The association between dietary total antioxidant capacity and prevalence of premenstrual syndrome among women of reproductive age: a cross-sectional study

Abstract

Women of reproductive age frequently suffer from premenstrual syndrome (PMS), a condition marked by behavioral, emotional and physical symptoms. The pathophysiology of PMS is linked to oxidative stress and inflammation, and dietary antioxidants may have preventive benefits. This study aims to investigate the relationship between the occurrence and severity of PMS in young females and dietary total antioxidant capacity (TAC). In a cross-sectional study, 490 healthy women with normal BMIs between the ages of 18 and 38 participated. Individuals who had recently used antioxidant supplements, metabolic problems, or chronic illnesses were not allowed to participate. A validated food frequency questionnaire was used to measure dietary intake, and the ORAC method was used to compute TAC. The Arabic Premenstrual Syndrome Scale (APMSS) was used to assess PMS symptoms. After dividing the participants into TAC tertiles, multivariable logistic regression was used to examine the relationships with PMS after controlling for age, BMI, energy consumption and lifestyle variables. In total, 33.7% of people had PMS, and 93% of them reported having at least one symptom. Higher TAC was linked to better dietary patterns, such as consuming more fruits, vegetables, legumes and whole grains and consuming less red meat, refined grains and salt. From the lowest to the highest TAC tertile, there was a substantial decrease in moderate-to-severe PMS symptoms, such as anxiety, exhaustion, irritability, depression and muscle/joint pain (all p < 0.01). There was a distinct dose-response pattern in the fully adjusted model, with patients in the highest TAC tertile having 64% lower odds of PMS than those in the lowest (OR = 0.36, 95% CI: 0.23–0.56; p < 0.001). Higher dietary TAC was associated with a lower prevalence and severity of PMS. Antioxidant-rich diets may be associated with a lower burden of PMS symptoms, potentially through mechanisms related to oxidative stress and inflammation. However, the cross-sectional design precludes causal inference. These findings support further prospective and interventional studies investigating whether antioxidant-rich dietary patterns may play a role in PMS management.