1
|
Mansouri F, de Simone G, Bordoni L, Gabbianelli R. The effects of non-soy legumes consumption on serum levels of inflammatory biomarkers and Adiponectin in overweight/obese adults: A systematic review and meta-analysis of Randomized Controlled Trials. J Nutr Biochem 2024:109718. [PMID: 39103105 DOI: 10.1016/j.jnutbio.2024.109718] [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: 03/15/2024] [Revised: 07/22/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024]
Abstract
OBJECTIVES Non-soy legumes offer many health benefits, including improved arterial function, reduced cholesterol levels, and better management of cardiovascular diseases and type 2 diabetes. This systematic review and meta-analysis aim to clarify the inconclusive findings from randomized controlled trials (RCTs) by comprehensively evaluating the effects of non-soy legumes consumption on serum levels of inflammatory biomarkers and Adiponectin. METHODS The search encompassed databases up to January 2024, including PubMed, EMBASE, MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL to retrieve all RCTs examining the effects of non-soy legumes on inflammatory biomarkers or Adiponectin. The effect sizes quantified as mean differences (MD) and standard deviations (SD) of outcomes, and an overall effect estimate was derived using a random-effects model. RESULTS RCTs examining serum levels of C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNF-α), Interleukin-1β (IL-1β), and Adiponectin were included in the final meta-analysis. Results revealed that consumption of non-soy legumes increased Adiponectin serum levels (p = 0.0017) and reduced IL-1β serum levels (p < 0.0001). However, it may not significantly affect CRP (p = 0.2951), IL-6 (p = 0.2286), and TNF-α (p = 0.6661) levels. Subgroup analyses showed that non-soy legumes consumption significantly decreased TNF-α serum levels in studies involving healthy participants. Additionally, sensitivity analysis using the leave-one-out method suggested a potential significant reduction in serum levels of IL-6. CONCLUSIONS This study indicates that consuming non-soy legumes can increase levels of Adiponectin and decrease serum levels of IL-1β in overweight or obese adults.
Collapse
Affiliation(s)
- Fatemeh Mansouri
- School of Advanced Studies, University of Camerino, Italy; Unit of Molecular Biology and Nutrigenomics, School of Pharmacy and Health Products, University of Camerino, Italy
| | - Gaia de Simone
- School of Advanced Studies, University of Camerino, Italy; Unit of Molecular Biology and Nutrigenomics, School of Pharmacy and Health Products, University of Camerino, Italy
| | - Laura Bordoni
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy and Health Products, University of Camerino, Italy.
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy and Health Products, University of Camerino, Italy.
| |
Collapse
|
2
|
Fu J, Chen Y, Huang Z, Wang X. The effect of Bushenhuoxue nutritional decoction in the treatment of overweight patients with polycystic ovarian syndrome. Pak J Med Sci 2024; 40:1105-1110. [PMID: 38952537 PMCID: PMC11190424 DOI: 10.12669/pjms.40.6.9304] [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: 12/12/2023] [Revised: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 07/03/2024] Open
Abstract
Objective To assess the effect of Traditional Chinese Medicine (TCM) nutrition treatment (Bushenhuoxue nutritional decoction) in overweight patients with polycystic ovary syndrome (PCOS). Methods Retrospective analysis of 96 overweight patients with PCOS who received treatment in our hospital from October 2020 to June 2022 was done. Among them, 46 patients received routine drug treatment and daily dietary intervention (control group), while 50 patients received additional TCM nutrition support in addition to routine treatment (observation group). Glucose and lipid metabolism indicators and hormone levels were compared between the two groups before and after the treatment. Ovulation rate, pregnancy rate, and adverse reactions were compared between both groups one year after the treatment. Results After treatment, the improvement of glucose and lipid metabolism indicators and hormone levels in the observation group was significantly better than in the control group (P<0.05). After treatment, the TCM syndrome scores of the two groups were lower than that before treatment (P < 0.001), and the TCM syndrome scores of the observation group was lower than that of the control group (P < 0.001).Ovulation and pregnancy rates were significantly higher in the observation group compared to the control group at 1-year follow up (P<0.05), and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). Conclusions Combined with conventional drug treatment, TCM nutrition treatment can significantly improve glucose and lipid metabolism, hormone levels, and TCM syndrome of overweight PCOS patients, increase the ovulation and pregnancy rates, and reduce potential adverse reactions.
Collapse
Affiliation(s)
- Jiaowen Fu
- Jiaowen Fu, Department of Traditional Chinese Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province 570102, P.R. China
| | - Yingqi Chen
- Yingqi Chen, Department of Chinese medicine prescription, Hainan Medical University, Haikou, Hainan Province 571199, P.R. China
| | - Zongwen Huang
- Zongwen Huang, Department of Traditional Chinese Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province 570102, P.R. China
| | - Xiaojing Wang
- Xiaojing Wang, Department of Clinical Nutrition, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province 570000, P.R. China
| |
Collapse
|
3
|
Iahtisham-Ul-Haq, Akram A, Yasmin I, Sharif HR, Nayik GA, Ramniwas S, Siddiqui SA. Compositional profiling and bioefficacy studies of pulses-supplemented isocaloric designer biscuits for recently diagnosed diabetic individuals. Food Chem X 2024; 22:101305. [PMID: 38559441 PMCID: PMC10978483 DOI: 10.1016/j.fochx.2024.101305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/07/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
This study addresses global concerns about diabetes mellitus by exploring a novel approach to manage hyperglycemia through pulses-supplemented designer biscuits. Control and designer biscuits were prepared with varying proportions of wheat flour and pulses (chickpea, mungbean). The pulses-supplemented biscuits exhibited increased protein content and reduced readily available carbohydrates. Selected designer biscuits, with 12.5 % incorporation of chickpea and mungbean pulse flour, demonstrated significantly lower glycemic index (69.17 ± 5.01) and higher satiety index (122.19 ± 8.85) compared to control biscuits. These showed 13 % less glycemic index and 9 % higher satiety index as compared to control biscuits. A four-week bio-efficacy trial involving diabetic subjects consuming these biscuits as a routine snack resulted in an 11.45 % decrease in fasting blood glucose and a 19.15 % reduction in random blood glucose levels. Insulin and HDL levels also significantly improved. The study concludes that these designer biscuits possess a hypoglycemic effect, offering a potential dietary intervention for managing diabetes.
Collapse
Affiliation(s)
- Iahtisham-Ul-Haq
- Kauser Abdulla Malik School of Life Sciences, Forman Christian College (A Chartered University), Lahore, Pakistan
| | - Aqsa Akram
- Department of Diet and Nutritional Sciences, Faculty of Allied Health Sciences, Imperial College of Business Studies (ICBS), Lahore, Pakistan
| | - Iqra Yasmin
- Department of Human Nutrition and Dietetics, University of Chakwal, Chakwal, Pakistan
| | - Hafiz Rizwan Sharif
- Department of Food Science and Technology, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Gulzar Ahmad Nayik
- Department of Food Science & Technology, Government Degree College Shopian, 192303 Jammu and Kashmir, India
| | - Seema Ramniwas
- University Centre for Research and Development, Chandigarh University, Gharuan, Mohali, Punjab, India
| | - Shahida Anusha Siddiqui
- Technical University of Munich, Campus Straubing for Biotechnology and Sustainability, Essigberg 3, 94315 Straubing, Germany
- German Institute of Food Technologies (DIL e.V.), Prof.-von-Klitzing Str. 7, 49610, Quakenbrück, Germany
| |
Collapse
|
4
|
Almhmoud H, Alatassi L, Baddoura M, Sandouk J, Alkayali MZ, Najjar H, Zaino B. Polycystic ovary syndrome and its multidimensional impacts on women's mental health: A narrative review. Medicine (Baltimore) 2024; 103:e38647. [PMID: 38905372 PMCID: PMC11191963 DOI: 10.1097/md.0000000000038647] [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: 02/08/2024] [Accepted: 05/30/2024] [Indexed: 06/23/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects approximately 8% to 13% of women of reproductive age worldwide. It is characterized by a range of symptoms, including hirsutism, acne, and menstrual irregularities, and poses a significant psychological burden, including anxiety and depression. The evolving definition of PCOS, from the 1990 NIH conference to the 2003 Rotterdam conference, highlights its multifaceted nature, encompassing metabolic, reproductive, and psychological aspects. This overview aims to elucidate the complex interplay between PCOS's physiological and psychological dimensions. It focuses on understanding the heightened risk of psychiatric disorders, including depression and anxiety, among women with PCOS and explores the contributing factors, such as obesity, body image issues, and stress. The etiology of PCOS involves a complex mixture of genetic, hormonal, and lifestyle factors that contribute to its pathophysiology and the associated mental health challenges. Stress, in various forms, including metabolic, inflammatory, oxidative, and emotional, is identified as a significant contributor to the pathogenesis of PCOS. Management strategies highlighted include lifestyle modifications, dietary and exercise interventions, and psychological therapies, underscoring the need for comprehensive and integrated care approaches that address the broad spectrum of PCOS effects. A multifaceted treatment approach that goes beyond just the physical symptoms of PCOS to also include its significant psychological effects is emphasized, reinforcing the necessity for a comprehensive, integrated care strategy to manage this complex condition effectively.
Collapse
Affiliation(s)
- Haya Almhmoud
- Faculty of Medicine-Tishreen University, Lattakia, Syria
| | - Lara Alatassi
- Department of Laboratory Medicine, Aleppo University Hospital, Aleppo, Syria
| | - Mouna Baddoura
- Faculty of Medicine-Damascus University, Damascus, Syria
| | - Joudy Sandouk
- Faculty of Medicine-Damascus University, Damascus, Syria
| | | | - Hasan Najjar
- Faculty of Medicine-Damascus University, Damascus, Syria
| | - Basem Zaino
- Department of Pathology, Tishreen University Hospital, Lattakia, Syria
| |
Collapse
|
5
|
Klobodu C, Vitolins MZ, Deutsch JM, Fisher K, Nasser JA, Stott D, Murray MJ, Curtis L, Milliron BJ. Examining the Role of Nutrition in Cancer Survivorship and Female Fertility: A Narrative Review. Curr Dev Nutr 2024; 8:102134. [PMID: 38584676 PMCID: PMC10997918 DOI: 10.1016/j.cdnut.2024.102134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Female cancer survivors have a higher chance of experiencing infertility than females without a history of cancer diagnosis. This risk remains high despite advances in fertility treatments. There is a need to augment fertility treatments with cost-effective methods such as nutritional guidance to improve fertility chances. The aim of this review article is to connect the current literature on cancer survivorship nutrition and fertility nutrition, focusing on the importance of integrating nutritional guidance into fertility counseling, assessment, and treatment for female cancer survivors. Consuming a healthful diet comprising whole grains, soy, fruits, vegetables, seafood, and unsaturated fats has improved both female fertility and cancer survivorship. Similarly, maintaining a healthy body weight also improves female fertility and cancer survivorship. Therefore, dietary interventions to support female cancer survivors with fertility challenges are of immense importance. The period of follow-up fertility counseling and assessment after cancer treatment may provide a unique opportunity for implementing nutritional guidance for female cancer survivors. Dietary interventions are a promising strategy to improve pregnancy chances and overall quality of life among female cancer survivors; thus, researchers should investigate perceptions regarding fertility, barriers, and challenges to changing nutrition-related behaviors, and preferences for nutritional guidance to support fertility treatments in this population.
Collapse
Affiliation(s)
- Cynthia Klobodu
- Department of Nutrition and Food Science, California State University, Chico, College of Natural Sciences, CA, United States
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jonathan M Deutsch
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Kathleen Fisher
- Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Jennifer A Nasser
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Dahlia Stott
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Michael J Murray
- Northern California Fertility Medical Center, Sacramento, CA, United States
| | - Laura Curtis
- Department of Nutrition and Food Science, California State University, Chico, College of Natural Sciences, CA, United States
| | - Brandy-Joe Milliron
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
6
|
Wang F, Dou P, Wei W, Liu PJ. Effects of high-protein diets on the cardiometabolic factors and reproductive hormones of women with polycystic ovary syndrome: a systematic review and meta-analysis. Nutr Diabetes 2024; 14:6. [PMID: 38424054 PMCID: PMC10904368 DOI: 10.1038/s41387-024-00263-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
The optimal dietary regimen for polycystic ovary syndrome (PCOS) has not been identified. High-protein diets (HPDs) are effective for weight control in individuals with metabolic abnormalities, but no systematic meta-analyses have yet summarised the effects of HPDs on PCOS. Seven electronic databases were searched from inception to 30 April 2023, and studies comparing the effects of HPDs and other diets on the anthropometrics, metabolic factors, and hormonal profiles for PCOS were identified. Data were pooled using random-effects models and expressed as weighted mean differences and 95% confidence intervals. The risk of bias was assessed by Cochrane Collaboration tool. Eight trials involving 300 women with PCOS were included. Compared with isocaloric balanced diets (BDs), HPDs significantly reduced fasting insulin (-2.69 μIU/mL, 95% CI [-3.81, -1.57], P < 0.0001, I2 = 46%) and homoeostatic model assessment for insulin resistance (HOMA-IR-0.41, 95% CI [-0.80, -0.02], P = 0.04, I2 = 94%) in women with PCOS. However, HPDs and BDs had comparable effects on weight loss, abdominal adiposity, lipid profiles, and reproductive hormones (all P ≥ 0.05). HPDs may benefit women with PCOS in terms of improving insulin resistance, supporting for their use as one of the dietary management options for PCOS, however further RCTs in larger and broader settings are required to confirm these observations and investigate the mechanism behind it.
