anti-inflammatory foods

Dietary Acid Load, Empirical Dietary Inflammatory Index, and Literature-Based Adherence to Mediterranean Diet Score Relationship With Primary Dysmenorrhea

27 April 2026

Salek M, Teymoori F, Haghighi L, Salehi M, Tavakkoli S, HasanRashedi M, Shidfar F.

Summary

What the study found

This cross-sectional study investigated whether dietary patterns that are inflammatory, acid-forming, or aligned with the Mediterranean diet influence the presence or severity of period pain. Researchers discovered that none of these dietary indices were significantly linked to the intensity of menstrual pain or its associated symptoms among the university students surveyed.

Key findings

The dietary acid load (DAL), which measures the potential renal acid load of food intake, showed no correlation with the intensity of menstrual cramps.
Higher scores on the empirical dietary inflammatory index (eDII) did not significantly increase the likelihood of suffering from painful periods.
Adherence to a Mediterranean diet did not appear to offer a protective effect against primary dysmenorrhea in this specific population.
Statistical analysis confirmed that these dietary scores were not significant predictors for the clinical severity or physical complications of menstrual pain.

Practical takeaways

While long-term dietary habits are essential for general health, this study suggests that following a Mediterranean or low-acid diet may not specifically reduce menstrual pain in the short term. Health-conscious individuals should prioritize overall nutritional balance while acknowledging that primary dysmenorrhea may be influenced by biological factors beyond these specific dietary indices.

Limitations

The study utilized a cross-sectional design, which prevents the determination of cause-and-effect relationships over time. Furthermore, the small sample size of 105 participants and the reliance on self-reported dietary data may limit the ability to generalize these results.

Abstract

Primary dysmenorrhea is a prevalent health issue that has a negative impact on women's well-being. This study sought to explore the potential connection between dietary indices including dietary acid load (DAL), empirical dietary inflammatory index (eDII), and Literature-Based Adherence to Mediterranean diet Score (MEDI-LITE) with primary dysmenorrhea. A total of 105 university students including 57 with and 48 without primary dysmenorrhea participated in this cross-sectional study. Dietary data were collected using a 117-time Food Frequency Questionnaire (FFQ), and the dietary indices were calculated using developed formulas. Using pre-designed questionnaires, the Visual Analog Scale (VAS) and the Verbal Multidimensional Scoring System (VMS) were computed and used to determine the severity of dysmenorrhea pain and side effects. Dietary indices and primary dysmenorrhea relationship assessed by regression analysis adjusted for potential confounders. In the adjusted linear regression models, none of the dietary indices, including eDII, MEDI-LITE, and DAL, showed a statistically significant association with VAS scores. Similarly, the odds of primary dysmenorrhea across tertiles of these dietary indices did not differ significantly. No significant associations were observed between any of the dietary indices and the severity or complications of dysmenorrhea. The result of ROC analysis showed that the mentioned dietary indices were not significant predictors of dysmenorrhea status. The findings of our study showed no significant association between DAL, eDII, and MEDI-LITE and primary dysmenorrhea. Further, well-designed prospective studies are required to confirm these findings, with particular attention to the timing and pattern of dysmenorrhea symptoms.

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