Dietary Assessment Methods And Age Criteria For Women In The PCOS Study

Discuss about the BUS302 Business Language and Culture. The questionnaires were then distributed to the selected sample of 30 participants regarding their eating habits to mean that food frequency questionnaires (FFQs).

Age Criteria for PCOS Study Participants

Age played a big role in the exclusion criteria. The study was interested in women of age between 20 and 45 years. In that regards therefore, females whose age were below 20 years were automatically out of interest of the study thus not included in the sample during the sampling process. On the same, women whose age were above the maximum set age of interest (45 years) were as well excluded from the study since they were of no target in either of the two groups used (the control and PCOS) groups. The criteria of this study was thus formulated and strictly followed based on the age factor of the participants.

Dietary being one of the most important elements of metabolism, its assessment is taken through three major methods including diet record, 24 hours recall and the food frequency questionnaire which were all observed in this research (Ortega, Pérez-Rodrigo and López-Sobaler, 2015; Imamura et al, 2015). Diet record is concerned with all the food and beverages consumed by individuals under study (Daugherty et al, 2012; Kobayashi et al, 2012) in this case women and must be with or without polycystic ovary syndrome (PCOS) and must be of age between 20 and 45 years. The records were taken for a certain consecutive period of time in terms of days. For the 24 hour recall method, the participants are required to give records of their food and beverages consumed in the last 24 hours with which in this case, questionnaires were used to request for such information (Fiedler, Martin-Prével, and Moursi, 2013; Grimes, Riddell, Campbell, and Nowson, 2013; Thompson and Subar, 2013). Lastly in the third method, the food frequency questionnaire is supplied to the participants to account for the frequency at which they consumed a certain food or beverage within a given period of time (Buscemi et al, 2015; Barbieri, Crivellenti, Nishimura and Sartorelli, 2015).

Each if the methods mentioned used in the dietary assessment have their advantages and disadvantages. One of the advantages of dietary record method is the quantification of intake of food or beverage consumed (Clare, 2014). Being that the records are taken consecutively within some period of time (days), the behaviour change of a person can be influenced since it allows self-monitoring. As a result, alterations of the eating behaviours of an individual which might alter the real results thus forms the limitation of the method (Tabacchi, Amodio, Di Pasquale, Bianco, Jemni, and Mammina, 2014). Diet record method is time consuming since it needs several records over a relatively longer period of time to come up with the true picture of the individual’s habitual intake.

Advantages of the 24 hour recall method is the quantification of the intake and less subject burden as compared to diet record method (Martin et al, 2012). Also, it has no effect on the altering or changing the eating behaviour of the targeted population. On the other hand, some of the disadvantages associated with 24 hour recall method is the reliance on memory retentiveness which might fail at times which might lead to false information in such cases (Bross et al, 2010). It is difficult for the participants to give accurate records of the past meals they took especially when the referred past period is relatively long.

Dietary Assessment Methods Used in the PCOS Study

Lastly, food frequency questionnaire (FFQ) method is preferred since it results to less subject and staff burden and has absolutely no effect on the eating behaviours of the targeted group of individuals and as well covers the habitual intake of those under examination (Forster et al, 2014; Fallaize et al, 2014). In relations to the method, its reliance on recall subject and lack of quantifiable precisions are some of the disadvantages when the method is applied. Also, since the method involve reading, understanding and writing, it is only suitable for the literate group of individuals as opposed to 24 hour recall method which don not require literate population (Mulligan et al, 2014).

The questionnaires were then distributed to the selected sample of 30 participants regarding their eating habits to mean that food frequency questionnaires (FFQs) were used in this study which require the respondents to provide records for food and beverages  they consumed for the past weeks days and hours.

Table 1: Descriptive statistics for weight of the respondents

The mean weight for both groups (control and PCOS) used in the sample was 68.83kg with the standard deviation of 11.98658kg. The minimum and maximum recorded weight by the participants in the questionnaires were 60.5 and 85.5kg respectively. The data had the skewness vale of 0.7449 which indicated the data was positively skewed and was having longer tail to the right of the mean weight. Regarding the skewness of data to the right, most of the participants had their weights above the mean weight (68.83kg) but not exceeding the maximum weight (85.5kg).

