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Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, Blackmore R, Naderpoor N, Bennett C, Ee C, Rao V, Mousa A, Alesi S, Moran L. Lifestyle management in polycystic ovary syndrome - beyond diet and physical activity. BMC Endocr Disord 2023; 23:14. [PMID: 36647089 PMCID: PMC9841505 DOI: 10.1186/s12902-022-01208-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/09/2022] [Indexed: 01/18/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with reproductive, metabolic and psychological consequences. Weight and lifestyle (diet, physical activity and behavioural) management are first-line therapy in international evidence-based guidelines for PCOS. While these recommend following population-level diet and physical activity guidelines, there is ongoing interest and research in the potential benefit of including psychological and sleep interventions, as well as a range of traditional, complimentary and integrative medicine (TCIM) approaches, for optimal management of PCOS. There is limited evidence to recommend a specific diet composition for PCOS with approaches including modifying protein, carbohydrate or fat quality or quantity generally having similar effects on the presentations of PCOS. With regards to physical activity, promising evidence supports the provision of vigorous aerobic exercise, which has been shown to improve body composition, cardiorespiratory fitness and insulin resistance. Psychological and sleep interventions are also important considerations, with women displaying poor emotional wellbeing and higher rates of clinical and subclinical sleep disturbance, potentially limiting their ability to make positive lifestyle change. While optimising sleep and emotional wellbeing may aid symptom management in PCOS, research exploring the efficacy of clinical interventions is lacking. Uptake of TCIM approaches, in particular supplement and herbal medicine use, by women with PCOS is growing. However, there is currently insufficient evidence to support integration into routine clinical practice. Research investigating inositol supplementation have produced the most promising findings, showing improved metabolic profiles and reduced hyperandrogenism. Findings for other supplements, herbal medicines, acupuncture and yoga is so far inconsistent, and to reduce heterogeneity more research in specific PCOS populations, (e.g. defined age and BMI ranges) and consistent approaches to intervention delivery, duration and comparators are needed. While there are a range of lifestyle components in addition to population-recommendations for diet and physical activity of potential benefit in PCOS, robust clinical trials are warranted to expand the relatively limited evidence-base regarding holistic lifestyle management. With consumer interest in holistic healthcare rising, healthcare providers will be required to broaden their knowledge pertaining to how these therapies can be safely and appropriately utilised as adjuncts to conventional medical management.
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Affiliation(s)
- Stephanie Cowan
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
| | - Siew Lim
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - Chelsea Alycia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Stephanie Pirotta
- Health and Social Care Unit, Monash University, Clayton, Victoria, Australia
| | - Rebecca Thomson
- Robinson Research Institute, The University of Adelaide, North Adelaide, South Australia, Australia
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
- Te Tātai Hauora o Hine - National Centre for Women's Health Research Aotearoa, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Rebecca Blackmore
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Christie Bennett
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Vibhuti Rao
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Simon Alesi
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
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Saei Ghare Naz M, Jahanfar S, Ramezani Tehrani F. An overview on effects of micronutrients and macronutrients interventions in management of polycystic ovary syndrome. Clin Nutr ESPEN 2022; 52:218-228. [PMID: 36513457 DOI: 10.1016/j.clnesp.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 10/16/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
