search in Google Scholar

30. United States Department of Agriculture (USDA). Nutrient database, Release 25. Available at: http://ndb.nal.usda.gov/. Accessed 10 June 2014. Search in Google Scholar

31. Deaton A, Drèze J. Food and nutrition in India: facts and interpretations. Econ Polit Wkly 2009;44:42–65. Search in Google Scholar

32. Jacobsen BK, Heuch I, Kvåle G. Association of low age at menarche with increased all-cause mortality: a 37-year follow-up of 61,319 Norwegian women. Am J Epidemiol 2007;166:1431–7. Search in Google Scholar

Received: 2014-9-16
Accepted: 2015-1-1
Published Online: 2015-3-7
Published in Print: 2015-11-1

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