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 "While there are dietary recommendations to alleviate symptoms, such
as increasing complex carbohydrates or to reduce sugar intake, there
has been very little research done on risk factors for developing
PMS," lead author Serena Houghton told Reuters Health in an email.
"Women with clinically significant PMS have symptoms that interfere
with so many aspects of their life, like work, school and
interactions with their friends and family, and being able to
prevent this in the first place would be beneficial for a number of
women," said Houghton, a researcher at the University of
Massachusetts Amherst.
Up to 20 percent of women experience physical and emotional symptoms
leading up to and during the first few days of their periods each
month, Houghton and her colleagues write in European Journal of
Clinical Nutrition.
To see whether carbs or fiber in the diet in the years before PMS
begins have any influence on the risk of developing it, the study
team looked at data from a large long-term study of women.
Participants included female nurses who were between 25 and 42 years
old when the study began in 1989 and who answered yearly
questionnaires about their diets and health.
When the researchers compared 1,234 women who were eventually
diagnosed with PMS to 2,426 women who did not have the condition,
they found no difference in risk of developing PMS during 14 years
of follow-up based on daily intakes of total sugar, added sugars,
natural sugars, sucrose, fructose or glucose.
"Overall, it does not appear that the amount of carbohydrates and
types of carbohydrates are associated with a woman's risk of
developing PMS; but eating a healthy diet with complex carbs has
other health benefits," Houghton said.
Only one sugar, maltose, was linked to a 45 percent increased risk
for PMS among women who ate a lot of it compared with those who ate
the least. Researchers say that result needs further study to
explain.
"Maltose tends to be consumed in small quantities from foods like
cooked sweet potatoes, beer and other malted beverages, and
processed foods," Houghton said
In the same study population, alcohol, including beer, had very
minimal risk, so having a 45 percent increase in risk was somewhat
surprising, Houghton remarked.
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The strengths of this study include that it followed a large group
of premenopausal women over a significant period of time and there
was a high response rate throughout, said Dr. Talitha Bruney, an
obstetrician and gynecologist with Montefiore Medical Center in New
York.
"The drawbacks include (that) all the evaluation and diagnoses were
done by questionnaire format only, which can lead to its own lack of
objectively," Bruney, who was not involved in the study, told
Reuters Health by email.
"However, the overall findings showed no significant association,
which appears to be a similar finding when compared to other
studies," she added.
When a woman does develop PMS, Bruney said, treatment depends on the
severity of symptoms, and often multiple options may have to be
tailored to meet the needs of the patient.
"Mild symptoms can often be treated with exercise and relaxation,"
she said.
It's unclear whether diet modification and supplements improve
symptoms when compared to placebo. But there may be some benefit
from consuming a diet rich in complex carbohydrates, Bruney said.
"There is poor data supporting the efficacy of calcium, magnesium,
vitamin B6 supplementation, and since there may be an associated
risk of toxicity, it may be wise to refrain from recommending
routine use," she said.
Proven therapies include the use of drugs that prevent ovulation
such as oral contraceptives pills and antidepressants such as
selective serotonin receptor inhibitors, especially in patients with
significant mood symptoms, Bruney noted.
"NSAIDs can help reduce pain and diuretics can relieve bloating
symptoms," she said.
SOURCE: http://go.nature.com/2GiEX5h European Journal of Clinical
Nutrition, online January 29, 2018.
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