New insights into the association of mid-childhood macronutrient intake to pubertal development in adolescence using nutritional geometry

Abstract

Nutritional geometry (NG) is a novel dietary analysis approach that considers nutrient balance, rather than single nutrient effects, on health and behaviour. Through NG, recent animal experiments have found that lifespan and reproduction are differentially altered by dietary macronutrient distribution. Epidemiological research using NG reports similar findings for human ageing. Yet, the relation of macronutrient balance to human reproduction, especially reproductive maturation, remains undefined. We studied the impact of childhood macronutrient intake on pubertal maturation, by applying NG to an Australian longitudinal adolescent dataset. Food records, collected at age 8 years from 142 pre-pubertal children (females, 92; males, 50), were analysed for absolute energy, percentage energy and energy-adjusted residuals from protein, carbohydrate and fat. Pubertal stage change (assessed at 8, 13 and 15 years) was modelled to obtain individual mathematical estimates of pubertal timing and tempo. Timing of menarche was recorded. The association of macronutrients to pubertal timing/tempo was assessed via NG, involving generalised additive models and heat maps to aid interpretation. Results showed lower dietary protein (relative to carbohydrate and fat) in girls consistently predicted earlier pubertal timing and menarche, and was related to faster pubertal tempo (all P < 0·05). No significant associations were identified in boys for both timing and tempo. Results suggest a role of non-protein macronutrients in facilitating female maturation; corroborating feeding and reproductive behaviour patterns observed in earlier NG studies of primates. Application of NG to other adolescent datasets is required to confirm the present findings. Such work would advance understanding of how nutrient balance shapes human development and health.

A Systematic Literature Review of Factors Affecting the Timing of Menarche: The Potential for Climate Change to Impact Women’s Health

“…The variables associated with late menarche included high vegetable intake [36], flavonol intake [41], and food insecurity [42]. Another study found that nutritional geometry and lower dietary protein (relative to carbohydrates and fats) predicted early puberty and timing of menarche, suggesting that non-protein macronutrients are also important [43]. This seems to contradict earlier studies that suggested that high protein intake was associated with early menarche [36], indicating that perhaps it is the relative balance of nutrients (protein vs. carbohydrates and fats) [43] that ultimately plays a role in timing of menarche.…”

“…Taken together, these studies indicate that the appropriate intake of protein, vegetables, leptin, flavonols, and soy is necessary for normal timing of menarche. Additionally, a study by Cheng et al found that the relative balance of nutrients (protein vs. carbohydrates and fats) [43] ultimately plays an important role in timing of menarche. In summary, the ratios of these dietary food stuffs can result in either early or late menarche, which have both been linked with specific disease consequences ( Figure 3C).…”

Children with Early Sexual Maturation Exhibit Changes in Dairy and Soybean Consumption: A 6-Year Nationwide Study

“…Similarly, Chen et al [11] found no association between precocious puberty and "traditional diet" included white meat, seafood, vegetables, fruits, and dairy products. Our "traditional diet" pattern included a high intake of animal protein which has been found not associated with early menarche [39,40]. Meat consumption was not associated with IGF-1 and IGF-binding protein 3 levels that regulate growth and pubertal development [41,42].…”

The overall diet quality in childhood is prospectively associated with the timing of puberty

“…To date, the influence of modifiable risk factors such as nutrition on puberty onset has been addressed: some [10][11][12], but not all [13][14][15] prospective observational studies suggested a role for dietary intakes of nutrients or food groups during pre-puberty: higher energy intake [16] and intakes of animal protein [10,12], milk [17,18], red meat [11], and sweetened soft drinks [19,20] were associated with earlier menarche, whereas higher intakes of total protein [21], carbohydrate [16], fiber [22], isoflavones [23], or yogurt [24] were related to later menarche. However, most of these studies [10][11][12][13][14][15][17][18][19][20][21][22][23][24] were focused solely on a single pubertal marker. The use of different pubertal markers covering the range from earlier [pubertal stage 2 for breast in girls/genital development in boys (B2/G2)] to later stages [menarche in girls or voice break in boys (M/VB)] of pubertal development might help to elucidate potential mechanisms involved.…”

“…The use of different pubertal markers covering the range from earlier [pubertal stage 2 for breast in girls/genital development in boys (B2/G2)] to later stages [menarche in girls or voice break in boys (M/VB)] of pubertal development might help to elucidate potential mechanisms involved. Moreover, most of the above studies [10][11][12][13][14][15][17][18][19][20][21][22][23][24] were conducted in Western countries. In recent years, a secular trend of earlier puberty onset has been observed in both Chinese boys [25] and girls [26].…”