Nutrients as novel therapeutic approaches for metabolic disturbances in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women. This disease is characterized by infertility, menstrual dysfunction, and hyperandrogenism. Also, PCOS is often associated with hyperlipidemia and impaired glucose tolerance, conditions that are associated with cardiovascular disorder, type 2 diabetes, cancer and hypertension. Evidence supports that some nutrients may affect the hormonal and metabolic disturbances of PCOS. Here in this study, we aimed to review the available literature that assessed the nutrients such as inostol, isoflavonids, resveratrol, vitamin D, and PUFA (polyunsaturated fatty acids), known to influence the hormonal and metabolic disturbances of PCOS, along with the strategies and future directions of nutrient supplementations in such patients

n-3 fatty acids as preventive and therapeutic agents in attenuating PCOS complications

To our knowledge, in spite of several trials exploring the beneficial effect of n-3 polyunsaturated fatty acids (PUFA) on polycystic ovary syndrome (PCOS), no comprehensive evidence has investigated the effects of n-3 PUFA consumption on PCOS complications. Therefore, our aim was to conduct a review to investigate the possible effect and related mechanisms. A comprehensive systematic search was conducted in Embase, MED-LINE/PubMed, Google Scholar, and SCOPUS, to identify studies investigating n-3 fatty acids as a preventative or therapeutic agent for the attenuation of PCOS complications. Subsequently, the impact of omega-3 on PCOS, omega-3 and inflammation, omega-3 and insulin resistance, omega-3 and adipokines, omega-3 and lipid metabolism, omega-3 and endothelial function and omega-3 and hormonal factors were discussed. There are multiple mechanisms by which n-3 PUFAs may exert their beneficial effects on PCOS, including anti-obesity, glycemic and hormonal hemostasis, anti-inflammatory, regulation of adipokine production and enhancement of endothelial function. N-3 PUFAs are a promising agent in relieving complications associated with PCOS. Although most of the studies in patients with PCOS reported an improvement in most complications after administration of omega-3 supplements, there is a distinct dearth of studies investigating the dietary intake of these types of fatty acids. Moreover, favorable effects regarding the improvement of dyslipidemia, regulation of adipokines, regulation of hormonal factors and enhancement of endothelial function are limited. Therefore, more trials are warranted to investigate palatable mechanisms for clarifying the metabolic and hormonal effects of these agents in PCOS. © 2019, Leibniz Research Centre for Working Environment and Human Factors. All rights reserved

Overview of the current state of the art in nutritional interventions for polycystic ovary syndrome

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021O Síndrome do ovário poliquístico (SOP) é um complexo transtorno endócrino e metabólico frequentemente associado a infertilidade, obesidade e a insulinorresistência. A etiologia da doença permanece mal compreendida, apesar de causas poligenicas e multifatoriais parecerem estar envolvidas, incluindo, em particular, elementos ambientais, onde se destaca a dieta e outros fatores do estilo de vida. Neste contexto, a terapêutica da SOP deve ser ajustada de acordo com a gravidade das manifestações e necessidades da doença e, partindo da modificação do estilo de vida, conjuntamente com potenciais abordagens farmacológicas e/ou cirúrgicas. A presente revisão tem por objetivo fornecer uma revisão compreensiva do estado atual da investigação no que respeita ao tratamento e gestão de mulheres com SOP, focando-se, em particular, nas intervenções nutricionais, pois são estas consideradas opções de tratamento de primeira linha. A dieta e proporção relativa de macronutrientes ideal, em situações de SOP, ainda não foi passível de ser identificada e globalmente reconhecida, já que a heterogeneidade dos resultados encontrados é significativa. Não obstante, uma distribuição de macronutrientes similar à descrita na dieta Mediterrânica mostrou impactos positivos e revelou-se adequada para manutenção a longo prazo. A suplementação de certos elementos em défice pode também desempenhar um papel de interesse na abordagem destes doentes sendo que a vitamina D e os ácidos gordos polinsaturados n3 mostraram os resultados mais consistentes. Mais ainda, a disbiose da microbiota intestinal parece não só influenciar a patogénese da doença como também a sua correção, através de agentes prébióticos e probióticos, parece constituir uma intervenção terapêutica promissora. Apesar da constante publicação de novos dados, esta área de investigação carece ainda de mais estudos de qualidade, visto que devem ser contempladas intervenções com maior duração e com grupos em estudo de maior dimensão e mais diversificados, especialmente no que se refere à etnicidade dos mesmos.Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder frequently associated with infertility, obesity and insulin resistance. The etiology of the disease remains poorly understood, despite polygenic and multifactorial causes are thought to be involved and from which environmental elements should be emphasised, these including diet and lifestyle factors. In this regard, treatment of PCOS should be adjusted accordingly to the severity of manifestations and necessities of the patient. The approach should be, ideally, based on lifestyle modifications, these eventually in conjunction with a pharmacologic and/or surgical approach. This article aims to provide a comprehensive review of the current state of research in what regards the therapeutic strategies and management of women with PCOS, however, focusing, particularly, in dietary interventions as these are considered first line treatment options. The optimal diet and macronutrient balance, in the PCOS setting, is yet to be identified and globally recognised, as heterogeneity in the available data is still significant. Nevertheless, a macronutrient distribution similar to the one found in a Mediterranean diet showed positive impacts and suitable for long-term maintenance. Supplementation of specific lacking elements may also play an important role in the approach of these patients, expressly vitamin D as well as omega-3 polyunsaturated fatty acids having the most consistent evidence-based results. Furthermore, dysbiosis of the gut microbiota may influence the pathogenesis of the disease and its correction, through prebiotic and probiotic agents, a promising treatment option. Despite the fact that new data is constantly published, this area of research is still in lack of further good quality studies, as broader time of intervention as well as broader and more diverse intervention groups should be contemplated, especially in what refers to ethnicity variety

