Age at menarche and general and abdominal obesity in older Brazilian women: ELSI-Brazil
DOI:
https://doi.org/10.11606/s1518-8787.2026060007243Palavras-chave:
Menarche, Waist Circumference, Body Mass Index, Obesity, Women's HealthResumo
OBJECTIVE: To examine the association between age at menarche and general and/or abdominal obesity in Brazilian women aged ≥ 50 years.
METHODS: Cross-sectional study conducted with data from the second wave of the Brazilian Longitudinal Study of Aging (Estudo Longitudinal da Saúde dos Idosos Brasileiros — ELSI (ELSI-Brazil, 2019–2021), in a nationally representative sample of community-dwelling individuals aged ≥ 50 years. Self-reported age at menarche was categorized as ≤ 12 years, 13–15 years, and ≥ 16 years. General obesity was defined as a body mass index of ≥ 30 kg/m2, and abdominal obesity as a waist circumference of ≥ 88 cm. The variables were combined into “general or abdominal obesity” and “general and abdominal obesity”. Multinomial logistic regression adjusted for sociodemographic and lifestyle characteristics was used.
RESULTS: Among the 4,229 participants, 41.1% (95% confidence interval —95%CI 37.9–44.3) reported menarche at ≤ 12 years and 9.3% (95%CI 8.0–10.9) at ≥ 16 years. The prevalence of general or abdominal obesity was 36.6% (95%CI 33.7–39.5), while the prevalence of general and abdominal obesity was 35.0% (95%CI 32.5–37.7). After adjustments, women with age at menarche of ≤ 12 and 13–15 years had, respectively, 84% (odds ratio — OR = 1.84; 95%CI 1.14–2.98) and 64% (OR = 1.64; 95%CI 1.04–2.57) greater odds of general and abdominal obesity compared with those with menarche at ≥ 16 years. There was no significant association between age at menarche and general or abdominal obesity.
CONCLUSION: Menarche before age 16 is associated with a higher odds of general and abdominal obesity combined, but not in isolation, suggesting its potential as a relevant marker for the formulation of public policies aimed at preventing obesity in girls from school age onwards.
Referências
1. Canelón SP, Boland MR. A systematic literature review of factors affecting the timing of menarche: the potential for climate change to impact women’s health. Int J Environ Res Public Health. 2020;17(5):1703. https://doi.org/10.3390/ijerph17051703
2. Yermachenko A, Dvornyk V. Nongenetic determinants of age at menarche: a systematic review. Biomed Res Int. 2014;2014:371583. https://doi.org/10.1155/2014/371583
3. Gallicchio L, Flaws JA, Smith RL. Age at menarche, androgen concentrations, and midlife obesity: findings from the Midlife Women’s Health Study. Menopause. 2016;23:1182-8. https://doi.org/10.1097/GME.0000000000000691
4. Newby PK, Dickman PW, Adami HO, Wolk A. Early anthropometric measures and reproductive factors as predictors of body mass index and obesity among older women. Int J Obes (Lond). 2005;29(9):1084-92. https://doi.org/10.1038/sj.ijo.0802996
5. Yang L, Li L, Millwood IY, Lewington S, Guo Y, Sherliker P, et al. Adiposity in relation to age at menarche and other reproductive factors among 300 000 Chinese women: findings from China Kadoorie Biobank study. Int J Epidemiol. 2017;46(2):502-12. https://doi.org/10.1093/ije/dyw165
6. Trikudanathan S, Pedley A, Massaro JM, Hoffmann U, Seely EW, Murabito JM, et al. Association of female reproductive factors with body composition: the Framingham Heart Study. J Clin Endocrinol Metab. 2013;98(1):236-44. https://doi.org/10.1210/jc.2012-1785
7. Devi KS, Dhall M, Kapoor S. Adiposity markers and its association with age at menarche: A comparative study among rural and urban Meitei females of Manipur, North-East India. Diabetes Metab Syndr. 2019;13(1):500-3. https://doi.org/10.1016/j.dsx.2018.11.028
8. Bleil ME, Appelhans BM, Adler NE, Gregorich SE, Sternfeld B, Cedars MI. Pubertal timing, androgens, and obesity phenotypes in women at midlife. J Clin Endocrinol Metab. 2012;97(10):E1948-52. https://doi.org/10.1210/jc.2012-1972
9. World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253. PMID: 11234459.
10. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva: World Health Organization; 2008.
