Menarche, the first event in a woman’s reproductive phase, It occurs between the age of 9- 16 years. This would differ with physical, hereditary and cultural base of an individual. The dietary customs emphasize the consumption of specific foods to support the hormonal balance, encourage regular menstruation and improve general well-being and the menarche has been celebrated through various cultural practices. The aim of the study is to compile the information of dietary customs and cultural practices followed at the time of menarche and its importance Method: A 6-month study was conducted in 7 districts of Kerala, involving 70 female participants aged 30-80, who were surveyed using a self-structured questionnaire. Results: In this study, 63% of them informed about special diet during menarche. 14% of them informed about certain cultural practices. Conclusion: Without being aware of the nutritional value and health advantages, the people have followed the specific diet as a custom. This study suggests that intake of a traditional diet rich in essential nutrients is paramount. A wholesome nutritious diet and practices play a crucial role in sustaining hormonal balance and support the reproductive health.
Menarche, the initial menstrual period, signifies the beginning of a woman’s reproductive life. It occurs between the ages of 9- 16 years which is considered as normal. It is a natural biological process.
The pituitary gland releases luteinizing hormone and follicle-stimulating hormone in response to gonadotropin-releasing hormone. These hormones stimulate the ovaries to produce estrogen and progesterone. When estrogen levels peak, a surge in LH triggers ovulation. The remaining follicle transforms into the corpus luteum, which secretes high levels of progesterone and estrogen to prepare the uterine lining for possible implantation. If fertilization does not occur, the corpus luteum breaks down, leading to a decrease in hormone levels, the shedding of the uterine lining and menstrual bleeding. [1].
The age of attaining menarche is influenced by surrounding and hereditary factors, with nutritional factors playing a significant role. During this time period, people have been following specific traditional food habits, social taboos and stigmas according to their culture in each and every religion and community. The traditional diet places a strong emphasis on consuming the specific foods that are thought to support optimal hormone balance, maintain regular menstruation, and improve general well-being.
Dietary customs and cultural practices associated with menarche embody traditional knowledge passed down through generations. Adhering to these dietary practices and celebrating menarche through cultural rituals can enhance women's overall well-being and empowerment. Preserving and acknowledging these customs supports women's physical and mental health while honoring cultural heritage.
After the approval received from the IEC (IEC No: NIS/24/IEC/2023/MP/47), this cross-sectional study was carried out from July 2023 and completed on November 2023 in seven districts of Kerala: Ernakulam, Thrissur, Thiruvananthapuram, Idukki, Kozhikode, Malappuram and Wayanad. The study group comprised 70 participants, with 10 participants from each district, all women aged between 30 and 80 years. The selected women were briefed about the study's protocol and purpose and were asked to complete questionnaires to provide information regarding menarche.
Table 1: Profile of the respondents (n=70)
|
Components |
Rate |
|
Age in annual period 30 to 39 40 to 49 50 to 59 Greater than 60
Religion Hindu Christian Muslim
|
21% 17% 20% 41%
63% 13% 24% |
Regarding age, 41% of the respondents were in the group over the age of 60, out of 70 participants, 21% of them belongs to age group between 30-39, 17% of them belongs to between 40-49, 20% of them belongs to 50-59. p
The study revealed that out of 70 participants, 63% of them are Hindu, 24% of them are Muslim and 13% of them are Christian.
Table 2: Contents of the study
|
Contents |
Frequency |
|
Isolation during menarche Yes No Isolation days 5 days 7 days 8 days 16 days Special diets Yes No Food avoidance Yes No Oil bath Yes No Bath powders Yes No Cultural activities Yes No Restrictions Yes No |
70% 30%
36% 21% 11% 2%
63% 37%
69% 31%
74.3 25.7%
34.3% 65.7%
14% 86%
69% 31% |
Special diet: 63% of them explained about the special diet during menarche. In Ernakulam district, sarkkarachoru and uluva verakiyath (venthaya kali) were advised. In Thrissur district, karupettikurukku and avilvilayichathu were advised.
In Trivandrum district, Seem paal (Bovine colostrum) was advised, and kali was prepared using vallarai leaves (Centella asiatica), and cooked rice was also advised. In Kozhikode district, mildly roasted shallot and garlic were given on the first day of menarche, and puttu (Rice steam cake) was prepared using notchi leaves (Vitex negundo). In Malappuram district, raw banana soup and chembilaadukku were advised. In Idukki district, finger millet idli and a dish prepared using tapioca were advised. In Wayanad district, thengin poo kurukku and ulunthu kali were advised.
Chart 1: Commonly followed diets
Among 70 participants, 67 of them were informed about the intake of country raw egg with sesame oil 65 of them were informed about the intake of Black sesame ball in the diet. 65 of them were informed about the intake of arissi puttu in the diet. 56 of them were informed about the intake of Thengin poo kurukku in the diet. 49 of them were informed about the intake of ulli legiyam in the diet. 26 of them were informed about the intake of neyvalli kurukku in the diet. 17 of them were informed about the intake of meat soup in the diet.
