Purdue-Smithe, A. C., Manson, J. E., Hankinson, S. E., & Bertone-Johnson, E. R. (2016). A prospective study of caffeine and coffee intake and premenstrual syndrome. The American journal of clinical nutrition, 104(2), 499-507. https://doi.org/10.3945/ajcn.115.127027
Purdue-Smithe AC, Manson JE, Hankinson SE, Bertone-Johnson ER. A prospective study of caffeine and coffee intake and premenstrual syndrome. The American journal of clinical nutrition. 2016;104(2):499-507. doi:10.3945/ajcn.115.127027
Purdue-Smithe, Alexandra C., et al. "A prospective study of caffeine and coffee intake and premenstrual syndrome." The American journal of clinical nutrition, vol. 104, no. 2, 2016, pp. 499-507.
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Eunice Kennedy Shriver National Institute of Child Health and Human Development04byxyr05
Caffeine intake was not associated with later PMS in nurses
In a case-control study nested in the Nurses' Health Study II, women with the highest caffeine intake had no higher odds of developing premenstrual syndrome (PMS) than women with the lowest intake after adjustment for smoking and other factors. The study compared 1234 women with new PMS and 2426 controls.
Key Findings
The study included 1234 women with a new PMS diagnosis between 1993 and 2005 and 2426 controls, all free of PMS at baseline in 1991.
The highest fifth of caffeine intake compared with the lowest fifth gave an adjusted OR of 0.79 (95% CI: 0.61, 1.04; P-trend = 0.31).
Adjusting for age alone gave an OR of 1.20 (95% CI: 0.96, 1.51) for the same comparison. The association was attenuated completely after adjusting for smoking, BMI and other factors.
Four or more cups of caffeinated coffee a day, against fewer than one a month, gave an OR of 0.73 (95% CI: 0.48, 1.12; P-trend = 0.44) for PMS with breast tenderness.
Two or more cups a day of caffeinated tea gave an OR of 1.04 (95% CI: 0.82, 1.34; P-trend = 0.89), against almost no tea.
Interpretation
The study is a case-control analysis nested in a prospective cohort. Women were free of PMS at baseline, and food-frequency questionnaires recorded caffeine intake every 4 years. The authors also analyzed intake 2 to 4 years before diagnosis, with similar results. Smoking was the strongest confounder, and the authors suggest that missing control for it may explain the positive links in earlier studies. The cohort consists of US nurses aged 25 and older, mostly non-Hispanic white and college-educated. The authors note that daily symptom diaries were not feasible at this scale. PMS was identified by clinician diagnosis plus a retrospective symptom questionnaire. The question studied was the development of PMS.
RRM Context
The authors name daily symptom diaries as the clinical standard for diagnosing PMS. Fertility awareness charting supplies such a record, because it places each symptom within the cycle. The same cohort has linked PMS to other dietary factors, including B vitamins, minerals, calcium and vitamin D.
Our editorial summary of this paper, not the article's abstract.
Abstract
Background
Clinically significant premenstrual syndrome (PMS) affects 15-20% of premenopausal women, substantially reducing quality of life. Women with PMS often are counseled to minimize caffeine intake, although only limited evidence supports this recommendation.
Objective
We evaluated the association between total caffeine, coffee, and tea intake and the development of PMS in a case-control study nested within the prospective Nurses' Health Study II.
Design
All participants were free from PMS at baseline (1991). PMS cases reported a new clinician-made diagnosis of PMS on biennial questionnaires between 1993 and 2005, and then confirmed symptom timing and moderate-to-severe impact and severity of symptoms with the use of a retrospective questionnaire (n = 1234). Controls did not report PMS and confirmed experiencing no symptoms or few mild symptoms with limited personal impact (n = 2426). Caffeine, coffee, and tea intake was measured by food-frequency questionnaires every 4 y, and data on smoking, body weight, and other factors were updated every 2-4 y. Logistic regression was used to evaluate the associations of total caffeine intake and frequency of coffee and tea consumption with PMS.
Results
After adjustment for age, smoking, and other factors, total caffeine intake was not associated with PMS. The OR comparing women with the highest (quintile median = 543 mg/d) to the lowest (quintile median = 18 mg/d) caffeine intake was 0.79 (95% CI: 0.61, 1.04; P-trend = 0.31). High caffeinated coffee intake also was not associated with risk of PMS or specific symptoms, including breast tenderness (OR for ≥4 cups/d compared with <1/mo: 0.73; 95% CI: 0.48, 1.12; P-trend = 0.44).
Conclusions
Our findings suggest that caffeine intake is not associated with PMS, and that current recommendations for women to reduce caffeine intake may not help prevent the development of PMS.
Alexandra C Purdue-Smithe, JoAnn E Manson, Susan E Hankinson, Elizabeth R Bertone-Johnson
Alex Purdue-Smithe, A Purdue-Smithe, J Manson, Sue Hankinson, S Hankinson, Liz Bertone-Johnson, Beth Bertone-Johnson, Betsy Bertone-Johnson, E Bertone-Johnson
PMID 27385613 27385613 DOI 10.3945/ajcn.115.127027 10.3945/ajcn.115.127027 Purdue-Smithe et al. 2016, Purdue-Smithe 2016
Keywords
caffeine, coffee, premenstrual syndrome, tea, women’s health
