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 Food Frequency Questionnaire. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (95%CIs) 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 32 specific premenstrual symptoms, only headache was inversely associated with Mediterranean-style diet adherence in the Moderate versus Low mMDS group (OR=0.75, 95%CI:0.59–0.95), but not in the High versus 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 to clarify the relationship between adherence to the Mediterranean diet and PMS severity in European women.