The effect of omega 3 fatty acid supplementation on premenstrual syndrome and health-related quality of life: a randomized clinical trial

Effect of nutritional interventions on the psychological symptoms of premenstrual syndrome in women of reproductive age: a systematic review of randomized controlled trials

CONTEXT

Premenstrual syndrome (PMS) affects approximately 48% of women of reproductive age worldwide. It can lead to functional impairment, lower quality of life, and decreased work productivity. Despite the availability of medical treatment options, women are seeking alternative interventions because of concerns of harmful side effects and limited evidence of efficacy associated with pharmacological treatments. To date, high-quality research investigating the effects of dietary and nutrient intervention on PMS is limited.

OBJECTIVE

This systematic review investigated the effect of nutritional interventions on the psychological symptoms of PMS.

DATA SOURCES

Five electronic databases were searched for randomized controlled trials (RCTs) published in English from inception to October 2022. Trials eligible for inclusion were nutritional intervention studies involving women of reproductive age that measured PMS-associated psychological outcomes.

DATA EXTRACTION

Articles were selected using prespecified inclusion criteria. Data screening and extraction and risk-of-bias assessments were conducted by 3 independent reviewers using article screening software and the Cochrane Risk of Bias 2 tool.

DATA ANALYSIS

Thirty-two articles reporting on 31 RCTs involving 3254 participants, ranging in age from 15 to 50 years were included and narratively reviewed. Only 1 of the included studies had a low risk of bias. Treatment with vitamin B6, calcium, and zinc consistently had significant positive effects on the psychological symptoms of PMS. There was insufficient evidence to support the effects of vitamin B1, vitamin D, whole-grain carbohydrates, soy isoflavones, dietary fatty acids, magnesium, multivitamin supplementation, or PMS-specific diets.

CONCLUSIONS

There is some evidence to support the use of nutritional interventions for improving psychological symptoms of PMS. However, more research using consistent protocols, procedures to minimize risk of bias, intention-to-treat analysis, and clearer reporting is required to provide conclusive nutritional recommendations for improving PMS-related psychological outcomes.

PROSPERO REGISTRATION NO

CRD42022369999.

The effect of hydrogen-rich water consumption on premenstrual symptoms and quality of life: a randomized controlled trial

BACKGROUND

Premenstrual syndrome (PMS) consists of psychiatric or somatic symptoms negatively affecting the daily life. PMS treatment can involve the use of complementary-alternative approaches. Hydrogen-rich water (HRW) has antioxidant and anti-inflammatory properties that may treat PMS. This study aimed to investigate the effect of drinking HRW on the severity of premenstrual symptoms and the quality of life of women who suffer from PMS.

METHODS

This study is a randomized controlled trial. Participants were randomized into two groups (intervention group=33, control group=32) using the block randomization method. Participants were requested to consume 1500-2000 mL of HRW daily in the intervention group and drink water in the placebo group. Participants began drinking either HRW or placebo water from day 16 of their menstrual cycle until day 2 of the following cycle for three menstrual cycles. The research data were collected using a Demographic Information Form, Premenstrual Syndrome Scale (PMSS), and Short form of the World Health Organization Quality of Life Questionnaire (WHOQOL- BREF).

RESULTS

The intervention group had significantly lower mean scores than the control group in both the first and second follow-ups on the PMSS (P<0.05). In the first follow-up, the intervention group had significantly higher mean scores in the Physical Health and Psychological domains of the WHOQOL-BREF compared to the control group (P<0.05). Group × time interaction was significant for PMSS (F = 10.54, P<0.001). Group × time interaction was insignificant for WHOQOL- BREF (P>0.05).

CONCLUSIONS

The consumption of HRW reduces the severity of premenstrual symptoms and improves individuals' quality of life in physical and psychological domains.

Omega-3 supplementation and outcomes of heart failure: A systematic review of clinical trials

BACKGROUNDS

Omega-3 supplements are endorsed for heart failure (HF) patients to reduce hospitalizations and mortality, offering anti-inflammatory and cardioprotective benefits.

METHODS

A comprehensive search was conducted in various databases until November 2022. Eligible studies included clinical trials on patients with HF. Data extraction covered study details, omega-3 specifics, outcomes, and limitations. The JADAD scale was used to assess the risk of bias in randomized controlled trials.

RESULTS

The review process involved 572 records from database searches, resulting in 19 studies after eliminating duplicates and screening. These studies assessed the impact of omega-3 on various clinical outcomes, such as mortality, hospitalization, cardiac function, and quality of life. Studied duration varied from weeks to years. Omega-3 supplementation demonstrated potential benefits such as improved heart function, reduced inflammation, and decreased risk of cardiovascular events.

CONCLUSION

Omega-3 supplementation could benefit heart disease treatment, potentially reducing therapy duration and improving outcomes. Starting omega-3 supplementation for HF patients seems favorable.

Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and meta-analysis

INTRODUCTION

To date, no definitive results have been reported on the effect of omega-3 fatty acids on premenstrual syndrome (PMS). Therefore, this systematic review and meta-analysis aimed to determine the effect of omega-3 fatty acids on PMS.

METHODS

In this systematic review and meta-analysis, the databases were searched. In this regard, randomized clinical trials investigating the effect of omega-3 fatty acids on PMS were included. The quality of the studies was assessed using the Cochrane Collaboration's Risk of Bias tool. Meta-analysis was done based on random effects model and calculation of standardized mean difference (SMDs).

