Diet Quality and Nutritional Intake Differences Between Young Adult and Middle Aged Women with and Without Uterine Fibroids Participating in the National Nutrition and Health Examination Survey (NHANES) 2001-2006
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Gloede, Lise
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Abstract
Background: Uterine fibroids are a common condition for many premenopausal women with painful side effects and reproductive ramifications. Treatment options are limited and little is known about prevention. Dietary intake and food patterns are modifiable lifestyle factors which may play a role in this condition. Objective: To evaluate differences in dietary patterns, as measured using the Healthy Eating Index (HEI)-2010, and macronutrient intake between women with and without uterine fibroids. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) cycles 2001-2002, 2003-2004, and 2005-2006 was obtained to examine a sample of young adult and middle aged women in the United States, excluding those who were pregnant or breastfeeding. Self-reported dietary intake from one day of 24-hour recalls, anthropometric measurements, reproductive health, and demographic information was collected as part of NHANES. Demographic and reproductive health characteristics were compared between groups using regression and chi-squared tests. HEI-2010 scores and energy adjusted macronutrient intake differences between groups were compared using linear regression adjusting for covariates of age, BMI, race, smoking status, marital status, and educational level. Results: This analysis included 87 women reporting previous uterine fibroid diagnosis and 743 women without a previous diagnosis. Women with fibroids were older (p<0.001), more likely to be college graduates (p=0.05) and be married (p=0.02). After adjustment, no differences in HEI-2010 scores or macronutrient intakes were noted between groups. Subgroup analysis, of women diagnosed only within the past five years, found fibroid diagnosis was associated with an increase in empty calories subcomponent score of 2.53 (95% CI: 1.12, 3.93, p=0.002)) and a decrease in whole fruit subcomponent score of 0.73 (95% CI: -1.44, -0.028, p=0.044) compared to women without a fibroids diagnosis. Conclusion: Women with fibroids did not have significantly different scores in HEI total and subcomponent scores as well as energy adjusted macronutrient intakes. However, women with fibroids diagnosed within the past five years had different scores suggesting differing dietary patterns may be present in women diagnosed more recently, though the subsample size was limited. Due to limitations in this study of use of 1-day of 24-hour recall data, potential misclassification of fibroids, and not controlling for health literacy, further research via prospective cohort studies to examine food intake patterns and possible relationships with uterine fibroids is warranted.
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Keywords
Uterine fibroids, Diet quality, Healthy Eating Index, HEI, Uterine leiomyoma, NHANES