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Published in: Nutrition Journal 1/2020

Open Access 01-12-2020 | Polycystic Ovary Syndrome | Research

The effects of spinach-derived thylakoid supplementation in combination with calorie restriction on anthropometric parameters and metabolic profiles in obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial

Authors: Fatemeh Pourteymour Fard Tabrizi, Mahdieh Abbasalizad Farhangi, Maryam Vaezi, Salar Hemmati

Published in: Nutrition Journal | Issue 1/2020

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Abstract

Background

There is a promising outlook regarding the potential effect of spinach-derived thylakoids in the management of obesity and its associated metabolic disturbances. This research aimed to evaluate the effects of spinach-derived thylakoids supplementation combined with a calorie-restricted diet on anthropometric and metabolic profiles in obese women with the polycystic ovary syndrome (PCOS).

Methods

In a 12-week double-blind placebo-controlled randomized clinical trial, 48 females with obesity and PCOS were randomly allocated into either intervention (5 g/day thylakoid) or placebo (5 g/day cornstarch) groups along with calorie-restricted diets. Anthropometric measures, physical activity levels, dietary intakes, insulin resistance markers, as well as serum levels of insulin, fasting blood glucose (FBG), non-esterified fatty acids (NEFA), and sex hormones including dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), and free androgen index (FAI) were evaluated pre-and post-intervention.

Results

After the 12-week intervention, there were significant decreases in weight (− 6.97 ± 0.52 vs. -3.19 ± 0.72 kg; P < 0.001), waist circumference (− 7.78 ± 2.50 vs. -3.73 ± 1.40 cm; P < 0.001), fat mass (− 5.19 ± 0.53 vs. -1.36 ± 0.39 kg; P < 0.001), and insulin levels (− 5.40 ± 1.86 vs. -1.19 ± 0.85 μU/mL; P < 0.001) in the spinach-derived thylakoid group compared to the placebo group. Furthermore, insulin resistance markers and serum levels of testosterone decreased significantly in the thylakoid group compared to the placebo group (P < 0.05). The changes in other parameters did not show significant differences between the two groups.

Conclusions

Spinach-derived thylakoid supplementation resulted in more favorable improvements in anthropometric indices and insulin sensitivity compared to the calorie restriction alone.

