A Systematic Review on the Effects of DASH Diet on Metabolic Outcomes, Oxidative Stress, Inflammatory Factors and Sex Hormones in Patients with Polycystic Ovary Syndrome

Document Type : Review Article

Authors

1 B.Sc. Student of Nutrition Sciences, Student Research Committee, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 M.Sc. Student of Clinical Nutrition, Student Research Committee, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Cellular and Molecular Nutrition, School of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting many women of reproductive age. This systematic review was performed with aim to determine the effects of the Dietary Approaches to Stop Hypertension (DASH) on metabolic outcomes, oxidative stress, inflammatory factors and sex hormones in patients with PCOS.
Methods: In this systematic review, the keywords related to PCOS, lipid profile, glycemic status, anthropometric factors, oxidative stress, inflammatory factors, sex hormones, and DASH were searched in databases including Medline, Scopus, Embase, Science Direct, Magiran, ISD, ISC, and Cochrane in both Persian and English languages until January 2024.
Results: Four original research articles with a clinical trial design and an intervention period of 8-12 weeks using the DASH in PCOS patients were analyzed. The findings of these studies showed that following the DASH led to weight loss, reduced body mass index, waist circumference, and hip circumference. It also resulted in lower serum levels of triglycerides, very low density lipoproteins, insulin resistance, androstenedione, antimullerin hormone, free androgen index, malondialdehyde, and high-sensitivity C-reactive protein. Additionally, it was associated with improved sensitivity to insulin, increased total plasma antioxidant capacity, higher levels of total glutathione, sex hormone-binding globulin, and nitric oxide in the blood.
Conclusion: Following the DASH is associated with various health benefits, including weight loss, improved lipid profile, antioxidant status, sex hormones, insulin sensitivity, and markers of oxidative stress and inflammation in PCOS patients.