Collapse
Affiliation(s)
- Fang Wang
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Dongdansantiao, Dongcheng District, 100730, Beijing, China
| | - Pan Dou
- Department of Clinical Nutrition, Peking University First Hospital, No.7 Xishiku Dajie, Xicheng District, 100034, Beijing, China
| | - Wei Wei
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Dongdansantiao, Dongcheng District, 100730, Beijing, China
| | - Peng Ju Liu
- Department of Clinical Nutrition, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Dongdansantiao, Dongcheng District, 100730, Beijing, China.
| |
Collapse
|
7
|
Yu J, Sun M, Jiang S, Jiang C, Mu G, Tuo Y. Oral Administration of Fermented Milk from Co-Starter Containing Lactobacillus plantarum Y44 Shows an Ameliorating Effect on Hypertension in Spontaneously Hypertensive Rats. Foods 2024; 13:641. [PMID: 38472752 DOI: 10.3390/foods13050641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
Fermented dairy foods such as yogurt exhibit some beneficial effects on consumers, including relieving the symptoms of hypertension. This study aims to obtain fermented dairy products from a co-starter that have a great flavor and the auxiliary function of reducing blood pressure after longtime consumption. Commercial starter cultures composed of Lactobacillus delbrueckii subsp. bulgaricus CICC 6047 and Streptococcus thermophilus CICC 6038 were combined with Lactobacillus plantarum strains Y44, Y12, and Y16, respectively, as a combined starter culture to ferment the mixed milk of skim milk and soybean milk. The fermented milk produced using the combined starter culture mixed with L. plantarum Y44 showed an angiotensin-converting-enzyme (ACE) inhibitory activity (53.56 ± 0.69%). Some peptides that regulate blood pressure were released in the fermented milk, such as AMKPWIQPK, GPVRGPFPII, LNVPGEIVE, NIPPLTQTPV, and YQEPVL. In spontaneously hypertensive rat (SHR) oral-administration experiments compared with the gavage unfermented milk group, the gavage feeding of SHRs with the fermented milk produced using the combined starter culture mixed with L. plantarum Y44 significantly reduced the blood pressure of the SHRs after long-term intragastric administration, shown with the systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreasing by 23.67 ± 2.49 mmHg and 15.22 ± 2.62 mmHg, respectively. Moreover, the abundance of short-chain fatty acids (SCFA), bacterial diversity in the gut microbiota, and SCFA levels including acetic acid, propionic acid, and butyric acid in the feces of the SHRs were increased via oral administration of the fermented milk produced using the combined starter culture containing L. plantarum Y44. Furthermore, the ACE-angiotensin II (Ang II)-angiotensin type 1 (AT 1) axis was downregulated, the angiotensin-converting-enzyme 2 (ACE 2)-angiotensin(1-7) (Ang1-7)-Mas receptor axis of the SHRs was upregulated, and then the RAS signal was rebalanced. The fermented milk obtained from the combined starter culture shows the potential to be a functional food with antihypertension properties.
Collapse
Affiliation(s)
- Jiang Yu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
- Dalian Probiotics Function Research Key Laboratory, Dalian Polytechnic University, Dalian 116034, China
| | - Mengying Sun
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
- Dalian Probiotics Function Research Key Laboratory, Dalian Polytechnic University, Dalian 116034, China
| | - Shilong Jiang
- Heilongjiang Feihe Dairy Co., Ltd., Beijing 100016, China
| | - Chuqi Jiang
- Heilongjiang Feihe Dairy Co., Ltd., Beijing 100016, China
| | - Guangqing Mu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
- Dalian Probiotics Function Research Key Laboratory, Dalian Polytechnic University, Dalian 116034, China
| | - Yanfeng Tuo
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, China
- Dalian Probiotics Function Research Key Laboratory, Dalian Polytechnic University, Dalian 116034, China
| |
Collapse
|
8
|
Keshani M, Feizi A, Askari G, Sharma M, Bagherniya M. Effects of therapeutic lifestyle change diets on blood lipids, lipoproteins, glycemic parameters, and blood pressure: a systematic review and meta-analysis of clinical trials. Nutr Rev 2024; 82:176-192. [PMID: 37352395 DOI: 10.1093/nutrit/nuad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
CONTEXT Cardiovascular disease is the leading cause of death worldwide. Low-calorie, low-fat therapeutic diets (TDs) developed by the US National Cholesterol Education Program, ie, the Step I and II diets and the therapeutic lifestyle changes diet, are approximately similar and are the initial therapeutic interventional approaches for lifestyle modification. OBJECTIVE This systematic review with meta-analysis was undertaken to evaluate the effects of TDs diet on blood lipids, apolipoprotein A-1, apolipoprotein B, blood pressure, fasting blood glucose, and insulin. DATA SOURCES A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases until October 2022 was performed to identify clinical trials investigating the effects of TDs on the aforementioned parameters. DATA EXTRACTION One investigator screened the records and extracted data, and another reviewed the extracted data. DATA ANALYSIS A total of 910 records were retrieved. After records were screened for eligibility, 34 clinical trials met the inclusion criteria. The pooled analysis from the random-effects model revealed a significant reduction in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B in the TD intervention group vs the control group. The overall effects of TDs on fasting blood glucose, insulin, and blood pressure were not significant, but the results of subgroup analysis revealed a significant reduction in fasting blood glucose with the Step II diet and an intervention duration of more than 24 weeks. For blood pressure, the Step I diet and an intervention duration of more than 24 weeks resulted in significant reduction. There was no evidence of publication bias, but strong heterogeneity was observed. CONCLUSION Therapeutic diets have promising effects on lipid profile parameters, glycemic indexes, and blood pressure, which can promote cardiovascular health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021259355.
Collapse
Affiliation(s)
- Mahdi Keshani
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
9
|
Herbert S, Woolf K. Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS). Nutrients 2023; 15:5069. [PMID: 38140328 PMCID: PMC10745999 DOI: 10.3390/nu15245069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/02/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder experienced by women. PCOS is a lifelong condition associated with reproductive, metabolic, and psychological presentations. PCOS is also linked with increased prevalence of cardiometabolic risk factors. While an association between body weight and PCOS has been noted, cardiometabolic risk factors are prevalent in individuals with PCOS across body weights. Currently, no consensus exists as to the most appropriate lifestyle strategy for mitigating cardiometabolic risk in PCOS. A large proportion of the literature is focused on weight loss for individuals with PCOS who are overweight or experience obesity, despite PCOS being prevalent across body sizes. The aim of this narrative review is to assess dietary and lifestyle interventions aimed at reducing cardiometabolic risk in individuals with PCOS across body sizes. A total of 51 articles are included in this review. Overall, randomized controlled trials are limited and most studies focus on weight loss, excluding individuals classified within a healthy body weight range. Studies that modified the dietary pattern without an energy deficit saw improvements in cardiometabolic risk. Thus, less restrictive dietary approaches may be effective at reducing cardiometabolic risk in this population. This review also highlights the need for more sustainable lifestyle interventions that meet the needs of individuals with PCOS of varying body weights.
Collapse
Affiliation(s)
| | - Kathleen Woolf
- Department of Nutrition and Food Studies, Steinhart School of Culture, Education, and Human Development, New York University, New York, NY 10003, USA;
| |
Collapse
|
10
|
Liu Y, Guo Y, Yan X, Ding R, Tan H, Wang Y, Wang X, Wang L. Assessment of health literacy in patients with polycystic ovary syndrome and its relationship with health behaviours: a cross-sectional study. BMJ Open 2023; 13:e071051. [PMID: 38000817 PMCID: PMC10680007 DOI: 10.1136/bmjopen-2022-071051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE Healthy behaviours are important for people with polycystic ovary syndrome (PCOS). However, adopting and maintaining lifestyle changes involves a complex set of behavioural changes, which most patients fail to adhere to. The current research on health literacy, which includes individual and social skills needed in health self-management, in patients with PCOS is limited. Therefore, this study aimed to explore health literacy, health behaviours and the relationship between the two to expand research on PCOS management. DESIGN Cross-sectional study. SETTING A gynaecological outpatient clinic. PARTICIPANTS A total of 286 patients with PCOS (≥18 years, diagnosed via Rotterdam criteria, able to self-report and give informed consent) were recruited from March to June 2022. OUTCOME MEASURES Health literacy and health behaviours in patients with PCOS were assessed using the Health Literacy Management Scale and the Health Promoting Lifestyle Profile (Chinese version). Multiple logistic regression was used to analyse the factors influencing health literacy, and linear regression to assess the relationship between health literacy and health behaviours, with an F-significance test; p<0.05 was considered statistically significant. RESULTS Overall, most patients with PCOS had insufficient health literacy (55.9%). The influencing factors of health literacy in patients with PCOS were age (β=0.154, p<0.05), Body Mass Index (β=-0.140, p<0.05), income (β=1.228, p<0.05), duration of illness (β=0.110, p<0.05) and educational level (β=1.552, p<0.05). Moreover, 40.6% of patients with poor health behaviours, and 31.8% with moderate health behaviours, needed to improve their health behaviours. Health literacy was positively correlated with health behaviours in patients with PCOS (r=0.473, p<0.05). CONCLUSION The positive correlation between health literacy and health behaviour in patients with PCOS indicates that promoting health literacy in future treatment and management of PCOS may be beneficial.
Collapse
Affiliation(s)
- Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing College, ZunYi Medical University, ZunYi, GuiZhou, China
| |
Collapse
|
11
|
Nam T, Kim A, Oh Y. Effectiveness of Chickpeas on Blood Sugar: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2023; 15:4556. [PMID: 37960209 PMCID: PMC10647263 DOI: 10.3390/nu15214556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Diabetes affects one in eleven adults globally, with rising cases in the past 30 years. Type 1 and type 2 cause blood sugar problems, increasing cardiovascular risks. Dietary control, including chickpeas, is suggested but needs more research. Comprehensive searches were conducted across multiple databases for the randomized controlled trial efficacy of chickpea consumption to lower blood sugar levels to a healthy range, with data extraction and risk of bias assessment performed independently by two researchers. Statistical analysis was performed using RevMan 5.4, expressing continuous data as mean differences and risk ratios with 95% confidence intervals, and a summary of the findings is provided considering the variations in study characteristics. A total of 118 articles were initially identified from seven databases, primarily from Anglo-American countries, resulting in 12 selected studies after the identification and screening processes. These studies involved 182 participants, focusing on healthy or normoglycemic adults, and assessed the effects of chickpeas compared to various foods such as wheat, potatoes, pasta, sauce, cheese, rice, and corn. A meta-analysis involving a subset of studies demonstrated that chickpeas were more effective in reducing blood glucose iAUC compared to potatoes and wheat. Chickpeas offer the potential for blood sugar control through low starch digestibility, high fiber, protein, and hormonal effects. Although insulin benefits are seen, statistical significance varies, supporting their role in diabetic diets focusing on nutrient-rich foods over processed carbs.
Collapse
Affiliation(s)
- Taegwang Nam
- College of Korean Medicine, Woosuk University, Jeonju 54986, Republic of Korea;
| | - Anna Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Yongtaek Oh
- College of Korean Medicine, Woosuk University, Jeonju 54986, Republic of Korea;
| |
Collapse
|
12
|
Grdeń P, Jakubczyk A. Health benefits of legume seeds. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:5213-5220. [PMID: 36988580 DOI: 10.1002/jsfa.12585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 03/06/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
Pulses have been part of human nutrition for centuries. They are also used in folk medicine as products with multidirectional medicinal effects. They are annual plants representing the Fabaceae family. Their edible part is the fruit, i.e. the so-called pods. Whole pods or their parts can be eaten, depending on the species and fruit ripeness. Beans, peas, peanuts, chickpeas, lentils, broad beans and soybeans are edible legume species. Legume seeds are characterized by high nutritional value. Compared to seeds from other plants, they have high protein content ranging, on average, from 20% to 35%, depending on the type, growing conditions and maturity of the fruit. This review focuses on various health-promoting properties of legumes and presents their nutritional value and compounds exerting health-promoting effects. Many pulses have a low glycemic index, which is important for prevention and treatment of diabetes. In addition to their low glycemic index and high fiber content, pulses have α-amylase and α-glucosidase inhibitors, which reduce the absorption of glucose from the gastrointestinal tract. These compounds have antidiabetic and anti-inflammatory effects. Pulses have been shown to contain bioactive peptides with angiotensin-converting enzyme inhibitory properties; hence, they are useful in the treatment of cardiovascular diseases. Pulses used in the nutrition of obese individuals provide compounds with pancreatic lipase inhibitory properties, thus promoting weight reduction and control. © 2023 Society of Chemical Industry.