Chart 2: Oils used for bath
Among 70 participants, 33 of them were informed about the usage of gingelly oil ; 31 of them were informed about the usage of coconut oil ; 15 of them were informed about the usage of Naalparamathy oil ; 13 of them were informed about the usage of self-prepared oil ; 9 of them were informed about the usage of virgin coconut oil. This was followed in their family and nearby areas during menarche for bath.
In this study, an overview of the documentation of dietary customs and cultural practices followed during menarche in various areas of Kerala provided an idea about the cultural practices and traditional follow-up, which had been seen for several generations for the wellness of women. Members in the study were aged between 30 and 80 years, and each of them had acquired knowledge about traditional foods and practices. The practice of isolating menstruating individuals during menarche stemmed from cultural beliefs and taboos surrounding menstruation, which were prevalent in many societies. In some cultures, menstruating women are considered impure, leading to practices of isolation to prevent this perceived impurity from affecting others or sacred spaces. Isolation often took the form of providing a separate room for menstruating individuals. In some cultures, girls would traditionally stay in small huts made of coconut leaves at the time of menstruation, but this practice had declined in recent times. Isolation during menarche could also be driven by concerns about hygiene and sanitation, as well as by a lack of comprehensive education about menstruation, which perpetuated myths and misconceptions. Overall, the reasons for segregation during menarche were complex and influenced by cultural, religious, and social factors. Addressing these reasons required sensitivity to diverse cultural perspectives and a commitment to promoting awareness and education about menstruation. People adhere to a traditional dietary practice passed down from their ancestors without proper understanding of its nutritional benefits or health advantages. This custom includes a unique diet followed during the onset of menstruation.
Sarkkarachoru, which has palm jaggery as its primary ingredient. Palm jaggery contains essential nutrients such as calcium, potassium, iron, vitamin A, vitamin C, and vitamin B1[3] . The crucial mineral iron helps to increase haemoglobin levels and may reduce fatigue [4]. The recommended avil vilayichathu (Rice flakes) contain calcium, iron, zinc and vitamin B1 along with antioxidant properties. Calcium plays a crucial role in strengthening the bone & tooth development. Calcium supplements may effectively reduce the symptoms of PMS (Premenstrual Syndrome) [5]. Bovine colostrum contains high levels of proteins, including immunoglobulins, lactoferrin and cytokines. These components play crucial roles in strengthening the immune system, protecting against infections and promoting overall health[6]. The recommended vallarai kali, the Centella asiatica contains Vitamin A, Vitamin K, Vitamin C and minerals like Magnesium, Iron and Calcium and also contains some phytonutrients such as flavonoids and triterpenoids[ 7]. It helps in digestion and in addition to overcome the tiredness during menarche. The tradition of giving mildly roasted shallot and garlic on the first day of menarche is often seen in certain cultures as a symbol of transition, while it may vary in significance across cultures. Both shallots and garlic have immune-boosting properties due to their antioxidant content, which helps in fighting off infections and diseases. Garlic and shallots have prebiotic properties, encouraging the development of advantageous bacteria in the gut and supporting digestive health [8]. Puttu (Rice steam cake) is prepared by using Notchi leaves (Vitex negundo) is also advised. The Notchi leaves contain various phytochemicals, including flavonoids and alkaloids, which may have antioxidant and anti-inflammatory properties [9] and it contains dopaminergic substances as well. These substances may be used to managing premenstrual mastodynia and other symptoms associated with premenstrual syndrome [10]. Raw Banana rich in fibre, which may aids in digestion and promotes a healthy gut.
Chembila adukku (a dish containing Colocasia leaves), Vitamins like C, A and minerals like calcium and iron are abundant in Colocasia leaves. They are calorie free and high in dietary fiber, making them beneficial for digestion.
Finger Millet (Ragi) is high in calcium, which is essential for bone strengthening and also rich in iron, which making it beneficial for preventing iron deficiency, is a common concern for menstruating individuals. Tapioca is a good source of carbohydrates, providing energy for daily activities and also contains vitamin C and folate. Vitamin C is essential for the absorption of iron, promoting iron utilization in the body. Thengin poo kurukku (coconut flower pudding), the coconut flowers are abundant in vitamins and minerals like vitamin C, potassium and manganese. The Coccus nucifera have androgenic in action and which may regulate the hormones such as FSH and LH thereby regulate the menstrual cycle[11]. Ulunthu kali (urad dhal porridge), it contains iron, which is important for preventing iron deficiency. Urad dhal is high in dietary fibre, aiding digestion and promoting gut health. It has astringent and analgesic property and it also contains phytoestrogen, which may control the excessive menstrual bleeding, reduces the menstrual pain and also strengthen the pelvic bone and muscles.
