Vegetables and lean proteins–based and processed meats and refined grains –based dietary patterns in early childhood are associated with pubertal timing in a sex-specific manner: a prospective study of children from Mexico City

Abstract Childhood diet has been implicated in timing of sexual maturation. A key limitation of published studies is the focus on individual foods rather than patterns. We hypothesized that dietary patterns characterized by fruits and vegetables during early childhood (age 3 years) would be associated with delayed pubertal timing, whereas energy-dense and meat-based dietary patterns would relate to earlier puberty. The study population included 496 participants of a Mexico City birth cohort. The exposures of interest were dietary patterns derived from principal component analysis of dietary data collected via a semiquantitative food frequency questionnaire when the children were 3 years of age, and the outcomes were physician-assessed Tanner stages for pubic hair, breast (girls), genitalia, and testicular volume (boys) between 9 and 18 years, and initiation of menarche (girls). In regression analyses, we estimated adjusted hazard ratios and 95% confidence intervals for having reached Tanner stage ≥4 or initiation of menarche in girls and testicular volume ≥15 mL in boys. Among girls, those in the highest vs lowest tertile of vegetables and lean proteins pattern had a 35% (95% confidence interval 3%-67%) lower adjusted probability of having reached breast stage ≥4. Among boys, the processed meats and refined grain pattern score was associated with more advanced testicular development (adjusted hazard ratio = 3.58 [0.62-6.53]). Early childhood dietary patterns may play a role in the tempo of sexual maturation, which could ultimately carry implications for chronic disease susceptibility.