Journals / Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi / 2026 / Cilt: 17 Sayı: 2

The Association Between Adherence to the Mediterranean Diet and Premenstrual Syndrome: A Cross-Sectional Study

Akdeniz Diyetine Uyum ile Premenstrüel Sendrom Arasındaki İlişki: Kesitsel Bir Çalışma

Kadriye Toprak(ANKARA MEDİPOL UNIVERSITY)0000-0001-8706-8689
Aliye Kuyumcu(SULEYMAN DEMIREL UNIVERSITY)0000-0002-6830-1534
Pages
346–353
Publication Date
2026-08-24
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

However, further research is needed to confirm these findings and apply them in clinical practice.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Premenstrual syndrome (PMS) is a widespread condition that significantly impacts women’s quality of life.
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Key Findings & Data:Material and Methods: A total of 682 female students were divided into two groups based on their premenstrual syndrome status (n = 382 with PMS, n = 300 without PMS), according to the American College of Obstetricians and Gynecologists' diagnostic criteria and scores from the Premenstrual Syndrome Scale.
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Conclusion & Impact:However, further research is needed to confirm these findings and apply them in clinical practice.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Premenstrüel sendrom · Akdeniz diyeti · MEDAS

Abstract

Objective: Premenstrual syndrome (PMS) is a widespread condition that significantly impacts women’s quality of life. While dietary factors have been proposed to influence PMS symptoms, there is limited evidence on the effects of following a Mediterranean diet. This study explored how adhering to a Mediterranean diet affects premenstrual syndrome in female university students pursuing nursing degrees. Material and Methods: A total of 682 female students were divided into two groups based on their premenstrual syndrome status (n = 382 with PMS, n = 300 without PMS), according to the American College of Obstetricians and Gynecologists' diagnostic criteria and scores from the Premenstrual Syndrome Scale. The scale was also used to assess the severity of premenstrual symptoms. A 24-hour dietary recall was conducted, and the Mediterranean Diet Adherence Scale (MEDAS) was used to evaluate adherence to the Mediterranean diet. Results: Students with PMS had significantly lower Mediterranean Diet Adherence scores than those without PMS (p<0.001). As adherence to the Mediterranean diet increased, PMS scores decreased (p<0.001). Each one-point increase in MEDAS score was associated with a 10.9% higher likelihood of not having PMS (p<0.001). Conclusion: The findings suggest that following a Mediterranean diet, a recognized cultural heritage, may help reduce PMS symptoms among students. However, further research is needed to confirm these findings and apply them in clinical practice.

Özet

Amaç: Premenstrüel sendrom (PMS), kadınların yaşam kalitesini önemli ölçüde etkileyen yaygın bir durumdur. Diyetle ilgili bazı faktörlerin PMS semptomlarını etkileyebileceği öne sürülmüş olsa da Akdeniz diyetinin bu semptomlar üzerindeki etkilerine ilişkin kanıtlar hala sınırlıdır. Bu çalışmada, hemşirelik bölümünde okuyan üniversite öğrencilerinde Akdeniz diyetine uyumun premenstrüel sendrom ile ilişkisi incelenmiştir. Gereç ve Yöntemler: Toplam 682 kız öğrenci, Amerikan Kadın Hastalıkları ve Doğum Uzmanları Koleji’nin (ACOG) tanı kriterleri ve Premenstrüel Sendrom Ölçeği puanlarına göre PMS durumu dikkate alınarak iki gruba ayrılmıştır (n=382 PMS’li, n=300 PMS’siz). Premenstrüel Sendrom Ölçeği aynı zamanda premenstrüel semptomların şiddetini değerlendirmek için de kullanılmıştır. Beslenme durumunun saptanması için 24 saatlik geriye dönük besin tüketim kaydı alınmış ve Akdeniz Diyeti Uyum Ölçeği (MEDAS) uygulanmıştır. Bulgular: Sonuçlar, PMS’li öğrencilerin MEDAS puanlarının, PMS görülmeyen öğrencilere kıyasla istatistiksel olarak anlamlı düzeyde daha düşük olduğunu ortaya koymuştur (p<0.001). Ayrıca, Akdeniz diyetine uyum düzeyindeki artış ile PMS semptom şiddetinde anlamlı bir azalma arasında ters yönlü bir ilişki saptanmıştır (p<0.001). Bireylerin MEDAS puanındaki her bir birimlik artış, PMS görülmeme olasılığında %10,9 oranında bir yükselme ile ilişkili bulunmuştur (p<0.001). Sonuç: Elde edilen bu sonuçlar, kültürel bir miras olarak bilinen Akdeniz diyetine uyumun, öğrencilerde PMS semptomlarını azaltmaya yardımcı olabileceğini düşündürmektedir. Ancak, bu sonuçların doğrulanması ve klinik uygulamalara yansıtılması için daha ileri araştırmalara ihtiyaç vardır.