Trial registration

The study was approved by the Ethics Committee of Research Vice-chancellor of Tabriz University of Medical Sciences, Tabriz, Iran, and was registered in the Iranian Registry of Clinical Trials (registration ID: IRCT201409070190​82N9).
Literature
1.
go back to reference Fauser BCJM, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertil Steril. 2012;97:28–38.CrossRef Fauser BCJM, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertil Steril. 2012;97:28–38.CrossRef
2.
go back to reference Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductiveaged women of different ethnicity: a systematic review and meta-analysis. Oncotarget. 2017;8:96351–8.CrossRef Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductiveaged women of different ethnicity: a systematic review and meta-analysis. Oncotarget. 2017;8:96351–8.CrossRef
3.
go back to reference Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: a meta-analysis. Int J Reprod Biomed. 2015;13:591–604. Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: a meta-analysis. Int J Reprod Biomed. 2015;13:591–604.
4.
go back to reference Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia. 2009;13:90–2.PubMedPubMedCentral Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia. 2009;13:90–2.PubMedPubMedCentral
5.
go back to reference Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4565–92.CrossRef Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4565–92.CrossRef
6.
go back to reference Catteau-Jonard S, Dewailly D. Pathophysiology of polycystic ovary syndrome: the role of hyperandrogenism. Front Horm Res. 2013;40:22–7.CrossRef Catteau-Jonard S, Dewailly D. Pathophysiology of polycystic ovary syndrome: the role of hyperandrogenism. Front Horm Res. 2013;40:22–7.CrossRef
7.
go back to reference DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005;83:1454–60.CrossRef DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril. 2005;83:1454–60.CrossRef
8.
go back to reference Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.CrossRef Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:618–37.CrossRef
9.
go back to reference Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What’s new? Adv Clin Exp Med. 2017;26:359–67.CrossRef Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What’s new? Adv Clin Exp Med. 2017;26:359–67.CrossRef
10.
go back to reference Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110:364–79.CrossRef Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110:364–79.CrossRef
11.
go back to reference Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril. 2008;89:899–906.CrossRef Panidis D, Farmakiotis D, Rousso D, Kourtis A, Katsikis I, Krassas G. Obesity, weight loss, and the polycystic ovary syndrome: effect of treatment with diet and orlistat for 24 weeks on insulin resistance and androgen levels. Fertil Steril. 2008;89:899–906.CrossRef
12.
go back to reference Davoodi SH, Ajami M, Ayatollahi SA, Dowlatshahi K, Javedan G, Pazoki-Toroudi HR. Calorie shifting diet versus calorie restriction diet: a comparative clinical trial study. Int J Prev Med. 2014;5:447–56.PubMedPubMedCentral Davoodi SH, Ajami M, Ayatollahi SA, Dowlatshahi K, Javedan G, Pazoki-Toroudi HR. Calorie shifting diet versus calorie restriction diet: a comparative clinical trial study. Int J Prev Med. 2014;5:447–56.PubMedPubMedCentral
13.
go back to reference Costello MF, Misso ML, Wong J, Hart R, Rombauts L, Melder A, et al. The treatment of infertility in polycystic ovary syndrome: a brief update. Aust New Zeal J Obstet Gynaecol. 2012;52:400–3.CrossRef Costello MF, Misso ML, Wong J, Hart R, Rombauts L, Melder A, et al. The treatment of infertility in polycystic ovary syndrome: a brief update. Aust New Zeal J Obstet Gynaecol. 2012;52:400–3.CrossRef
14.
go back to reference Papavasiliou K, Papakonstantinou E. Nutritional support and dietary interventions for women with polycystic ovary syndrome. Nutr Diet Suppl. 2017;9:63–85.CrossRef Papavasiliou K, Papakonstantinou E. Nutritional support and dietary interventions for women with polycystic ovary syndrome. Nutr Diet Suppl. 2017;9:63–85.CrossRef
15.
go back to reference Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC Complement Altern Med. 2017;17:500.CrossRef Arentz S, Smith CA, Abbott J, Bensoussan A. Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC Complement Altern Med. 2017;17:500.CrossRef
16.
go back to reference Stenblom E-L, Egecioglu E, Landin-Olsson M, Erlanson-Albertsson C. Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women. Appetite. 2015;91:209–19.CrossRef Stenblom E-L, Egecioglu E, Landin-Olsson M, Erlanson-Albertsson C. Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women. Appetite. 2015;91:209–19.CrossRef
17.
go back to reference Albertsson PÅ, Köhnke R, Emek SC, Mei J, Rehfeld JF, Åkerlund HE, et al. Chloroplast membranes retard fat digestion and induce satiety: effect of biological membranes on pancreatic lipase/co-lipase. Biochem J. 2007;401:727–33.CrossRef Albertsson PÅ, Köhnke R, Emek SC, Mei J, Rehfeld JF, Åkerlund HE, et al. Chloroplast membranes retard fat digestion and induce satiety: effect of biological membranes on pancreatic lipase/co-lipase. Biochem J. 2007;401:727–33.CrossRef
18.