The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility

In female mammals, mechanisms have been developed, throughout evolution, to integrate environmental, nutritional and hormonal cues in order to guarantee reproduction in favorable energetic conditions and to inhibit it in case of food scarcity. This metabolic strategy could be an advantage in nutritionally poor environments, but nowadays is affecting women's health. The unlimited availability of nutrients, in association with reduced energy expenditure, leads to alterations in many metabolic pathways and to impairments in the finely tuned inter-relation between energy metabolism and reproduction, thereby affecting female fertility. Many energetic states could influence female reproductive health being under- and over-weight, obesity and strenuous physical activity are all conditions that alter the profiles of specific hormones, such as insulin and adipokines, thus impairing women fertility. Furthermore, specific classes of nutrients might affect female fertility by acting on particular signaling pathways. Dietary fatty acids, carbohydrates, proteins and food-associated components (such as endocrine disruptors) have per se physiological activities and their unbalanced intake, both in quantitative and qualitative terms, might impair metabolic homeostasis and fertility in premenopausal women. Even though we are far from identifying a "fertility diet", lifestyle and dietary interventions might represent a promising and invaluable strategy to manage infertility in premenopausal women

Pharmacological Potential of Hippophae rhamnoides L. Nano-Emulsion for Management of Polycystic Ovarian Syndrome in Animals’ Model: In Vitro and In Vivo Studies

The most common female endocrinopathy, polycystic ovarian syndrome (PCOS), generally affects women of childbearing age. Hippophae rhamnoides L. has been traditionally used to improve menstrual cyclicity. Gas chromatography by flame ionization detection analysis showed that it contained various phytoconstituents such as omega-3 fatty acid, phytosterols, palmitic acid, oleic acid, and linoleic acid. H. rhamnoides L. (HR) nano-emulsion was also formulated. HR and its encapsulated nano-emulsion (HRNE) were evaluated for the treatment of PCOS. Thirty-five healthy female adult albino rats were acquired and divided into seven groups (n = 5). Letrozole (1 mg/kg) was used for 5 weeks to induce the disease. To confirm disease (PCOS) induction, the animals were weighed weekly and their vaginal smears were analyzed daily under a microscope. After PCOS induction, animals were treated with metformin, HR, and HRNE with two different doses (0.5/kg and 1 g/kg, p.o.) for 5 weeks. At the end of the treatment, animals were euthanized, and blood was collected for hormonal assessment, lipid profiling, and liver functioning test assessment. Both the ovaries were preserved for histopathology and liver for the purpose of assessment of antioxidant potential. The results revealed that HR and HRNE at both doses improved the hormonal imbalance; follicle-stimulating hormone, estrogen, and progesterone levels are increased, while luteinizing hormone surge and testosterone level are controlled. Insulin sensitivity is improved. Ovarian histopathology showed that normal ovarian echotexture is restored with corpus luteum and mature and developing follicles. HR and HRNE also improved the lipid profile and decreased lipid peroxidation (MDA) with improved antioxidant markers (SOD, CAT, and GSH). Results were statistically analyzed by one-way analysis of variance and were considered significant only if p < 0.05. In conclusion, it can be postulated that H. rhamnoides L. proved effective in the management of PCOS and its nano-emulsion effects were statistically more significant, which might be due to better bioavailability

Lifestyle and food habits impact on chronic diseases: Roles of PPARs

Peroxisome proliferator-activated receptors (PPARs) are nuclear receptors that exert important functions in mediating the pleiotropic effects of diverse exogenous factors such as physical exercise and food components. Particularly, PPARs act as transcription factors that control the expression of genes implicated in lipid and glucose metabolism, and cellular proliferation and differentiation. In this review, we aim to summarize the recent advancements reported on the effects of lifestyle and food habits on PPAR transcriptional activity in chronic disease

