Carbohydrate Intake and Bacterial Vaginosis: A Systematic Review

Bacterial vaginosis (BV) is the most prevalent vaginal infection of reproductive-aged women, with unclear causes and links to adverse gynaecological health outcomes. Fluctuations in gut microbiota from dietary carbohydrate intake may alter the vaginal microbiota. This systematic review aimed to identify an association between BV and dietary carbohydrate intake, Glycaemic index (GI) and Glycaemic Load (GL), total sugars, and dietary fibre. A literature search was conducted in April 2022 using MEDLINE, CINAHL, and Scopus databases. The pre-determined inclusion criteria were females, nutritional intake, diet, macronutrients, BV, and vaginal dysbiosis. The risk of bias was assessed using the AXIS tool for cross-sectional studies, and the CASP tool quality assessed the case-control. Four studies met the inclusion criteria: 3 cross-sectional and 1 case-control. The findings showed a positive association between higher GL intake and BV and an inverse association between higher dietary fibre intake and BV. However, the overall risk of bias was moderate to high. While a diet high in fibre may be protective and high GL may increase BV risk, the limited and inadequate quality evidence means these findings should be interpreted with caution. Further research is necessary to confirm these associations and inform dietary recommendations.