{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:22:54Z","timestamp":1788474174487,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Characterizing the timing of menarche and the factors that are associated with it is important for understanding a population's reproductive health needs and long\u2010term health trajectories. We estimated the age at the menstrual onset among adolescent girls and the association between dietary and nutritional factors and menarche in four sub\u2010Saharan African urban sites. We used cross\u2010sectional school\u2010based data from 2307 female adolescents aged 10\u201314 years collected by the Africa Research, Implementation Science, and Education (ARISE) Network in Ouagadougou, Burkina Faso; Addis Ababa, Ethiopia; Khartoum, Sudan; and Dar es Salaam, Tanzania. Logit models were used to estimate the median age at menarche at each site. Associations between menarche and BMI\u2010for\u2010age, stunting, dietary quality\u00a0and food insecurity across settings were assessed using Poisson regression models adjusted for country and school levels. The estimated median age at menarche was 13.1 years (95% confidence interval: 12.7, 13.5) in Ouagadougou; 12.9 (12.6, 13.2) in Addis Ababa; 13.3 (12.7, 13.6) in Khartoum; and 13.2 (12.3, 14.0) in Dar es Salaam. Between 18% and 49% of the girls in each setting had already menstruated. Based on the pooled multivariable models, underweight participants were 42% less likely (adjusted prevalence ratio [PR]\u00a00.58 [0.44, 0.77]) to have experienced menarche in comparison to normal\u2010weight individuals. The likelihood of experiencing menarche increased for overweight [PR 1.47 (1.30,1.66)] and obese [PR 1.57 (1.35,1.82)] in comparison to normal\u2010weight girls. Those stunted were 47% less likely to have experienced menarche [PR 0.53 (0.41, 0.69)] than their nonstunted counterparts. A lower likelihood of menarche among those experiencing moderate\/severe hunger when compared to those with no\/little hunger was also observed (PR 0.78 [0.63,0.96]). No evidence of association with dietary quality was found. Further research is needed to strengthen the body of evidence and inform evidence\u2010based initiatives in low\u2010 and middle\u2010income settings.<\/jats:p>","DOI":"10.1111\/mcn.13583","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T15:43:20Z","timestamp":1722613400000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Estimated timing of the first menstrual period and dietary and nutritional correlates of menarche among urban school\u2010going adolescents in four sub\u2010Saharan African sites"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-8685","authenticated-orcid":false,"given":"Jana\u00edna Calu","family":"Costa","sequence":"first","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2282-7696","authenticated-orcid":false,"given":"Anne Marie","family":"Darling","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6369-4212","authenticated-orcid":false,"given":"Sachin","family":"Shinde","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amare W.","family":"Tadesse","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology London School of Hygiene and Tropical Medicine London UK"},{"name":"Addis Continental Institute of Public Health Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huda","family":"Sherfi","sequence":"additional","affiliation":[{"name":"School of Health Sciences Ahfad University for Women Omdurman Sudan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Mwanyika\u2010Sando","sequence":"additional","affiliation":[{"name":"Africa Academy of Public Health Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Tinkasimile","sequence":"additional","affiliation":[{"name":"Africa Academy of Public Health Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Sharma","sequence":"additional","affiliation":[{"name":"United Nations Children's Fund New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Baernighausen","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"},{"name":"Heidelberg Institute of Global Health Heidelberg University Heidelberg Germany"},{"name":"Africa Health Research Institute Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaie W.","family":"Fawzi","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"},{"name":"Department of Epidemiology Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"},{"name":"Department of Nutrition Harvard T. H. Chan School of Public Health, Harvard University Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-12995-3"},{"key":"e_1_2_10_3_1","first-page":"360","volume-title":"Household hunger scale: Indicator definition and measurement guide","author":"Ballard T.","year":"2011"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-21"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7827-9-125"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpem-2011-0277"},{"issue":"6","key":"e_1_2_10_7_1","first-page":"468","article-title":"Diagnosis and management of endometrial cancer","volume":"93","author":"Braun M. 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