Turner-McGrievy Gabrielle, Davidson Charis R, Billings Deborah L
Department of Health Promotion, Education, and Behavior, University of South Carolina, Arnold School of Public Health , Columbia, SC , USA.
Hum Fertil (Camb). 2015 Mar;18(1):16-21. doi: 10.3109/14647273.2014.922704. Epub 2014 Jun 12.
The Healthy Eating for Reproductive Health study was conducted among 18 (45% non-white) mostly obese (BMI 39.9 ± 6.1) women with polycystic ovary syndrome (PCOS) who were experiencing infertility and interested in losing weight. A variety of markers were measured at baseline: body mass index (BMI), diet, physical activity, eating behaviors (using an Eating Behavior Inventory, a questionnaire which assesses both positive and negative eating behaviors associated with weight status, with a higher score indicating adoption of eating behaviors which have been shown in prior weight-loss research to promote a healthy weight (EBI) and the Three-Factor Eating Questionnaire, which assesses cognitive and behavioral components of eating among overweight adults), and a quality of life (PCOS Health-Related Quality of Life (PCOSQ)) index, which assesses satisfaction around five 'domains': emotional health, presence of body hair, infertility, weight, and menstrual problems). A comparison group of overweight women without PCOS (n = 28) was used to examine differences in measured outcomes between women with and without PCOS. Participants' habitual diets were high in fat and saturated fat and low in fiber, folate, and iron and contained significantly lower amounts of carbohydrate, iron, and whole grains compared with women without PCOS who had enrolled in a behavioral weight loss programme. Participants had a low EBI (indicating that most were not adopting eating behaviors associated with achieving a healthy weight), disinhibition (indicating participants had a tendency to overeat in the presence of highly palatable foods or were susceptible to emotional cues for eating, such as stress), and hunger scores (indicating participants did not report being susceptible to hunger, prompting overeating) and moderate dietary restraint (indicating they were not consistently attempting to restrict food intake consciously). PCOSQ scores were lowest for infertility and weight domains (indicating low satisfaction with current infertility and weight status); however all domains received low scores (emotional health, body hair, and menstrual problems). Higher energy intakes (kcal/day) were associated with a lower EBI score (r = - 0.60, P = 0.02), lower dietary restraint (r =- 0.50, P = 0.04), and higher disinhibition (r = 0.63, P = 0.01). Greater energy expenditure (kcal/day) was associated with lower PCOSQ scores for body weight (r =-0.54, P = 002) and infertility (r =- 0.51, P = 0.003) domains. Results suggest that overweight women with PCOS-related infertility have poor dietary intake, particularly in terms of whole grains, fiber, and iron, and eating behaviors inconsistent with achieving a healthy body weight, as well as low scores for PCOS-related quality of life.
“生殖健康的健康饮食”研究针对18名患有多囊卵巢综合征（PCOS）的女性开展，她们大多肥胖（体重指数为39.9±6.1），正面临不孕问题且有减肥意愿，其中18人中有45%为非白人。在基线时测量了多种指标：体重指数（BMI）、饮食、身体活动、饮食行为（使用饮食行为量表，这是一份问卷，评估与体重状况相关的积极和消极饮食行为，得分越高表明采用了先前减肥研究中显示有助于维持健康体重的饮食行为（EBI））以及三因素饮食问卷，该问卷评估超重成年人饮食的认知和行为成分），还有生活质量（PCOS健康相关生活质量（PCOSQ））指数，该指数评估五个“领域”的满意度：情绪健康、多毛症、不孕、体重和月经问题。使用一组无PCOS的超重女性（n = 28）作为对照组，以检验患有和未患有PCOS的女性在测量结果上的差异。与参加了行为减肥计划的无PCOS女性相比，参与者的习惯性饮食中脂肪和饱和脂肪含量高，纤维、叶酸和铁含量低，碳水化合物、铁和全谷物的含量显著更低。参与者的EBI得分较低（表明大多数人没有采用与实现健康体重相关的饮食行为）、去抑制得分较高（表明参与者在面对美味食物时容易暴饮暴食，或者容易受到饮食的情绪暗示，如压力）、饥饿得分较低（表明参与者没有报告容易饥饿并因此暴饮暴食）以及适度的饮食克制得分（表明他们没有持续有意识地试图限制食物摄入量）。PCOSQ得分在不孕和体重领域最低（表明对当前的不孕和体重状况满意度低）；然而所有领域的得分都很低（情绪健康、多毛症和月经问题）。较高的能量摄入量（千卡/天）与较低的EBI得分（r = - 0.60，P = 0.02）、较低的饮食克制（r = - 0.50，P = 0.04）以及较高的去抑制得分（r = 0.63，P = 0.01）相关。较高的能量消耗（千卡/天）与体重（r = - 0.54，P = 0.02）和不孕（r = - 0.51，P = 0.003）领域较低的PCOSQ得分相关。结果表明，患有与PCOS相关不孕症的超重女性饮食摄入较差，尤其是在全谷物、纤维和铁方面，饮食行为与实现健康体重不一致，并且与PCOS相关的生活质量得分较低。
