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Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded

2015

Month Degree Awarded

September

First Advisor

Alayne Ronnenberg

Second Advisor

Liz Bertone-Johnson

Third Advisor

Carol Bigelow

Fourth Advisor

Nancy Cohen

Subject Categories

Nutrition

Abstract

Abnormal menstrual cycle length, pattern and bleed duration are associated with reduced fecundity and increased risk of miscarriage. The menstrual cycle is governed by the hypothalamus-pituitary-ovarian (HPO) axis, and nutritional factors may affect menstrual characteristics by influencing the HPO axis. Identifying these factors may lead to cost effective ways to improve reproductive outcomes.

In a cross-sectional analysis of 164 18- to 30-year-old women, we examined the association of adiposity, dietary fat intake and vitamin D status with menstrual cycle characteristics. Adiposity was measured using dual-energy X-ray absorptiometry (DXA); dietary intake was assessed using a food frequency questionnaire, and fasting venous samples were collected for measurement of vitamin D.

Most study participants were Caucasians (83%). Approximately 20% of women were overweight (BMI 25-29.9 kg/m2); 6% were obese (BMI ≥ 30 kg/m2). However, when using DXA measurements, 45% of women had a percent total body fat (%TBF) > 32, indicating obesity. The odds of having an irregular cycle pattern were three times higher among women with < 32% TBF compared to those with more adiposity [OR=3.1 95% CI (0.9 to 10.2) p=0.07]. When considering body fat distribution, the odds of an irregular cycle were 2.8 times higher in women with ≤ 41% gynoid fat [OR=2.8 95% CI(0.9, 8.6) p=0.07]; a one standard deviation increase in G/A (gynoid/android) fat mass was associated with a 50% decreased odds of an irregular cycle pattern [OR=0.45 95% CI (0.21, 1.1) p=0.07]. Among dietary factors, higher intake of n-6 PUFA was associated with irregular cycles (β= 0.16, p=0.05) and both short (β= 0.23, p 50nmol/L) was 80% lower among women with irregular cycles compared to those with regular cycles (OR= 0.19; 95% CI: 0.04, 0.92). Our findings suggest that dietary factors are associated with menstrual cycle characteristics, particularly cycle regularity. If our findings are confirmed in larger prospective studies, they suggest that dietary manipulation may be one approach to improving menstrual cycle function.

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Nutrition Commons

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