اثر هشت هفته رژیم کتوژنیک و تمرین مقاومتی بر شاخص مقاومت به انسولین و نیمرخ لیپیدی در زنان مبتلا به سندرم تخمدان پلی کیستیک

نوع مقاله : مقاله پژوهشی Released under (CC BY-NC 4.0) license I Open Access I

نویسندگان

1 دانشجوی کارشناسی ارشد فیزیولوژی ورزش، تغذیه ورزشی، گروه تربیت بدنی و علوم ورزشی، دانشکده ادبیات، علوم انسانی و اجتماعی، واحد علوم تحقیقات تهران، تهران- ایران.

2 دانشیار، گروه تربیت بدنی و علوم ورزشی، دانشکده ادبیات، علوم انسانی و اجتماعی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی ، تهران، ایران

3 استادیار،گروه زنان و زایمان, دانشکده پزشکی، دانشگاه علوم پزشکی آزاد اسلامی تهران، تهران- ایران.

10.22049/jahssp.2023.28362.1546

چکیده

هدف: سندرم تخمدان پلی کیستیک ((PCOS یکی از شایع­ترین اختلالات غدد درون‌ریز زنان، بخصوص در سنین باروری است. پژوهش حاضر باهدف تأثیر هشت هفته تمرین مقاومتی و رژیم کتوژنیک بر مقاومت به انسولین و نیمرخ لیپیدی در زنان دارای اضافه‌وزن و چاق مبتلا به PCOS انجام شد. روش‌شناسی: در این پژوهش 60 زن )15-40 سال( مبتلا به PCOS  و دارای BMI 9/39 - 25 و درصد چربی 38-29% ، به­طور تصادفی ‌در چهار گروه کنترل (15n=)، رژیم غذایی (15n=)، تمرین مقاومتی (15n=) و تمرین+رژیم غذایی (15n=) تقسیم شدند. گروه تمرین و گروه تمرین+رژیم غذایی، هشت هفته در برنامه­ی تمرین مقاومتی شرکت کردند و گروه رژیم غذایی فقط از برنامه غذایی تنظیم‌شده استفاده کرد. 48 ساعت قبل از شروع دوره­ی تمرینی و بعد از اتمام آن از آزمودنی­ها خون‌گیری به عمل آمد. برای آنالیز آماری از نرم­افزار SPSS26 استفاده شد (05/0p<).  یافته‌ها: پس از 8 هفته ، تفاوت معناداری میان گروه­ها در متغیرهای ترکیب بدن، پروفایل لیپیدی، شاخص مقاومت به انسولین مشاهده شد (001/0p=). پس از بررسی پس­آزمون نسبت به پیش­­آزمون در گروه کنترل با افزایش معنادار به‌غیراز HDL-C و در گروه­های تداخل با کاهش معنادار به‌غیراز HDL-C در متغیرهای مذکور همراه بود. نتیجه‌گیری: اصلاح سبک زندگی (رژیم کتوژنیک+ورزش منظم)، یک استراتژی درمانی ترجیحی در زنان دارای اضافه‌وزن و چاق مبتلا به PCOS هست. بااین‌حال، این نتایج به زنان دارای اضافه وزن و چاق مبتلا به سندرم تخمدان پلی­کیستیک محدود است و تحقیقات بیشتری موردنیاز است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of eight weeks of ketogenic diet and resistance training on insulin resistance index and lipid profile in women with polycystic ovary syndrome

نویسندگان [English]

  • Mahnoush Mehrzad Samarin 1
  • Mandana Gholami 2
  • Freshteh Shahmohamadi 3
1 Masters student in exercise physiology, sports nutrition, Department of Physical Education and Sports Sciences, Faculty of Literature, Humanities and Social Sciences, Science and Research branch, Islamic Azad University, Tehran, Iran
2 Associate Professor, Department of Physical Education and Sports Sciences, Faculty of Literature, Humanities and Social Sciences, Science and Research branch, Islamic Azad University, Tehran, Iran
3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran Islamic Azad University of Medical Sciences, of Tehran - Iran.
چکیده [English]

Aim:      PCOS is a common endocrine disorder in women of reproductive age. The present study aimed to investigate the effect of 8 weeks of resistance training and a ketogenic diet on insulin resistance and lipid profile in overweight and obese women with PCOS. Methods: This study involved 60 women (15–40 years) with a BMI of 25-39.9 and a fat percentage of 29-38% being randomly divided into four groups. Control (n=15), diet (n=15), resistance training (n=15), and exercise+diet (n=15). The exercise group and the exercise group + diet both participated in the exercise program for 8 weeks, with the diet group only adhering to an adjusted diet. Blood was drawn from subjects 48 hours before the training period began and after it concluded. Results: The findings indicated that, after 8 weeks, there was a significant disparity observed in the body composition variables, lipid profile, and insulin resistance index (p 0.05). Upon examining the post-test results compared with the pre-test results in the control group, it was found that there was a significant increase in HDL-C, whereas, in the intervention groups, there was a significant decrease in HDL-C. Conclusion:  To improve their weight and health, overweight women with PCOS should modify their lifestyle by ketogenic diet and engaging in regular exercise. However, this is limited to overweight and obese women with PCOS; more research is needed.
 

