gms | German Medical Science

50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Reproductive and dietary determinants of the age at natural menopause in EPIC-Heidelberg

Meeting Abstract

  • Gabriele Nagel - Deutsches Krebsforschungszentrum, Heidelberg
  • Hans-Peter Altenburg - Deutsches Krebsforschungszentrum, Heidelberg
  • Alexandra Nieters - Deutsches Krebsforschungszentrum, Heidelberg
  • Paolo Boffetta - IARC, Lyon
  • Jakob Linseisen - Deutsches Krebsforschungszentrum, Heidelberg

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds333

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2005/05gmds150.shtml

Veröffentlicht: 8. September 2005

© 2005 Nagel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objectives

The menopausal status is an important determinant for the development of some tumours as well as of other chronic diseases. Smoking, socio-economic class and parity was associated with age at menopause. Also dietary factors with antioxidative or hormone-related properties were found to influence the onset of menopause, but studies on diet-related factors and the age of menopause are scarce. The aim of the study, therefore, was to explore the influence of reproductive and dietary factors on the age at natural menopause.

Material and Methods

The European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg is a prospective cohort study to investigate of the association between diet, lifestyle and chronic diseases with emphasis on cancer. Between 1994 and 1998, 13,612 women aged 35 to 65 years were recruited, of which 6098 women without self-report of cancer, hysterectomy or ovarectomy (uni- or bilateral) were menstruating. Women with extreme values of total energy intake (below 1000 or above 7500 kcal/day) and women in perimenopausal state were excluded. During the follow-up of the cohort (mean duration 5.8 years) 1009 women experienced natural menopause, which was defined as 12 consecutive months of amenorrhoea. They were compared to 3798 women who did not experience menopause.

Baseline dietary intake at food group level and alcohol consumption was calculated based on the data collected with a self-administered and validated food frequency questionnaire. Data on reproductive history and medication was collected using questionnaires. Nutrient intake data were calculated from the food intake data by means of the German Food Composition Table BLS, Version II.3. Cox’ proportional hazard models were used in order to identify determinants of the age at natural menopause.

Results

Compared to nullipara, women with 1 to 2 children experienced menopause at older age (HR: 0.74, 95% CI: 0.62-0.87). Breast feeding for 1-5 months was associated with older age at menopause (HR: 0.81; 95% CI: 0.69- 0.94). A longer interval between menarche and the onset of regular menses was associated with later menopause (p for trend 0.012). Smoking at enrolment in the study was related to younger age at menopause, whereas for ex-smokers no effect on the age at menopause was found.

High carbohydrate consumption and high intake of vegetables, fibre, and cereal products was associated with earlier onset of natural menopause. High total fat consumption was associated with delayed menopause. Additionally, increasing meat intake was associated with later menopause (p for trend = 0.046), as was, in tendency, protein intake (p for trend=0.086).

Discussion

The results of this prospective study confirm the established association between current smoking and younger age at menopause. Older age at the first full term pregnancy and the time between menarche and, in particular, the onset of regular menses were associated with older age at menopause. In addition, associations between dietary factors and the age at natural menopause were observed. Further studies including biological markers are needed to clarify these associations.

Acknowledgement

Supported by grants from the European Community (SI2.326938) and Deutsche Krebshilfe e.V. (70-2488).