Collapse
Affiliation(s)
- Paula Grdeń
- Department of Biochemistry and Food Chemistry, University of Life Sciences in Lublin, Lublin, Poland
| | - Anna Jakubczyk
- Department of Biochemistry and Food Chemistry, University of Life Sciences in Lublin, Lublin, Poland
| |
Collapse
|
13
|
Reyneke GL, Beck EJ, Lambert K, Neale EP. The Effect of Non-Oil Seed Legume Intake on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:637-651. [PMID: 37031751 PMCID: PMC10334154 DOI: 10.1016/j.advnut.2023.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023] Open
Abstract
Hypertension is a primary modifiable risk factor for CVD, whereby even small reductions in blood pressure (BP) can decrease risk for CVD events. Modification of dietary patterns is an established, nonpharmacologic approach for the prevention and management of hypertension. Legumes are a prevailing component of dietary patterns associated with lower BP in observational research, but there is a need to understand the effects of legume consumption on BP. This study aimed to synthesize evidence from randomized controlled trials (RCTs) for the effects of non-oil seed legume consumption on systolic blood pressure (SBP) and diastolic blood pressure (DBP) (PROSPERO registration: CRD42021237732). We searched CINAHL, Cochrane, Medline, and PubMed scientific databases from inception through November 2022. A random-effects meta-analysis was conducted to assess the mean differences (MDs) for each outcome variable between legume-based and comparator diets. This review included 16 RCTs and 1092 participants. Studies ranged in duration (4-52 wk), participant age (17-75 y), and weekly legume dose (450-3150 g) in whole or powdered form. No significant overall effect between legume consumption and BP amelioration was observed in the meta-analysis (SBP-MD: -1.06 mm Hg; 95% CI: -2.57, 0.4410 mm Hg; I2 = 45%; DBP-MD: -0.48 mm Hg; 95% CI: -1.06, 0.10 mm Hg; I2 = 0%). The certainty of evidence was determined as low for SBP and DBP. Significant subgroup differences in SBP were found when studies were grouped according to participant BMI, with SBP reduction found for participants with overweight/obese BMI (MD -2.79 mm Hg, 95% CI: -4.68, -0.90 mm Hg). There is a need for large, high-quality trials to clearly define the benefits and mechanisms of legume consumption in BP management. Consideration of the relevance in individuals with obesity, overweight, and hypertension may also be warranted. This trial was registered at PROSPERO as CRD42021237732.
Collapse
Affiliation(s)
- Gynette L Reyneke
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
| | - Eleanor J Beck
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia; School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
| | - Elizabeth P Neale
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, Australia.
| |
Collapse
|
14
|
Barrea L, Verde L, Camajani E, Cernea S, Frias-Toral E, Lamabadusuriya D, Ceriani F, Savastano S, Colao A, Muscogiuri G. Ketogenic Diet as Medical Prescription in Women with Polycystic Ovary Syndrome (PCOS). Curr Nutr Rep 2023; 12:56-64. [PMID: 36695999 PMCID: PMC9974679 DOI: 10.1007/s13668-023-00456-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW The polycystic ovary syndrome (PCOS) is an endocrine dysfunction associated with a myriad of metabolic disorders and high rate of infertility. In order to aid its management, several lifestyle/dietary interventions have been evaluated. Very low-calorie ketogenic diet (VLCKD) is rapidly showing promising benefits not only in obesity but also in the treatment of other metabolic diseases. The main objective of this review is to assess the scientific evidence in support of this dietary pattern as an effective measure for treating PCOS and the metabolic disorders associated with it. RECENT FINDINGS Preliminary data suggested significant improvements in body weight and composition, metabolic profile (glucose, serum insulin, triglycerides, total and low-density lipoprotein cholesterol), and insulin resistance following VLCKD. However, the evidence is still scarce and needs to be more substantiated. Weight reduction in women with PCOS has been shown to improve metabolic derangements and body composition, but there is no consensus on the ideal dietary pattern or macronutrient composition. There is some evidence supporting the possible role of the Mediterranean diet in improving infertility (along with other well-known metabolic benefits) in women with PCOS. Of note, VLCKD might be considered a potential intervention for the short-term treatment of PCOS, but it must be prescribed and carefully guided by professionals.
Collapse
Affiliation(s)
- Luigi Barrea
- Dipartimento di Scienze Umanistiche, Università Telematica Pegaso, Via Porzio, Centro isola F2, 80143, Naples, Italy
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166, Rome, Italy
- PhD Program in Endocrinological Sciences, Department of Experimental Medicine, University of Rome "La Sapienza", Piazzale Aldo Moro, 5, 00185, Rome, Italy
| | - Simona Cernea
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures/Internal Medicine I, Târgu Mureş, Romania
- Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Târgu Mureş, Romania
| | | | - Dilusha Lamabadusuriya
- University Hospital General Sir John Kotelawala Defence University, Boralesgamuwa, Sri Lanka
| | - Florencia Ceriani
- Nutrition School, Universidad de la Republica (UdelaR), Montevideo, Uruguay
| | - Silvia Savastano
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Annamaria Colao
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", Federico II University, Naples, Italy
| | - Giovanna Muscogiuri
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
- Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", Federico II University, Naples, Italy.
| |
Collapse
|
15
|
Rehm CD, Goltz SR, Katcher JA, Guarneiri LL, Dicklin MR, Maki KC. Trends and patterns of chickpea consumption among U.S. adults: analyses of NHANES data. J Nutr 2023; 153:1567-1576. [PMID: 36990184 DOI: 10.1016/j.tjnut.2023.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Chickpeas are an affordable and nutrient-dense legume, but there is limited U.S. data on consumption patterns and the relationship between chickpea consumption and dietary intakes. OBJECTIVE This study examined trends and socio-demographic patterns among chickpea consumers and the relationship between chickpea consumption and dietary intake. METHODS Adults consuming chickpeas or chickpea-containing foods on one or both of the 24-hour dietary recalls were categorized as chickpea consumers. Data from National Health and Nutrition Examination Surveys 2003-2018 were used to evaluate trends and socio-demographic patterns in chickpea consumption (n=35,029). The association between chickpea consumption and dietary intakes was compared to other legume consumers and non-legume consumers from 2015-2018 (n=8,342). RESULTS The proportion of chickpea consumers increased from 1.9% in 2003-2006 to 4.5% in 2015-2018 (p-value for trend<0.001). This trend was consistent across age group, gender, race/ethnicity, education, and income. In 2015-2018, chickpea consumption was highest among individuals with higher incomes (2.4% among those with incomes <185% of the federal poverty guideline vs. 6.4% with incomes ≥300%), education levels (1.0% for <high school vs. 10.2% for college graduates), physical activity levels (1.9% for no physical activity vs. 7.7% for ≥430min of moderate-equivalent physical activity per week), and those with better self-reported health (1.7% fair poor vs. 6.5% for excellent/very good, p-trend<0.001 for each). Chickpea consumers had greater intakes of whole grains (1.48 oz/d for chickpea consumers vs. 0.91 for non-legume consumers) and nuts/seeds (1.47 vs. 0.72 oz/d), less intake of red meat (0.96 vs. 1.55 oz/d), and higher Healthy Eating Index scores (62.1 vs. 51.2) compared to both non-legume and other legume consumers (p-value<0.05 for each). CONCLUSIONS Chickpea consumption among U.S. adults has doubled between 2003 and 2018, yet intake remains low. Chickpea consumers have higher socioeconomic status and better health status, and their overall diets are more consistent with healthy eating.
Collapse
Affiliation(s)
- Colin D Rehm
- Health and Nutrition Sciences, PepsiCo, Purchase, NY, United States.
| | - Shellen R Goltz
- Health and Nutrition Sciences, PepsiCo, Chicago, IL, United States
| | - Julia A Katcher
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, United States
| | | | | | - Kevin C Maki
- Midwest Biomedical Research, Addison, IL, United States; Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| |
Collapse
|
16
|
Nazarudin AA, Zulkarnain N, Mokri SS, Zaki WMDW, Hussain A, Ahmad MF, Nordin INAM. Performance Analysis of a Novel Hybrid Segmentation Method for Polycystic Ovarian Syndrome Monitoring. Diagnostics (Basel) 2023; 13:750. [PMID: 36832237 PMCID: PMC9954948 DOI: 10.3390/diagnostics13040750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Experts have used ultrasound imaging to manually determine follicle count and perform measurements, especially in cases of polycystic ovary syndrome (PCOS). However, due to the laborious and error-prone process of manual diagnosis, researchers have explored and developed medical image processing techniques to help with diagnosing and monitoring PCOS. This study proposes a combination of Otsu's thresholding with the Chan-Vese method to segment and identify follicles in the ovary with reference to ultrasound images marked by a medical practitioner. Otsu's thresholding highlights the pixel intensities of the image and creates a binary mask for use with the Chan-Vese method to define the boundary of the follicles. The acquired results were compared between the classical Chan-Vese method and the proposed method. The performances of the methods were evaluated in terms of accuracy, Dice score, Jaccard index and sensitivity. In overall segmentation evaluation, the proposed method showed superior results compared to the classical Chan-Vese method. Among the calculated evaluation metrics, the sensitivity of the proposed method was superior, with an average of 0.74 ± 0.12. Meanwhile, the average sensitivity for the classical Chan-Vese method was 0.54 ± 0.14, which is 20.03% lower than the sensitivity of the proposed method. Moreover, the proposed method showed significantly improved Dice score (p = 0.011), Jaccard index (p = 0.008) and sensitivity (p = 0.0001). This study showed that the combination of Otsu's thresholding and the Chan-Vese method enhanced the segmentation of ultrasound images.
Collapse
Affiliation(s)
- Asma’ Amirah Nazarudin
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Noraishikin Zulkarnain
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Siti Salasiah Mokri
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Wan Mimi Diyana Wan Zaki
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Aini Hussain
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Mohd Faizal Ahmad
- Advanced Reproductive Centre, Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuala Lumpur Campus, Universiti Kebangsaan Malaysia, Cheras 56000, Kuala Lumpur, Malaysia
| | - Ili Najaa Aimi Mohd Nordin
- Department of Electrical Engineering Technology, Faculty of Engineering Technology, Universiti Tun Hussein Onn Malaysia, Bandar Universiti Pagoh, KM1, Panchor, Pagoh 86400, Johor, Malaysia
| |
Collapse
|
17
|
Sadeghian Bakhi E, Hayati Roodbari N, Anvari M, Ramezani Tehrani F. Prenatal kisspeptin antagonist exposure prevents polycystic ovary syndrome development in prenatally-androgenized rats in adulthood: An experimental study. Int J Reprod Biomed 2023; 21:99-110. [PMID: 37034298 PMCID: PMC10073872 DOI: 10.18502/ijrm.v21i2.12801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/26/2022] [Accepted: 12/05/2022] [Indexed: 04/11/2023] Open
Abstract
Background Increased levels of kisspeptin are associated with hypothalamus-pituitary-ovary axis dysfunction. It may lead to the development of polycystic ovary syndrome (PCOS). Objective We aimed to investigate the effect of prenatal kisspeptin antagonist exposure on the development of PCOS in prenatally androgenized rats in adulthood. Materials and Methods In this experimental study, pregnant rats were injected with free testosterone (T, 5 mg/day) or T+P271 (kisspeptin antagonist) on the 20 th day of the pregnancy period (n = 5 in each group), while rats in the control group received solvent. Female offspring were examined in terms of anogenital distance (AGD), anovaginal distance (AVD), vaginal opening, serum total testosterone (TT) levels, ovarian follicles, and the regularity of estrous cycles in adulthood. AGD and AVD were measured using a vernier caliper. TT levels were measured using the enzyme-linked immunosorbent assay method. Ovaries were fixed in 10% formalin, tissue processing was done by a standard protocol, and then ovaries embedded in paraffin. 5 μm-thickness ovarian sections mounted on a glass slide, deparaffinized, and stained using Harris's Hematoxylin and Eosin Y. Results AGD, AVD (p < 0.001), TT levels (p = 0.02), and the numbers of preantral and antral follicles (p < 0.001) in the ovaries were significantly decreased in prenatally T-P271-exposed rats compared to prenatally T-exposed rats. The age of vaginal opening was early in T-P271-exposed rats compared to prenatally T-exposed rats (p < 0.001). The number of corpora lutea was significantly increased in T-P271-exposed rats (p < 0.001). No cystic follicles were observed in the ovaries of prenatally T-P271-exposed rats. Prenatally T-P271-exposed rats had regular estrous cycles compared to prenatally T-exposed rats. Conclusion Prenatal exposure to kisspeptin antagonist can prevent PCOS development in prenatally androgenized rats in adulthood.
Collapse
Affiliation(s)
- Elahe Sadeghian Bakhi
- Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nasim Hayati Roodbari
- Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Morteza Anvari
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
18
|
Guo F, Huang Y, Fernando T, Shi Y. Altered Molecular Pathways and Biomarkers of Endometrial Receptivity in Infertile Women with Polycystic Ovary Syndrome. Reprod Sci 2022; 29:3335-3345. [PMID: 35006579 DOI: 10.1007/s43032-022-00845-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/31/2021] [Indexed: 12/14/2022]
Abstract
Anovulation is the most prominent cause of infertility in polycystic ovary syndrome (PCOS) patients. Although ovulation can be corrected pharmacologically, the number of pregnancies remains low. Even if excellent embryos are transferred by IVF, it does not change the high miscarriage rate of PCOS patients. These facts collectively indicate that there is a disorder of endometrial development and receptivity to the embryo in PCOS patients, including the decrease of receptive ability, inhibition of embryo adhesion, undersupply of energy, poor blood perfusion, and pro-inflammatory status in the endometrium. However, it has never received the same attention as ovulatory dysfunction. Here we list some alternations of endometrial receptivity in women with PCOS, discuss the underlying intricate mechanisms, and try to find out the possible therapeutic targets, which may bring new perspectives to those who are able to provide high-quality embryos.
