Association between Healthy Eating Index-2015 total and component food scores with reproductive lifespan among postmenopausal women: a population-based study from NHANES 2005-2016.

Background: Prior research has demonstrated that nutrition plays a crucial role in the establishment and maturation of the reproductive lifetime. Although the specific dietary components involved in preventing or postponing the reproductive lifespan are still unknown, a healthy diet can affect the reproductive lifespan. Here, the study aimed to explore the relationship between reproductive lifespan and diet quality by utilizing the Healthy Eating Index-2015 (HEI-2015).

Methods: In this study, a total of 2761 postmenopausal women were selected from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2016. Diet quality was determined using HEI-2015 based on two 24-hour dietary recalls. Reproductive lifespan was defined as the number of years between self-reported age at menarche and menopause. Weighted linear regression and eXtreme Gradient Boosting (XGBoost) models were used to analyze the relationship between HEI-2015 and reproductive lifespan. Subsequently, the impact of various components of HEI-2015 on reproductive lifespan was assessed through weighted quantile sum (WQS) regression models.

Results: Among 2761 postmenopausal women, the mean age was 63.7 years. 41.5% were obese, and 49.7% were non-Hispanic white. After adjusting for sociodemographic characteristics, lifestyle factors, and medical history, individuals in the highest tertile of HEI-2015 had a 4.81% (95% CI: 1.82-7.79%) longer reproductive time life. Higher HEI-2015 was also significantly associated with a higher likelihood of late menopause (p for trend < 0.05). Based on XGBoost models, the relative importance of HEI-2015 on reproductive lifespan was determined. Whole fruits, whole grains, total protein foods, and greens and beans significantly contributed to extending age at menopause and reproductive time life in the HEI-2015. The weights of the WQS index for age at menopause were 27.1%, 23.2%, 10.1%, and 7.5% respectively, while the weights of the WQS index for reproductive time life were 30.2%, 14.6%, 9.3%, and 14.0% respectively.

Conclusion: There is a positive association between the HEI-2015 and reproductive lifespan. This underscores the significance of enhancing adherence to healthy dietary patterns in preventing a shorter reproductive lifespan.