go back to reference Montelius C, Erlandsson D, Vitija E, Stenblom EL, Egecioglu E, Erlanson-Albertsson C. Body weight loss, reduced urge for palatable food and increased release of GLP-1 through daily supplementation with green-plant membranes for three months in overweight women. Appetite. 2014;81:295–304.CrossRef Montelius C, Erlandsson D, Vitija E, Stenblom EL, Egecioglu E, Erlanson-Albertsson C. Body weight loss, reduced urge for palatable food and increased release of GLP-1 through daily supplementation with green-plant membranes for three months in overweight women. Appetite. 2014;81:295–304.CrossRef
19.
go back to reference Erlanson-Albertsson C, Albertsson P-Å. The use of green leaf membranes to promote appetite control, suppress hedonic hunger and loose body weight. Plant Foods Hum Nutr. 2015;70:281–90.CrossRef Erlanson-Albertsson C, Albertsson P-Å. The use of green leaf membranes to promote appetite control, suppress hedonic hunger and loose body weight. Plant Foods Hum Nutr. 2015;70:281–90.CrossRef
20.
go back to reference Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25.
21.
go back to reference Stenblom EL, Montelius C, Erlandsson D, Skarping L, Fransson M, et al. Decreased urge for palatable food after a two-month dietary intervention with green-plant membranes in overweight women. J Obes Weight Loss Ther. 2014;04:1–8. Stenblom EL, Montelius C, Erlandsson D, Skarping L, Fransson M, et al. Decreased urge for palatable food after a two-month dietary intervention with green-plant membranes in overweight women. J Obes Weight Loss Ther. 2014;04:1–8.
22.
go back to reference Frankenfield DC, Rowe WA, Smith JS, Cooney RN. Validation of several established equations for resting metabolic rate in obese and nonobese people. J Am Diet Assoc. 2003;103:1152–9.CrossRef Frankenfield DC, Rowe WA, Smith JS, Cooney RN. Validation of several established equations for resting metabolic rate in obese and nonobese people. J Am Diet Assoc. 2003;103:1152–9.CrossRef
23.
go back to reference Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, et al. Macronutrients, food groups, and eating patterns in the Management of Diabetes. Diabetes Care. 2012;35:434–45.CrossRef Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, et al. Macronutrients, food groups, and eating patterns in the Management of Diabetes. Diabetes Care. 2012;35:434–45.CrossRef
24.
go back to reference Montelius C, Gustafsson K, Weström B, Albertsson PÅ, Emek SC, Rayner M, et al. Chloroplast thylakoids reduce glucose uptake and decrease intestinal macromolecular permeability. Br J Nutr. 2011;106:836–44.CrossRef Montelius C, Gustafsson K, Weström B, Albertsson PÅ, Emek SC, Rayner M, et al. Chloroplast thylakoids reduce glucose uptake and decrease intestinal macromolecular permeability. Br J Nutr. 2011;106:836–44.CrossRef
25.
go back to reference Emek SC, Szilagyi A, Åkerlund HE, Albertsson PÅ, Köhnke R, Holm A, et al. A large scale method for preparation of plant thylakoids for use in body weight regulation. Prep Biochem Biotechnol. 2010;40:13–27.CrossRef Emek SC, Szilagyi A, Åkerlund HE, Albertsson PÅ, Köhnke R, Holm A, et al. A large scale method for preparation of plant thylakoids for use in body weight regulation. Prep Biochem Biotechnol. 2010;40:13–27.CrossRef
26.
go back to reference Leszczak J, Czenczek-Lewandowska E, Przysada G, Wyszyńska J, Weres A, Baran J, et al. Diet after stroke and its impact on the components of body mass and functional fitness—a 4-month observation. Nutrients. 2019;11:1227.CrossRef Leszczak J, Czenczek-Lewandowska E, Przysada G, Wyszyńska J, Weres A, Baran J, et al. Diet after stroke and its impact on the components of body mass and functional fitness—a 4-month observation. Nutrients. 2019;11:1227.CrossRef
27.
go back to reference Pisprasert V, Ingram KH, Lopez-Davila MF, Munoz AJ, Garvey WT. Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans. Diabetes Care. 2013;36:845–53.CrossRef Pisprasert V, Ingram KH, Lopez-Davila MF, Munoz AJ, Garvey WT. Limitations in the use of indices using glucose and insulin levels to predict insulin sensitivity: impact of race and gender and superiority of the indices derived from oral glucose tolerance test in African Americans. Diabetes Care. 2013;36:845–53.CrossRef
28.
go back to reference Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91:456–88.CrossRef Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The androgen excess and PCOS society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. 2009;91:456–88.CrossRef
29.
go back to reference Pourteymour Fard Tabrizi F, Abbasalizad Farhangi M. A Systematic Review of the Potential Effects of Thylakoids in the Management of Obesity and Its Related Issues. Food Rev Int. 2020; in Press. Pourteymour Fard Tabrizi F, Abbasalizad Farhangi M. A Systematic Review of the Potential Effects of Thylakoids in the Management of Obesity and Its Related Issues. Food Rev Int. 2020; in Press.
30.
go back to reference Kohnke R, Lindbo A, Larsson T, Lindqvist A, Rayner M, Emek SC, et al. Thylakoids promote release of the satiety hormone cholecystokinin while reducing insulin in healthy humans. Scand J Gastroenterol. 2009;44:712–9.CrossRef Kohnke R, Lindbo A, Larsson T, Lindqvist A, Rayner M, Emek SC, et al. Thylakoids promote release of the satiety hormone cholecystokinin while reducing insulin in healthy humans. Scand J Gastroenterol. 2009;44:712–9.CrossRef