11. Rubino F, Cummings DE, Eckel RH, Cohen RV, Wilding JPH, Brown WA, et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;13:221-62. https://doi.org/10.1016/S2213-8587(24)00316-4
12. Bosello O, Vanzo A. Obesity paradox and aging. Eat Weight Disord. 2021;26(1):27-35. https://doi.org/10.1007/s40519-019-00815-4
13. Fan H, Li X, Zheng L, Chen X, Lan Q, Wu H, et al. Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Sci Rep. 2016;6:21521. https://doi.org/10.1038/srep21521
14. Theodoro H, Rodrigues AD, Mendes KG, Liane RH, Paniz VMV, Olinto MTA. Reproductive characteristics and obesity in middle-aged women seen at an outpatient clinic in southern Brazil. Menopause. 2012;19(9):1022-8. https://doi.org/10.1097/gme.0b013e3182503834
15. Marinho MR, Garcez A, Theodoro H, Costa JSD, Olinto MTA. Prevalence of abdominal obesity and associated factors in urban Brazilian women: a comparison between two population-based cross-sectional studies in 2003 and 2015. Metab Syndr Relat Disord. 2024;22(1):59-68. https://doi.org/10.1089/met.2023.0069
16. World Health Organization. Progress on drinking water, sanitation and hygiene in schools 2015–2023: special focus on menstrual health. New York: World Health Organization; 2024.
17. Martinho LCAP. Associação entre idade na menarca e fatores de risco cardiovascular em uma população brasileira: Estudo Corações de Baependi [dissertação]. Manaus: Universidade Federal do Amazonas; 2024.
18. Lima-Costa MF, Andrade FB, Souza Jr PRB, Neri AL, Duarte YAO, Castro-Costa E, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): objectives and design. Am J Epidemiol. 2018;187(7):1345-53. https://doi.org/10.1093/aje/kwx387
19. Lima-Costa MF, Mambrini JVM, Andrade FB, Souza PRB, Vasconcellos MTL, Neri AL, et al. Cohort profile: the Brazilian Longitudinal Study of Ageing (ELSI-Brazil). Int J Epidemiol. 2023;52(1):e57-e65. https://doi.org/10.1093/ije/dyac132
20. Ygnatios NTM, Moreira BS, Lima-Costa MF, Torres JL. Diferenças urbano-rurais relativas ao consumo e ambiente alimentar e aos parâmetros antropométricos de adultos mais velhos: resultados do ELSI-Brasil. Cad Saude Publica. 2023;39(7):e00179222. https://doi.org/10.1590/0102-311XPT179222
21. Peixoto SV, Mambrini JVM, Firmo JOA, Loyola Filho AI, Souza Junior PRB, Andrade FB, et al. Physical activity practice among older adults: results of the ELSI-Brazil. Rev Saude Publica. 2019;52(S2):5s. https://doi.org/10.11606/S1518-8787.2018052000605
22. Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. Questionário Internacional De Atividade Física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fís Saúde. 2012;6(2):5-18. https://doi.org/10.12820/rbafs.v.6n2p5-18