کلیدواژه‌ها [English]

  • Resistance training
  • ketogenic diet
  • polycystic ovary syndrome
  • insulin resistance
  • lipid profile

مراجع

  1. Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocrine reviews. 2016;37(5):467-520.
  2. Ajmal N, Khan SZ, Shaikh R. Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. European Journal of Obstetrics & Gynecology and reproductive biology: X. 2019;3:100060.
  3. Khan MJ, Ullah A, Basit S. Genetic basis of polycystic ovary syndrome (PCOS): current perspectives. The application of clinical genetics. 2019:249-60.
  4. Anagnostis P, Tarlatzis BC, Kauffman RP. Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism. 2018;86:33-43.
  5. Patel S. Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. The Journal of steroid biochemistry and molecular biology. 2018;182:27-36.
  6. Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2019(3).
  7. Brennan L, Teede H, Skouteris H, Linardon J, Hill B, Moran L. Lifestyle and behavioral management of polycystic ovary syndrome. Journal of women's health. 2017;26(8):836-48.
  8. Woodward A, Klonizakis M, Broom D. Exercise and polycystic ovary syndrome. Physical Exercise for Human Health. 2020:123-36.
  9. Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, et al. Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Systematic reviews. 2019;8:1-28.
  10. Patten RK, Boyle RA, Moholdt T, Kiel I, Hopkins WG, Harrison CL, et al. Exercise interventions in polycystic ovary syndrome: a systematic review and meta-analysis. Frontiers in physiology. 2020:606.
  11. Lara LAS, Ramos FKP, Kogure GS, Costa RS, Silva de Sá MF, Ferriani RA, et al. Impact of physical resistance training on the sexual function of women with polycystic ovary syndrome. The Journal of sexual medicine. 2015;12(7):1584-90.
  12. Pericleous P, Stephanides S. Can resistance training improve the symptoms of polycystic ovary syndrome? BMJ open sport & exercise medicine. 2018;4(1):e000372.
  13. Vizza L, Smith CA, Swaraj S, Agho K, Cheema BS. The feasibility of progressive resistance training in women with polycystic ovary syndrome: a pilot randomized controlled trial. BMC sports science, medicine, and rehabilitation. 2016;8(1):1-12.
  14. Campa F, Maietta Latessa P, Greco G, Mauro M, Mazzuca P, Spiga F, et al. Effects of different resistance training frequencies on body composition, cardiometabolic risk factors, and handgrip strength in overweight and obese women: A randomized controlled trial. Journal of Functional Morphology and Kinesiology. 2020;5(3):51.
  15. Kogure GS, Miranda-Furtado CL, Pedroso DC, Ribeiro VB, Eiras MC, Silva RC, et al. Effects of progressive resistance training on obesity indices in polycystic ovary syndrome and the relationship with telomere length. Journal of Physical Activity and Health. 2019;16(8):601-7.
  16. Miranda-Furtado CL, Ramos FKP, Kogure GS, Santana-Lemos BA, Ferriani RA, Calado RT, et al. A nonrandomized trial of progressive resistance training intervention in women with polycystic ovary syndrome and its implications in telomere content. Reproductive Sciences. 2016;23(5):644-54.
  17. Gregory RM, Hamdan H, Torisky D, Akers J. A low-carbohydrate ketogenic diet combined with 6-weeks of CrossFit training improves body composition and performance. Int J Sports Exerc Med. 2017;3(2):1-10.
  18. Hansen CD, Gram-Kampmann E-M, Hansen JK, Hugger MB, Madsen BS, Jensen JM, et al. Effect of Calorie-Unrestricted Low-Carbohydrate, High-Fat Diet Versus High-Carbohydrate, Low-Fat Diet on Type 2 Diabetes and Nonalcoholic Fatty Liver Disease: A Randomized Controlled Trial. Annals of Internal Medicine. 2022.
  19. Silverii GA, Cosentino C, Santagiuliana F, Rotella F, Benvenuti F, Mannucci E, et al. Effectiveness of Low Carbohydrate diets for long‐term weight loss in obese individuals: a meta‐analysis of randomized controlled trials. Diabetes, Obesity, and Metabolism. 2022.
  20. Joshi S, Ostfeld RJ, McMacken M. The ketogenic diet for obesity and diabetes—enthusiasm outpaces evidence. JAMA Internal Medicine. 2019;179(9):1163-4.