Collapse
Affiliation(s)
- Fei Guo
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, China
| | - Yufan Huang
- Department of Pharmacy, Mindong Hospital, Fujian Medical University, Ningde, 355000, Fujian, China
| | - Taniya Fernando
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, China
| | - Yingli Shi
- Department of Gynecology, Hospital of Obstetrics and Gynecology, Fudan University, Shanghai, 200011, China.
| |
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|
20
|
Kazemi M, Kim JY, Wan C, Xiong JD, Michalak J, Xavier IB, Ganga K, Tay CT, Grieger JA, Parry SA, Moran LJ, Lujan ME. Comparison of dietary and physical activity behaviors in women with and without polycystic ovary syndrome: a systematic review and meta-analysis of 39 471 women. Hum Reprod Update 2022; 28:910-955. [PMID: 35639552 PMCID: PMC9629501 DOI: 10.1093/humupd/dmac023] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/08/2022] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Lifestyle (dietary and/or physical activity [PA]) modification is recommended as first-line therapy to manage polycystic ovary syndrome (PCOS). Current recommendations are based on healthy lifestyle practices for the general public since evidence for unique lifestyle approaches in PCOS is limited and low quality. OBJECTIVE AND RATIONALE We aimed to synthesize evidence on dietary and PA behaviors between women with PCOS and those without PCOS. Primary outcomes were overall diet quality, total energy intake and total PA, and secondary outcomes included macronutrients, micronutrients, food groups, foods, glycemic indices, sedentary time and sitting levels. We conducted this work to identify any unique lifestyle behaviors in women with PCOS that could underlie the propensity of weight gain and obesity in PCOS and be targeted for precision nutrition and PA interventions. These findings could be used to inform future practice recommendations and research that more effectively address complications (weight gain, obesity, diabetes, infertility, cardiovascular disease and mental health) in this high-risk population. SEARCH METHODS Databases of MEDLINE, Web of Science, Scopus and CINAHL were searched until 15 February 2022 to identify observational studies documenting dietary and PA behaviors between women with PCOS and without PCOS (Controls). Studies on children, adolescents (<18 years), pregnant or menopausal-aged women (>50 years) were excluded. Data were pooled by random-effects models and expressed as (standardized) mean differences (MD) and 95% CIs. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS). OUTCOMES Fifty-four studies (N = 39 471 participants; [n = 8736 PCOS; 30 735 Controls]) were eligible (96%; [52/54] NOS scores ≥ 7). Women with PCOS had higher cholesterol (MD: 12.78, 95% CI: 1.48 to 24.08 mg/day; P = 0.03; I2 = 19%), lower magnesium (MD: -21.46, 95% CI: -41.03 to -1.91 mg/day; P = 0.03; I2 = 76%), and a tendency for lower zinc (MD: -1.08, 95% CI: -2.19 to -0.03 mg/day; P = 0.05; I2 = 96%) intake, despite lower alcohol consumption (MD: -0.95, 95% CI: -1.67 to 0.22 g/day; P = 0.02; I2 = 0%) versus Controls. Also, women with PCOS had lower total PA (standardized mean difference: -0.38, 95% CI: -0.72 to 0.03; P = 0.03; I2 = 98%). Conversely, energy, macronutrients (carbohydrate, fat, protein, fiber), micronutrients (folic acid, iron, calcium, sodium), glycemic index and glycemic load were similar (all: P ≥ 0.06). Most eligible studies reported lower total adherence to healthy eating patterns or poorer consumption of major food groups (grains, fruits, vegetables, proteins, seeds, nuts, dairy) in women with PCOS, as described narratively since variable study methodology did not permit meta-analyses. WIDER IMPLICATIONS Collective evidence supports that women with PCOS have a lower overall diet quality, poorer dietary intakes (higher cholesterol, lower magnesium and zinc) and lower total PA, despite lower alcohol consumption versus those without PCOS. Considerable heterogeneity among studies reinforces the need for research to address any relative contributions of other factors (e.g. genetic, metabolic or sociodemographic) to the observed differences. These clarifications may contribute to future evidence-based guideline recommendations on monitoring and managing PCOS in the era of precision lifestyle medicine.
Collapse
Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
- Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joy Y Kim
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Cynthia Wan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Julia D Xiong
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Julia Michalak
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Isabella B Xavier
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Kiran Ganga
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Chau Thien Tay
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, USA
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
- Robinson Research Institute, University of Adelaide, North Adelaide, SA, Australia
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| |
Collapse
|
21
|
Eight weeks of lentil consumption attenuates insulin resistance progression without increased gastrointestinal symptom severity – A Randomized Clinical Trial. Nutr Res 2022; 106:12-23. [DOI: 10.1016/j.nutres.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022]
|
22
|
H Al Wattar B, M Hussain N, S Khan K. Lifestyle interventions in women with polycystic ovary syndrome: A scoping systematic review of randomised evidence. Semergen 2022; 48:186-194. [PMID: 35153107 DOI: 10.1016/j.semerg.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Lifestyle interventions (LSI) are recommended as first-line treatment for polycystic ovary syndrome (PCOS), yet the strength of evidence underpinning LSIs effectiveness remains unclear. We systematically reviewed the literature on LSIs in PCOS, evaluated evidence quality and summarised recommendations for clinical practice. MATERIAL AND METHODS We searched MEDLINE, EMBASE and CENTRAL for all randomised trials evaluating any LSI in PCOS until April 2021. We extracted data on the LSIs' characteristics, dietary composition, duration, implementation, compliance assessment, and reported outcomes. We evaluated the evidence gap using a network-map of evaluated interventions. RESULTS We screened 550 citations and included 79 trials (n=4659 women). Most trials were from high-income countries (57/79, 72%) over a decade ago (48/79, 61%) and enrolled obese/overweight women (57/77, 74%). BMI was the commonest reported outcome (58/79, 73%), followed by weight (49/79, 62%), and testosterone (45/79, 57%). More than half of the trials had high-risk of randomisation (51/79, 65%) and allocation bias (49/79, 62%). Only 27 were registered prospectively (27/79, 34%). Two-thirds evaluated a dietary intervention (70/79, 88%), most commonly a hypocaloric diet (32/70, 46%); nineteen evaluated a combined dietary with pharmacological intervention (19/79, 24%), six combined diet with physical or behavioural intervention (6/79, 8%), and only one trial included all four elements. CONCLUSIONS Evidence on LSI in PCOS is of poor quality with high variations in trial design, comparisons, and outcome reporting. Hypocaloric diet is the most commonly recommended LSI intervention for primary care. Future trials are needed to evaluate pragmatic and simple LSIs in robust multicenter studies. PROSPERO REGISTRATION CRD42020186571.
Collapse
Affiliation(s)
- B H Al Wattar
- Reproductive Medicine Unit, University College London Hospitals, London, UK.
| | - N M Hussain
- The University of Birmingham, College of Medical and Dental Sciences, Spain
| | - K S Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; CIBER Epidemiology and Public Health, Madrid, Spain
| |
Collapse
|
23
|
Kazemi M, Kim JY, Wan C, Xiong JD, Parry SA, Azziz R, Lujan ME. Comprehensive evaluation of disparities in cardiometabolic and reproductive risk between Hispanic and White women with polycystic ovary syndrome in the United States: a systematic review and meta-analysis. Am J Obstet Gynecol 2022; 226:187-204.e15. [PMID: 34384776 DOI: 10.1016/j.ajog.2021.07.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to comprehensively compare cardiometabolic and reproductive health risk between Hispanic and White women with polycystic ovary syndrome in the United States in response to the call by the international guideline for polycystic ovary syndrome to delineate health disparities. DATA SOURCES Databases of MEDLINE, Web of Science, and Scopus were initially searched through October 25, 2020, and confirmed on February 1, 2021. STUDY ELIGIBILITY CRITERIA Observational studies comparing glucoregulatory, lipid profile, anthropometric, blood pressure, androgen, ovarian morphology, oligoanovulation, and infertility status between Hispanic and White women with polycystic ovary syndrome were included. The primary outcome was metabolic syndrome risk. Furthermore, major cardiovascular events (stroke, coronary heart disease, and heart failure) and mortality rate (cardiovascular death and total mortality) data were evaluated. Studies on adolescents (<2 years after menarche), pregnant, or menopausal-aged women (>50 years) were excluded. METHODS Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Risk of bias was assessed by the Newcastle-Ottawa Scale. RESULTS A total of 11 studies (n=2267; 589 Hispanic and 1678 White women) were eligible. All studies, including both White and Hispanic women, had high-quality assessment (Newcastle-Ottawa Scale score of ≥8). Hispanic women exhibited comparable metabolic syndrome prevalence (7% [95% confidence interval, -1 to 14]; P=.06; I2=0%); however, Hispanic women exhibited higher modified Ferriman-Gallwey score (0.60 [95% confidence interval, -0.01 to 1.21]; P=.05; I2=0%), fasting insulin (5.48 μIU/mL [95% confidence interval, 3.11-7.85]; P≤.01; I2=40.0%), and homeostatic model assessment of insulin resistance (1.20 [95% confidence interval, 0.50-1.89]; P≤.01; I2=43.0%) than White women. The 2 groups had comparable glucose, lipid profile, waist circumference, blood pressure, and androgen status (all P≥.08). Findings about group differences in certain reproductive outcomes (ie, ovarian dysmorphology and infertility) were contradictory and described only narratively as inclusion in the meta-analyses was not possible. No study reported on cardiovascular events or mortality. CONCLUSION Hispanic women with polycystic ovary syndrome exhibited greater impairments in glucoregulatory status than White women. Disparities in reproductive risks could not be concluded. The degree to which glucoregulatory aberrations translate into patient-pressing diseases (diabetes mellitus and infertility) remains a major roadblock given the paucity of available evidence. Our observations have supported the consideration of these disparities in the diagnostic, monitoring, and management practices for polycystic ovary syndrome and reinforced the need to elucidate mechanisms that account for the observed disparities to foster equity in polycystic ovary syndrome care.
Collapse
Affiliation(s)
- Maryam Kazemi
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Joy Y Kim
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Cynthia Wan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Julia D Xiong
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL; Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York, Albany, NY
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| |
Collapse
|
24
|
Floyd R, Gryson R, Mockler D, Gibney J, Duggan SN, Behan LA. The Effect of Time-Restricted Eating on Insulin Levels and Insulin Sensitivity in Patients with Polycystic Ovarian Syndrome: A Systematic Review. Int J Endocrinol 2022; 2022:2830545. [PMID: 36159086 PMCID: PMC9507776 DOI: 10.1155/2022/2830545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
RESULTS 2662 papers were identified with 37 selected for full-text review and one paper meeting criteria for inclusion. Ramadan fasting was the only time-restricted eating regimen trialled in this population with no strong evidence of a significant effect on insulin levels. CONCLUSION As the systematic review retrieved only one study investigating time-restricted eating to reduce insulin in patients with PCOS, there is no evidence to suggest that this intervention is effective. From the narrative review, based on studies in other patient groups, time-restricted eating could improve insulin resistance in those with PCOS; however, well-designed studies are required before this intervention can be recommended.
Collapse
Affiliation(s)
- R. Floyd
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R. Gryson
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - D. Mockler
- John Stearne Medical Library, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin, Ireland
| | - J. Gibney
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S. N. Duggan
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - L. A. Behan
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
25
|
Hadi A, Asbaghi O, Kazemi M, Haghighian HK, Pantovic A, Ghaedi E, Abolhasani Zadeh F. Consumption of pistachio nuts positively affects lipid profiles: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2021:1-14. [PMID: 34933637 DOI: 10.1080/10408398.2021.2018569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of consuming pistachio nuts on lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]). Databases of PubMed, Scopus, ISI Web of Science, and Cochrane Library were searched from inception to June 2019 to identify RCTs documenting the effects of consuming pistachio nuts on blood lipid profiles in adults. Effect sizes were reported as weighted mean difference (WMD) and 95% confidence interval (CI) using the random-effects models (DerSimonian-Laird method). Twelve eligible RCTs were included. Consumption of pistachio nuts decreased TC (WMD: -7.48 mg/dL; 95% CI, -12.62 to -2.34), LDL-C (WMD: -3.82 mg/dL; 95% CI, -5.49 to -2.16) and TG (WMD: -11.19 mg/dL; 95% CI, -14.21 to -8.17) levels. However, HDL-cholesterol levels (WMD: 2.45 mg/dL; 95% CI, -2.44 to 7.33) did not change following pistachio consumption. Consuming pistachio nuts may improve lipid profiles (TC, LDL-C, TG) in adults and may be protective against cardiometabolic diseases. However, further studies with larger sample sizes are required to confirm these results.