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Cite This Article

Toprak, K., Kuyumcu, A. (2026). The Association Between Adherence to the Mediterranean Diet and Premenstrual Syndrome: A Cross-Sectional Study. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi, Cilt: 17 Sayı: 2, 346–353. https://doi.org/10.22312/sdusbed.1800551

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References (35)

  1. Hofmeister S, Bodden S. Premenstrual syndrome and premenstrual dysphoric disorder. Am Fam Physician. 2016;94(3):236-240.
  2. World Health Organization. International Classification of Diseases, 11th Revision (ICD-11) [Internet]. Available from: https://icd.who.int/en [(accessed on 02 August 2025)].
  3. Frey Nascimento A, Gaab J, Kirsch I, Kossowsky J, Meyer A, et al. Open-label placebo treatment of women with premenstrual syndrome: study protocol of a randomised controlled trial. BMJ Open. 2020;10(2):e032868.
  4. Goker A, Artunc-Ulkumen B, Aktenk F, Ikiz N. Premenstrual syndrome in Turkish medical students and their quality of life. Obstet Gynecol. 2014;35(3),275–278.
  5. Yamamoto K, Okazaki A, Sakamoto Y, Funatsu M. The relationship between premenstrual symptoms, menstrual pain, irregular menstrual cycles, and psychosocial stress among Japanese college students. J Physiol Anthropol. 2009;28(3):129-36.
  6. Cheng SH, Shih CC, Yang YK, Chen KT, Chang YH, et al. Factors associated with premenstrual syndrome - a survey of new female university students. Kaohsiung J Med Sci. 2013;29(2):100-5.
  7. Long J, Wang Y, Liu L, Zhang J. The prominent role of the temporal lobe in premenstrual syndrome and premenstrual dysphoric disorder: evidence from multimodal neuroimaging. Front. Psychiatry. 2022;13:954211.
  8. MoradiFili B, Ghiasvand R, Pourmasoumi M, Feizi A, Shahdadian F, et al. Dietary patterns are associated with premenstrual syndrome: Evidence from a case-control study. Public Health Nutr. 2020;23(5):833–842.
  9. Farasati N, Siassi F, Koohdani F, Qorbani M, Abashzadeh K, et al. Western dietary pattern is related to premenstrual syndrome: a case–control study. Br J Nutr. 2015;114(12):2016-2021.
  10. Zabaleta ME. Mediterranean diet: Woman fertility and pregnancy. Mediterr. J. Nutr. Metab. 2020;13(1):101-111.
  11. Szmidt MK, Granda D, Madej D, Sicinska E, Kaluza J. Adherence to the mediterranean diet in women and reproductive health across the lifespan: a narrative review. Nutrients. 2023;15(9):2131.
  12. Robinson J, Ferreira A, Iacovou M, Kellow NJ. Effect of nutritional interventions on the psychological symptoms of premenstrual syndrome in women of reproductive age: a systematic review of randomized controlled trials. Nutr Rev. 2024;nuae043.
  13. Kwon YJ, Sung DI, Lee JW. Association among premenstrual syndrome, dietary patterns, and adherence to mediterranean diet. Nutrients. 2022;14(12):2460.
  14. American College of Obstetricians and Gynecologists. Management of Premenstrual Disorders: ACOG Clinical Practice Guideline No. 7. Obstet Gynecol 142(6):1516-1533, December 2023.
  15. Gencdogan B. A new instrument for premenstrual syndrome. Turk Psikiyatri Derg. 2006;8(2):81-87.
  16. Martínez-González MA, García-Arellano A, Toledo E, Salas-Salvadó J, Buil-Cosiales P, et al. A 14-Item Mediterranean Diet Assessment Tool and Obesity Indexes among High-Risk Subjects: The PREDIMED Trial. PLoS ONE 2012;7(8):e43134.
  17. Pehlivanoglu Ozkan EF. Balcioglu H. Unluoglu I. Turkish validation and reliability of mediterranean diet adherence screener. OJM. 2020;42(2):160-164.