Polycystic ovary syndrome (PCOS) is one of the common endocrinopathies among women. Changing dietary behaviors for PCOS management has been an important research focus during the last decades. This review has discussed current evidence and clinical trial studies relating to the impact of macronutrients and micronutrients in the management of different clinical feature of PCOS. The possible relationship between the quality and quantity of micronutrients and macronutrients and PCOS as well as the necessity to manage PCOS as a complex condition highlights the importance of diet-related interventions. The growing number of clinical trials related to the effect of micronutrients (zinc, chromium, selenium, vitamin D, inositol, and vitamin E) and macronutrients interventions (manipulation of fat, carbohydrate, protein, and MedDiet, Calorie restriction, Low Glycemic Diet) have been demonstrated to be practical approaches for managing clinical and biochemical features of PCOS, however the potential benefit of micronutrient and macronutrient approaches could be different from one by one, particularly in different phenotypes of PCOS. To achieve optimum outcomes, providing information regarding safety and the best dose selection of micronutrients and macronutrients is necessary. Hence, to better understand the approaches' risk/benefit in women with PCOS, future trials with a large sample size are recommended.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine,Tufts University School of Medicine USA
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Vajdi M, Musazadeh V, Karimi A, Heidari H, Tarrahi MJ, Askari G. Effects of Chromium Supplementation on Lipid Profile: an Umbrella of Systematic Review and Meta-analysis. Biol Trace Elem Res 2022:10.1007/s12011-022-03474-2. [PMID: 36376714 DOI: 10.1007/s12011-022-03474-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
Dyslipidemia is one of the most well-established modifiable risk factors for cardiovascular disease (CVD) development. Several meta-analyses have revealed the improving effects of chromium on dyslipidemia, while some studies have reported controversial results. This study aimed to summarize meta-analyses of randomized controlled trials (RCTs) that examined the effects of chromium supplementation on lipid profiles in adults. The literature search was conducted using Embase, Scopus, Web of Science, Cochrane Central Library, and PubMed databases with appropriate keywords from the beginning to May 2022. Based on the pooled analysis results, a random-effects model was used to determine the effects of chromium on blood lipid levels. Heterogeneity, publication bias, and sensitivity analysis were also evaluated using standard methods. A total of eight meta-analyses were included in this study. The pooled analysis of eight meta-analyses did not find any significant effect of chromium supplementation on triglycerides (TG) (ES = - 0.20 mg/dl; 95% CI: - 0.50, 0.10, p = 0.185), total cholesterol (TC) (ES = - 0.14 mg/dl, 95% CI: - 0.43, 0.16; p = 0.369), low-density lipoprotein cholesterol (LDL-c) (ES = - 0.08 mg/dl; 95% CI: - 0.19, 0.03; p = 0.142), and high-density lipoprotein cholesterol (HDL-C) levels (ES: 0.05 mg/dl, 95% CI: - 0.05, 0.14, p = 0.312). However, subgroup analysis by the intervention dose suggested that chromium supplementation in doses higher than 500 µg/day could significantly decrease TG. The available evidence proposes no beneficial effects of chromium intervention on blood lipids. As a result, it cannot be used as a single therapy to treat adults with lipid abnormalities.
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Affiliation(s)
- Mahdi Vajdi
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vali Musazadeh
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Karimi
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hajar Heidari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Tarrahi
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Gholamreza Askari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Ray A, Jankar JS. A Comparative Study of Chromium: Therapeutic Uses and Toxicological Effects on Human Health. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221128646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Chromium is an essential trace element whose deficiency can cause impairment of glucose tolerance, growth and various biological functions. There are two isotopes of chromium-trivalent chromium and hexavalent chromium. Both the isotopes of chromium have quite different effects on the human body. The objective of this narrative review is to compile the different effects of the two isotopes of chromium and give a comprehensive analysis of the effects of hexavalent and trivalent chromium. Data from various studies across different forums were compared to provide a concrete analysis of the therapeutic and harmful effects of two isotopes of chromium on human health. Chromium plays a vital role in the biological functions of the body. It might be helpful in balancing the glycaemic levels, triglyceride levels and cholesterol levels in the body. Excessive intake of chromium is harmful for health. Overexposure to chromium can lead to carcinogenic effects. Consumption of an insufficient amount of chromium might not be adequate as well. Trivalent chromium can be quite beneficial if taken in proper quantities. Hexavalent chromium can cause cancer. Trivalent chromium is beneficial, while hexavalent chromium is harmful to human health.