Keywords

Main Subjects

References

  1. Skiba MA, Islam RM, Bell RJ, Davis SR. Understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction update 2018; 24(6):694-709.
  2. Farhadi-Azar M, Behboudi-Gandevani S, Rahmati M, Mahboobifard F, Khalili Pouya E, Ramezani Tehrani F, et al. The prevalence of polycystic ovary syndrome, its phenotypes and cardio-metabolic features in a community sample of Iranian population: Tehran lipid and glucose study. Frontiers in Endocrinology 2022; 13:825528.
  3. Teede HJ, Tay CT, Laven JJ, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. European journal of endocrinology 2023; 189(2):G43-64.
  4. Bremer AA. Polycystic ovary syndrome in the pediatric population. Metabolic syndrome and related disorders 2010; 8(5):375-94.
  5. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, et al. Polycystic ovary syndrome: etiology, current management, and future therapeutics. Journal of Clinical Medicine 2023; 12(4):1454.
  6. Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinology 2018; 14(5):270-84.
  7. Eslamian G, Baghestani AR, Eghtesad S, Hekmatdoost A. Dietary carbohydrate composition is associated with polycystic ovary syndrome: a case–control study. Journal of Human Nutrition and Dietetics 2017; 30(1):90-7.
  8. Eslamian G, Hekmatdoost A. Nutrient patterns and risk of polycystic ovary syndrome. Journal of reproduction & infertility 2019; 20(3):161.
  9. Shoaibinobarian N, Eslamian G, Noormohammadi M, Malek S, Rouhani S, Mirmohammadali SN. Dietary total antioxidant capacity and risk of polycystic ovary syndrome: a case-control study. International Journal of Fertility & Sterility 2022; 16(3):200.
  10. Lorzadeh AH, Noormohammadi M, Eslamian G. The effects of ketogenic diet on the outcomes of polycystic ovary syndrome: A systematic review on clinical trials. Iranian Journal of Obstetrics, Gynecology and Infertility 2022; 25(7):128-138.
  11. Cowan S, Lim S, Alycia C, Pirotta S, Thomson R, Gibson-Helm M, et al. Lifestyle management in polycystic ovary syndrome–beyond diet and physical activity. BMC endocrine disorders 2023; 23(1):14.
  12. Song Y, Lobene AJ, Wang Y, Hill Gallant KM. The DASH diet and cardiometabolic health and chronic kidney disease: a narrative review of the evidence in East Asian countries. Nutrients 2021; 13(3):984.
  13. Suri S, Kumar V, Kumar S, Goyal A, Tanwar B, Kaur J, et al. DASH dietary pattern: A treatment for non-communicable diseases. Current hypertension reviews 2020; 16(2):108-14.
  14. Chiavaroli L, Viguiliouk E, Nishi SK, Blanco Mejia S, Rahelić D, Kahleová H, et al. DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses. Nutrients 2019; 11(2):338.
  15. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England journal of medicine 2001; 344(1):3-10.
  16. Amouian S, Mohammadian S, Behnampour N, Tizrou M. Trace elements in febrile seizure compared to febrile children admitted to an academic hospital in Iran, 2011. Journal of clinical and diagnostic research: JCDR 2013; 7(10):2231.
  17. Asemi Z, Samimi M, Tabassi Z, Shakeri H, Sabihi SS, Esmaillzadeh A. Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: a randomized clinical trial. Nutrition 2014; 30(11-12):1287-93.
  18. Azadi‐Yazdi M, Karimi‐Zarchi M, Salehi‐Abargouei A, Fallahzadeh H, Nadjarzadeh A. Effects of Dietary Approach to Stop Hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial. Journal of human nutrition and dietetics 2017; 30(3):275-83.
  19. Foroozanfard F, Rafiei H, Samimi M, Gilasi HR, Gorjizadeh R, Heidar Z, et al. The effects of dietary approaches to stop hypertension diet on weight loss, anti‐Müllerian hormone and metabolic profiles in women with polycystic ovary syndrome: a randomized clinical trial. Clinical endocrinology 2017; 87(1):51-8.
  20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj 2021; 372.
  21. Sterne JA, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. bmj 2019; 366.
  22. Asemi Z, Esmaillzadeh A. DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: a randomized controlled clinical trial. Hormone and metabolic research 2015; 47(03):232-8.
  23. Soltani S, Shirani F, Chitsazi MJ, Salehi‐Abargouei A. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta‐analysis of randomized controlled clinical trials. Obesity reviews 2016; 17(5):442-54.
  24. Liu S, Willett WC, Manson JE, Hu FB, Rosner B, Colditz G. Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. The American journal of clinical nutrition 2003; 78(5):920-7.
  25. Fan R, Koehler K, Chung S. Adaptive thermogenesis by dietary n-3 polyunsaturated fatty acids: emerging evidence and mechanisms. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids 2019; 1864(1):59-70.
