Diet and Physical Exercise in Polycystic Ovary Syndrome Management Research Paper

Introduction

Polycystic ovary syndrome (PCOS) refers to a disease that is common among middle-aged women and is attributed to hormonal disproportions. Women with the disorder present with elevated androgen levels, prolonged or infrequent menstrual periods, and enlarged ovaries containing follicles around the ova. These changes lead to irregularity in ovarian function in PCOS patients. Causes include heredity, low-grade inflammation, and excess insulin. Six percent of women of the productive age are affected by polycystic ovary syndrome. Those infected are at risk of poor prognosis, including complications such as endometrial cancer, eating disorders, anxiety, depression, type 2 diabetes, sleep apnea, metabolic syndrome, miscarriages, infertility, nonalcoholic steatohepatitis, and gestational diabetes.^{1, 3} Obesity has been known to enhance these complications among PCOS patients. This explains why dietary management and physical exercise are among the two main recommendations to improve the patients’ condition.

Polycystic ovary syndrome, according to the world health organization (WHO), is the primary cause of infertility among women of reproductive age. These rates are even higher in obese women due to the higher risk and severity of complications. The condition is usually overlooked, but its prognosis, especially in obese women, is alarmingly poor, thus calling for the need to research and advance the already existing knowledge about the condition.³ This review seeks to provide an insight on physical exercise and dietary measures as management approaches in terms of their efficiency in improving the state, prevention, and prognosis of PCOS patients.

This study is based on selected research articles with different approaches with the aim of determining the efficiency of management modalities of polycystic ovary syndrome. The articles reviewed feature various researches conducted (different research methods), results, discussion, and conclusion. This paper will analyze the results and review the conclusions reached at the end of the conducted studies to come up with a recommendation on the best treatment option for polycystic ovary syndrome.

Objective

This study aims at evaluating the efficiency of a healthy diet compared to physical exercise in improving the condition of polycystic ovary syndrome patients.

Methods

This study reviewed five primary research articles published within the last ten years. The research articles reviewed employed the cross-sectional and prospective cohort study methods. Experiments were conducted in some of the articles to determine the effective implementations in the management of PCOS. The results and conclusions were also made in the articles reviewed.

Analysis approach

The study compiled data and analyzed the results from five different articles published in the last ten years. The studies in focus were conducted using different research methods. Most of the featured articles include experimental assessment of PCOS patients against healthy control groups. Other variables considered ensuring a detailed inclusion and accuracy of the results include the participants’ age, lifestyle, body mass index, and hormonal and dietary inclinations.

Cao et al., (2016): The target of the research is to ascertain whether physical exercise intervention upholds PCOS prevention. This study used a rat model where fifty-six-weeks-old Sprague Dawley female mice with a weight of roughly 180g were held in isolated cages under supervised environmental conditions.¹ They were then randomly classified into five groups: a model group, a healthy control group, and three intervention groups. Also, the study used statistical analysis techniques, and the data were synthesized by one-way evaluation of variants, proceeded by a Tukey post hoc evaluation for the wide range of contrasts and displayed in the form of mean, standard deviation.

Guvenc et al. (2016): The objective of the study was to ascertain serum vaspin and chemerin in obese against moderate-weight polycystic ovary syndrome patients and study the anticipated connection between the metabolic syndrome and adipocytes. It was cross-sectional research performed on forty women with PCOS and thirty healthy, normal women. Among those with the condition, eighteen were overweight, while twenty-two were of normal weight. The study was done in the gynecology and obstetrics department at Celal Bayer University Hospital, Manisa, in Turkey.² The control group included women who had attended the clinic for any other issues apart from menstrual or hormonal abnormalities. For diagnosis of polycystic ovary syndrome, the Rotterdam method was applied, and women with at least two oligoovutation or anovulation biochemically verified hyperandrogenism or clinically valid and typical morphology of the ovaries on pelvic ultrasonography were included.

Ribeiro et al., (2019): The goal of the research was to ascertain and contrast the consequences of constant aerobic physical exercise and randomized aerobic physical exercise routine on the standards of living of the subjects. Women between the age of 17 years and 37 years with PCOS were included in the research. The probe was a randomized clinical evaluation, whereas the diagnosis criteria used was the Rotterdam criteria. Participants were recruited through announcements on the university website and the city’s newspaper.³ There was a total of 126 volunteers, but 16 were dropped during the first examination. The remaining 111, 22 volunteers dropped out during the research proceedings, while 86 finished the exercise. The volunteers were grouped into three groups: the aerobic, continuous training group, the aerobic, intermittent training group, and the control, healthy group without training.

Tagliaferri et al., (2017): The target of the research was to determine the outcome of six months of the introduction of melatonin on clinical, metabolic, and endocrine qualities of women with PCOS. A prospective cohort study on forty women with a moderate weight with positive PCOS status for over six months from January to September of 2016.⁴ All the subjects were volunteers of viable age and gave informed consent for the study. The anthropometric features measured were height, weight, and circumference of the hip and waist to determine the waist-to-hip ratio. The diagnosis criteria preferred in the discovery of PCOS was the Rotterdam method. The exclusion criteria for this study were pregnancy, history of cardiovascular disease, diabetes mellitus, high blood pressure, among other serious complications.

