Associations of ultra-processed food consumption and mindful eating with premenstrual syndrome severity in young adult women

Abstract Premenstrual syndrome (PMS) is a common condition among women of reproductive age. Evidence suggests that dietary factors, ultra-processed food (UPF) consumption and overall diet quality may be associated with symptom severity. This study aimed to examine the relationships between UPF consumption, adherence to the Mediterranean diet, mindful eating, and PMS severity in young adult women. This cross-sectional study assessed PMS severity using the Premenstrual Syndrome Scale (PMSS), UPF consumption using the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF), Mediterranean diet adherence using the Mediterranean Diet Adherence Screener (MEDAS), and mindful eating using the Four-Facet Mindful Eating Scale (FFaMES). Pearson correlation and multiple linear regression analyses were performed, including a fully adjusted model accounting for sociodemographic, anthropometric, and reproductive characteristics. Participants were recruited through non-probability snowball sampling via university networks, social media platforms, and participant referrals. A total of 607 young adult women aged between 18 and 30 years were recruited to this study. sQ-HPF scores were positively correlated with PMSS scores ( r = 0.152, p < 0.001), while Non-reactance ( r = − 0.330, p < 0.001) and Non-judgment ( r = − 0.276, p < 0.001) were inversely correlated with PMSS scores. Internal Awareness ( r = 0.221, p < 0.001) and External Awareness ( r = 0.234, p < 0.001) showed positive bivariate correlations. Mediterranean diet adherence showed a weak inverse correlation with PMS severity ( r = − 0.091, p = 0.025). In the fully adjusted model (R 2 = 0.190), Non-reactance (β = −0.176, p = 0.003) and Non-judgment (β = −0.188, p < 0.001) remained inversely associated with PMS severity, whereas Internal Awareness (β = − 0.022, p = 0.658) and External Awareness (β = 0.066, p = 0.163) were not independently associated. sQ-HPF scores remained positively associated with PMS severity (β = 0.081, p = 0.040), while MEDAS scores were not independently associated (β = − 0.036, p = 0.348). Higher sQ-HPF scores were associated with greater PMS severity, whereas the Non-reactance and Non-judgment facets of mindful eating showed independent inverse associations. The awareness-related facets and Mediterranean diet adherence were not independently associated with PMS severity in the fully adjusted model. These findings highlight the importance of examining individual mindful eating facets rather than relying on a composite score. Given the cross-sectional design and psychometric limitations, causal interpretations are not warranted.