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

Journal article
Authors Kai Triebner
Iana Markevych
Steinar Hustad
Bryndís Benediktsdóttir
Bertil Forsberg
Karl A. Franklin
José Antonio Gullón Blanco
Mathias Holm
Bénédicte Jaquemin
Debbie Jarvis
Rain Jõgi
Bénédicte Leynaert
Eva Lindberg
Jesús Martínez-Moratalla
Nerea Muniozguren Agirre
Isabelle Pin
José Luis Sánchez-Ramos
Joachim Heinrich
Francisco Gómez Real
Payam Dadvand
Published in Environment International
Volume 132
ISSN 0160-4120
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Language en
Links https://doi.org/10.1016/j.envint.20...
Keywords Greenspace, Menopause, NDVI, Reproductive aging, Sex hormones
Subject categories Public health science

Abstract

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.

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