  18. Helmy NA, Kamel DM, Gabr AA, Shehata MMA. Do dietary habits affect the premenstrual syndrome severity among a cohort of Egyptian females? A cross-sectional study. Bull Fac Phys Ther 2023;28 11.
  19. Bazyar H, Mirzaee F, Akbari-Panah E, Jafarirad S. The prevalence of premenstrual syndrome and its relationship with food intake, anxiety and digestive disorders in university student girls. MOJ Food Process Technol. 2017;5(3):321–6.
  20. Rogan MM, Black KE. Dietary energy intake across the menstrual cycle: A narrative review. Nutr. Rev. 2023;81:869–886.
  21. Quaglia C, Nettore IC, Palatucci G, Franchini F, Ungaro P, et al. Association between Dietary Habits and Severity of Symptoms in Premenstrual Syndrome. Int. J. Environ. Res. Public Health 2023;20(3):1717.
  22. Strahler J, Hermann A, Schmidt NM, Stark R, Hennig J, et al. Food cue-elicited brain potentials change throughout menstrual cycle: Modulation by eating styles, negative affect, and premenstrual complaints. Horm. Behav. 2020, 124, 104811.
  23. Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, et al. Premenstrual Syndrome Is Associated with Dietary and Lifestyle Behaviors among University Students: A Cross-Sectional Study from Sharjah, UAE. Nutrients. 2019;11(8):1939.
  24. Houghton SC, Manson JE, Whitcomb BW, Hankinson SE, Troy LM, et al. Carbohydrate and fiber intake and the risk of premenstrual syndrome. Eur. J. Clin. Nutr. 2018;72:861–870.
  25. Houghton SC, Manson JE, Whitcomb BW, Hankinson SE, Troy LM, et al. Protein intake and the risk of premenstrual syndrome. Public Health Nutr. 2019;22(10):1762-1769.
  26. Almahareeq M, Hamdan M, Vanoh D, Shawarb N, Herbawi J, et al. Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study. BMC Womens Health 2024;24, 360.
  27. Bertone-Johnson ER, Ronnenberg AG, Houghton SC, Nobles C, Zagarins SE. Association of inflammation markers with menstrual symptom severity and premenstrual syndrome in young women. Hum Reprod. 2014;29(9):1987–1994.
  28. Mohammadi MM, Dehghan Nayeri N, Mashhadi M, Varaei S. Effect of omega-3 fatty acids on premenstrual syndrome: a systematic review and meta-analysis. J. Obs. Gynaecol. Res. 2022;48:1293–1305.
  29. Ott J, Nouri K, Hrebacka D, Gutschelhofer S, Huber J, Wenzl R. Endometriosis and nutrition-recommending a mediterranean diet decreases endometriosis-associated pain: an experimental observational study. J Aging Res Clin Practice. 2012;1:162–6.
  30. Sohrabi N, Kashanian M, Ghafoori SS, Malakouti SK. Evaluation of the effect of omega-3 fatty acids in the treatment of premenstrual syndrome: "a pilot trial". Complement Ther Med. 2013;21:141.
  31. Cross GB, Marley J, Miles H, Willson, K. Changes in nutrient intake during the menstrual cycle of overweight women with premenstrual syndrome. Br. J. Nutr. 2001;85(4):475–482.
  32. Saura-Calixto F. Dietary fiber as a carrier of dietary antioxidants: an essential physiological function. J. Agric. Food Chem. 2011;59(1):43–49.
  33. Taheri R, ZareMehrjardi F, Heidarzadeh-Esfahani N, Hughes JA, Reid RER, et al. Dietary intake of micronutrients are predictor of premenstrual syndrome, a machine learning method. Clin. Nutr. ESPEN 2023 (55):136–143.
  34. Panay N. Guidelines on Premenstrual Syndrome. London: The National Association for Premenstrual Syndrome (NAPS). [2024] [cited 2025 July 18]. Available from: https://www.pms.org.uk/app/uploads/2018/06/guidelinesfinal60210.pdf.
  35. Freeman EW, Stout AL, Endicott J, Spiers P. Treatment of premenstrual syndrome with a carbohydrate-rich beverage. Int. J. Gynaecol. Obstet. 2002;77(3):253–254. 10.1016/S0020-7292(02)00033-4