23. World Health Organization. Global recommendations on physical activity for health. Geneva: WHO; 2010.
24. Martos-Moreno GA, Chowen JA, Argente J. Metabolic signals in human puberty: effects of over and undernutrition. Mol Cell Endocrinol. 2010;324(1-2):70-81. https://doi.org/10.1016/j.mce.2009.12.017
25. LeBlanc ES, Kapphahn K, Hedlin H, Desai M, Parikh NI, Liu S, et al. Reproductive history and risk of type 2 diabetes mellitus in postmenopausal women: findings from the Women’s Health Initiative. Menopause. 2017;24(1):64-72. https://doi.org/10.1097/GME.0000000000000714
26. Farahmand M, Tehrani FR, Khalili D, Cheraghi L, Azizi F. Is there any association between age at menarche and anthropometric indices? A 15-year follow-up population-based cohort study. Eur J Pediatr. 2020;179(9):1379-88. https://doi.org/10.1007/s00431-020-03575-x
27. Gill D, Brewer CF, Del Greco FM, Sivakumaran P, Bowden J, Sheehan NA, et al. Age at menarche and adult body mass index: a Mendelian randomization study. Int J Obes (Lond). 2018;42(9):1574-81. https://doi.org/10.1038/s41366-018-0048-7
28. Kaltiala-Heino R, Marttunen M, Rantanen P, Rimpelä M. Early puberty is associated with mental health problems in middle adolescence. Soc Sci Med. 2003;57(6):1055-64. https://doi.org/10.1016/s0277-9536(02)00480-x
29. Shope MM, Freeman AJ, Culbert KM. Elucidating early pubertal timing effects on disordered eating symptoms in young adult women. Eat Behav. 2022;45:101602. https://doi.org/10.1016/j.eatbeh.2022.101602
30. Nasiri S, Dolatian M, Tehrani FR, Majd HA, Bagheri A. The relationship between social determinants of health and girls’ age at menarche based on the world health organization model: path analysis. Heliyon. 2022;8(10):e10794. https://doi.org/10.1016/j.heliyon.2022.e10794
31. Lee JS, Lee YA, Shin CH, Suh DI, Lee YJ, Yon DK. Long-term health outcomes of early menarche in women: an umbrella review. QJM. 2022;115(12):837-47. https://doi.org/10.1093/qjmed/hcac187
32. Kvalheim S, Sandvik L, Winsvold B, Hagen K, Zwart JA. Early menarche and chronic widespread musculoskeletal complaints‐-results from the HUNT study. Eur J Pain. 2016;20(3):458-64. https://doi.org/10.1002/ejp.747
33. Blyth FM, Noguchi N. Chronic musculoskeletal pain and its impact on older people. Best Pract Res Clin Rheumatol. 2017;31(2):160-8. https://doi.org/10.1016/j.berh.2017.10.004
34. Idris IM, Wolday SJ, Habteselassie F, Ghebremichael L, Andemariam M, Azmera R, et al. Factors associated with early age at menarche among female secondary school students in Asmara: a cross-sectional study. Glob Reprod Health. 2021;6(2):e51. https://doi.org/10.1097/GRH.0000000000000051
35. Marques A, Branquinho C, Matos MG. Girls’ physical activity and sedentary behaviors: does sexual maturation matter? A cross‐sectional study with HBSC 2010 Portuguese survey. Am J Hum Biol. 2016;28(4):471-5. https://doi.org/10.1002/ajhb.22814
36. Guasch-Ferré M, Bulló M, Martínez-González MA, Corella D, Estruch R, Covas MI, et al. Waist-to-height ratio and cardiovascular risk factors in elderly individuals at high cardiovascular risk. PLoS One. 2012;7(8):e43275. https://doi.org/10.1371/journal.pone.0043275
37. Lundblad MW, Jacobsen BK. The reproducibility of self-reported age at menarche: the Tromsø Study. BMC Womens Health. 2017;17(1):62. https://doi.org/10.1186/s12905-017-0420-0
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Direitos autorais (c) 2026 Nair Tavares Milhem Ygnatios, Juliana Vaz de Melo Mambrini, Juliana Lustosa Torres, Núbia Carelli Pereira de Avelar, Ana Lúcia Danielewicz, Rosana Carolina Souza Duarte de Matos, Luciana de Souza Braga, Maria Fernanda Lima-Costa, Bruno de Souza Moreira
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