Linkages between lifestyle practices, dietary habits, and premenstrual syndrome among college students

Premenstrual syndrome (PMS) is a common condition characterized by physical, emotional, and behavioral symptoms that occur during the luteal phase of the menstrual cycle. Emerging evidence suggests that dietary and lifestyle factors may be associated with the occurrence and severity of PMS. A cross-sectional study was conducted among 502 female undergraduate students recruited through a convenience sampling approach at King Faisal University, Saudi Arabia. Data were collected using a self-administered questionnaire, the Shortened Premenstrual Assessment Form (SPAF), and a Food Frequency Questionnaire (FFQ). Associations between self-reported PMS symptoms, dietary habits, and lifestyle factors were examined using correlation analyses, group comparisons, and multivariable logistic regression. The mean BMI of the participants was 22.5 ± 5.1 kg/m 2 , and 62.0% met the predefined SPAF threshold (score ≥27) for clinically significant self-reported PMS symptoms. Regular physical activity was significantly more common among participants below the SPAF threshold. BMI was weakly but significantly associated with PMS symptom severity (r = 0.111, p = 0.013). Multivariable logistic regression analysis identified smoking, self-perceived dysmenorrhea, and the consumption of burgers, hard cheese, oranges, potato chips, coffee, and tea as factors associated with higher odds of clinically significant self-reported PMS symptoms. No significant differences were observed between participants below and above the SPAF threshold regarding age, overall daily caffeine intake, or daily water consumption. This study identified modest associations between selected dietary habits, lifestyle factors, and clinically significant self-reported PMS symptoms among female university students. Regular exercise was associated with lower odds of clinically significant self-reported PMS symptoms, whereas smoking and the consumption of several food items were associated with higher odds. Given the cross-sectional nature of the study, causal relationships cannot be established. Further longitudinal and intervention studies are needed to clarify the direction and magnitude of these associations.