Collapse
Affiliation(s)
- Amir Hadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Kazemi
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Hossein Khadem Haghighian
- Metabolic Diseases Research Center, Research Institute for Prevention of on-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ana Pantovic
- Faculty of Biology, University of Belgrade, Belgrade, Serbia
| | - Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
26
|
Missel AL, O’Brien AV, Maser H, Kanwal A, Bayandorian H, Martin S, Carrigan P, McNamee R, Daubenmier J, Isaman DJ, Padmanabhan V, Smith YR, Aikens JE, Saslow LR. Impact of an online multicomponent very-low-carbohydrate program in women with polycystic ovary syndrome: a pilot study. F S Rep 2021; 2:386-395. [PMID: 34934978 PMCID: PMC8655401 DOI: 10.1016/j.xfre.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To study the impact of a very-low-carbohydrate (VLC) diet for 16 weeks in overweight or obese women with polycystic ovary syndrome (PCOS). DESIGN Single-arm prospective pilot study. SETTING We recruited participants using medical records from an academic medical center. PATIENTS Twenty-nine overweight or obese women (body mass index, 25-50 kg/m2) with PCOS. INTERVENTIONS We taught participants to follow a VLC diet and provided information about a variety of behavioral skills including mindfulness and positive affect using an online 16-week intervention. MAIN OUTCOME MEASURES Changes in body weight, glycated hemoglobin, and PCOS-related quality of life. RESULTS The intervention led to positive health outcomes including decreases in percent weight (mean difference = -7.67, SD = 6.10) and glycated hemoglobin level (mean difference = -0.21%, SD = 0.27), an increase in sex hormone binding globulin level (mean difference = 9.24 nmol/L, SD = 16.34), and increases in PCOS-related quality of life measures, including menstrual predictability (mean difference = 2.10, SD = 2.76) and body hair (mean difference = 1.14, SD = 1.04). The low-density lipoprotein cholesterol level increased (mean difference = 0.23 mmol/L, SD = 0.49). CONCLUSIONS The results suggest that a VLC dietary intervention has potential to promote both weight loss and glycemic control in overweight and obese adults with PCOS, two key components in the prevention of type 2 diabetes. TRIAL REGISTRATION NUMBER NCT03987854.
Collapse
Affiliation(s)
- Amanda L. Missel
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Alison Virginia O’Brien
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Haley Maser
- Central Michigan University College of Medicine, Mt. Pleasant, Michigan
| | - Amreen Kanwal
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Michigan
| | | | - Symone Martin
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Paige Carrigan
- University of Michigan College of Pharmacy, Ann Arbor, Michigan
| | | | - Jennifer Daubenmier
- Department of Recreation, Parks and Tourism, College of Health and Social Sciences, San Francisco State University, San Francisco, California
| | - Deanna J.M. Isaman
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Vasantha Padmanabhan
- Department of Pediatrics, University of Michigan, Medical Professional Building, Ann Arbor, Michigan
| | - Yolanda R. Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - James E. Aikens
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Laura R. Saslow
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
27
|
Saadati N, Haidari F, Barati M, Nikbakht R, Mirmomeni G, Rahim F. The effect of low glycemic index diet on the reproductive and clinical profile in women with polycystic ovarian syndrome: A systematic review and meta-analysis. Heliyon 2021; 7:e08338. [PMID: 34820542 PMCID: PMC8600081 DOI: 10.1016/j.heliyon.2021.e08338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/07/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022] Open
Abstract
Background Treatment for polycystic ovary syndrome (PCOS) usually initiates with a series of lifestyle modifications such as diet, weight loss, and exercise. Aims We, therefore, conducted this meta-analysis to systematically review and evaluate the possible benefits of LGD on a range of anthropometric, clinical, and biochemical parameters in women with PCOS. Methods We performed a systematic search through major indexing databases, including Scopus, Pubmed/Medline, ISI web of science, Embase, Cochrane central, and CINAHL (1966-April 30, 2021) using key concepts of PCOS. Results Of 935 initial publications, 542 remain after duplicates removal. Then, 141 records were removed at the title and abstract screening level. After excluding 392 literatures, we finally included 8 articles. The final selected studies included 412 overweight and obese individuals with PCOS (207 cases in LGID group and 205 patients in comparators) with a mean age of 21-32 years. Measured emotional health (3 studies, 132 participants, SMD: -1.97; 95%CI:-3.54, -0.40, P = 0.01, I 2 = 89%) and body hair (3 studies, 132 participants, SMD: -0.40; 95%CI:-0.46, -0.35, P < 0.0001, I 2 = 0%), were found to be significantly lower in women in LGD vs control diet groups. Moreover, infertility (3 studies, 132 participants, SMD: 1.45; 95%CI: 0.30, 2.61, P = 0.01, I 2 = 79%) was significantly higher in women in LGD vs control diet groups. Conclusion The present meta-analysis has shown that LGD may play a significant role in reducing the risk and improving the clinical and biochemical features of PCOS. So far the evidences for choosing the best dietary modalities for PCOS are not strong to make a definite recommendation.
Collapse
Affiliation(s)
- Najmieh Saadati
- Fertility, Infertility, and Perinatology, Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Haidari
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Mojgan Barati
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Roshan Nikbakht
- Department of Nutrition Sciences, Nutrition and Metabolic Diseases Research Center, School of Paramedical Sciences, Ahvaz Jundishapur University of Medical Sciences, 61357-15794, Ahvaz, Iran
| | - Golshan Mirmomeni
- School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Hearing Research Center, Department of Audiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Health Research Institute, Thalassemia and Hemoglobinopathies Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Hearing Research Center, Department of Audiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
28
|
Nchanji EB, Ageyo OC. Do Common Beans ( Phaseolus vulgaris L.) Promote Good Health in Humans? A Systematic Review and Meta-Analysis of Clinical and Randomized Controlled Trials. Nutrients 2021; 13:3701. [PMID: 34835959 PMCID: PMC8619065 DOI: 10.3390/nu13113701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
The common bean is a nutrient-dense food empirically known to have beneficial effects on human health. Many studies have looked at the effects of "pulses" on different health issues, providing general overviews of the importance of each pulse in health studies. This study systematically reviews and provides meta-analyses of the effect of bean extract as a supplement or whole bean on four health issues (cardiovascular diseases, diabetes mellitus, obesity, and cancers) from a dissection of clinical and randomized controlled trials using human subjects. A digital search in PubMed and Google ScholarTM resulted in 340 articles, with only 23 peer-reviewed articles matching our inclusion criteria. Findings indicated that common beans reduced LDL cholesterol by 19 percent, risk of cardiovascular disease (CVD) by 11 percent, and coronary heart disease (CHD) by 22 percent. Besides this, we noted variances in the literature on cancer findings, with some authors stating it reduced the proliferation of some kinds of tumor cells and reduced the growth of polyps, while others did not specifically examine cancers but the predisposing factors alone. However, diabetes studies indicated that the postprandial glucose level at the peak of 60 min for common bean consumers was low (mean difference = -2.01; 95% CI [-4.6, -0.63]), but the difference between the treated and control was not significant, and there was a high level of heterogeneity among studies (I2 = 98%). Only obesity studies indicated a significantly high level of weight gain among control groups (mean difference = 1.62; 95% CI [0.37, 2.86]). There is a need for additional clinical trials using a standardized measure to indicate the real effect of the common bean on health.
Collapse
|
29
|
Che X, Chen Z, Liu M, Mo Z. Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome. ANNALS OF NUTRITION AND METABOLISM 2021; 77:313-323. [PMID: 34610596 DOI: 10.1159/000519302] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dietary interventions as a first-line treatment for patients with polycystic ovary syndrome (PCOS) have been evaluated, but the optimal diet has not been determined. Proper diet and the maintenance of adequate nutritional status are of great importance in the prevention of this disorder, and therapeutics and dietary habits play an important role in the recovery of patients with PCOS. SUMMARY A range of dietary patterns have been shown to impact weight loss and insulin resistance (IR) and improve reproductive function, including the Mediterranean diet, the ketogenic diet, Dietary Approaches to Stop Hypertension, and other dietary patterns. Key Messages: Diets that can reduce rates of obesity and IR are beneficial to women with PCOS, the status of obesity and IR should be determined at the early stage of the disease, so as to develop individualized and sustainable dietary intervention. The long-term efficacy, safety, and health benefits of diet management in patients with PCOS need to be tested by further researches.
Collapse
Affiliation(s)
- Xuan Che
- Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang, China, .,Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China,
| | - Zhuo Chen
- Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
| | - Mingqi Liu
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China
| | - Zhongcheng Mo
- Guangxi Key Laboratory of Diabetic Systems Medicine, Guilin Medical University, Guilin, China.,Guangxi Province Postgraduate Cotraining Base for Cooperative Innovation in Basic Medicine (Guilin Medical University and Yueyang Women & Children's Medical Center), Yueyang, China
| |
Collapse
|
30
|
Moore JM, Waldrop SW, Cree-Green M. Weight Management in Adolescents with Polycystic Ovary Syndrome. Curr Obes Rep 2021; 10:311-321. [PMID: 34043216 PMCID: PMC8898097 DOI: 10.1007/s13679-021-00437-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS) is a common condition that clinically presents during adolescence. PCOS is associated with increased rates of overweight and obesity, as well as higher rates of metabolic disease, especially type 2 diabetes. Weight loss decreases PCOS symptoms and risk for metabolic disease. The goal of this review is to evaluate recent studies describing the hormonal, metabolic, and weight effects of different weight loss strategies: dietary, physical activity, pharmacotherapy, bariatric surgery, mood modification, and sleep. RECENT FINDINGS Calorie restriction continues to be supported as the primary nutrition intervention to achieve weight loss in individuals with PCOS, and a dietary macronutrient composition with lower compared to higher glycemic carbohydrates may be more effective. There is limited data that vitamins, nutraceuticals, and probiotics may improve hormonal and metabolic outcomes. Most types of physical activity are effective in improving outcomes in PCOS and lowering weight. Whereas there are promising data on anti-obesity medications such as glucagon-like peptide-1 receptor agonists in adults with PCOS and adolescents with obesity, further work is needed to know if these therapies are effective in youth with PCOS. Research is lacking on the effectiveness of other anti-obesity medications in PCOS. Bariatric surgery is especially promising for decreasing weight in adults and youth, and reversing type 2 diabetes in youth, though PCOS data are lacking. Treatment of depression in adolescents with insulin resistance and women with PCOS is associated with improved weight loss. Adolescents with PCOS and obesity may have greater sleep-related risks including circadian misalignment and obstructive sleep apnea, interventions for which have not yet been conducted. Clinical trials on weight loss strategies in adolescents with PCOS remain limited, with most information inferred from studies in women with PCOS or adolescents with obesity. However, there are multiple options to optimize weight loss in dietary, activity, pharmacotherapy, bariatric surgery, mood modification, and sleep domains.
Collapse
Affiliation(s)
- Jaime M Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Stephanie W Waldrop
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Melanie Cree-Green
- Department of Pediatrics, Division of Pediatric Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
- Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, PO Box 265, 13123 E 16th Ave, Aurora, CO, 80045, USA.
| |
Collapse
|
31
|
Carter J, Mathers J, Fairweather‐Tait S, Jebb S, Sattar N, Jennings A, Minihane A. Medical Research Council Hot Topic workshop report: Planning a UK Nutrition and Healthy Life Expectancy Trial. NUTR BULL 2021. [DOI: 10.1111/nbu.12516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Jennifer Carter
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU) Nuffield Department of Population Medicine University of Oxford Oxford UK
| | - John Mathers
- Human Nutrition Research Centre Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK
| | | | - Susan Jebb
- Department of Primary Care Health Sciences University of Oxford Oxford UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences University of Glasgow Glasgow UK
| | - Amy Jennings
- Norwich Medical School University of East Anglia Norwich UK
| | | |
Collapse
|
32
|
Effects of probiotic supplementation on anthropometric and metabolic characteristics in adults with metabolic syndrome: A systematic review and meta-analysis of randomized clinical trials. Clin Nutr 2021; 40:4662-4673. [PMID: 34237694 DOI: 10.1016/j.clnu.2021.05.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 02/22/2021] [Accepted: 05/28/2021] [Indexed: 12/29/2022]
Abstract
AIMS We conducted a systematic review and meta-analysis to evaluate evidence from randomized controlled trials (RCTs) documenting the effectiveness of supplementation with pro-/synbiotics versus placebo controls on anthropometric and metabolic (glucoregulatory status, lipid profile) indices in adults with metabolic syndrome (MetS). METHODS Databases of MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library were searched through March 2020 to identify eligible RCTs evaluating the effects of pro-/synbiotic consumption in adults (≥18 years) with MetS. Mean differences (MDs) and 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS Ten eligible publications (9 RCTs, n = 344 participants) were included. Supplementation with pro-/synbiotics reduced total cholesterol (TC) in adults with MetS versus placebo (MD: -6.66 mg/dL, 95% CI: -13.25 to -0.07, P = 0.04, I2 = 28.8%, n = 7), without affecting weight, body mass index, waist circumference, fasting blood sugar, homeostasis model assessment for insulin resistance, insulin, triglyceride, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol (P > 0.05). CONCLUSIONS Pro-/synbiotic consumption may be beneficial in reducing TC levels in adults with MetS. However, our observations do not support the effectiveness of pro-/synbiotics consumption on other anthropometric or metabolic outcomes of MetS. Further investigations with larger sample sizes are required to confirm these findings.