  26. Jaceldo-Siegl K, Sabaté J, Rajaram S, Fraser GE. Long-term almond supplementation without advice on food replacement induces favourable nutrient modifications to the habitual diets of free-living individuals. British Journal of Nutrition 2004; 92(3):533-40.
  27. Josse AR, Atkinson SA, Tarnopolsky MA, Phillips SM. Increased consumption of dairy foods and protein during diet-and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women. The Journal of nutrition 2011; 141(9):1626-34.
  28. Liaset B, Øyen J, Jacques H, Kristiansen K, Madsen L. Seafood intake and the development of obesity, insulin resistance and type 2 diabetes. Nutrition Research Reviews 2019; 32(1):146-67.
  29. Lee J, Sohn C, Kim OY, Lee YM, Yoon MO, Lee M. The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis. Nutrition Research and Practice 2023; 17(2):175-91.
  30. Jain N, Minhajuddin AT, Neeland IJ, Elsayed EF, Vega GL, Hedayati SS. Association of urinary sodium-to-potassium ratio with obesity in a multiethnic cohort. The American journal of clinical nutrition 2014; 99(5):992-8.
  31. Zhu H, Pollock NK, Kotak I, Gutin B, Wang X, Bhagatwala J, et al. Dietary sodium, adiposity, and inflammation in healthy adolescents. Pediatrics 2014; 133(3):e635-42.
  32. Volp AC, Hermsdorff HH, Bressan J. Glycemia and insulinemia evaluation after high-sucrose and high-fat diets in lean and overweight/obese women. Journal of physiology and biochemistry 2008; 64(2):103-13.
  33. Volp AC, Hermsdorff HM, Bressan J. Effect of high sucrose-and high-fat diets ingested under free-living conditions in insulin resistance in normal weight and overweight women. Nutricion hospitalaria 2007; 22(1):46-60.
  34. Liang H, Habte-Tsion HM, Ge X, Ren M, Xie J, Miao L, et al. Dietary arginine affects the insulin signaling pathway, glucose metabolism and lipogenesis in juvenile blunt snout bream Megalobrama amblycephala. Scientific reports 2017; 7(1):7864.
  35. Ma B, Lawson AB, Liese AD, Bell RA, Mayer-Davis EJ. Dairy, magnesium, and calcium intake in relation to insulin sensitivity: approaches to modeling a dose-dependent association. American journal of epidemiology 2006; 164(5):449-58.
  36. Ndumele CE, Pradhan AD, Ridker PM. Interrelationships between inflammation, C‐reactive protein, and insulin resistance. Journal of the cardiometabolic syndrome 2006; 1(3):107-96.
  37. Portero-Otin M, de la Maza MP, Uribarri J. Dietary advanced glycation end products: Their role in the insulin resistance of aging. Cells 2023; 12(13):1684.
  38. Ding H, Zhang J, Zhang F, Zhang S, Chen X, Liang W, et al. Resistance to the insulin and elevated level of androgen: A major cause of polycystic ovary syndrome. Frontiers in endocrinology 2021; 12:741764.
  39. Chen X, Touyz RM, Park JB, Schiffrin EL. Antioxidant effects of vitamins C and E are associated with altered activation of vascular NADPH oxidase and superoxide dismutase in stroke-prone SHR. Hypertension 2001; 38(3):606-11.
  40. Zheltova AA, Kharitonova MV, Iezhitsa IN, Spasov AA. Magnesium deficiency and oxidative stress: an update. BioMedicine 2016; 6:1-7.
  41. Cho HJ, Kang HC, Ju YC, Lee HS, Kim HS, Park HJ. Augmentation of Ca2+-induced microsomal triglyceride transfer protein activity by glucose supply enhances hypertriglyceridemia in vivo. Biological and Pharmaceutical Bulletin 2006; 29(5):889-95.
  42. Zohrabi T, Sheikhha MH, Jambarsang S, Nadjarzadeh A, Aflatoonian A, Mozaffari-Khosravi H. Effect of dietary approaches to stop hypertension, and standard diets with and without curcumin on interleukin-1 alpha, 5-alpha reductase gene expressions, and androgenic and glycemic profile in polycystic ovary syndrome women undergoing in vitro fertilization treatment: A study protocol. International Journal of Reproductive BioMedicine 2023; 21(5):433.
  43. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Subcommittee on Interpretation, Uses of Dietary Reference Intakes, Subcommittee on Upper Reference Levels of Nutrients, Panel on Dietary Antioxidants, Related Compounds. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. National Academies Press; 2000.
  44. Steinberg D, Bennett GG, Svetkey L. The DASH diet, 20 years later. Jama 2017; 317(15):1529-30.
  45. Calcaterra V, Verduci E, Cena H, Magenes VC, Todisco CF, Tenuta E, et al. Polycystic ovary syndrome in insulin-resistant adolescents with obesity: the role of nutrition therapy and food supplements as a strategy to protect fertility. Nutrients 2021; 13(6):1848.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 5
July 2024
Pages 54-70

Files

Share

How to cite

Statistics