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

被引:33
|
作者
Kazemi, Maryam [1 ,2 ]
Kim, Joy Y. [1 ]
Wan, Cynthia [1 ]
Xiong, Julia D. [1 ]
Michalak, Julia [1 ]
Xavier, Isabella B. [1 ]
Ganga, Kiran [1 ]
Tay, Chau Thien [3 ]
Grieger, Jessica A. [4 ,5 ]
Parry, Stephen A. [6 ]
Moran, Lisa J. [3 ,4 ]
Lujan, Marla E. [1 ]
机构
[1] Cornell Univ, Div Nutrit Sci, Human Metab Res Unit, 216 Savage Hall, Ithaca, NY 14853 USA
[2] Icahn Sch Med Mt Sinai, Hilda & J Lester Gabrilove Div Endocrinol Diabet, Dept Med, 18-92 Floor 18 Annenberg Bldg,1468 Madison Ave, New York, NY 10029 USA
[3] Monash Univ, Sch Publ Hlth & Prevent Med, Monash Ctr Hlth Res & Implementat MCHRI, Clayton, Vic, Australia
[4] Univ Adelaide, Robinson Res Inst, Adelaide, SA, Australia
[5] Univ Adelaide, Adelaide Med Sch, Adelaide, SA, Australia
[6] Cornell Univ, Cornell Stat Consulting Unit, Ithaca, NY USA
基金
英国医学研究理事会; 美国国家卫生研究院; 加拿大健康研究院;
关键词
polycystic ovary syndrome; obesity; lifestyle; nutrition; exercise; reproduction; PCOS; TEST-RETEST RELIABILITY; HEALTHY EATING INDEX; QUALITY-OF-LIFE; RELATIVE VALIDITY; GLYCEMIC INDEX; VITAMIN-D; SYNDROME PCOS; ACTIVITY QUESTIONNAIRE; INSULIN-RESISTANCE; OVERWEIGHT WOMEN;
D O I
10.1093/humupd/dmac023
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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; I-2 = 19%), lower magnesium (MD: -21.46, 95% CI: -41.03 to -1.91 mg/day; P = 0.03; I-2 = 76%), and a tendency for lower zinc (MD: -1.08, 95% CI: -2.19 to -0.03 mg/day; P = 0.05; I-2 = 96%) intake, despite lower alcohol consumption (MD: -0.95, 95% CI: -1.67 to 0.22 g/day; P = 0.02; I-2 = 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; I-2 = 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.
引用
收藏
页码:910 / 955
页数:46
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