31.
go back to reference Rebello CJ, Chu J, Beyl R, Edwall D, Erlanson-Albertsson C, Greenway FL. Acute effects of a spinach extract rich in thylakoids on satiety: a randomized controlled crossover trial. J Am Coll Nutr. 2015;34:470–7.CrossRef Rebello CJ, Chu J, Beyl R, Edwall D, Erlanson-Albertsson C, Greenway FL. Acute effects of a spinach extract rich in thylakoids on satiety: a randomized controlled crossover trial. J Am Coll Nutr. 2015;34:470–7.CrossRef
32.
go back to reference Köhnke R, Lindqvist A, Göransson N, Emek SC, Albertsson PA, Rehfeld JF, Hultgårdh-Nilsson AE-AC. Thylakoids suppress appetite by increasing cholecystokinin resulting in lower food intake and body weight in high-fat fed mice. Phyther Res. 2009;23:1778–83.CrossRef Köhnke R, Lindqvist A, Göransson N, Emek SC, Albertsson PA, Rehfeld JF, Hultgårdh-Nilsson AE-AC. Thylakoids suppress appetite by increasing cholecystokinin resulting in lower food intake and body weight in high-fat fed mice. Phyther Res. 2009;23:1778–83.CrossRef
33.
go back to reference Maljaars J, Peters HPF, Masclee AM. The gastrointestinal tract: neuroendocrine regulation of satiety and food intake. Aliment Pharmacol Ther. 2007;26:241–50.CrossRef Maljaars J, Peters HPF, Masclee AM. The gastrointestinal tract: neuroendocrine regulation of satiety and food intake. Aliment Pharmacol Ther. 2007;26:241–50.CrossRef
34.
go back to reference Stenblom EL, Montelius C, Östbring K, Håkansson M, Nilsson S, Rehfeld JF, et al. Supplementation by thylakoids to a high carbohydrate meal decreases feelings of hunger, elevates CCK levels and prevents postprandial hypoglycaemia in overweight women. Appetite. 2013;68:118–23.CrossRef Stenblom EL, Montelius C, Östbring K, Håkansson M, Nilsson S, Rehfeld JF, et al. Supplementation by thylakoids to a high carbohydrate meal decreases feelings of hunger, elevates CCK levels and prevents postprandial hypoglycaemia in overweight women. Appetite. 2013;68:118–23.CrossRef
35.
go back to reference Panda V, Shinde P. Appetite suppressing effect of Spinacia oleracea in rats: involvement of the short term satiety signal cholecystokinin. Appetite. 2017;113:224–30.CrossRef Panda V, Shinde P. Appetite suppressing effect of Spinacia oleracea in rats: involvement of the short term satiety signal cholecystokinin. Appetite. 2017;113:224–30.CrossRef
36.
go back to reference Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef
37.
go back to reference Montelius C, Osman N, Weström B, Ahrné S, Molin G, Albertsson PÅ, et al. Feeding spinach thylakoids to rats modulates the gut microbiota, decreases food intake and affects the insulin response. J Nutr Sci. 2013;2:1–9.CrossRef Montelius C, Osman N, Weström B, Ahrné S, Molin G, Albertsson PÅ, et al. Feeding spinach thylakoids to rats modulates the gut microbiota, decreases food intake and affects the insulin response. J Nutr Sci. 2013;2:1–9.CrossRef
38.
go back to reference Montelius C, Szwiec K, Kardas M, Lozinska L, Erlanson-Albertsson C, Pierzynowski S, et al. Dietary thylakoids suppress blood glucose and modulate appetite-regulating hormones in pigs exposed to oral glucose tolerance test. Clin Nutr. 2014;33:1122–6.CrossRef Montelius C, Szwiec K, Kardas M, Lozinska L, Erlanson-Albertsson C, Pierzynowski S, et al. Dietary thylakoids suppress blood glucose and modulate appetite-regulating hormones in pigs exposed to oral glucose tolerance test. Clin Nutr. 2014;33:1122–6.CrossRef
39.
go back to reference Karpe F, Dickmann JR, Frayn KN. Fatty acids, obesity, and insulin resistance: time for a reevaluation. Diabetes. 2011;60:2441–9.CrossRef Karpe F, Dickmann JR, Frayn KN. Fatty acids, obesity, and insulin resistance: time for a reevaluation. Diabetes. 2011;60:2441–9.CrossRef
40.
go back to reference Mamtani M, Kulkarni H, Dyer TD, Almasy L, Mahaney MC, Duggirala R, et al. Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in Mexican American families. PLoS One. 2013;8:–e59153. Mamtani M, Kulkarni H, Dyer TD, Almasy L, Mahaney MC, Duggirala R, et al. Waist circumference independently associates with the risk of insulin resistance and type 2 diabetes in Mexican American families. PLoS One. 2013;8:–e59153.
41.
go back to reference Ye J. Mechanisms of insulin resistance in obesity. Front Med China. 2013;7:14–24.CrossRef Ye J. Mechanisms of insulin resistance in obesity. Front Med China. 2013;7:14–24.CrossRef
42.
go back to reference Böhm A, Heitmann BL. The use of bioelectrical impedance analysis for body composition in epidemiological studies. Eur J Clin Nutr. 2013;67:S79–85.CrossRef Böhm A, Heitmann BL. The use of bioelectrical impedance analysis for body composition in epidemiological studies. Eur J Clin Nutr. 2013;67:S79–85.CrossRef
Metadata
Title
The effects of spinach-derived thylakoid supplementation in combination with calorie restriction on anthropometric parameters and metabolic profiles in obese women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled clinical trial
Authors
Fatemeh Pourteymour Fard Tabrizi
Mahdieh Abbasalizad Farhangi
Maryam Vaezi
Salar Hemmati
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Nutrition Journal / Issue 1/2020
Electronic ISSN: 1475-2891
DOI
https://doi.org/10.1186/s12937-020-00601-4

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