Williams et al., (2014): The researchers of this case study explored the consequences of PCOS on the lives of women using photovoice. It is a qualitative research study done on thirty-four women. The inclusion criteria are women aged 19 years or more, living in the United Kingdom, exhibiting signs of or suffering from polycystic ovary syndrome.⁵ The exclusion criteria for this study are participants suffering from any other long-term or psychotic illness that was not attributed to polycystic ovary syndrome. The participants were recruited through a polycystic ovary syndrome charity website known as Verity.⁵ The method of collecting information used was photovoice, where the subjects were given cameras and instructed to record images to document their daily experiences. The participants were also provided with notebooks to record their experiences and write a diary entry for every image recorded. The data analysis method used is thematic analysis.

Results

Older age, body mass index (BMI), and a high random androgen index were the most regular variables in ladies with polycystic ovary syndrome. Most PCOS-positive women were found to be obese and had elevated levels of androgen, testosterone, and insulin. There was no major variance in omentin-1, serum vaspin, and chemerin levels between the healthy and PCOS patients.² However, these levels were greatly elevated in obese PCOS patients. Cholesterol levels were also prominent in PCOS patients. The studies also demonstrated an apparent connection between androgen and disorders of metabolism in patients with PCOS. It also highlighted diet and lifestyle changes as the most reliable in the control of polycystic ovary syndrome.

Cao et al., (2017). The rats subjected to low-intensity inductions added significant weight during the experiment compared to the healthy control group. The high-intensity group, however, demonstrated a decrease in weight to levels similar to the control group.

Guvenc et al., (2016). PCOS patients had significantly elevated levels of cholesterol, free androgen index, chemerin, and dehydroepiandrosterone sulfate.² Sex hormone-building globulin and lipoprotein cholesterol were lower in obese PCOS patients.² There was no difference between the healthy and PCOS patients in terms of omentin, vaspin, and serum chemerin.

Robeiro et al., (2021). Body composition indices, testosterone levels, and quality of life were reviewed on the sixteenth week of the experiment. It was determined that both interventions had positive impacts on the anthropometric levels, testosterone index, and the living standards of PCOS patients.

Tagliaferri et al., (2017). Insulin secretion and its peripheral sensitivity were not altered during the treatment of PCOS patients. Lipid profile, cholesterol, and plasma levels remained normal even after the sixth month of trial treatment. High cholesterol plasma levels were, however, significantly reduced.

Williams et al., (2016). This research used photovoice to determine the quality of life of the participants. Nine participants provided photographs of objects they regularly use in their lives. They also gave a detailed description of the objects in their diary entries. These entries were then used to derive conclusions concerning their quality of life. Three thematic aspects emerged from these conclusions, including their perception of their situation, control of their symptoms, and support in terms of education, healthcare facilities, and interactions.⁵ It was determined that social interaction websites and pets play a significant role in offering support and encouragement to PCOS patients.

Discussion

The study proved the initial hypothesis that there was no major difference in the level of omentin-1, serum vaspin, between the healthy and PCOS patients. PCOS patients were found to be obese with a high level of androgen and testosterone. The above findings show that PCOS genetics is insignificant in common variant susceptibility. The genetic similarity on biological pathways was also exhibited between PCOS and various disorders such as depression and menopause. The findings highlighted that frequent exercises are paramount since obesity is one of the main variants for women with polycystic ovary disease since a healthy body will curb metabolic maladies.

Conclusion

Physical exercise is essential in managing PCOS, as being overweight is one of the most highlighted variables among the affected women. However, a healthy diet exhibits better results as it addresses metabolism disorders such as dyslipidemia and help correct obesity. The two approaches of management produce the best outcomes when combined in the treatment and prevention of PCOS patients.

The articles reviewed in this study utilized different study methods, and were conducted over sufficient periods, and had an effective criterion of inclusion of participants. The results derived from the procedures were conclusive in nature. Each research review focused on different attributes of obesity and physical exercise in the management of PCOS patients. Body mass index, overweight, and the socio-economic factors of PCOS patients demonstrated significant involvement in the prognosis of these patients.^{1, 2, 3, 5} Dietary considerations and physical exercise are effectively provided they positively influence the levels of these three variables. This review also uncovered that hormonal considerations are also an important factor to consider in the management of PCOS patients. The dietary and physical interventions should therefore be aimed at regaining hormonal balance.

References

Cao SF, Hu WL, Wu MM, & Jiang LY. (2017). Effects of exercise intervention on preventing Letrozole-exposed rats from polycystic ovary syndrome. Reproductive Sciences, 24(3), 456–462. Web.

Guvenc Y, Var A, Goker A, & Kuscu NK. (2016). Assessment of serum chemerin, vaspin and omentin-1 levels in patients with polycystic ovary syndrome. Journal of International Medical Research, 796–805. Web.

Ribeiro VB, Lopes IP, Dos Reis RM, Silva RC, Mendes MC, Melo AS, De Souza HCD, Ferriani RA, Kogure GS, & Lara LA, da S. (2021). Continuous versus intermittent aerobic exercise in the improvement of quality of life for women with polycystic ovary syndrome: A randomized controlled trial. Journal of Health Psychology, 26(9), 1307–1317. Web.

Tagliaferri V, Romualdi D, Scarinci E, Cicco SD, Florio CD, Immediata V, Tropea A, Santarsiero CM, Lanzone A, & Apa R. (2018). Melatonin treatment may be able to restore menstrual cyclicity in women with PCOS: A pilot study. Reproductive Sciences, 25(2), 269–275. Web.

Williams S, Sheffield D, & Knibb RC. (2016). A snapshot of the lives of women with polycystic ovary syndrome: A photovoice investigation. Journal of Health Psychology, 21(6), 1170–1182. Web.