Collapse
|
33
|
Diet and Nutrition in Gynecological Disorders: A Focus on Clinical Studies. Nutrients 2021; 13:nu13061747. [PMID: 34063835 PMCID: PMC8224039 DOI: 10.3390/nu13061747] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
A healthy lifestyle and a balanced diet play a paramount role in promoting and maintaining homeostatic functions and preventing an array of chronic and debilitating diseases. Based upon observational and epidemiological investigations, it is clear that nutritional factors and dietary habits play a significant role in gynecological disease development, including uterine leiomyoma, endometriosis, polycystic ovary syndrome, and gynecological malignancies. Diets rich in fruits and vegetables, Mediterranean diets, green tea, vitamin D, and plant-derived natural compounds may have a long-term positive impact on gynecological diseases, while fats, red meat, alcohol, and coffee may contribute to their development. Data regarding the association between dietary habits and gynecological disorders are, at times, conflicting, with potential confounding factors, including food pollutants, reduced physical activity, ethnic background, and environmental factors limiting overall conclusions. This review provides a synopsis of the current clinical data and biological basis of the association between available dietary and nutritional data, along with their impact on the biology and pathophysiology of different gynecological disorders, as well as an outlook on future directions that will guide further investigational research.
Collapse
|
34
|
Kazemi M, Kim JY, Parry SA, Azziz R, Lujan ME. Disparities in cardio metabolic risk between Black and White women with polycystic ovary syndrome: a systematic review and meta-analysis. Am J Obstet Gynecol 2021; 224:428-444.e8. [PMID: 33316275 DOI: 10.1016/j.ajog.2020.12.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/26/2020] [Accepted: 12/05/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to summarize and quantitatively pool evidence on cardiometabolic health disparities between Black and White women with polycystic ovary syndrome in the United States in response to the call for further delineation of these disparities in the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. DATA SOURCES Databases of MEDLINE, Web of Science, and Scopus were searched initially through March 05, 2020, and confirmed on September 11, 2020. STUDY ELIGIBILITY CRITERIA Observational studies documenting cardiometabolic risk profile (glucoregulatory, lipid profile, anthropometric, and blood pressure status) in Black and White women with polycystic ovary syndrome were included. Studies on children (<17 years old) and pregnant or menopausal-aged women (>50 years) were excluded. The primary outcome was fasting glucose. Furthermore, data on major cardiovascular events (stroke, coronary heart disease, heart failure) and mortality rate (cardiovascular death, total mortality) were evaluated. METHODS Data were pooled by random-effects models and expressed as mean differences and 95% confidence intervals. Studies were weighted based on the inverse of the variance. Heterogeneity was evaluated by Cochran Q and I2 statistics. Study methodologic quality was assessed by the Newcastle-Ottawa scale. RESULTS A total of 11 studies (N=2851 [652 Black and 2199 White]) evaluated cardiometabolic risk profile and all had high quality (Newcastle-Ottawa scale score of ≥8). No studies reported on cardiovascular events and mortality rate. Black women had comparable fasting glucose (-0.61 [-1.69 to 2.92] mg/dL; I2=62.5%), yet exhibited increased fasting insulin (6.76 [4.97-8.56] μIU/mL; I2=59.0%); homeostatic model assessment of insulin resistance (1.47 [0.86-2.08]; I2=83.2%); systolic blood pressure (3.32 [0.34-6.30] mm Hg; I2=52.0%); and decreased triglyceride (-32.56 [-54.69 to -10.42] mg/dL; I2=68.0%) compared with White women (all, P≤.03). Groups exhibited comparable total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and diastolic blood pressure (all, P≥.06). CONCLUSIONS Black women with polycystic ovary syndrome have a greater tendency for an adverse cardiometabolic risk profile (increased insulin, homeostatic model assessment of insulin resistance, and systolic blood pressure) despite lower triglycerides than White women. Our observations support the consideration of these disparities for diagnostic, monitoring, and management practices in Black women and for future guideline recommendations. Given the heterogeneity among studies, future research should address the relative contributions of biologic, environmental, socioeconomic, and healthcare factors to the observed disparities. Furthermore, longitudinal research is required to address patient-pressing complications, including cardiovascular events and mortality rate in Black women with polycystic ovary syndrome as a high-risk yet understudied population.
Collapse
Affiliation(s)
- Maryam Kazemi
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| | - Joy Y Kim
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY
| | - Ricardo Azziz
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL; Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA; Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, Albany, NY
| | - Marla E Lujan
- Human Metabolic Research Unit, Division of Nutritional Sciences, Cornell University, Ithaca, NY.
| |
Collapse
|
35
|
Li C, Xing C, Zhang J, Zhao H, Shi W, He B. Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome. J Transl Med 2021; 19:148. [PMID: 33849562 PMCID: PMC8045367 DOI: 10.1186/s12967-021-02817-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Time-restricted feeding (TRF) is a form of intermittent fasting, which is beneficial for weight loss and cardiometabolic health. Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine and metabolic diseases affecting women of childbearing age. It is associated with an increased prevalence of metabolic syndrome, cardiovascular diseases and type 2 diabetes. The effects of TRF on PCOS patients remains undefined, here we investigated the impact of TRF on women with anovulatory PCOS. METHODS Eighteen PCOS women aged between 18 and 31 with anovulation participated in a 6-week trial which were divided into two consecutive periods: (1) 1-week baseline weight stabilization period and (2) 5-week TRF period. Fifteen participants completed the study. Changes in body weight, body mass index (BMI), Waist-to-Hip Ratio, skeletal muscle mass, body fat mass (BFM), body fat percentage (BF%), visceral fat area (VFA), luteinizing hormone (LH), follicle-stimulating hormone (FSH), LH/FSH, total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), fasting glucose, fasting insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), area under the curve (AUC) for insulin (AUCIns), area under the curve (AUC) for glucose (AUCGlu), AUCIns/AUCGlu Ratio, lipids, uric acid, alanine aminotransferase (ALT), aspartate aminotransferase, high-sensitivity C-reactive protein (hsCRP), insulin-like growth factor (IGF-1), menstrual cycle and eating behaviors were evaluated. RESULTS Significant changes in body weight, BMI, BFM, BF%, VFA, TT, SHBG, FAI, FINS, HOMA-IR, AUCIns, AUCIns/AUCGlu Ratio, ALT, hsCRP and IGF-1 were found after the TRF period. An improvement in menstrual cycle irregularity was detected in 73.3% (11/15) patients. CONCLUSION The diet of TRF may be beneficial to anovulatory PCOS on weight loss especially reducing body fat, improving menstruation, hyperandrogenemia, insulin resistance and chronic inflammation. Trial registration Clinicaltrial.gov, NCT04580433, registered October 8, 2020, https://clinicaltrials.gov/ct2/show/NCT04580433.
Collapse
Affiliation(s)
- Chunzhu Li
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China
| | - Chuan Xing
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China
| | - Jiaqi Zhang
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China
| | - Han Zhao
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China
| | - Wenjing Shi
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China
| | - Bing He
- Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, Liaoning, China.
| |
Collapse
|
36
|
Polycystic Ovary Syndrome: Pathophysiology, Presentation and Treatment a Mini-Review Article. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2020-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Polycystic ovary syndrome (PCOS) is a common heterogeneous disorder which is known as syndrome. The term ‘syndrome’ refers to a collection of clinical features or a phenotype. The specific features of the PCOS phenotype include clinical signs of androgen excess, elevated serum androgen concentrations, irregular menses, and infertility. It is common heterogenous disorder which affects women with different clinical presentations. In the basis of this disease is hormonal imbalance, such as insulin resistance and hyperinsulinemia. This review was based on searching all the available literature in the next databases: Pubmed, ClinicalTrials, Embase, Medline Complete, Web of Science, Cochrane Library, the Chinese Science and Technology Periodical Database (VIP), WanFang Database (Chinese Ministry of Science & Technology). The search terms included hormonal and metabolic aspects, therapy of PCOS, polycystic ovary syndrome, PCOS.We included only randomized clinical intervention trials in young women published in last five years and included 12 articles in our review analysis. More research is needed to clarify the complex pathophysiology of PCOS. No single test is currently available for its diagnosis. Additionally, once diagnosis is established, the options for treatment are of limited number and effectiveness because they target only the symptoms of PCOS. Finally, patients with PCOS have higher rates of metabolic complications, such as cardiovascular disease, but their impact on mortality is not clear. Therefore, more prospective epidemiologic studies on the topic are necessary.
Collapse
|
37
|
Wiebe N, Ye F, Crumley ET, Bello A, Stenvinkel P, Tonelli M. Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e211263. [PMID: 33710289 PMCID: PMC7955272 DOI: 10.1001/jamanetworkopen.2021.1263] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IMPORTANCE Obesity is associated with a number of noncommunicable chronic diseases and is purported to cause premature death. OBJECTIVE To summarize evidence on the temporality of the association between higher body mass index (BMI) and 2 potential mediators: chronic inflammation and hyperinsulinemia. DATA SOURCES MEDLINE (1946 to August 20, 2019) and Embase (from 1974 to August 19, 2019) were searched, although only studies published in 2018 were included because of a high volume of results. The data analysis was conducted between January 2020 and October 2020. STUDY SELECTION AND MEASURES Longitudinal studies and randomized clinical trials that measured fasting insulin level and/or an inflammation marker and BMI with at least 3 commensurate time points were selected. DATA EXTRACTION AND SYNTHESIS Slopes of these markers were calculated between time points and standardized. Standardized slopes were meta-regressed in later periods (period 2) with standardized slopes in earlier periods (period 1). Evidence-based items potentially indicating risk of bias were assessed. RESULTS Of 1865 records, 60 eligible studies with 112 cohorts of 5603 participants were identified. Most standardized slopes were negative, meaning that participants in most studies experienced decreases in BMI, fasting insulin level, and C-reactive protein level. The association between period 1 fasting insulin level and period 2 BMI was positive and significant (β = 0.26; 95% CI, 0.13-0.38; I2 = 79%): for every unit of SD change in period 1 insulin level, there was an ensuing associated change in 0.26 units of SD in period 2 BMI. The association of period 1 fasting insulin level with period 2 BMI remained significant when period 1 C-reactive protein level was added to the model (β = 0.57; 95% CI, 0.27-0.86). In this bivariable model, period 1 C-reactive protein level was not significantly associated with period 2 BMI (β = -0.07; 95% CI, -0.42 to 0.29; I2 = 81%). CONCLUSIONS AND RELEVANCE In this meta-analysis, the finding of temporal sequencing (in which changes in fasting insulin level precede changes in weight) is not consistent with the assertion that obesity causes noncommunicable chronic diseases and premature death by increasing levels of fasting insulin.
Collapse
Affiliation(s)
- Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Feng Ye
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ellen T. Crumley
- Department of Health, St Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Aminu Bello
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Peter Stenvinkel
- Department of Renal Medicine M99, Karolinska University Hospital, Stockholm, Sweden
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
38
|
Knowledge, Attitudes, and Barriers towards Dietary Pulse Consumption in Women with Polycystic Ovary Syndrome Participating in a Multi-Disciplinary Lifestyle Intervention to Improve Women’s Health. SEXES 2021. [DOI: 10.3390/sexes2010008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pulse (beans, lentils, chickpeas, peas) consumption is low in developed countries. Pulses have the potential to benefit the management of polycystic ovary syndrome (PCOS) because they improve aspects of metabolic derangements (dyslipidaemia, insulin resistance), which contribute to reproductive disturbances (oligo-amenorrhea, hyperandrogenism). We compared changes in knowledge, attitudes, and barriers towards pulse consumption in PCOS cohorts who participated in a pulse-based or a Therapeutic Lifestyle Changes (TLC) dietary intervention. Thirty women (18–35 years old) randomised to a pulse-based diet (supplied with pulse-based meals) and 31 women in a TLC group completed pulse consumption questionnaires before and after a 16-week intervention. The pulse-diet group demonstrated increased knowledge of pulses per Canada’s Food Guide recommendations versus the TLC group post-intervention (p < 0.05). In both groups, increased scores were evident in the domain of attitude about pulses (p < 0.01). The top-ranked barrier to pulse consumption in no-/low-consumers was lack of knowledge about cooking pulses pre- and post-intervention. We attributed increased knowledge about pulse consumption in the pulse group to greater awareness through education and consuming pulse foods during the intervention. Our observations highlight the importance of multi-dimensional behavioural counselling and education to integrate healthy dietary practices for improving reproductive and sexual health in this under-studied high-risk population (ClinicalTrials.gov identifier: NCT01288638).
