Nutritional Epigenetics Across the Female Lifespan: From Developmental Programming to Reproductive Health and Healthy Aging

Background/Objectives: Nutritional exposures may influence female reproductive health through metabolic and epigenetic pathways, including DNA methylation, chromatin regulation, and non-coding RNAs. However, evidence for direct nutritional–epigenetic mediation of reproductive outcomes remains heterogeneous. This narrative review examines the evidence linking nutrition, epigenetic regulation, and female reproductive health across developmental programming, adult reproductive function, pregnancy, reproductive disorders, and reproductive aging. Methods: A comprehensive literature search was performed in PubMed/MEDLINE, Scopus, and Web of Science to identify experimental, epidemiological, and clinical studies examining relationships among nutrition, metabolic status, epigenetic regulation, and female reproductive health. Evidence from molecular, animal, and human studies was critically synthesized, distinguishing epigenetic associations from evidence of mechanistic mediation. Results: Nutritional and metabolic exposures are associated with epigenetic pathways involved in ovarian and endometrial function, placental development, and reproductive aging. Experimental evidence supports nutrition-responsive epigenetic regulation, but evidence for epigenetic mediation of reproductive outcomes remains limited in humans. Similar limitations apply to major reproductive disorders and pregnancy complications. Conclusions: Nutritional epigenetics provides a biologically plausible framework linking diet, metabolism, and female reproductive health, but nutritional–epigenetic associations should not be interpreted as evidence of mediation without temporal and functional validation. Longitudinal and interventional studies integrating nutritional exposures with tissue-specific epigenomics and reproductive outcomes are needed before epigenetically informed biomarkers or personalized nutritional strategies can be translated into clinical practice.