The country raw egg with sesame oil, egg contains rich calcium and vitamin D which may strengthen the pelvic bone and also may reduce the severity of dysmenorrhoea. Black sesame ball contains Omega3 fatty acid[12], which may decrease the premenstrual symptoms such as anxiety, depression and nervousness as well as manage issues such as abdominal distension, headache and mastalgia[13]. Arissiputtu, is made primarily from rice flour and grated coconut. Rice flour which is rich in carbohydrates. Carbohydrates are essential for energy, especially important for growing children and adolescents. According to siddha literature the intake of arissiputtu which reduces excessive menstrual bleeding (Perumpadu)[14]. The ulli legiyam is prepared by using shallot and coconut milk. The coconut milk and shallot contain vitamin C, calcium and iron. The calcium may effective in reducing the premenstrual symptom, strengthen the pelvic bone[15] .
Avoiding specific food items during menarche is often rooted in traditional beliefs and practices. Avoid specific food items such as chicken, red meat, spicy food items, curd, pickle. It is believed that chicken and red meat, especially those not organically raised, may contain hormones, which could interfere with the natural hormonal level. Red meat can be harder to digest and may cause bloating or constipation, which could exacerbate menstrual cramps and discomfort. Spicy foods can trigger inflammation of the stomach lining, potentially resulting in digestive issues like acid reflux, indigestion, or diarrhoea, which can exacerbate menstrual discomfort. Pickles are high in sodium, which can lead to water retention and bloating. This can worsen the feeling of discomfort and bloating during menstruation.
The oil bath can symbolize purification and renewal. Oil baths are traditionally believed to nourish the skin and hair. Using oils like coconut, sesame or castor oil can moisturize and protect the skin, which might be particularly beneficial during the physiological changes during menarche. According to siddha literature, oil baths are considered beneficial for balancing the three doshas (life forces). They are believed to support overall health and well-being. Oil bath is advised to take twice a week, which may maintains the body temperature. The ritual often involves the participation of female family members and the community, providing emotional support and a sense of belonging during this significant time. The warm oil can provide a soothing effect, helping to relax muscles and potentially reduce menstrual cramps or discomfort associated with the onset of menstruation. Coconut oil has fatty acids and vitamin E, it provides protection and nourishment to the skin. Coconut oil is very calming and can help alleviate stress. Massaging the head with coconut oil gently can reduce mental fatigue. Gingelly oil contains antioxidants and vitamin E, which help to keep skin looking young and healthy. It helps relieve dry skin. An oil bath is a great way to combat anxiety and laziness since it increases blood circulation. Few of them informed about the usage of self-prepared oil, the commonly used ingredients in the self-prepared oils are hibiscus, shallot and raw turmeric. Oil baths during menarche can offer both physical benefits and cultural significance.
Bath powders have been used for centuries in various cultures as a natural and effective way to cleanse and nourish the skin. They are made from finely ground natural ingredients and are often used in the place of soap. Common ingredients in bath powders include green gram powder, sandalwood powder, Kasthurimanjal (Curcuma aromatica), and neem leaves. Each of these ingredients has unique properties that benefit the skin. They provide gentle cleansing, exfoliation, and nourishment, while also treating various skin conditions.
The cultural practices can vary significantly across different communities and regions within Kerala. Here are some of the unique cultural practices observed during menarche in Kerala, while the girl attains menarche, oil massage is given by gingelly oil from head to toe, then the coconut is placed above the head, cuted into 2 pieces and the coconut water is poured on the head. The menarche attained girls tied a piece of black thread on their feet, they believe it reduce the pain during the menstruation. When the girl attains menarche, a piece of thread as girls height is taken. It is threw on the roof of the house by the mother, they believe it reduces excessive menstrual bleeding. Many taboos were observed during menarche. The types of taboos included food limitations such as avoiding food made with certain sacred plants, restrict daily activities, restrict entry into the kitchen, touching others and cutting nails. These restrictions can vary widely but commonly involve limitations on physical activities, social interactions, and dietary choices. The underlying beliefs often revolve around notions of purity, cleanliness. These practices, while deeply ingrained in many cultures, can have significant psychological and social impacts on individuals experiencing menarche.
This documentation study was undertaken to examine the dietary habits and cultural rituals observed during the onset of menstruation. The informants revealed that families adhere to numerous rituals with specific beliefs during this time. Previous studies had not adequately documented these dietary customs and cultural practices, making this study particularly valuable for future research scholars seeking insights into these traditional practices. Previous studies might have insufficiently focused on the specific dietary components that influence menarche. Detailed dietary assessments, including specific nutrients and their sources, are crucial for understanding their impact on menarche. Many studies have been limited in scope, often focusing on specific regions, socio-economic groups, or cultural settings. This narrow focus can lead to incomplete representations of the diversity in dietary and cultural practices. A broader, more inclusive approach is necessary to capture the wide range of dietary customs and cultural practices across different populations. Adolescence is a crucial phase for girls, as they are the future mothers of the next generation. Therefore, ensuring proper care during menarche and throughout life through each menstrual cycle is essential for achieving a healthy life in women The study successfully highlighted dietary customs and their significance, offering valuable ancient wisdom for upcoming researchers while respecting the cultural values and beliefs associated with these practices.
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