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Affiliation(s)
- Anaiska Ray
- Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Jayshri Sadashiv Jankar
- Department of Biochemistry, BKL Walawalkar Rural Medical College, Sawarde, Ratnagiri, Maharashtra, India
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Moslehi N, Zeraattalab-Motlagh S, Rahimi Sakak F, Shab-Bidar S, Tehrani FR, Mirmiran P. Effects of nutrition on metabolic and endocrine outcomes in women with polycystic ovary syndrome: an umbrella review of meta-analyses of randomized controlled trials. Nutr Rev 2022; 81:555-577. [PMID: 36099162 DOI: 10.1093/nutrit/nuac075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Numerous meta-analyses have been conducted on the effects of nutritional interventions on various health outcomes in women with polycystic ovary syndrome (PCOS). However, the strength of the evidence and its clinical significance are unclear. OBJECTIVE This umbrella review aimed to summarize the effects of nutritional interventions on women with PCOS and assess the strength of the evidence. DATA SOURCES PubMed, Scopus, and Web of Science were searched from inception until March 17, 2021. DATA EXTRACTION Meta-analyses of randomized clinical trials (RCTs) that examined the impact of dietary modifications or supplementations on women with PCOS were selected. Data extraction, quality assessments of the meta-analyses, and evaluation of the strength of the evidence were conducted independently by 2 investigators and confirmed by a third. DATA ANALYSIS Twenty-eight RCT meta-analyses were included, reporting 40 different outcomes. Lower carbohydrate, Dietary Approaches to Stop Hypertension, or lower glycemic index/load diets in women with PCOS significantly improved some anthropometric and metabolic characteristics (with very low to low certainty). Probiotics/synbiotics reduced fasting plasma glucose, fasting insulin (FI), and homeostasis model assessment-estimated insulin resistance (HOMA-IR) (with moderate to high certainty). Curcumin supplementation decreased fasting plasma glucose, FI, and HOMA-IR (with moderate certainty). Fish oil supplementation decreased FI and HOMA-IR, and omega-3 reduced triglycerides (with moderate certainty). There were also improvements in FI after taking vitamin D or inositol supplements (with moderate certainty). Supplementation with fish oil increased adiponectin (with high certainty), and probiotics/synbiotics reduced total testosterone (with moderate certainty). In subfertile women with PCOS, inositol increased the ovulation rates (with moderate certainty). CONCLUSION There was no high-certainty evidence that diets alone in women with PCOS improved health or reproductive outcomes. Supplementation with vitamin D, probiotics/synbiotics, omega-3, inositol, and curcumin showed favorable effects on some metabolic outcomes. Probiotics/synbiotics possibly reduces total testosterone, and inositol stimulates ovulation in women with PCOS. REGISTRATION PROSPERO registration no. CRD42021251496.
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Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sheida Zeraattalab-Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rahimi Sakak
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Changes in serum heavy metals in polycystic ovary syndrome and their association with endocrine, lipid-metabolism, inflammatory characteristics and pregnancy outcomes. Reprod Toxicol 2022; 111:20-26. [DOI: 10.1016/j.reprotox.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
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Islam GMR, Rahman MM, Hasan MI, Tadesse AW, Hamadani JD, Hamer DH. Hair, serum and urine chromium levels in children with cognitive defects: A systematic review and meta-analysis of case control studies. CHEMOSPHERE 2022; 291:133017. [PMID: 34813844 PMCID: PMC8792285 DOI: 10.1016/j.chemosphere.2021.133017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/11/2021] [Accepted: 11/19/2021] [Indexed: 05/02/2023]
Abstract
Environmental chromium exposure may cause impaired development of children. We conducted a systematic review and meta-analysis. Electronic databases including PubMed, Embase, Web of Science and CINAHL were searched to identify case-control studies that reported childhood Cr exposure and cognitive development. The Newcastle-Ottawa Scale (NOS) was used to ensure the quality of the included studies. Cr levels were compared in cases and controls, and a random effect meta-analysis was performed using Stata version 16. Twelve of 61 studies identified in the literature search were eligible for this analysis. Hair, serum and urine Cr measurements were reported by seven, two and one studies, respectively. In addition, one study reported both serum and hair Cr exposure and another reported urine and hair Cr exposure. The pooled standard mean differences (SMD) showed that hair Cr levels were non-significantly lower among children with cognitive defects (-0.01 μg/g, 95% CI: -0.04, 00, p = 0.27). In serum and urine, the pooled SMD was higher in children with cognitive deficits compared with healthy control children (0.32 μg/g, 95% CI: -0.78, 1.42, p = 0.56 and 0.64 μg/g, CI: -0.07,1.36, p = 0.08; respectively). In summary, this systematic review found no significant differences in hair, serum and urine Cr levels between children with cognitive deficits and healthy control children when all study data were pooled in the meta-analysis. Larger studies using standardized criteria and longitudinal assessment of cognitive development are needed to determine whether there is a dose response effect of childhood Cr exposure on cognitive development of children.
