Abstract
Bacterial vaginosis (BV) is a prevalent vaginal infection in women of reproductive age, characterized by a dysbiosis of the vaginal microbiota. A healthy vaginal environment is typically dominated by Lactobacillus species, which maintain a low pH that inhibits pathogenic bacterial growth. Emerging evidence suggests that diet may significantly influence the composition and function of the vaginal microbiota, offering a modifiable risk factor for BV. This systematic review examines the relationship between dietary patterns and BV risk, focusing on the effect of vitamins/minerals, fruits/vegetables, dairy/probiotics, carbohydrates/sugar, grains/fibers, and protein on vaginal health. It has been shown that deficiencies in vitamins A, C, E, and D may increase susceptibility to BV due to their roles in immune function, antioxidative defense, and vaginal epithelial health. Increased fruit and vegetable consumption, which provides these essential vitamins alongside phytochemicals such as betaine, correlates with a reduced risk of BV. Conversely, high glycemic diets appear to promote BV through increased oxidative stress. Whole grains and dietary fiber, rich in anti-inflammatory compounds and essential nutrients, support Lactobacillus-dominant microbiota and reduce BV risk. Additionally, obesity is associated with increased BV prevalence, suggesting a potential link between metabolic health and vaginal microbiota. The role of probiotics and dairy in fostering Lactobacillus colonization shows promise, while plant-based protein sources may further support vaginal health by reducing inflammation and maintaining pH balance. Despite these findings, limitations exist, including the need for longitudinal studies to determine causality, dose-dependent relationships, and the impact of dietary interventions across diverse populations. Future research should explore the efficacy of specific dietary nutrients and probiotics, particularly in high-risk groups, to develop targeted dietary recommendations for BV prevention.