Collapse
|
39
|
Kazemi M, Hadi A, Pierson RA, Lujan ME, Zello GA, Chilibeck PD. Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Adv Nutr 2021; 12:161-178. [PMID: 32805007 PMCID: PMC7850057 DOI: 10.1093/advances/nmaa092] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023] Open
Abstract
Women with polycystic ovary syndrome (PCOS) exhibit cardiometabolic (e.g., insulin resistance) and associated reproductive disruptions. Lifestyle modification (e.g., diet) is recommended as the first-line therapy to manage PCOS; however, a favorable dietary regimen remains unclear beyond energy restriction. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to summarize evidence on impacts of dietary glycemic index (GI) or glycemic load (GL) on cardiometabolic and reproductive profiles to update the International Evidence-based Guideline for the Assessment and Management of PCOS. Databases of MEDLINE, Cochrane, Web of Science, and Scopus were searched through 30 October 2019, and confirmed on 25 March 2020, to identify RCTs (≥8 wk) comparing the effects of diets with lower (LGI/LGL) and higher (HGI/HGL) GI/GL on glucoregulatory outcomes, lipid profile, anthropometrics, and androgen status in PCOS. The primary outcome was HOMA-IR. Data were pooled by random-effects models and expressed as weighted mean differences and 95% CIs. The risk of bias was assessed by the Cochrane tool. Ten RCTs (n = 403) were eligible. Eight evaluated LGI and 2 LGL diets. LGI diets decreased HOMA-IR (-0.78; -1.20, -0.37; I2 = 86.6%), fasting insulin (-2.39; -4.78, 0.00 μIU/mL; I2 = 76.8%), total cholesterol (-11.13; -18.23, -4.04 mg/dL; I2 = 0.0%), LDL cholesterol (-6.27; -12.01, -0.53 mg/dL; I2 = 0.0%), triglycerides (-14.85; -28.75, -0.95 mg/dL; I2 = 31.0%), waist circumference (-2.81; -4.40, -1.23 cm; I2 = 53.9%), and total testosterone (-0.21; -0.32, -0.09 nmol/L; I2 = 8.6%) compared with HGI diets (all: P ≤ 0.05) without affecting fasting glucose, HDL cholesterol, weight, or free androgen index (all: P ≥ 0.07). Some results were contradictory and only described narratively for 2 RCTs that evaluated LGL diets, since inclusion in meta-analyses was not possible. LGI diets improved glucoregulatory outcomes (HOMA-IR, insulin), lipid profiles, abdominal adiposity, and androgen status, conceivably supporting their inclusion for dietary management of PCOS. Further RCTs should confirm these observations and address whether LGI diets improve more patient-pressing complications, including ovulatory cyclicity, infertility, and cardiovascular disease risk in this high-risk population. This review was registered at www.crd.york.ac.uk/PROSPERO as CRD42020175300.
Collapse
Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, Canada
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Roger A Pierson
- Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, USA
| | - Gordon A Zello
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatchewan, Canada
| | - Philip D Chilibeck
- College of Kinesiology, Physical Activity Complex, University of Saskatchewan, Saskatchewan, Canada
| |
Collapse
|
40
|
Are Dietary Indices Associated with Polycystic Ovary Syndrome and Its Phenotypes? A Preliminary Study. Nutrients 2021; 13:nu13020313. [PMID: 33499268 PMCID: PMC7911683 DOI: 10.3390/nu13020313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/13/2021] [Accepted: 01/20/2021] [Indexed: 12/25/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex hormonal disorder which impairs ovarian function. The adherence to healthy dietary patterns and physical exercise are the first line of recommended treatment for PCOS patients, but it is yet unclear what type of diet is more adequate. In this case-control study, we explored associations between adherence to five dietary quality indices and the presence of PCOS. We enrolled 126 cases of PCOS and 159 controls living in Murcia (Spain). Diagnostic of PCOS and its phenotypes were established following the Rotterdam criteria (hyperandrogenism (H), oligoanovulation (O), polycystic ovaries morphology (POM)). We used a validated food frequency questionnaires to calculate the scores of five dietary indices: alternate Healthy Eating index (AHEI), AHEI-2010, relative Mediterranean Dietary Score (rMED), alternate Mediterranean Dietary Score (aMED) and Dietary Approaches to Stop Hypertension (DASH). We used multivariable logistic regression to estimate adjusted odds ratios and confidence intervals. In the multivariable analysis, AHEI-2010 index was inversely associated with Hyperandrogenism + Oligoanovulation PCOS phenotype (ORQ3 vs. Q1 = 0.1; 95% CI: (0.0; 0.9); Pfor trend = 0.02). We did not find any statistical significant association between dietary indices and total anovulatory or ovulatory PCOS. However, further studies with higher sample sizes exploring these associations among the diverse phenotypes of PCOS are highly warranted.
Collapse
|
41
|
Ou M, Xu P, Lin H, Ma K, Liu M. AMH Is a Good Predictor of Metabolic Risk in Women with PCOS: A Cross-Sectional Study. Int J Endocrinol 2021; 2021:9511772. [PMID: 34422047 PMCID: PMC8376462 DOI: 10.1155/2021/9511772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/28/2021] [Accepted: 08/05/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The relationship between metabolic risk and ovarian function is ambiguous. This retrospective study analyzed the medical records of 461 PCOS patients collected between January 2019 and June 2020 to investigate the relationship between serum anti-Müllerian hormone (AMH) and parameters of metabolic risk in the population with polycystic ovary syndrome (PCOS). METHODS A total of 461 PCOS patients aged 20-40 years were included and stratified into four groups according to the AMH level. The association between AMH and the parameters related to metabolic risk in these groups was compared, and the discrepancies were further explored. Binary logistic regression was performed to examine the risk factors of HOMA-IR. The values of AMH that best predicted the risk of HOMA-IR were also analyzed by ROC curves. RESULTS AMH was negatively associated with HOMA-IR (odds ratio (OR) -0.279, 95% confidence interval (CI) -0.36 to -0.20), fasting insulin (OR -0.282, 95% CI -0.36 to -0.20), 1-hour postprandial insulin (OR -0.184, 95% CI -0.28 to -0.11), 2-hour postprandial insulin (-0.180, 95%CI -0.28 to -0.11), 3-hour postprandial insulin (OR -0.198, 95% CI -0.30 to -0.13), waist-hip ratio (OR -0.235, 95% CI -0.31 to -0.14), and body mass index (OR -0.350, 95% CI -0.43 to -0.27). There was no statistically significant relationship between blood pressure, serum glucose profile, or lipid levels and AMH. Binary logistic regression showed that AMH protected against the occurrence of PCOS patients (OR: 0.835, 0.776, and 0.898). For the prediction of HOMA-IR, AMH had an AUC-ROC of 0.704 (95% CI 0.652-0.755) with a cutoff value of 7.81 mmol/L, a sensitivity of 70.3%, and a specificity of 70.1%. CONCLUSIONS Higher AMH levels were significantly associated with a lower insulin profile and might be a useful predictor for HOMA-IR in PCOS patients.
Collapse
Affiliation(s)
- Miaoxian Ou
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Pei Xu
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Han Lin
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kaichi Ma
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingxing Liu
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
42
|
Vanden Brink H, Pea J, Lujan ME. Ultrasonographic features of ovarian morphology capture nutritional and metabolic influences on the reproductive axis: implications for biomarker development in ovulatory disorders. Curr Opin Biotechnol 2020; 70:42-47. [PMID: 33248350 DOI: 10.1016/j.copbio.2020.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/18/2020] [Accepted: 10/19/2020] [Indexed: 12/25/2022]
Abstract
Ultrasonographic imaging of ovarian morphology is used widely to inform reproductive health status in women. Metabolic disturbances induced by a negative energy balance (e.g. undernutrition) or positive energy balance (e.g. overnutrition, obesity) are known to drive or exacerbate reproductive dysfunction. Whether the utility of ultrasonographic metrics of ovarian morphology could be extended as biomarkers that detect and monitor the integration of metabolic and reproductive dysfunction is an emerging research area, and recent evidence is discussed. We note that unique variations in ovarian morphology emerge across the adiposity spectrum and highlight the potential for reproductive and metabolic 'tipping points' upon which such morphological variations may be detected on ultrasonography.
Collapse
Affiliation(s)
| | - Jeffrey Pea
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Marla E Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
| |
Collapse
|
43
|
Jiskoot G, Timman R, Beerthuizen A, Dietz de Loos A, Busschbach J, Laven J. Weight Reduction Through a Cognitive Behavioral Therapy Lifestyle Intervention in PCOS: The Primary Outcome of a Randomized Controlled Trial. Obesity (Silver Spring) 2020; 28:2134-2141. [PMID: 32969197 PMCID: PMC7702123 DOI: 10.1002/oby.22980] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/01/2020] [Accepted: 07/15/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Long-term weight loss is important and difficult to achieve for many women with polycystic ovary syndrome (PCOS). Lifestyle interventions (LS) in PCOS have shown moderate short-term effects. Three-component LS that combine nutrition advice, exercise, and cognitive behavioral therapy have not been tested in long-term interventions. METHODS Women (N = 183) with PCOS who were trying to conceive and had BMI > 25 kg/m2 were assigned to 20 group sessions of cognitive behavioral therapy combined with nutrition advice and exercise (LS with or without Short Message Service [SMS] via mobile phone) or care as usual (CAU). RESULTS More weight loss was observed in LS than in CAU (P < 0.001). Adding SMS was even more effective (P = 0.017). In CAU, 13 of 60 (21.8%) succeeded in achieving a 5% weight loss, as did 32 of 60 (52.8%) in LS without SMS and 54 of 63 (85.7%) in LS with SMS. The odds of achieving a 5% weight loss were 7.0 (P < 0.001) in LS compared with CAU. More than 18 of 60 (29.0%) of the women in CAU gained weight versus 5 of 60 (8.5%) and 2 of 63 (3.1%) in LS without or with SMS, respectively. The overall dropout rate was 116 of 183 (63.4%). CONCLUSIONS A three-component LS program resulted in reasonable weight loss in women with PCOS. Adding SMS resulted in more weight loss.
Collapse
Affiliation(s)
- Geranne Jiskoot
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamthe Netherlands
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamthe Netherlands
| | - Reinier Timman
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamthe Netherlands
| | - Annemerle Beerthuizen
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamthe Netherlands
| | - Alexandra Dietz de Loos
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamthe Netherlands
| | - Jan Busschbach
- Department of PsychiatrySection Medical Psychology and PsychotherapyErasmus MCRotterdamthe Netherlands
| | - Joop Laven
- Division of Reproductive Endocrinology and InfertilityDepartment of Obstetrics and GynecologyErasmus MCRotterdamthe Netherlands
| |
Collapse
|
44
|
Rodriguez Paris V, Solon-Biet SM, Senior AM, Edwards MC, Desai R, Tedla N, Cox MJ, Ledger WL, Gilchrist RB, Simpson SJ, Handelsman DJ, Walters KA. Defining the impact of dietary macronutrient balance on PCOS traits. Nat Commun 2020; 11:5262. [PMID: 33067453 PMCID: PMC7568581 DOI: 10.1038/s41467-020-19003-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/15/2020] [Indexed: 02/05/2023] Open
Abstract
Lifestyle, mainly dietary, interventions are first-line treatment for women with polycystic ovary syndrome (PCOS), but the optimal diet remains undefined. We combined a hyperandrogenized PCOS mouse model with a systematic macronutrient approach, to elucidate the impact of dietary macronutrients on the development of PCOS. We identify that an optimum dietary macronutrient balance of a low protein, medium carbohydrate and fat diet can ameliorate key PCOS reproductive traits. However, PCOS mice display a hindered ability for their metabolic system to respond to diet variations, and varying macronutrient balance did not have a beneficial effect on the development of metabolic PCOS traits. We reveal that PCOS traits in a hyperandrogenic PCOS mouse model are ameliorated selectively by diet, with reproductive traits displaying greater sensitivity than metabolic traits to dietary macronutrient balance. Hence, providing evidence to support the development of evidence-based dietary interventions as a promising strategy for the treatment of PCOS, especially reproductive traits.
Collapse
Affiliation(s)
- Valentina Rodriguez Paris
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | | | - Alistair M Senior
- Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia
| | - Melissa C Edwards
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, NSW, 2139, Australia
| | - Reena Desai
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, NSW, 2139, Australia
| | - Nicodemus Tedla
- School of Medical Sciences, Department of Pathology, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | - Madeleine J Cox
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | - William L Ledger
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | - Robert B Gilchrist
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia
| | - David J Handelsman
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, NSW, 2139, Australia
| | - Kirsty A Walters
- Discipline of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales Sydney, Sydney, NSW, 2052, Australia.
- Andrology Laboratory, ANZAC Research Institute, University of Sydney, Sydney, NSW, 2139, Australia.
| |
Collapse
|
45
|
Miketinas DC, Shankar K, Maiya M, Patterson MA. Usual Dietary Intake of Resistant Starch in US Adults from NHANES 2015-2016. J Nutr 2020; 150:2738-2747. [PMID: 32840627 DOI: 10.1093/jn/nxaa232] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/29/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Resistant starch (RS) confers many health benefits, mostly due to nonenzymatic human digestion and gut microbiota fermentation capacity. The usual intake of naturally occurring dietary RS in US adults is unclear. OBJECTIVES This study estimated usual daily RS intake in grams per 1000 kcal in US adults by sex, age, and ethnic group, as well as the most frequent food category contributing to RS intake using data from the NHANES 2015-2016. METHODS RS content of foods consumed was matched with Food and Nutrient Database for Dietary Studies food codes. The National Cancer Institute method was used to estimate adults' usual RS intake from 2 24-h dietary recalls. Day 1 RS contribution from food groups to overall RS intake was ranked for the total sample, across age-sex categories, and across ethnic groups. RESULTS In total, 5139 US adults (48.4% male) had a mean daily usual intake of RS of 1.9 ± 0.0 g/(1000 kcal⋅d). Males and females had a similar intake of RS [2.0 ± 0.0 g compared with 1.9 ± 0.0 g/(1000 kcal⋅d)] with no differences between sexes within the same age category. When comparing ethnic groups within each age category, the non-Hispanic white males and females had significantly lower RS intake than all other ethnic groups [range: 1.7-1.8 compared with 2.1-2.3 g RS/(1000 kcal⋅d), respectively], with no differences among the other ethnic groups. French fries and other fried white potatoes, rice, and beans, peas, and legumes were the most frequently consumed food categories contributing to RS intake in all adults. CONCLUSIONS US adults should improve the intake of natural RS food sources. Increasing RS intake will improve gastrointestinal health as a prebiotic and potentially increase insulin sensitivity with adequate consumption (e.g., ∼15 g/d).