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Affiliation(s)
- G M Rabiul Islam
- Harvard T.H. Chan School of Public Health, Harvard University, USA; Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Bangladesh.
| | | | - Mohammed Imrul Hasan
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Amare Worku Tadesse
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, SOAS University of London, UK
| | - Jena Derakhshani Hamadani
- Maternal and Child Health Division, International Center for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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Alesi S, Ee C, Moran LJ, Rao V, Mousa A. Nutritional Supplements and Complementary Therapies in Polycystic Ovary Syndrome. Adv Nutr 2021; 13:1243-1266. [PMID: 34970669 PMCID: PMC9340985 DOI: 10.1093/advances/nmab141] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/25/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) affects 1 in 5 women of reproductive age, and is characterized by menstrual irregularities, clinical or biochemical hyperandrogenism, and the presence of polycystic ovary morphology. One of the recommended treatment strategies in the international evidence-based guidelines is lifestyle modification, which includes diet and exercise, with the aim of improving a range of health outcomes. The incurable nature of PCOS reinforces the importance of developing novel and innovative symptomatic relief strategies, which are currently the only available approaches for improving quality of life for these women. Women with PCOS tend to be nutrient deficient in many common vitamins and minerals, thought to be associated with the psychological (depression, anxiety, etc.) and physiological (insulin resistance, diabetes, infertility, etc.) sequelae of the condition. Nutrient supplementation and the integration of complementary medicine as adjuncts to traditional lifestyle-based therapies in PCOS could therefore provide additional benefits to these women. In this review, we synthesize the evidence regarding nutrient supplementation and complementary therapies in PCOS, predominantly from randomized controlled trials, systematic reviews, and meta-analyses, to provide an overview of the state of knowledge in this field. The evidence to date suggests that specific vitamins (B-12, inositols, folate, vitamins D, E, and K), vitamin-like nutrients (bioflavonoids and α-lipoic acid), minerals (calcium, zinc, selenium, and chromium picolinate), and other formulations (melatonin, ω-3 fatty acids, probiotics, and cinnamon), as well as some complementary approaches such as acupuncture and yoga may be beneficial in PCOS. However, there remain areas of uncertainty and key limitations in the literature that must be overcome before these therapies can be integrated into routine clinical practice.
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Affiliation(s)
- Simon Alesi
- Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Victoria, Australia
| | - Carolyn Ee
- The National Institute of Complementary Medicine, Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Victoria, Australia
| | - Vibhuti Rao
- The National Institute of Complementary Medicine, Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Aya Mousa
- Address correspondence to AM (e-mail: )
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Nutrition Strategy and Life Style in Polycystic Ovary Syndrome-Narrative Review. Nutrients 2021; 13:nu13072452. [PMID: 34371961 PMCID: PMC8308732 DOI: 10.3390/nu13072452] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/02/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
Here we present an extensive narrative review of the broadly understood modifications to the lifestyles of women with polycystic ovary syndrome (PCOS). The PubMed database was analyzed, combining PCOS entries with causes, diseases, diet supplementation, lifestyle, physical activity, and use of herbs. The metabolic pathways leading to disturbances in lipid, carbohydrate, and hormonal metabolism in targeted patients are described. The article refers to sleep disorders, changes in mental health parameters, and causes of oxidative stress and inflammation. These conditions consistently lead to the occurrence of severe diseases in patients suffering from diabetes, the fatty degeneration of internal organs, infertility, atherosclerosis, cardiovascular diseases, dysbiosis, and cancer. The modification of lifestyles, diet patterns and proper selection of nutrients, pharmacological and natural supplementation in the form of herbs, and physical activity have been proposed. The progress and consequences of PCOS are largely modifiable and depend on the patient’s approach, although we have to take into account also the genetic determinants.
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Halder S, Kar R, Chakraborty S, Banerjee BD. Chromium Exposure in Late Gestation Period Caused Increased Levels of Cr in Brain Tissue: Association with Alteration of Activity and Gene Expression of Antioxidant Enzymes of F1 and F2 Generation Mice. Biol Trace Elem Res 2021; 199:2635-2643. [PMID: 32892319 DOI: 10.1007/s12011-020-02367-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
Chromium is a micronutrient which has found frequent use as supplements during pregnancy and could have a role in altering the antioxidant status in the brain. The present study was undertaken to estimate chromium levels in the brain, antioxidant enzyme activity with their gene expression, and learning and memory parameters on F1 and F2 generation mice when the F0 was exposed to chromium. The chromium levels in the brain were estimated using atomic absorption spectrophotometer. The enzyme activity of glutathione-s-transferase (GST) and catalase (CAT) was estimated and their gene expression was evaluated using RT-PCR. The spatial memory was tested using Morris water maze. The learning and recall memory was tested using the step down latency paradigm. The chromium levels were significantly raised in animals treated with Cr per se in F1 generation and quercetin cotreatment reduced the Cr levels in brain significantly. The enzyme activity of GST was significantly less in Cr-treated animals of both generations and this effect was significantly reversed on cotreatment with quercetin. The gene expression of GST matched the enzyme activity. However, catalase activity did not show significant decrease with Cr but cotreatment with quercetin resulted in significant decrease compared with control and this effect was not matched by its gene expression. We observed no significant change in learning and memory parameters in both generations following Cr exposure. Thus, this study demonstrates that chromium exposure in gestation causes changes in enzyme activity especially GST and this change was matched by change in gene expression in GST but not CAT. There was no effect on memory at the given dose.
