Dietary inflammatory index and dietary energy density are associated with menopausal symptoms in postmenopausal women: a cross-sectional study

Objectives: No previous study has evaluated the association of the dietary inflammatory index (DII) and dietary energy density (DED) with menopausal symptoms and its subclasses in postmenopausal women. The aim of this study was to evaluate the association of DII score and DED with menopausal symptoms and its subtypes in Iranian postmenopausal women. Methods: This cross-sectional study was conducted on 393 postmenopausal women who attended health centers in the south of Tehran, Iran. The DII score was calculated using dietary factors obtained by a validated food frequency questionnaire. DED was defined as average daily energy intake (kcal) per gram of food. The Menopause Rating Scale questionnaire was used to evaluate the menopausal symptoms. The total Menopause Rating Scale score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score. Linear regression analysis was used to assess the association of the DII score and DED with menopausal symptoms. Results: After adjusting for covariates, participants in the highest tertile of DII score had greater SS compared to those in the lowest tertile (beta(DIIt3vs1)= 0.032, 95% confidence interval (CI): 0.004-0.068,P= 0.04). No significant relationship was found between DII score and PS, urogenital score or TMRSS. Furthermore, higher DED was associated with greater SS (beta(DIIt3vs1)= 0.071, 95% CI: 0.028-0.115,P= 0.001), PS (beta(DIIt3vs1)= 0.065, 95% CI: 0.012-0.121,P= 0.01) and TMRSS (beta(DIIt3vs1)= 0.053, 95% CI: 0.017-0.088,P= 0.004). Conclusion: A proinflammatory diet was associated with higher menopause-specific somatic symptoms and higher DED was positively associated with menopausal symptoms.