Collapse
Affiliation(s)
- Derek C Miketinas
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, USA
| | - Kavitha Shankar
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, USA
| | - Madhura Maiya
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, USA.,Office of Research and Sponsored Programs, Texas Woman's University, Houston, TX, USA
| | - Mindy A Patterson
- Department of Nutrition and Food Sciences, Texas Woman's University Institute for Health Sciences, Houston, TX, USA.,Institute for Women's Health, Texas Woman's University Institute for Health Sciences, Houston, TX, USA
| |
Collapse
|
46
|
Chen Y, Zheng X, Ma D, Zheng S, Han Y, Su W, Liu W, Xiao F, Lin M, Yan X, Zhao T, Liu C. Neck circumference is a good predictor for insulin resistance in women with polycystic ovary syndrome. Fertil Steril 2020; 115:753-760. [PMID: 32917381 DOI: 10.1016/j.fertnstert.2020.07.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/14/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the role of neck circumference (NC) in assessing insulin resistance (IR) in polycystic ovary syndrome (PCOS). DESIGN A cross-sectional study. SETTING University-affiliated hospital. PATIENT(S) One hundred forty-three women with PCOS were recruited from November 2018 to February 2020. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The associations of NC with IR and the cutoff points of NC for IR. RESULT(S) The prevalence rates of IR were 64.3%. The patients with PCOS with IR had significantly greater values of systolic blood pressure, NC, body mass index, waist-to-hip ratio, waist circumference, fasting blood glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR). Pearson correlation analysis showed body mass index (log-transformed), waist circumference, waist-to-hip ratio, and HOMA-IR (log-transformed) were positively correlated with NC. Multivariable linear regression showed that NC was significantly associated with HOMA-IR (log-transformed), with the standardized regression coefficient of 0.330 with adjustment for potential confounding factors. Furthermore, multivariate logistic regression analyses showed NC was associated significantly with increased risk of IR, with the adjusted odds ratio of 1.423. Additionally, NC was able to identify IR in women with PCOS; the optimal cut-off points was 34.3 cm (Youden index = 0.586). CONCLUSION(S) Neck circumference is positively associated with IR in women with PCOS. We suggest NC as a novel, simple, practical, and reliable anthropometric measure to be used to predict the risk of IR in patients with PCOS.
Collapse
Affiliation(s)
- Yun Chen
- The School of Clinical Medicine, Fujian Medical University, Fujian, People's Republic of China
| | - Xin Zheng
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China
| | - Danyan Ma
- School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Silan Zheng
- School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Yan Han
- School of Medicine, Xiamen University, Xiamen, People's Republic of China
| | - Weijuan Su
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China
| | - Wei Liu
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China
| | - Fangsen Xiao
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China
| | - Mingzhu Lin
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China
| | - Xiaohong Yan
- Reproductive Medicine Center, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Tongjin Zhao
- Institute of Metabolism and Integrative Biology, Fudan University, Shanghai, People's Republic of China
| | - Changqin Liu
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China; The School of Clinical Medicine, Fujian Medical University, Fujian, People's Republic of China; Xiamen Clinical Medical Center for Endocrine and Metabolic Diseases, Fujian Province Key Laboratory of Diabetes Translational Medicine, Xiamen, People's Republic of China.
| |
Collapse
|
47
|
Kazemi M, Jarrett BY, Parry SA, Thalacker-Mercer AE, Hoeger KM, Spandorfer SD, Lujan ME. Osteosarcopenia in Reproductive-Aged Women with Polycystic Ovary Syndrome: A Multicenter Case-Control Study. J Clin Endocrinol Metab 2020; 105:5866600. [PMID: 32614948 PMCID: PMC7418445 DOI: 10.1210/clinem/dgaa426] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Osteosarcopenia (loss of skeletal muscle and bone mass and/or function usually associated with aging) shares pathophysiological mechanisms with polycystic ovary syndrome (PCOS). However, the relationship between osteosarcopenia and PCOS remains unclear. OBJECTIVE We evaluated skeletal muscle index% (SMI% = [appendicular muscle mass/weight (kg)] × 100) and bone mineral density (BMD) in PCOS (hyperandrogenism + oligoamenorrhea), and contrasted these musculoskeletal markers against 3 reproductive phenotypes (i): HA (hyperandrogenism + eumenorrhea) (ii); OA (normoandrogenic + oligoamenorrhea) and (iii), controls (normoandrogenic + eumenorrhea). Endocrine predictors of SMI% and BMD were evaluated across the groups. DESIGN, SETTING, AND PARTICIPANTS Multicenter case-control study of 203 women (18-48 years old) in New York State. RESULTS PCOS group exhibited reduced SMI% (mean [95% confidence interval (CI)]; 26.2% [25.1,27.3] vs 28.8% [27.7,29.8]), lower-extremity SMI% (57.6% [56.7,60.0] vs 62.5% [60.3,64.6]), and BMD (1.11 [1.08,1.14] vs 1.17 [1.14,1.20] g/cm2) compared to controls. PCOS group also had decreased upper (0.72 [0.70,0.74] vs 0.77 [0.75,0.79] g/cm2) and lower (1.13 [1.10,1.16] vs 1.19 [1.16,1.22] g/cm2) limb BMD compared to HA. Matsuda index was lower in PCOS vs controls and positively associated with SMI% in all groups (all Ps ≤ 0.05). Only controls showed associations between insulin-like growth factor (IGF) 1 and upper (r = 0.84) and lower (r = 0.72) limb BMD (all Ps < 0.01). Unlike in PCOS, IGF-binding protein 2 was associated with SMI% in controls (r = 0.45) and HA (r = 0.67), and with upper limb BMD (r = 0.98) in HA (all Ps < 0.05). CONCLUSIONS Women with PCOS exhibit early signs of osteosarcopenia when compared to controls likely attributed to disrupted insulin function. Understanding the degree of musculoskeletal deterioration in PCOS is critical for implementing targeted interventions that prevent and delay osteosarcopenia in this clinical population.
Collapse
Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, US
| | - Brittany Y Jarrett
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, US
| | - Stephen A Parry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, NY, US
| | - Anna E Thalacker-Mercer
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, US
| | - Kathleen M Hoeger
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Steven D Spandorfer
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, US
| | - Marla E Lujan
- Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University, Ithaca, NY, US
| |
Collapse
|
48
|
The Effects of Legume Consumption on Markers of Glycaemic Control in Individuals with and without Diabetes Mellitus: A Systematic Literature Review of Randomised Controlled Trials. Nutrients 2020; 12:nu12072123. [PMID: 32708949 PMCID: PMC7400945 DOI: 10.3390/nu12072123] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 01/23/2023] Open
Abstract
Legumes are a rich source of dietary fibre, plant protein, and low-Glycaemic Index (GI) carbohydrate. Evidence suggests a positive effect on glycaemic control following a single meal; however, the effects of habitual consumption are less clear. This review aimed to investigate whether medium-to-long-term legume consumption had an effect on markers of glycaemic control in individuals with diabetes mellitus, without diabetes mellitus, or with prediabetes. As per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, the online databases MEDLINE, Embase, CENTRAL, and CINAHL were searched from inception through to 31 March 2020. Randomised controlled trials (RCTs) ≥6 weeks in duration, reporting ≥1 of the following: fasting blood glucose (FBG), fasting blood insulin (FBI), glycosylated haemoglobin (HbA1c), homeostatic model assessment-insulin resistance (HOMA-IR), or 2-h postprandial glucose (2-h PPG), were deemed eligible. The overall quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment. A total of 18 RCTs were included, of which, 5 focused on individuals with diabetes mellitus, 12 on individuals without diabetes mellitus, and one on individuals with prediabetes. Only studies of those with type 2 diabetes mellitus (n = 5) reported significant effects for legume interventions, three of which consistently reported reductions in FBG, two reported reductions in HbA1c, one reported a reduction in FBI, and another a reduction in 2-h PPG (p < 0.05); however, the overall quality of evidence was very low. The findings of this review support the dietary inclusion of legumes; however, the need for further high-quality RCTs to be conducted is also highlighted, particularly among individuals with prediabetes, gestational diabetes mellitus and type 1 diabetes mellitus.
Collapse
|
49
|
Kazemi M, Jarrett BY, Vanden Brink H, Lin AW, Hoeger KM, Spandorfer SD, Lujan ME. Obesity, Insulin Resistance, and Hyperandrogenism Mediate the Link between Poor Diet Quality and Ovarian Dysmorphology in Reproductive-Aged Women. Nutrients 2020; 12:E1953. [PMID: 32629978 PMCID: PMC7399845 DOI: 10.3390/nu12071953] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
The relationship between diet quality and ovarian morphology has biological plausibility yet remains unclear and was therefore evaluated. In a multicenter cross-sectional analysis, four dietary patterns were scored for 111 consecutive reproductive-aged women (18-45 years) using (1) Healthy Eating Index (HEI-2015); (2) alternative HEI-2010; (3) alternate Mediterranean Diet (aMED); (4) and Dietary Approaches to Stop Hypertension (DASH) indices. Ovarian volume (OV) and follicle number per ovary (FNPO) were evaluated on transvaginal ultrasonography. Relationships between dietary and ovarian morphology indices were evaluated by linear regression and mediation analyses. Associations between aMED and DASH scores and OV/FNPO were completely mediated by obesity, insulin resistance, and hyperandrogenism (All: p < 0.05), unlike direct associations (All: p ≥ 0.89). Namely, a 1-standard deviation [SD] increase in aMED score was associated with decreases in OV (0.09 SD; 0.4 mL) through reducing waist circumference. Likewise, a 1 SD increase in aMED and DASH score was associated with decreases in OV (0.07 SD; 0.3 mL) by reducing glucose response to a 75 g glucose tolerance test. A 1 SD increase in DASH score was associated with decreased FNPO (0.07 SD; 2 follicles) by reducing free androgen index (All: p < 0.05). Adherence to aMED and DASH eating plans was indirectly associated with significant improvements in ovarian form, providing novel mechanistic insights for future interventions about contributions of diet quality on ovarian function.
Collapse
Affiliation(s)
- Maryam Kazemi
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA; (M.K.); (B.Y.J.); (H.V.B.)
| | - Brittany Y. Jarrett
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA; (M.K.); (B.Y.J.); (H.V.B.)
| | - Heidi Vanden Brink
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA; (M.K.); (B.Y.J.); (H.V.B.)
| | - Annie W. Lin
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL 60611, USA;
| | - Kathleen M. Hoeger
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14623, USA;
| | - Steven D. Spandorfer
- Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY 10065, USA;
| | - Marla E. Lujan
- Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL 60611, USA;
| |
Collapse
|
50
|
Kazemi M, Pierson RA, McBreairty LE, Chilibeck PD, Zello GA, Chizen DR. A randomized controlled trial of a lifestyle intervention with longitudinal follow-up on ovarian dysmorphology in women with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2020; 92:525-535. [PMID: 32092167 DOI: 10.1111/cen.14179] [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] [Received: 12/02/2019] [Revised: 02/15/2020] [Accepted: 02/22/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Effects of lifestyle modification on reproductive function in polycystic ovary syndrome (PCOS) remain poorly elucidated. We compared the effects of a pulse-based diet (lentils, beans, split peas and chickpeas) with Therapeutic Lifestyle Changes (TLC) diet on ultrasonographic markers of ovarian morphology, hyperandrogenism and menstrual irregularity in PCOS. DESIGN Randomized controlled trial. PATIENTS Women with PCOS (18-35 years). MEASUREMENTS Thirty women randomized to the pulse-based and 31 to TLC groups completed a 16-week intervention without energy restriction. Groups performed aerobic exercise (minimum of 5 days/wk; 45 minutes/d) and received health counselling (monthly) and longitudinal follow-up. Follicle numbers per ovary (FNPO, 2-9 mm), ovarian volume (OV), free androgen index (FAI) and menstrual cycle length were measured pre- and postintervention. RESULTS Follicle numbers per ovary (mean change ± SD, -10 ± 15), OV (-2.7 ± 4.8 mL), FAI (-3 ± 2) and menstrual cycle length (-13 ± 47 days) decreased over time in both groups (All: P < .01), without group-by-time interactions (All: P ≥ .13). Attrition rate was 33.7% and comparable between groups (P = .94). Adherence to diet intervention negatively correlated with changes in FNPO (r=-0.54), OV (r=-0.35) and FAI (r = -.29) in pooled groups (All: P ≤ .04). Groups maintained reduced OV, FNPO, FAI and menstrual cycles 6 months postintervention; however, decreased FNPO and FAI at 16 weeks tended to revert to baseline levels 12 months postintervention in both groups (All: P ≤ .05). CONCLUSIONS Both interventions improved ovarian dysmorphology, hyperandrogenism and menstrual irregularity in PCOS, and no diet appeared to be superior at improving reproductive outcomes. Our observations highlight the importance of longitudinal surveillance for sustainable adherence to newly adopted healthy lifestyle behaviours and reproductive health in PCOS (ClinicalTrials.gov identifier, NCT01288638).
Collapse
Affiliation(s)
- Maryam Kazemi
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Roger A Pierson
- Department of Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Laura E McBreairty
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Gordon A Zello
- Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna R Chizen
- Department of Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|