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      A comprehensive interventional program for promoting eating behaviors in adolescent girls with polycystic ovarian syndrome (PCOS): protocol for a mixed methods study

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          Abstract

          Background

          Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women. Inappropriate eating behaviors are some of the most important risk factors for obesity in all age groups. Therefore, performing comprehensive culturally sensitive interventions for modification of eating behaviors as a useful affordable strategy seems necessary. So, this study aims to present a comprehensive interventional program for promoting eating behaviors in adolescent girls with PCOS.

          Methods

          This study has a sequential exploratory mixed methods design including three sequential phases. The researcher represents eating behaviors among adolescent girls with PCOS using a qualitative approach. In the onset of the second phase, a comprehensive interventional program for promoting eating behaviors is designed for adolescent girls with PCOS. In this regard, in addition to qualitative studies, some related papers and texts are used. The suggested program of expert panel is approved based on prioritization guidelines. Then, in the third phase and after different stages of finalization of the program, its affectability is evaluated regarding improvement of eating behaviors in adolescent girls with PCOS.

          Discussion

          Results of the present mixed methods study, by presenting an interventional culturally sensitive program for promoting eating behaviors in adolescent girls with PCOS, lead to the improvements of the health of young girls. If this program works, it can become one of the leading education guidelines for eating behaviors in adolescent girls with PCOS.

          Trial registration

          IRCT20160224026756N6. Registered 18 Aug 2018.

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          Most cited references 8

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          Obesity and the polycystic ovary syndrome.

          The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype. Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and/or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.
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            Perceived social and physical environmental correlates of physical activity in older adolescents and the moderating effect of self-efficacy.

            To determine if perceptions of the social and physical environment are associated with active transport and leisure-time sports among Belgian youth and to investigate if this relationship is moderated by self-efficacy. In February-May 2008, 1445 adolescents (17.4+/-0.6 yrs) were recruited in 20 randomly selected Belgian schools. Physical activity, psychosocial, and environmental factors were assessed using validated questionnaires. Moderated multilevel regression analysis was used to examine the association between physical activity and possible correlates. Social environmental variables (modeling and social support) were positively associated with active transportation and leisure-time sports (p<0.05). Higher land use mix diversity, higher street connectivity, more attractive environments, better access to recreational facilities, and higher emotional satisfaction with the neighborhood were associated with more active transportation (p<0.05). Higher perceived safety from traffic, better access to recreational facilities, more physical activity equipment at home, and fewer electronic devices in the bedroom were associated with more leisure-time sports (p<0.05). Lower perceived safety and poorer access to (recreational) facilities were only associated with lower active transport among youth with lower self-efficacy (p<0.05). Creating more supportive environments could have the potential to affect the physical activity levels of Belgian adolescents with both high and low self-efficacy.
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              Insulin resistance index (HOMA-IR) levels in a general adult population: curves percentile by gender and age. The EPIRCE study.

              To describe the distribution of HOMA-IR levels in a general nondiabetic population and its relationships with metabolic and lifestyles characteristics. Cross-sectional study. Data from 2246 nondiabetic adults in a random Spanish population sample, stratified by age and gender, were analyzed. Assessments included a structured interview, physical examination, and blood sampling. Generalized additive models (GAMs) were used to assess the effect of lifestyle habits and clinical and demographic measurements on HOMA-IR. Multivariate GAMs and quantile regression analyses of HOMA-IR were carried out separately in men and women. This study shows refined estimations of HOMA-IR levels by age, body mass index, and waist circumference in men and women. HOMA-IR levels were higher in men (2.06) than women (1.95) (P=0.047). In women, but not men, HOMA-IR and age showed a significant nonlinear association (P=0.006), with increased levels above fifty years of age. We estimated HOMA-IR curves percentile in men and women. Age- and gender-adjusted HOMA-IR levels are reported in a representative Spanish adult non-diabetic population. There are gender-specific differences, with increased levels in women over fifty years of age that may be related with changes in body fat distribution after menopause. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Contributors
                leila.hajivandi@gmail.com
                +989131150973 , noroozi@nm.mui.ac.ir
                mostafavi@hlth.mui.ac.ir
                ekramzadeh@sums.ac.ir
                Journal
                Reprod Health
                Reprod Health
                Reproductive Health
                BioMed Central (London )
                1742-4755
                4 December 2018
                4 December 2018
                2018
                : 15
                Affiliations
                [1 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Faculty of Nursing and Midwifery, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [2 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, , Isfahan University of Medical Sciences, ; Isfahan, Iran
                [3 ]ISNI 0000 0001 1498 685X, GRID grid.411036.1, Department of Health Education and Promotion, , School of Health, Isfahan University of Medical Sciences, ; Isfahan, Iran
                [4 ]ISNI 0000 0000 8819 4698, GRID grid.412571.4, Department of Clinical Nutrition, School of Nutrition and Food Sciences, , Shiraz University of Medical Sciences, ; Shiraz, Iran
                Article
                652
                10.1186/s12978-018-0652-y
                6278146
                30514396
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003970, Isfahan University of Medical Sciences;
                Award ID: 395885
                Award Recipient :
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2018

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