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Affiliation(s)
- Sumita Halder
- Department of Pharmacology, University College of Medical Sciences and G. T. B. Hospital, New Delhi, 110095, India.
| | - Rajarshi Kar
- Department of Biochemistry, University College of Medical Sciences and G. T. B. Hospital, New Delhi, 110095, India
| | - Sucharita Chakraborty
- Geological Oceanographic Division, National Institute of Oceanograhy, Panaji, Goa, India
- Department of Geology and Geophysics, Indian Institute of Technology, Kharagpur, India
| | - Basu D Banerjee
- Department of Biochemistry, University College of Medical Sciences and G. T. B. Hospital, New Delhi, 110095, India
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Frias-Toral E, Garcia-Velasquez E, de Los Angeles Carignano M, Rodriguez-Veintimilla D, Alvarado-Aguilera I, Bautista-Litardo N. Polycystic ovary syndrome and obesity: clinical aspects and nutritional management. Minerva Endocrinol (Torino) 2021; 47:215-241. [PMID: 33792235 DOI: 10.23736/s2724-6507.21.03349-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine and metabolic disorder characterized by androgen excess, oligo-anovulatory infertility, polycystic ovaries in ultrasound examination, insulin resistance, and cardiometabolic disorders, with overweight/obesity and visceral adiposity. This review aims to provide an overview of the clinical characteristics and nutritional therapy of PCOS and obesity. METHODS The authors analyzed the updated and relevant publications found on Pubmed about clinical aspects and nutritional management of PCOS and obesity in studies done in animal and human models. DISCUSSION It is crucial an early detection and intervention in PCOS patients to avoid the more challenging control of the onset of more impaired-health conditions that this pathology causes. It is presented evidence that clearly shows the close interaction among oxidative stress, low-grade inflammation, and PCOS. It is also analyzed the relevance of treating metabolic and nutritional correlations of PCOS with a complete therapeutic strategy that includes individualized medication, diet, and healthy habits. CONCLUSIONS By an integral approach and treatment that includes not only medications for PCOS symptoms, supplementation of minerals and vitamins to control PCOS complications but an antiinflammatory diet, nutritional education, exercise individualized program, lifestyle changes, it is possible to improve insulin resistance, sustained weight loss, ovulation rates, among other goals for the management of this disease. Further studies are needed to clarify mechanisms, beneficial effects, and doses of supplements and precise medication to determine the best combination of diets and exercise programs according to these patients' specific requirements.
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Affiliation(s)
- Evelyn Frias-Toral
- Research Committee, SOLCA Guayaquil, Av. Pedro Menendez Gilbert, Guayaquil, Ecuador - .,Palliative Care Residency from Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador -
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12
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Neves LPP, Marcondes RR, Maffazioli GDN, Simões RS, Maciel GAR, Soares JM, Baracat EC. Nutritional and dietary aspects in polycystic ovary syndrome: insights into the biology of nutritional interventions. Gynecol Endocrinol 2020; 36:1047-1050. [PMID: 32960105 DOI: 10.1080/09513590.2020.1822797] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder, which affects 5-17% of reproductive age women and is often associated with obesity and metabolic impairment. Common treatment strategies are based on exercise, diet and nutrient supplementation since PCOS is often linked with obesity and metabolic impairment. Studies have recommended that nutrition is a key factor in the health maintenance of women with PCOS, however, little is known about the subject in the context of such a disease. This narrative review aims to identify dietary and nutritional aspects of PCOS and discuss the role of nutrients in management of polycystic ovary syndrome in view of clinical trials.