Information was collected about the waist and circumference of the women with polycystic ovary syndrome (PCOS). Two groups were involved in filling the questionnaire with 15 participants being individuals with no PCOS (the control group) and another group of 15 individuals being those with (PCOS). The questions were moderated and made uniform for both groups of individuals. The importance of moderating the questions and making them uniform to both groups was to result to fairness of information thus resulting to a fair comparison of the two groups from the sample that depicts the true picture of what is in the entire population of women in regards to the subject of study.

Results

Demographic information

One of the demographic information of the participants that was collected was age of the respondents. The age formed a criterial factor for which the participants were selected to take part in the study. The age bracket used was between 20 and 45 years.

From the sample size of 30 respondents for the control group and the women with PCOS, 56.7% of the women sampled had the age of 20-25 years. 33.3% of the sample had the age of 26-30, 3.3% of the respondents had the age bracket of 31-35 and the remaining proportion of the sample were in the age bracket of 36-40 as represented by 6.7%. It was evident from table 2, that majority of the respondent had their age in the bracket of 20-25 years.

Advantages and Disadvantages of Dietary Assessment Methods

Dietary impact in women with PCOS

In regards to the dietary records of the participants, the number of meals consumed per day by the respondents from both groups was asked for in the questionnaire. In response to the question, 36.7% of the respondents from both groups responded that they did take 1-2 meals per day, 23.3% of the respondents responded to that questions that they did take 2-3 meals per day, 30% of the participants said that they did take 3-4 meals per day and lastly, a proportion of the sample represented by 10% responded that they did take 4-5 meals every day. Most of the participants in the sample responded were represented by 36.7% and responded that they were used to taking 1-2 meals per day.

Forty percent of the women with PCOS responded that they did take 1-2 meals per day in regards to the question about the number of meals per day they used to take. 20% responded that they were taking 2-3 meals per day, 33.3% of the PCOS women sampled responded that they did take 3-4 meals per day and lastly, 6.7% of the PCOS women responded that they did take 4-5 meals per day. In regards to the respondents from table 4, most of the PCOS women took the meals 1-2 times in a day.

Figure 1 above gives the comparison of the number of meals taken per day by control and PCOS groups. Five control group against six PCOS group people responded that they did take meals 1-2 time in a day. Four control group women took 2-3 meals per day against the PCOS three group. Four control group women took 3-4 meals per day against five PCOS group women who took the same number of meals. Lastly, 2 control group women took 4-5 meals per day against only one PCOS group women who took the same number of meals per day. The majority of the PCOS women fed 1-2 times in a day as compared to the control group women. Most of the control group women compared to the PCOS group fed 4-5 times in a day.

The participants were required to record the frequency for which they used to take breakfast in a week. From the responses covering both groups, 40% of the respondents responded that they used to take breakfast in 1-3 days of the week. 43.3% of the respondents responded that they used to take breakfast in 3-7days per week while the remaining 16.7% responded that they never used to take breakfast at all.

The PCOS women took breakfast in 1-3 days per week as represented by 33.3%, 53.3% of the PCOS women responded that they used to take breakfast in 3-7 days per week while another fraction represented by 13.3% never used to take breakfast. From table 6, it was evident that the majority of the PCOS women took breakfast almost every day of the week as responded to by 53.3%.

The control group women used represented by 58.3% used to take breakfast in 1-3days per week against 41.7% of the PCOS women who also used to take breakfast in the same number of days of the week. 38.5% of the control group women took breakfast 3-7 days per week against 61.5% of the PCOS women. 60% of the control group used never to take breakfast against only 40% of the women with PCOS.

Distribution of Food Frequency Questionnaires to Participants

The type of bread consumed by the respondents from both groups was a concern in the questionnaire out of which 28.6% of the women in the control group responded that they sued to take heavy grain toast bread as compared to 71.4% of the PCOS women group who responded that they used to take heavy grain toast bread. 55.6% women without PCOS used to take light grain toast bread against 44.4% of the women with PCOS that used the same type of toast of bread. 50% of the women without PCOS fed on white bread against 50% of the women with PCOS. None of the women with PCOS fed on other types of toast of bread apart from the aforementioned while women without PCOS did.

Questionnaire required the participants to provide for the food they ate in the past four weeks out of which, 54.5% of the women responded that they ate chicken while 45.5% of the women with PCOS ate chicken too. 50% of the women without PCOS ate processed meat against 50% of the women with PCOS. Seafood was also eaten in the fifty-fifty fractions and those who ate no meat out of the total number of women who ate no meat, 40% were women without PCOS while the remaining 60% were women with PCOS.