RESULTS

The results of meta-analysis showed that omega-3 fatty acids were efficient in reducing the severity of PMS in women (SMD = -0.968, 95% confidence interval [CI]: -1.471 to -0.464). In addition, the results showed that the studies were heterogeneous (I²  = 89.11%, p <0.001). Based on meta-regression analysis, aging (β = -0.150, 95% CI -0.202 to -0.098, p <0.001) and increasing the duration of intervention (β = -0.579, 95% CI -0.781 to -0.378, p <0.001) had a significant effect on the severity of PMS. We also found that omega-3 fatty acids could significantly reduce the somatic (SMD = -0.800, 95% CI: -1.126 to -0.474) and psychological (SMD = -0.373, 95% CI: -0.686 to -0.061) symptoms of PMS.

CONCLUSION

Omega-3 fatty acids could reduce the severity of PMS. However, we should caution in the conclusion in affirming the beneficial effects of n-3 PUFAs on PMS, since the heterogeneity is evident in the analysis. The efficacy of the treatment was enhanced by increase of the treatment duration.

Insomnia, Inattention and Fatigue Symptoms of Women with Premenstrual Dysphoric Disorder

Aim: Premenstrual dysphoric disorder (PMDD) has predictable, cyclic, psychological, and somatic symptoms, such as sleep problems. They result in functional impairment, are aggravated in the late luteal phase of the menstrual cycle, and are resolved by menstruation. The present study evaluated the insomnia, inattention, and fatigue symptoms of PMDD and their fluctuations during the menstrual cycle. Methods: A total of 100 women were diagnosed as having PMDD based on psychiatric interviews and a prospective investigation of three menstrual cycles. A total of 96 individuals without PMDD were recruited as controls. Their symptoms, namely insomnia, inattention, and fatigue as well as functional impairment were assessed by using the premenstrual symptoms screening tool, the Pittsburgh insomnia rating scale, the attention and performance self-assessment scale, and the fatigue-assessment scale during both premenstrual and follicular phases. Results: In both the premenstrual and follicular phases, women with PMDD experienced more severe insomnia, inattentiveness, and fatigue than did women in the control group. A paired t-test demonstrated that women with PMDD had more severe severity insomnia, inattentiveness, and fatigue in the luteal phase than in the follicular phase. A repeated-measures analysis of variance demonstrated that the interaction period of PMDD and a menstrual cycle was significantly associated with insomnia, inattentiveness, and fatigue. A further correlation analysis demonstrated that all three symptoms were positively associated with self-reported functional impairment due to PMDD. Conclusions: Our results demonstrated that women with PMDD experienced an exacerbation of insomnia, memory problems, difficulty maintaining focus, and fatigue in the premenstrual phase. These symptoms are correlated with PMDD symptoms severity and functional impairment, and as such, they should be evaluated, and interventions should be employed in the late luteal phase of women with PMDD.

Polyunsaturated fatty acids, lung function, and health-related quality of life in patients with chronic obstructive pulmonary disease

Background

Dietary polyunsaturated fatty acids (PUFA) are thought to modify systemic inflammation. The present study aimed to evaluate the relationship between PUFA intake, lung function, and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD).

Methods

In this study, we used the dataset of 6th Korea National Health and Nutrition Examination Survey, in which, a total of 22,948 individuals including 573 participants with a high probability of developing COPD were enrolled. Participants with missing data for the investigated variables were excluded. Linear regression analyses were used to evaluate the association between PUFA intake (omega-3 [N3], omega-6 [N6], and total) with lung function, and HRQoL. HRQoL was determined according to the European Quality of Life-5 Dimensions (EQ-5D). Subgroup analysis of older patients was performed. Age, sex, body mass index, smoking, alcohol, education, residence, total calorie intake, and predicted FEV₁% were adjusted in all analyses.

Results

Although lung function was not associated with PUFA intake, EQ-5D index was remarkably associated with N3, N6, and total PUFA intake in a dose-dependent manner. This association was more pronounced in elderly COPD patients. Mean levels of N3, N6, and total PUFA intake were significantly higher in patients having better HRQoL with respect to mobility, self-care, and usual activities.

Conclusion

Our results suggest that N3, N6, and total PUFA intake are associated with HRQoL in COPD patients. This association may be attributed to mobility, self-care, and usual activities. Further longitudinal study is required to clarify this relationship.

Treatment of premenstrual syndrome: Appraising the effectiveness of cognitive behavioral therapy in addition to calcium supplement plus vitamin D

Premenstrual syndrome (PMS) consists of repetitious physical and psychological symptoms. The symptoms occur during the luteal phase of the menstrual period and cease when the menstrual period starts. This study included pre-test and post-test experiments between a control group and a test group. The statistical population involved 40 females, chosen based on multistage cluster sampling. The participants were then divided into four groups to undergo treatment with calcium supplement plus vitamin D together with cognitive behavioral therapy (CBT), and were screened with the Premenstrual Syndrome Screening Test (PSST). The pre-test and post-test scores in the PSST, the General Health Questionnaire (GHQ-28), and Bell's Adjustment Inventory (BAI) were used as assessment tools (p < .05). According to the parameters of PMS symptoms, when evaluating the pre-test and post-test scores, the overall score of each individual in the experimental group was improved and a significant effect for the combination of calcium supplement plus vitamin D together with CBT was observed in comparison to the post-test control group. A comparison of multivariate analysis of covariance (MANCOVA) results collected from the pre-test and post-test scores revealed that the method of treatment was beneficial for PMS, adjustment, and general health.