title: Diet and lifestyle factors associated with premenstrual symptoms in a racially diverse community sample: Study of Women's Health Across the Nation (SWAN).
abstract: OBJECTIVE
  We sought to determine if the frequency of reported physical or emotional premenstrual symptoms (PMSx) was associated with (1) dietary intake of phytoestrogens, fiber, fat, or calcium, (2) consumption of alcohol or caffeine, (3) active or passive smoke exposure or lack of physical exercise, and (4) race/ethnicity or socioeconomic status.
  
  
  METHODS
  A cross-sectional analysis was conducted of PMSx and demographic and lifestyle factors reported at baseline in the multiethnic sample of 3302 midlife women in the Study of Women's Health Across the Nation (SWAN). Stepwise multiple logistic regression analyses were performed for the overall sample and for each racial/ethnic group for each of five PMSx groupings.
  
  
  RESULTS
  Most dietary factors were not related to PMSx. Fat intake was negatively associated with craving and bloating (adjusted odds ratio [AOR] = 0.56, p = 0.024), and fiber intake was positively associated with breast pain (AOR = 1.39, p = 0.037). Alcohol intake was negatively associated with anxiety and mood changes (AOR = 0.63, p = 0.045) and headaches (AOR = 0.50, p = 0.009). Current smoking (AOR = 1.60, p = 0.028) and passive smoke exposure (AOR = 1.56, p = 0.050) were positively associated with cramps and back pain. Symptom reporting differed significantly by race/ethnicity. PMSx were also associated with comorbidities, early perimenopausal status, depressive symptoms, and symptom sensitivity.
  
  
  CONCLUSIONS
  We found little evidence to support a role for diet in PMSx reporting. However, alcohol intake was positively associated with premenstrual anxiety and mood changes, and active and passive smoke exposure was associated with a number of PMSx. Ethnic differences in symptom reporting and associations of comorbidities, early perimenopausal status, depressive symptoms, and symptom sensitivity with reported PMSx were also observed.
authors.affiliation: Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California 95616, USA. ebgold@ucdavis.edu
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Gold
authors.forename: Yali
authors.initials: Y
authors.lastname: Bair
authors.forename: Gladys
authors.initials: G
authors.lastname: Block
authors.forename: Gail A
authors.initials: GA
authors.lastname: Greendale
authors.forename: Siobán D
authors.initials: SD
authors.lastname: Harlow
authors.forename: Susan
authors.initials: S
authors.lastname: Johnson
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.forename: Marianne O'Neill
authors.initials: MO
authors.lastname: Rasor
authors.forename: Amna
authors.initials: A
authors.lastname: Siddiqui
authors.forename: Barbara
authors.initials: B
authors.lastname: Sternfeld
authors.forename: Jessica
authors.initials: J
authors.lastname: Utts
authors.forename: Guili
authors.initials: G
authors.lastname: Zhang
mesh_terms: D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005518:Food Preferences / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D015999:Multivariate Analysis; D011293:Premenstrual Syndrome / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health / Q000208:ethnology*