Major dietary patterns in relation to menstrual pain: a nested case control study Original paper

What was studied?

This nested case–control study examined the relationship between habitual dietary patterns and the risk of moderate to severe dysmenorrhea among female university students. Researchers applied factor analysis to categorize dietary intake into three major patterns, the “lacto‑vegetarian,” “snacks,” and “mixed food items,” and then assessed how adherence to each pattern influenced the likelihood of experiencing menstrual pain graded as moderate to severe (grades 2–3). Logistic regression, both crude and adjusted for family history of dysmenorrhea, quantified these associations to identify dietary behaviors that may exacerbate menstrual discomfort.

Who was studied?

The study population comprised 293 single, healthy female students aged 19–30 years at Urmia University of Medical Sciences in Iran, recruited via proportional cluster sampling. After excluding participants with incomplete dietary data, extreme energy intakes, chronic disease, or genital disorders detected by ultrasonography, 46 students reporting moderate to severe dysmenorrhea were designated as cases and 54 students without dysmenorrhea as controls. All participants completed a validated 115‑item food frequency questionnaire reflecting intake over the previous six months, and underwent assessments for menstrual characteristics, physical activity, and psychosocial factors.

Most important findings

Factor analysis revealed three distinct dietary patterns explaining 23.65% of intake variance. The “snacks” pattern, characterized by high consumption of sugars, salty snacks, sweets, desserts, tea and coffee, salt, fruit juices, and added fats, was significantly associated with increased dysmenorrhea risk. Participants in the second and third tertiles of the “snacks” pattern experienced higher odds of moderate to severe menstrual pain compared to those in the lowest tertile, even after controlling for family history. No significant associations emerged for the “lacto‑vegetarian” or “mixed food items” patterns.

Key implications

These findings suggest that clinicians should consider dietary counseling aimed at reducing intake of snack‐type foods when advising young women with dysmenorrhea. Emphasizing balanced meals over high‐sugar and high‐fat snacks may mitigate prostaglandin‐mediated uterine contractions that underlie menstrual pain. Further research should explore underlying mechanisms, potentially including inflammatory and metabolic pathways influenced by diet, to inform comprehensive management strategies.