Adherence to a Mediterranean Diet and Lifestyle and Associations with Global Endometriosis Symptoms: A Cross-Sectional Analysis of Australian Women

Courtney Harris, Villani A, Scannell N, Nina A. Wilson, Mantzioris E
In: Nutrients · 2026 · vol. 18(21) , pp. 3544 · doi:10.3390/nu18213544 · W7223926251
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A cross-sectional analysis of 103 Australian women found no association between adherence to a Mediterranean diet or associated lifestyle and the intensity of global endometriosis symptoms.

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Abstract

Background/Objectives: Adherence to a Mediterranean diet (MedDiet) has been shown to improve women’s reproductive health. However, there is a lack of evidence on the potential efficacy in attenuating the intensity of global symptoms related to endometriosis. This was a cross-sectional analysis investigating the association between MedDiet (and associated lifestyle) adherence and intensity of global endometriosis symptoms in Australian women. Methods: Adherence to a MedDiet (and associated lifestyle) was assessed using the Mediterranean Diet Adherence Screener (MEDAS) and MEDiterranean LIFEstyle Index (MEDLIFE), and the impact of endometriosis symptoms was assessed using the Endometriosis Impact Questionnaire (EIQ-63). Results: A total of n = 103 participants (29.7 ± 8.6 years; BMI: 27.1 ± 6.8 kg/m2) were included in the final analyses. Participants reported moderate MEDLIFE adherence scores (12.1 ± 3.2) and low-to-moderate adherence to a MedDiet (5.6 ± 2.0). Few participants achieved normative serve size criteria for core dietary constituents of a MedDiet, including legumes (n = 14, 16.7%), fruit (n = 11, 13.1%), fish and seafood (n = 9, 10.7%), nuts (n = 15, 17.9%) and olive oil (n = 2, 2.4%). MEDLIFE index or MEDAS adherence were not associated with global impact symptoms of endometriosis. Conclusions: Despite the null findings, these results provide an important contribution to the existing literature, highlighting the importance of diet quality on women’s health more broadly. Exploration of these findings using well-controlled longitudinal analyses and robust clinical trials is needed to discover causal relationships.

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