Childhood Diet Quality Influences Age of First Period

New research published in Human Reproduction has uncovered a significant connection between childhood dietary patterns and the timing of a girl’s first menstrual period, independent of body weight or height.

The study, following over 7,500 girls for several years, found that those who consumed healthier diets experienced menarche at a later age—a finding with potentially far-reaching implications for women’s lifelong health. This research offers new insights into how nutrition during childhood might influence reproductive development and provides compelling evidence that dietary interventions could help mitigate risk factors for serious health conditions later in life, including diabetes, cardiovascular disease, and breast cancer.

The large-scale investigation, led by researchers at Fred Hutchinson Cancer Center and published May 7, 2025, is the first to examine specific dietary patterns in relation to menstrual timing while also analyzing whether body size modified these associations—a critical advancement in understanding the complex relationship between nutrition and female reproductive development.

Diet Quality Linked to Menstrual Timing, Regardless of Body Size

Using data from the Growing Up Today Study (GUTS), researchers tracked nearly 7,000 girls from childhood through adolescence, gathering detailed information about their eating habits before their first period and then monitoring when menarche occurred. The participants completed food frequency questionnaires every one to three years, allowing researchers to assess their diets against two established dietary patterns.

The results were striking: girls whose diets ranked in the top fifth for healthfulness (as measured by the Alternative Healthy Eating Index) were 8% less likely to start menstruating in any given month compared to those with the least healthy diets. Conversely, girls whose diets were most inflammatory (ranking in the top fifth of the Empirical Dietary Inflammatory Pattern scale) showed a 15% increased likelihood of beginning menstruation in the next month.

“We observed that these two dietary patterns were associated with age at menarche, indicating that a healthier diet was linked to menstrual periods starting at an older age,” explained Holly Harris, MPH, ScD, an associate professor at the Fred Hutchinson Cancer Center who led the study. “Importantly, these results were independent of BMI and height, demonstrating the importance of a healthy diet regardless of body size.”

Key Findings About Diet and Menstruation Timing

• Healthier diets rich in vegetables, legumes, and whole grains were associated with later onset of menstruation
• Diets promoting inflammation (high in red/processed meats and refined grains) were linked to earlier menstruation
• These associations persisted even after accounting for BMI and height
• The relationship between diet and menstruation timing was observed across weight categories
• 93% of the study participants (6,992 girls) experienced menarche during the research period
• On average, participants completed their baseline dietary questionnaire 1.75 years before menarche

Implications for Long-Term Health

The findings have particular significance because early menstruation has been consistently linked to increased health risks later in life. Previous research has established that women who begin menstruating at younger ages face higher risks of several serious health conditions.

“As earlier age at menarche is associated with multiple later life outcomes, including higher risk of diabetes, obesity, cardiovascular disease and breast cancer, this may be an important period for trying to reduce the risk of these chronic diseases,” noted Harris.

What makes this study particularly valuable is its prospective design—researchers collected data on diet before participants began menstruating, rather than asking them to recall information after the fact. This approach reduces the likelihood of recall bias and strengthens the reliability of the findings.

The Role of Inflammation vs. Body Size

While previous studies have established connections between body size and menstruation timing, this research suggests that dietary inflammation may be an independent pathway influencing reproductive development. The study measured diets using two key metrics: the Alternative Healthy Eating Index (AHEI), which scores diets based on overall healthfulness, and the Empirical Dietary Inflammatory Pattern (EDIP), which evaluates a diet’s inflammatory potential.

Statistical analysis revealed that neither BMI nor height substantially mediated the relationship between dietary patterns and menstruation timing. This finding challenges previous assumptions that diet’s effect on menstruation timing works primarily through changes in body size.

Could inflammation rather than weight be the key mechanism? The researchers believe their findings suggest that “the type of food eaten by girls during childhood and adolescence and its impact on inflammation may be what is influencing the time of menarche, rather than height and BMI.”

Practical Implications for Families and Public Health

These findings underscore the importance of promoting healthy eating patterns during childhood and adolescence—not just for immediate health benefits, but potentially for reproductive development and long-term disease prevention.

“I think our findings highlight the need for all children and adolescents to have access to healthy meal options, and the importance of school-based breakfasts and lunches being based on evidence-based guidelines,” Harris emphasized.

What constitutes a beneficial diet pattern? The researchers point to specific dietary components that appear most influential: “Generally, eating fruits, vegetables, whole grains, fatty fish, nuts and legumes, polyunsaturated fatty acids, while limiting intake of red and processed meats, refined grains, sugar-sweetened beverages and added salt, benefits everyone regardless of age,” said Harris.

While this study focused on a predominantly white population in the United States, researchers plan to examine whether these patterns hold across different racial and ethnic groups. They are also planning to investigate how childhood dietary patterns might affect menstrual cycle characteristics into adulthood.

As the first study to connect these specific dietary patterns with menstruation timing, this research opens a promising avenue for understanding how early-life nutrition might influence reproductive development and potentially modify disease risk throughout a woman’s life.