Adherence to Mediterranean-style diet and premenstrual syndrome severity: a cross-sectional study

Evidence on the association between the Mediterranean diet and premenstrual syndrome (PMS) remains inconclusive; therefore, this study examined the relationship between adherence to a Mediterranean-style diet and overall PMS severity and specific psychological and physical symptoms. This cross-sectional study included 606 women aged 18-35 years. Premenstrual symptoms and their severity were assessed using the validated Premenstrual Symptoms Screening Tool and the Calendar of Premenstrual Experiences. Adherence to the Mediterranean diet was assessed using a modified Mediterranean diet score (mMDS; range 0-9 points), derived from a validated 138-item semi-quantitative FFQ. Logistic regression was used to estimate OR with 95 % CI to examine the association between adherence to the Mediterranean-style diet and PMS severity. Three overall PMS severity groups were identified: No-PMS (21·8 %), Mild-PMS (50·2 %) and Moderate/Severe-PMS (28·0 %). No association was observed between adherence to the Mediterranean-style diet and overall PMS severity. Compared with women with Low mMDS (0-3 points), women with Moderate mMDS (4-5 points) had an OR of 1·11 (95 % CI 0·63, 1·94) for Moderate/Severe-PMS. Among women with High mMDS (6-9 points), the corresponding OR was 1·37 (95 % CI 0·75, 2·53). Of the thirty-two specific premenstrual symptoms, only headache was inversely associated with Mediterranean-style diet adherence in the Moderate v. Low mMDS group (OR = 0·75, 95 % CI 0·59, 0·95), but not in the High v. Low mMDS group (OR = 0·80, 95 % CI 0·63, 1·03). Given the lack of a significant association, further prospective and intervention studies are needed.