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Affiliation(s)
- Luísa Pinheiro Pimenta Neves
- Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rodrigo Rodrigues Marcondes
- Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Giovana De Nardo Maffazioli
- Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Ricardo Santos Simões
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | - Gustavo Arantes Rosa Maciel
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | - Jose Maria Soares
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
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Jamilian M, Foroozanfard F, Kavossian E, Kia M, Aghadavod E, Amirani E, Asemi Z. Effects of Chromium and Carnitine Co-supplementation on Body Weight and Metabolic Profiles in Overweight and Obese Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 2020; 193:334-341. [PMID: 30977089 DOI: 10.1007/s12011-019-01720-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/03/2019] [Indexed: 01/19/2023]
Abstract
The primary aim of our study was to determine the influence of taking chromium plus carnitine on insulin resistance, with a secondary objective of evaluating the influences on lipid profiles and weight loss in overweight subjects with polycystic ovary syndrome (PCOS). In a 12-week randomized, double-blind, placebo-controlled clinical trial, 54 overweight women were randomly assigned to receive either supplements (200 μg/day chromium picolinate plus 1000 mg/day carnitine) or placebo (27/each group). Chromium and carnitine co-supplementation decreased weight (- 3.6 ± 1.8 vs. - 1.0 ± 0.7 kg, P < 0.001), BMI (- 1.3 ± 0.7 vs. - 0.3 ± 0.3 kg/m2, P < 0.001), fasting plasma glucose (FPG) (- 5.1 ± 6.0 vs. - 1.1 ± 4.9 mg/dL, P = 0.01), insulin (- 2.0 ± 1.4 vs. - 0.2 ± 1.2 μIU/mL, P < 0.001), insulin resistance (- 0.5 ± 0.4 vs. - 0.04 ± 0.3, P < 0.001), triglycerides (- 18.0 ± 25.2 vs. + 5.5 ± 14.4 mg/dL, P < 0.001), total (- 17.0 ± 20.3 vs. + 3.6 ± 12.0 mg/dL, P < 0.001), and LDL cholesterol (- 13.3 ± 19.2 vs. + 1.4 ± 13.3 mg/dL, P = 0.002), and elevated insulin sensitivity (+ 0.007 ± 0.005 vs. + 0.002 ± 0.005, P < 0.001). In addition, co-supplementation upregulated peroxisome proliferator-activated receptor gamma (P = 0.02) and low-density lipoprotein receptor expression (P = 0.02). Overall, chromium and carnitine co-supplementation for 12 weeks to overweight women with PCOS had beneficial effects on body weight, glycemic control, lipid profiles except HDL cholesterol levels, and gene expression of PPAR-γ and LDLR. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N38.
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Affiliation(s)
- Mehri Jamilian
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Foroozanfard
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Elham Kavossian
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Mersedeh Kia
- Department of Midwifery, Gorgan Branch, Islamic Azad University, Gorgan, Iran
| | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Elaheh Amirani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran.
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14
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Piotrowska A, Pilch W, Czerwińska-Ledwig O, Zuziak R, Siwek A, Wolak M, Nowak G. The Possibilities of Using Chromium Salts as an Agent Supporting Treatment of Polycystic Ovary Syndrome. Biol Trace Elem Res 2019; 192:91-97. [PMID: 30715682 PMCID: PMC6820608 DOI: 10.1007/s12011-019-1654-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/24/2019] [Indexed: 02/07/2023]
Abstract
The polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy in women in reproductive age with the so far undetermined causes of development. In the etiopathogenesis of PCOS, the role of insulin resistance is emphasised, which was an indication for the attempts at using chromium III salts (Cr) in augmenting pharmacotherapy applied in patients. The analysis of the usefulness and efficacy of this approach was the direct goal of this thesis. Animal tests confirmed the efficacy of chromium in maintaining the appropriate level of glycaemia and insulinaemia, normalisation of plasma concentrations of microelements and also a correlation between the Cr level, insulin and dehydroepiandrosterone (DHEA) was found. A decrease in the expression of 3β-hydroxysteroid dehydrogenase and 17β-hydroxysteroid dehydrogenase was identified in adipose tissue. Clinical studies, although sparse, show that the supplementation with chromium can improve BMI and the parameters evaluating the control of glycaemia and increase the chances for ovulation and regular menstruation. However, the small number and a variability in study protocols makes comparing them very difficult. A completely new subject that has not been yet studied is the possibility of using chromium in levelling mood disorders in patients with PCOS. Currently, there are still no sufficient proofs for introducing chromium as a standard in treating and preventing insulin resistance in patients with PCOS. However, this direction remains open, and treating insulin resistance is an important challenge in clinical practice.
