Impact of Nutrition Interventions on Symptoms of Polycystic Ovarian Syndrome (PCOS) among Women of Reproductive Age (20-45 Years)
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Date
2022-11
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Publisher
Avinashilingam
Abstract
Polycystic ovarian syndrome is a gynecological endocrine disorder affecting
women of reproductive age and is most commonly seen in young adult women. Women
with PCOS might have problems like irregular menstruation, obesity, acne, hirsutism,
hyperinsulinemia, etc. due to hyperandrogenemia which results in
oligoovulation/anovulation. It is also considered as a lifestyle disorder which can be
preventable using appropriate health and nutrition strategies. Though the incidence of
PCOS is rapidly increasing, adolescent girls and young adult women are unaware and
have inadequate knowledge about PCOS and its complications. Hence, the present
research has focused on searching for new alternative medical nutrition therapy options
for the management of symptoms of polycystic ovarian syndrome with the prime objective
of assessing the efficiency of dietary intervention strategies on signs and symptoms of
PCOS among the selected group of Reproductive age women. The secondary objectives
were to find out the prevalence of PCOS among women in the Reproductive age ( 20-45
years),identification of women having PCOS for collection of Socioeconomic profile,
dietary and lifestyle pattern, Nutritional status and Reproductive health status, formulation
and evaluation of micronutrient-dense health mix supplement powder , development of
Nutrition and health education modules for nutrition interventions and finally to find out the
Impact of Nutrition interventions on Nutritional status and Nutritional knowledge among
the selected Women of Reproductive age (20-45 years).
In the first phase of the present study, a quick screening of symptoms of PCOS
carried out among the 810 women who came for consulting the Gynecologist. Among the
810 subjects, 284 subjects were identified with PCOS using the Rotterdam criteria(2003)
.The survey was carried out among the selected 284 subjects to collect the data related to
demographic profile, age, educational, marital status, income levels, family history, medical and
reproductive profile including disease history such as diabetes mellitus, hypertension, menstrual
irregularities, hirsutism and alopecia, dietary pattern , food frequency pattern ,24 hour recall and
food consumption details. The next phase, for Nutrition Intervention, 93 subjects were
identified from 284 subjects on the basis of their willingness, cooperation and nutritional
and health status. They were systematically grouped into three, named Experimental
Group I (Nutrition Supplementation and Nutrition Education), Experimental Group II
(Nutrition Education), and Control Group (Medication) respectively .Simultaneously
formulation and nutritional evaluation of micronutrient-dense Health mix powder was
carried out. The acceptability trials were executed and the highest-scored variation in
terms of sensory evaluation score, nutrient content and cost-effectiveness was selected
for the Nutrition Intervention. The present study was also focused on the development
and validation of health and nutrition education modules which were tailor-made to fulfill
the nutritional care and support of the selected PCOS participants. All the selected
participants in Experimental Group I (N=32) were properly instructed to consume the
Nutrient-dense Health mix powder 30g daily without any wastage for three months.
Selected 32 women in Experimental Group I and 31 women in Experimental Group II
were also provided Nutrition education using the developed booklet, leaflets and
PowerPoint presentation and nutrition education sessions provided as one-to-one
counseling initially. Before and after the nutrition interventions, anthropometric
measurements, biochemical estimation, clinical examination and individual dietary intake
were assessed to find out the effect of Interventions on the nutritional status and
Nutritional knowledge of the selected participants.
ANOVA was performed to analyze the effectiveness of nutrition intervention
strategies. Post hoc comparison confirmed as significantly higher mean difference
between Experimental group I and control group with weight difference (MD= 4.9), waist
circumference ( MD=1.41), Hip Difference(M=1.26),body fat (MD=1.27)and BMI
difference (MD=1.98 )respectively. There was a significant mean difference in the values
of cholesterol ( p=0.004) ,Triglycerides( p=0.05) ,Cholesterol to HDL ratio ( p=0.017) and
testosterone levels ( p=0.000). Between the group comparison using post hoc analysis
showed significant mean difference of cholesterol (MD=20.58), Triglycerides(MD=24.78)
between Experimental group I and Control group. There was also significant mean
difference of cholesterol to HDL ratio ( p=0.012) and VLDL ( P=0.004) between
Experimental group I and Control group. The difference in rate of change was compared
between the interventions also confirmed the same results. The regularization of
menstrual cycle showed that participants in the Experimental group I had 4.3 times higher
chance of experiencing regular periods compared to the control group (OR=4.33 Cl1.385-
13.552). Participants in the Experimental group I had 9.1 times higher chance of
experiencing regular periods compared to those who only received nutrition education
alone in Experimental group II ( OR=9.1,Cl2.84-29.146)
From the research study, it is evident that the nutrition intervention strategies
including nutrition education, supplementation, adoption of physical activities and stress
management were proven to be effective in the Experimental group I and II during the
study period of 90 days.The highest significant changes in nutritional status and
nutritional knowledge was among the participants in the Experimental group I . Screening
provides an opportunity for the target group of the population to promote healthy lifestyles
and early nutrient intervention for the prevention of future co-morbidities.
Description
Keywords
Food Science and Nutrition