Fat feeding potentiates the diabetogenic effect of dexamethasone in Wistar rats

<p>Abstract</p> <p>Background</p> <p>The role of cortisol and its increased action/availability is implicated in the pathogenesis of insulin resistance associated with obesity and metabolic syndrome but the mechanism of increased action/availability is not known. Availability of several other lipophilic hormones, drugs and pollutants are also reported to be increased in obesity. Increased lipids in the circulation are reported to alter the fluidity and permeability of membranes. Hyperlipidemia is also reported to alter the pharmacokinetics and pharmacodynamics of lipophilic molecules and also membrane fluidity and permeability. In this context we assumed that the hyperlipidemia associated with human obesity might play a role in the altered action/availability of cortisol and this in turn might have initiated the metabolic complications. To evaluate our assumption we have administered dexamethasone [low [50 μg/kg/day] or high [250 μg/kg/day] dose] to high-fat [coconut oil & vanaspati] fed rats and the results were compared with rats administered with either dexamethasone or high-fat.</p> <p>Results and Discussion</p> <p>Within two weeks, the rats co-administered with high-fat and dexamethasone developed severe hyperglycemia, hyperlipidemia and insulin resistance compared to rats treated either of them alone. High-fat fed rats treated with higher dose of dexamethasone were presented with severe hyperglycemia, insulin resistance and also severe glycosuria. The hyperlipidemia caused by high-fat feeding might have altered the transport and distribution of dexamethasone, probably by altering the physical state of membranes and transport proteins.</p> <p>Conclusion</p> <p>From the results obtained, it can be speculated that the altered lipid and cortisol metabolism could affect one another, forming a vicious cycle.</p

Bioactive compounds in childhood obesity and associated metabolic complications: Current evidence, controversies and perspectives

Obesity represents the most frequent chronic disease among children worldwide, with a significant global burden on society. Metabolically unhealthy obesity (MUO) can affect children since their first years of life, and novel therapeutic strategies to tackle metabolic complications are under investigation. This review focuses on bioactive compounds and their possible beneficial effects on obesity, particularly omega-3, docosahexaenoic acid, vitamin D, biotics, polysaccharide macromolecules, polyphenols, inositols, alpha lipoic acid, and bromelaine. Our aim is to summarize current evidence about bioactive compounds in the treatment of obesity, highlighting recent findings on their use in children and adolescents. Most studied molecules are omega-3 and vitamin D, despite the heterogeneity between the studies. Moreover, given the emerging interest in the gut-brain axis in the link between metabolic health and microbiota, various studies on prebiotics, probiotics, synbiotics, postbiotics and polysaccharide macromolecules have been considered. Some preclinical studies seem to highlight a possible role of the polyphenols, even if their clinical evidence is still discussed. Lastly, we describe possible effects of inositols and alpha-lipoic acid. Despite some dietary supplements seem to be promising in overweight subjects, only in a few of them a dose/response efficacy has been found in the pediatric age. Innovative, well-designed and targeted clinical trials are then needed to prove the beneficial effects of these compounds that could support the standard behavioral therapy for obesity

Polyunsaturated fatty acid status in individuals with Poly Cystic Ovarian Syndrome

Global Health: Human Nutritio

Association of Dietary Factors with Menstrual Cycle Characteristics

Abnormal menstrual cycle length, pattern and bleed duration are associated with reduced fecundity and increased risk of miscarriage. The menstrual cycle is governed by the hypothalamus-pituitary-ovarian (HPO) axis, and nutritional factors may affect menstrual characteristics by influencing the HPO axis. Identifying these factors may lead to cost effective ways to improve reproductive outcomes. In a cross-sectional analysis of 164 18- to 30-year-old women, we examined the association of adiposity, dietary fat intake and vitamin D status with menstrual cycle characteristics. Adiposity was measured using dual-energy X-ray absorptiometry (DXA); dietary intake was assessed using a food frequency questionnaire, and fasting venous samples were collected for measurement of vitamin D. Most study participants were Caucasians (83%). Approximately 20% of women were overweight (BMI 25-29.9 kg/m2); 6% were obese (BMI ≥ 30 kg/m2). However, when using DXA measurements, 45% of women had a percent total body fat (%TBF) \u3e 32, indicating obesity. The odds of having an irregular cycle pattern were three times higher among women with \u3c 32% TBF compared to those with more adiposity [OR=3.1 95% CI (0.9 to 10.2) p=0.07]. When considering body fat distribution, the odds of an irregular cycle were 2.8 times higher in women with ≤ 41% gynoid fat [OR=2.8 95% CI(0.9, 8.6) p=0.07]; a one standard deviation increase in G/A (gynoid/android) fat mass was associated with a 50% decreased odds of an irregular cycle pattern [OR=0.45 95% CI (0.21, 1.1) p=0.07]. Among dietary factors, higher intake of n-6 PUFA was associated with irregular cycles (β= 0.16, p=0.05) and both short (β= 0.23, p 50nmol/L) was 80% lower among women with irregular cycles compared to those with regular cycles (OR= 0.19; 95% CI: 0.04, 0.92). Our findings suggest that dietary factors are associated with menstrual cycle characteristics, particularly cycle regularity. If our findings are confirmed in larger prospective studies, they suggest that dietary manipulation may be one approach to improving menstrual cycle function