Determinants of polycystic ovary syndrome: A matched case–control study

• Published in: Journal of human nutrition and dietetics Vol. 37; no. 2; pp. 583 - 592
• Main Authors: Kaur, Ishwarpreet, Kishore, Kamal, Suri, Vanita, Sahni, Nancy, Rana, Satya Vati, Singh, Amarjeet
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2024
• Subjects: Adipose tissue; adiposity; Behavior modification; Body Mass Index; Body size; Case studies; Case-Control Studies; Clinical outcomes; cognition; Cognitive ability; conditional logistic regression; confidence interval; Constraints; crude fiber; Diet; Diet - adverse effects; dietary restriction; dietetics; Disease prevention; Eating; Eating behavior; eating behaviour; Economic factors; Economics; Education; Endocrine disorders; Etiology; Exercise; Female; food frequency questionnaire; Health behavior; Health education; Health promotion; Health risks; Humans; Impact analysis; lifestyle; Lifestyles; low educational status; obesity; Obesity - complications; Ovaries; Physical activity; Polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; protective effect; protein intake; Proteins; regression analysis; Reproductive health; risk; Risk factors; Risk taking; Socioeconomic factors; socioeconomics; Statistical analysis; Sugar; sugars; women's health; Womens health; food frequency questionnaire; eating behaviour; obesity; conditional logistic regression; women's health; lifestyle
• ISSN: 0952-3871; 1365-277X; 1365-277X
• DOI: 10.1111/jhn.13282

Background Polycystic ovarian syndrome (PCOS) is a multifaceted endocrine disorder of women of reproductive age with a multifactorial aetiology. Despite much research, there is still inconclusive data on the impact of dietary, lifestyle and socio‐economic factors on PCOS aetiology. Thus, the present study explored the association of PCOS with diet, eating behaviour, other lifestyle and socio‐economic factors. Methods A matched‐pair case–control study was conducted on 150 women with PCOS and 150 healthy controls. Information on diet, eating behaviour and physical activity, and also anthropometric and socio‐economic data were collected through standard questionnaires. The adjusted odds ratios (AmOR) were calculated and reported using conditional multivariable logistic regression. Results The results showed low education level (AmOR = 8.44; 95% confidence interval [CI] = 1.63–43.68), high sugar consumption (AmOR = 11.61; 95% CI = 2.05–65.72) along with higher body mass index (BMI) and inactivity to be significantly associated with PCOS. Also, a significant protective effect was found for cognitive dietary restraint (AmOR = 0.79; 95% CI = 0.66–0.93), crude fibre (AmOR = 0.61; 95% CI = 0.45–0.82) and protein intake. Conclusions Low education status may contribute to higher receptiveness to choosing unhealthy diets and lifestyles, resulting in adiposity and an increased risk of PCOS. Low education status with an inability to resist immediate gratification may contribute to the higher receptiveness of females to choose unhealthy diets and lifestyles, resulting in adiposity and an increased risk of polycystic ovarian syndrome (PCOS). Highlights Despite having a high prevalence and being the subject of extensive research, evidence of the aetiological factors for polycystic ovary syndrome (PCOS) remains inconclusive. This matched case–control study aimed to holistically investigate the association of dietary, lifestyle and socio‐economic factors on disease aetiology among Indian women with PCOS. It also aimed to identify the most critical determinants of PCOS after adjusting for confounding factors. The study included 150 PCOS women and 150 age‐matched healthy women volunteers. In the study, females with less education had a higher risk of developing PCOS than their highly educated counterparts. The results also showed high sugar consumption, a higher body mass index and inactivity to be significantly associated with PCOS. Cognitive dietary restraint, crude fibre and protein intake had a protective effect on PCOS. Education level, or socio‐economic status, does not have a direct biological link. However, it is dominant in mediating behavioural risk factors such as an unhealthy diet, physical inactivity and other unhealthy lifestyle factors resulting in adiposity and an increased risk of PCOS. The present study highlights the need for behaviour modification interventions focusing on education regarding healthy dietary and lifestyle behaviours.