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Affiliation(s)
- Anna Piotrowska
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland.
| | - Wanda Pilch
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Olga Czerwińska-Ledwig
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Roxana Zuziak
- Department of Biochemistry and Basics of Cosmetology, University of Physical Education, Kraków, Poland
| | - Agata Siwek
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
| | - Małgorzata Wolak
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
| | - Gabriel Nowak
- Department of Pharmacobiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Neurobiology, Laboratory of Trace Elements Neurobiology, Institute of Pharmacology PAS, Kraków, Poland
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15
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Caparros-Gonzalez RA, Giménez-Asensio MJ, González-Alzaga B, Aguilar-Garduño C, Lorca-Marín JA, Alguacil J, Gómez-Becerra I, Gómez-Ariza JL, García-Barrera T, Hernandez AF, López-Flores I, Rohlman DS, Romero-Molina D, Ruiz-Pérez I, Lacasaña M. Childhood chromium exposure and neuropsychological development in children living in two polluted areas in southern Spain. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 252:1550-1560. [PMID: 31277024 DOI: 10.1016/j.envpol.2019.06.084] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 05/28/2023]
Abstract
This study aimed to assess the association between exposure to chromium and neuropsychological development among children. A cross-sectional study was conducted with 393 children aged 6-11 years old randomly selected from State-funded schools in two provinces in Southern Spain (Almeria and Huelva), in 2010 and 2012. Chromium levels in urine and hair samples were analyzed by inductively coupled plasma mass spectrometry with an octopole reaction system. Neuropsychological development was evaluated using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and three computerized tests from the Behavioural Assessment and Research System (BARS): Reaction Time Test (RTT), Continuous Performance Test (CPT) and Selective Attention Test (SAT). Multivariable linear regression models adjusted for potential confounders, including heavy metals, were applied to examine the association between chromium levels and neuropsychological outcomes. A 10-fold increase in urine chromium levels was associated with a decrease of 5.99 points on the WISC-IV Full-Scale IQ (95% CI: 11.98 to -0.02). Likewise, a 10-fold increase in urine chromium levels in boys was associated with a decrease of 0.03 points in the percentage of omissions (95% CI: 0.0 to 0.05) in the SAT, with an increase of 68.35 points in latency (95% CI: 6.60 to 130.12) in the RTT, and with an increase in the number of trials with latencies > 1000 ms (β = 37.92; 95% CI: 2.73 to 73.12) in the RTT. An inverse significant association was detected between chromium levels in hair and latency in the SAT in boys (β = -50.53; 95% CI: 86.86 to -14.22) and girls (β = -55.95; 95% CI: 78.93 to -32.97). Excluding trials with latencies >1000 ms in the RTT increased latency scores by 29.36 points in boys (95% CI: 0.17 to 58.57), and 39.91 points in girls (95% CI: 21.25 to 58.59). This study is the first to show the detrimental effects of postnatal chromium exposure on neuropsychological development in school-aged children.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Mind, Brain and Behaviour Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain; Department of Nursing, Faculty of Health Sciences, University of Jaen, Jaen, Spain
| | | | - Beatriz González-Alzaga
- Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | | | - J Andrés Lorca-Marín
- Department of Clinical, Experimental and Social Psychology, University of Huelva, Huelva, Spain; Natural Resources, Health, and Environment Research Centre (RENSMA), University of Huelva, Huelva, Spain
| | - Juan Alguacil
- Natural Resources, Health, and Environment Research Centre (RENSMA), University of Huelva, Huelva, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - José L Gómez-Ariza
- Professor José Carlos Vílchez Martín, Department of Chemistry, University of Huelva, Huelva, Spain; Natural Resources, Health, and Environment Research Centre (RENSMA), University of Huelva, Huelva, Spain
| | - Tamara García-Barrera
- Professor José Carlos Vílchez Martín, Department of Chemistry, University of Huelva, Huelva, Spain; Natural Resources, Health, and Environment Research Centre (RENSMA), University of Huelva, Huelva, Spain
| | - Antonio F Hernandez
- Department of Legal Medicine, Toxicology and Physical Anthropology, University of Granada, Granada, Spain
| | - Inmaculada López-Flores
- Department of Genetics, Faculty of Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - Diane S Rohlman
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, USA
| | - Desiree Romero-Molina
- Department of Statistics and Operational Research, Faculty of Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - Isabel Ruiz-Pérez
- Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marina Lacasaña
- Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain; CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:99-111. [DOI: 10.1016/j.jogn.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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