  21. Li S, Ding L, Xiao X. Comparing the efficacy and safety of low-carbohydrate diets with low-fat diets for type 2 diabetes mellitus patients: a systematic review and meta-analysis of randomized clinical trials. International journal of endocrinology. 2021;2021.
  22. Vidić V, Ilić V, Toskić L, Janković N, Ugarković D. Effects of calorie-restricted low carbohydrate high fat ketogenic vs. non-ketogenic diet on strength, body composition, hormonal and lipid profile in trained middle-aged men. Clinical Nutrition. 2021;40(4):1495-502.
  23. Urbain P, Strom L, Morawski L, Wehrle A, Deibert P, Bertz H. Impact of a 6-week non-energy-restricted ketogenic diet on physical fitness, body composition and biochemical parameters in healthy adults. Nutrition & metabolism. 2017;14(1):1-11.
  24. Valsdottir TD, Øvrebø B, Falck TM, Litleskare S, Johansen EI, Henriksen C, et al. Low-carbohydrate high-fat diet and exercise: Effect of a 10-week intervention on body composition and CVD risk factors in overweight and obese women—A randomized controlled trial. Nutrients. 2020;13(1):110.
  25. Gram‐Kampmann EM, Hansen CD, Hugger MB, Jensen JM, Brønd JC, Hermann AP, et al. Effects of a 6‐month, low‐carbohydrate diet on glycaemic control, body composition, and cardiovascular risk factors in patients with type 2 diabetes: An open‐label randomized controlled trial. Diabetes, Obesity, and Metabolism. 2022;24(4):693-703.
  26. Tobias DK, Chen M, Manson JE, Ludwig DS, Willett W, Hu FB. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis. The Lancet Diabetes & Endocrinology. 2015;3(12):968-79.
  27. Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JP, et al. Effect of low-fat vs low-carbohydrate diet on 12-month weight loss in overweight adults and the association with genotype pattern or insulin secretion: the DIETFITS randomized clinical trial. Jama. 2018;319(7):667-79.
  28. Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, et al. Resistance training for older adults: a position statement from the National Strength and conditioning association. The Journal of Strength & Conditioning Research. 2019;33(8).
  29. Clark JE. Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight loss and changes in fitness for adults (18–65 years old) who are overfat, or obese; systematic review and meta-analysis. Journal of Diabetes & Metabolic Disorders. 2015;14(1):1-28.
  30. Magkos F. The role of dietary protein in obesity. Reviews in Endocrine and Metabolic Disorders. 2020;21(3):329-40.
  31. Vargas S, Romance R, Petro JL, Bonilla DA, Galancho I, Espinar S, et al. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. Journal of the International Society of Sports Nutrition. 2018;15(1):31.
  32. Valenzuela PL, Castillo-García A, Lucia A, Naclerio F. Effects of Combining a Ketogenic Diet with Resistance Training on Body Composition, Strength, and Mechanical Power in Trained Individuals: A Narrative Review. Nutrients. 2021;13(9):3083.
  33. Kong Z, Hu M, Liu Y, Shi Q, Zou L, Sun S, et al. Affective and enjoyment responses to short-term high-intensity interval training with low-carbohydrate diet in overweight young women. Nutrients. 2020;12(2):442.
  34. Sjödin A, Hellström F, Sehlstedt E, Svensson M, Burén J. Effects of a ketogenic diet on muscle fatigue in healthy, young, normal-weight women: a randomized controlled feeding trial. Nutrients. 2020;12(4):955.
  35. Lee JE, Titcomb TJ, Bisht B, Rubenstein LM, Louison R, Wahls TL. A modified MCT-based ketogenic diet increases plasma β-hydroxybutyrate but has less effect on fatigue and quality of life in people with multiple sclerosis compared to a modified paleolithic diet: a waitlist-controlled, randomized pilot study. Journal of the American College of Nutrition. 2021;40(1):13-25.
  36. Iolanda, Barbarisi Maria, Corbianco Anna Maria, and Andreea Popa. "PCOS AND INSULIN RESISTANCE: THE ROLE OF KETOGENIC DIET." (2020).
مطالعات کاربردی تندرستی در فیزیولوژی ورزش
دوره 11، شماره 1
فروردین 1403
صفحه 67-81

فایل ها

سابقه مقاله

  • تاریخ دریافت: 09 اسفند 1401
  • تاریخ بازنگری: 16 شهریور 1402
  • تاریخ پذیرش: 17 شهریور 1402

هم رسانی

ارجاع به این مقاله

آمار