Out of the total number of women who fed on none of the red meat, 66.7% were those without PCOS while 33.3% were those women with PCOS. 43.8% control group women fed on red meat 1-2 times per week while 56.2% of the those who fed on red meat 1-2 times were women with PCOS. 57.1% of the women without PCOS fed on red meat 2-3 times per week against 42.9% women with PCOS. 66.7% of the women without PCOS fed on red meat 3-4 times per week against 33.3% of the women with polycystic ovary syndrome.

Averagely, the amount of water consumed by individuals per week was recorded for both the non-polycystic women and polycystic women where in response to the question, 13.3% of the respondents took water 1-2 times per week, 30% of the respondents took water in 2-3 times per week, 23.3% of the respondents took water 3-4 times per week and lastly, 33.3% of the respondents took water to over four times per week as in the table above.

The average alcohol consumed by the women was referred to in the questions out of which 56.7% of the respondents responded that they took no alcohol, 33.3% of the respondents from both groups responded that they took alcohol drinks in 1-2 times per week while the remaining fraction of the respondents responded that they could take alcohol drinks in 2-3 times per week.

Both the polycystic and non-polycystic women consumed milk in the frequency that will be provided as in the table above. 6.7% of the respondents consumed no milk, 63.3% of the respondents consumed ilk 1-2 times per week, 20% of the respondents consumed milk 2-3 times per week and lastly, 10% of the respondents consumed milk -4 times per week.  

Descriptive Statistics of Weight for PCOS Study Participants

Among the questions that were outlined in the questionnaire were concerning the use of cocking fats in making the meals. In response to that question, out of the women who never used fats in the preparation of their meals came from the control (non-polycystic) group. Those who used cocking fat in the preparation of their meals 1-2 times per week from the control group were represented by 80% against 20% women with PCOS. Those who used cocking fats 2-3 times per week were 444% control group and 55.6% women with PCOS. The women who used the cocking fat in the preparation of their meals 3-4 times per week were; 22.2% control group women against 77.8% women from PCOS women. Some of the women used cocking fat in preparing their meals in about four times and above per week.

Women with PCOS were requested to provide the information concerning the frequency at which they were feeding on snacks which are believed to be rich in carbohydrates. In the response to that question, 6.7% of the respondents responded that they fed on snacks 1-2 times per week, 26.7% of the women with PCOS respondent that they fed on snacks 2-3 time per week with the remaining whooping percentage of the respondents represented by 66.7% responding that they fed on snacks 3-4 times per week.

Circumference of women’s with PCOS

The weight was measured in regards to measuring the circumference of the women with polycystic ovary syndrome. In response to the question, out of all the women with 46-75kg, 55% were the women who were non-polycystic while 45% were the women with polycystic ovary syndrome. Out of those who weighed 76-95kg, 40% of them were the women without PCOS while the remaining 60% were women with PCOS. The majority of the women with PCOS were overweight as compared to their counterparts who had no PCOS.

The height of the respondents was as well measured and have the measurements recorded in centimeters. Women whose height were 146-155 cm were that 33.3% were women without PCOS and 66.7% being the women with PCOS. For those who had the height of 156-165 cm, 50% were women from the control group and another 50% were women with PCOS. The women whose height measured 166-175 cm, 75% were from the control group while the remaining 25% were from women with PCOS. Lastly, those women whose height measurement was 176-185 cm, all of them were women without PCOS as none of the women with PCOS recorded such height.

The hypothesis was tested to check for the mean difference between circumference of the waist of women with polycystic ovary syndrome and those who did not have polycystic ovary syndrome. In regards to that, being that the effects of PCOS on women is addition of weight, weight was used in the determination of the difference between the women in the control group (those who were non-polycystic) and those who were with PCOS. The null and alternative hypothesis were as stated below;

H₀: The mean waist circumference of women with PCOS would be larger than those without

H₁: The mean waist circumference of women with PCOS would not be larger than those without

Table 18: T-test for the mean difference between weights of control group against PCOS group

From the hypothesis tested, the t-statistic value was (t = -0.75593) and the t-critical value (t_{(28, 0.05)} = 2.04847) and the p-value (0.456005) which was much greater than the significant value (0.05). For the rejection of the null hypothesis, t-statistics should be greater than the t-critical and p-value less than the p-significant value. In this test, we failed to reject the null hypothesis being that the rejection rule was not met. As a result we concluded that the mean waist of the women with PCOS would be larger than the women who were non-polycystic.

