Changes in Premenstrual Syndrome Severity, Nutrition Knowledge, and Eating Attitudes Following Online Nutrition Education in Female University Students: An Uncontrolled Single-Arm Pretest-Posttest Study

Abstract

Background/Objectives: This study evaluated changes in PMS severity, nutrition knowledge, and eating attitudes over a 6-week online nutrition education programme delivered to female university students. Methods: This uncontrolled single-arm pretest/posttest study included 112 female university students recruited by convenience sampling from a women's dormitory. Nutrition education was delivered daily for 6 weeks via WhatsApp as 42 informational cards. Measurements were taken before and after the programme. Attitudes and behaviours associated with disordered eating were screened using the Eating Attitudes Test-26 (EAT-26), nutrition knowledge using the Nutrition Knowledge Level Scale for Adults (NKLSA), and premenstrual symptom severity using the Premenstrual Syndrome Scale (PMSS). Results: No significant changes occurred in nutrition knowledge (p = 0.409) or eating attitudes (p = 0.654). The PMSS score significantly decreased (mean change = 14.28 +/- 46.34; 95% CI 5.60-22.96; p = 0.001, dz = 0.31, 95% CI 0.12-0.50), with decreases across eight subscales (dz = 0.19-0.38; BH q < 0.05), whereas appetite changes were unchanged (p = 0.423); the largest standardized changes were observed for depressive mood and bloating. PMSS change was not correlated with knowledge (r = 0.001) or knowledge with eating attitudes (r = 0.057); PMSS and eating attitude changes were weakly positively correlated (r = 0.187, p = 0.048; exploratory, not corrected for multiplicity). Conclusions: Following a 6-week WhatsApp-based nutrition education programme, self-reported PMS severity decreased, particularly mood and somatic symptoms, without changes in nutrition knowledge or eating attitudes. The uncontrolled single-arm design precludes attributing these changes to the programme.