Residential surrounding greenspace and age at menopause: A 20-year European study (ECRHS)

Abstract

Publisher's version (útgefin grein). ; Background: Menopause is associated with a number of adverse health effects and its timing has been reported to be influenced by several lifestyle factors. Whether greenspace exposure is associated with age at menopause has not yet been investigated. Objective: To investigate whether residential surrounding greenspace is associated with age at menopause and thus reproductive aging. Methods: This longitudinal study was based on the 20-year follow-up of 1955 aging women from a large, population-based European cohort (ECRHS). Residential surrounding greenspace was abstracted as the average of satellite-based Normalized Difference Vegetation Index (NDVI) across a circular buffer of 300 m around the residential addresses of each participant during the course of the study. We applied mixed effects Cox models with centre as random effect, menopause as the survival object, age as time indicator and residential surrounding greenspace as time-varying predictor. All models were adjusted for smoking habit, body mass index, parity, age at menarche, ever-use of contraception and age at completed full-time education as socio-economic proxy. Results: An increase of one interquartile range of residential surrounding greenspace was associated with a 13% lower risk of being menopausal (Hazard Ratio: 0.87, 95% Confidence Interval: 0.79–0.95). Correspondingly the predicted median age at menopause was 1.4 years older in the highest compared to the lowest NDVI quartile. Results remained stable after additional adjustment for air pollution and traffic related noise amongst others. Conclusions: Living in greener neighbourhoods is associated with older age at menopause and might slow reproductive aging. These are novel findings with broad implications. Further studies are needed to see whether our findings can be replicated in different populations and to explore the potential mechanisms underlying this association. ; Kai Triebner has received a postdoctoral fellowship from theUniversity of Bergen. Payam Dadvand is funded by a Ramón y Cajalfellowship (Grant: RYC-2012-10995) awarded by the Spanish Ministryof Economy and Finance. The present analyses are part of a projectfunded by the Norwegian Research Council (Grant: 228174).Coordination of the ECRHS I was supported by the EuropeanCommission as part of the"Quality of Life"program and the authorsand participants are grateful to the late C. Baya and M. Hallen for theirhelp during the study and K. Vuylsteek and the members of the COMACfor their support. Coordination of the ECRHS II was supported by theEuropean Commission as part of the"Quality of Life"program (Grant:QLK4-CT-1999-01237). The coordination of the ECRHS 3 was fundedthrough the Medical Research Council (Grant: 92091). NDVI calcula-tions were conducted within the framework of the Ageing Lungs InEuropean Cohorts study that was funded by the European Union'sHorizon 2020 research and innovation program under (Grant: 633212).Bodies funding the local studies are listed in the online data supple-ment. The funding sources were not involved in the conduct of theresearch and/or preparation of the article, in study design, in the col-lection, analysis and interpretation of data, in the writing of the reportor in the decision to submit the article for publication. ; Peer Reviewed