Girls who often drink sugar-sweetened beverages are more likely to start their menstrual periods at a younger age than those who do not, study results published in Human Reproduction suggest.

Although consumption of sugar-sweetened beverages has been linked to metabolic changes that may affect onset of menstruation, data on direct associations between these drinks and age at menarche are lacking, according to background information in the study.

To learn more, the researchers examined data from the Growing Up Today Study, which is a prospective cohort study of 16,875 children of Nurses’ Health Study II participants. A total of 5,583 girls aged 9 to 14 years who had not yet experienced onset of menarche between 1996 and 2001 were included in the study.

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Ninety-four percent reported age at menarche during 10,555 person-years of follow-up, while 3% had not yet started their menstrual periods in 2001.

The researchers used the Youth/Adolescent Food Frequency Questionnaires from 1996 to 1998 to measure cumulative updated sugar-sweetened beverage consumption, which included non-carbonated fruit drinks, sugar-sweetened soda and iced tea.

Data indicated that girls who drank more than 1.5 servings of sugary beverages per day vs. those who drank two servings per week at most were 24% more likely to experience onset of menstrual periods in the next month (P-trend<.001).

The association persisted even after adjustment for other determinants of age at menarche, including race/ethnicity, activity, inactivity, birth weight, maternal age at menarche, frequency of eating dinner as a family, household composition and height.

After adjustment for BMI, the relationship between sugary drink consumption and age at menarche was somewhat attenuated, but remained significant, with girls consuming the most sugary drinks being 22% more likely to experience onset of menstruation in the next month vs. those consuming the least (P-trend<.001) .

Additionally, girls who drank more than 1.5 servings of sugary beverages per day had their first menstrual period about 2.7 months earlier than those who drank two servings or less per week (95% CI, –4.1 to –1.3).

Average age of menarche among girls drinking the most sugary drinks was 12.8 years vs. 13 years for those drinking the least, according to the study results.

The researchers observed that the frequency with which girls drank fruit drinks and sugary soda also predicted early onset of menstruation (P-trend=.03 and .001, respectively). The same was not true, however, for iced tea consumption (P-trend=.49).

Diet soda and fruit juice were not linked to age at onset of menstruation.

“Our study adds to the increasing concern about the widespread consumption of sugar-sweetened drinks among children and adolescents in the USA and elsewhere. The main concern is about childhood obesity, but our study suggests that age of first menstruation (menarche) occurred earlier, independently of body mass index, among girls with the highest consumption of drinks sweetened with sugar,” Karin B. Michels, ScD, PhD, said in a press release.

“These findings are important in the context of earlier puberty onset among girls, which has been observed in developed countries and for which the reason is largely unknown.”

Dr. Michels also noted that these results further bolster the evidence indicating that public health efforts are needed to reduce the consumption of sugary drinks.


  1. Carwile JL et al. Hum Reprod. 2015;doi:10.1093/humrep/deu349.