Dietary patterns supportive of gut microbiota and bacterial vaginosis: A cross-sectional analysis from NHANES 2001 to 2004

Bacterial vaginosis (BV) is the leading form of vaginal microbiome imbalance in women of reproductive age and has been associated with dietary patterns and gut microbial profiles. This study investigated the association between a literature-based dietary index for gut microbiota (DI-GM) and BV prevalence in US women. We conducted a cross-sectional analysis of 1169 nonpregnant women aged 20 to 49 years from the National Health and Nutrition Examination Survey 2001 to 2004 with Nugent score measurements and complete dietary data. BV was defined as a Nugent score ≥ 7. Dietary intake was assessed via two 24-hour recalls, and DI-GM was computed based on 14 food groups classified as beneficial or unbeneficial for gut microbial health. Multivariable survey-weighted logistic regression models were used to estimate odds ratios and 95% confidence intervals. BV prevalence was 31.2%. Higher DI-GM scores were associated with lower odds of BV; women with scores ≥6 had reduced odds compared with those with scores of 0 to 3 (adjusted odds ratio = 0.75; 95% confidence interval: 0.60-0.94; P = .015; P-trend = .013). In conclusion, higher DI-GM scores were inversely associated with BV prevalence in this cross-sectional study. These findings should be interpreted cautiously, and prospective studies are needed to confirm causality.