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. 2025 Oct 21;15(1):36750.
doi: 10.1038/s41598-025-20621-6.

Mediterranean diet adherence and healthy diet indicator might decrease odds of endometriosis

Morvarid Noormohammadi  1 , Fatemeh Sadat Hashemi Javaheri  2   3 , Sakine Ghasemisedaghat  4 , Seyed Mojtaba Ghoreishy  1 , Ghazaleh Eslamian  5 , Mehran Nouri  6 , Seyyedeh Neda Kazemi  7 , Elahe Nematifard  8 , Bahram Rashidkhani  9 , Robabeh Taheripanah  10
Affiliations

Mediterranean diet adherence and healthy diet indicator might decrease odds of endometriosis

Morvarid Noormohammadi et al. Sci Rep. .

Abstract

Diet may play a crucial role in managing endometriosis. Dietary interventions could help women with endometriosis improve their quality of life and reduce pain symptoms. The aim of this study was to examine the association between adherence to the Mediterranean diet and the Healthy Diet Indicator (HDI) with the odds of endometriosis among Iranian women. In this hospital-based case-control study conducted in Tehran, Iran, from February to September 2021, women diagnosed with endometriosis and healthy controls were recruited. Dietary intake was assessed using a validated 168-item food frequency questionnaire. Logistic regression analysis was performed to evaluate the association of the Mediterranean diet (assessed using the MEDI-Lite score) and HDI with the odds of endometriosis. Logistic regression analysis showed that women with greater adherence to the Mediterranean diet (MEDI-Lite score > mean) had 94% lower odds of endometriosis (OR = 0.06; 95% CI: 0.02-0.17; p < 0.001). Similarly, women with higher HDI scores had 95% lower odds of endometriosis (adjusted OR = 0.05; 95% CI: 0.02-0.12; p < 0.001). These findings suggest an inverse association between endometriosis and adherence to both the Mediterranean diet and HDI. Greater adherence to these dietary patterns may be recommended as part of preventive and therapeutic strategies for endometriosis.

Keywords: Case-control; Endometriosis; Healthy diet indicator; Mediterranean diet.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics statement: This study was approved by Medical Ethical Committee of National Nutrition and Food Technology Research Institute of Shahid Beheshti University of Medical Sciences (IR.SBMU.NNFTRI.REC.1399.062), in Iran, according to the Declaration of Helsinki. All of the participants provided written informed consent. Data confidentiality was also ensured.

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