The measure of the normality of data was conducted basing on the mid-point weight of the respondents. From the measure, the skewness value was positive indicating that the data was positively skewed and thus was having more sampled weights of the respondents to the right of the mean weight of the respondents i.e. (68.83333). This further implied that the tail of the data was longer to the right than to the left of the mean value. Demographic information that was used in this research was the age of the participants. From that, the criteria for which the respondents were selected to participate in the study was achieved out of which, those women whose weight fall out of the bracket (20 to 45) years were not qualified to take part in the study. Majority of the participants in this research were of age 20-25 years as represented by more than half the entire sample used (56.7%) with the least represented being those of age 31-35 years taking only 3.3% of the entire sample.

For the test of the dietary impact in women with PCOS, studies suggest that the glucose tolerance test (GTT) would show the positive changes if the PCOS patient minimize the intake of carbohydrates within just 16 days (Yildiz, Bozdag, Yapici, Esinler and Yarali, 2012; Morin-Papunen et al, 2012). Hormone imbalance particularly caused by the insulin which is the fat storing hormone, women living with PCOS have been studied to develop insulin resistance thus increasing the level of their blood sugar thus gaining much weight faster than their counterparts who do not PCOS (Goodman, Cobin, Futterweit, Glueck, Legro, and Carmina, 2015; Li et al, 2015). In connection to that, from the results, majority of women with PCOS represented by 40% ate 1-2 times per day as the relatively bigger percentage of 33.3% ate 3-4 times per day consuming particularly the carbohydrates rich food such as the white toast bread and snacks represented by 71.4%. Most of the women who were non-polycystic hardly fed on heavy grain bread toast as represented by only 28.6%. It is then advisable to feed on fats and proteins rich food such as seafood, chicken and processed meat to ameliorate the blood sugar (von Holstein-Rathlou et al, 2016). The larger percentage of the women with PCOS represented by 60% responded that they took no meat. Proteins being one of the nutrient contents in meat, it can be seen that they were inhibiting the intake of protein and preferring other meals such as the snacks which was highly preferred by most of the women with PCOS at 66.7% with the frequency of consumption being 3-4 times per week. Refined carbohydrates are known to cause inflammation resulting to insulin resistance which might lead to PCOS, in that regards therefore the PCOS women are supposed to avoid such sugary food i.e. white bread, sugary snacks etc. (Ley, Hamdy, Mohan and Hu, 2014; Oliveira et al, 2013). From the studies, PCOS cause hormone imbalance. Therefore, consumption of alcohol which as well have the effects of increasing the oestrogen level thus imbalance of hormones should be avoided by the PCOS patients (Jones et al, 2012). Increased levels of alcohol would result to adverse effects of PCOS in the patients. Water is important for its increased effects on weight loss. Since PCOS is associated with weight gain, taking water would help in flushing out toxins and increasing energy thus reducing the severity of PCOS (Stabile et al, 2014; Niu, Lin, Gu, Sun, and Feng, 2014). A relatively high percentage of the PCOS respondents at (33.3%) were taking water 3-4 times per week.

The insulin resistance led to increase in blood sugar hence results to weight gain faster in the women with PCOS thus increased their waist circumference. Consequently, from the results, the women with higher weights in the range of 76-95 kg were the women with PCOS as it was represented by 60% against 40% of the women who were non-polycystic. On the same, women with PCOS showed to have lower heights from the results as they dominated the lowest height range 146-155 cm at 66.7%. Taking all discussed in relation to effects of PCOS to body weight, the test confirmed that the waist circumference was indeed larger than that of women who were non-polycystic.

Conclusion

In conclusion, water consumption, fatty and protein rich foods helps in reducing the sugar levels caused by PCOS as a result of hormonal imbalance. Increased intake of carbohydrates rich meals such as snacks, white bread, sweets would lead to adverse effects of PCOS in its patients since they keep high blood sugar levels in the body. Baby weight gain is associated with increased waist circumference hence the women with PCOS being that they had higher mean weight than the women without PCOS, this showed and was confirmed by the test that the circumference of the waist of the women with PCOS was larger.

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