Carbohydrate and fiber intake and the risk of premenstrual syndrome

Eur J Clin Nutr. 2018 Jun;72(6):861-870. doi: 10.1038/s41430-017-0076-8. Epub 2018 Jan 29.


Background/objectives: Women with premenstrual syndrome (PMS) are encouraged to reduce sugar and increase fiber intake to reduce symptoms. However, research supporting these recommendations is limited, and their role in PMS development is unclear. This study examines the relation between carbohydrate and fiber intake and the risk of PMS nested within the prospective Nurses' Health Study II cohort.

Subjects/methods: Carbohydrate and fiber intake were assessed at baseline and three additional times during follow up by food frequency questionnaire. Incident cases of PMS were identified by self-reported PMS diagnosis during 14 years of follow up and validated by supplemental questionnaire (n = 1234). Women were classified as controls if they did not report PMS diagnosis during follow up and confirmed minimal or no premenstrual symptoms (n = 2426). We estimated relative risks (RR) and 95% confidence intervals (CI) using multivariable logistic regression.

Results: Total carbohydrate intake 2-4 years before reference year was not associated with PMS development (RR quintile 5 versus 1 = 0.99; 95% CI = 0.74-1.33). Intakes of specific carbohydrates or fibers were not associated with PMS development, except maltose. Adjusting for body mass index, smoking, and other factors, women with the highest maltose intake (median = 3.0 g/day) had a RR of 1.45 (95% CI = 1.11-1.88) compared to those with the lowest intake (median = 1.2 g/day).

Conclusions: Overall, carbohydrate and fiber consumption was not associated with risk of PMS. As this is the first study to suggest that maltose may be associated with PMS development, further replication is needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Case-Control Studies
  • Diet
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / adverse effects
  • Dietary Fiber / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Micronutrients / administration & dosage
  • Premenstrual Syndrome / epidemiology
  • Premenstrual Syndrome / prevention & control*
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires


  • Dietary Carbohydrates
  • Dietary Fiber
  • Micronutrients