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Development and Effects of College-Based Lifestyle Modification Program for Menstrual Health of Young Adult Women with Irregular Menses: A Randomized Controlled Trial.
Park, YJ, Shin, H, Jeon, S, Cho, I, Park, HJ
International journal of environmental research and public health. 2020;18(1)
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Irregular menstruation is characterized by abnormal uterine bleeding, unpredictable menstrual volume, and irregularity of menstruation. A regular menstrual cycle demonstrates a normal sex hormone profile and functioning of reproductive organs, whereas irregularity may suggest a dysfunctional sex hormone profile or disorder of reproductive organs. This study is a randomised controlled trial intended to develop a College-based Lifestyle Modification Programme (LMP) to improve the menstrual health of young adult women who experienced irregular menstruation less than ten times a year, and its effects on their health. The study has two arms: intervention and control group. Female participants (n=46) were randomly assigned 1:1 to one of the two groups. Results show that the College-based LMP had positive effects on the alleviation of depression and anxiety, and improvement of sleep duration. Whereas there were no significant differences for certain variables (menstrual cycle index, sex hormone binding globulin, testosterone, free androgen index), overall premenstrual syndrome, menstrual volume, body composition parameters, and nutrient intake. Authors conclude that their findings demonstrated the importance of lifestyle modifications, which could provide ordinary young adult women with healthy menstruation. However, further studies with the use of supplements are required to address the limitations of the current study.
Abstract
Purpose: This study was conducted to develop the 'College-based Lifestyle Modification Program' (College-based LMP) for young adult women with irregular menstruation and examine its effects after intervention. Methods: The College-based LMP consisted of small group education, individual physical exercise counseling/training, individual diet counseling, and feedback and support. Participants were comprised of 38 females who reported less than 10 irregular menstruations in a year and were randomly assigned to the experimental and control groups. The primary outcome variables consisted of menstrual cycle index (MCI), sex hormone binding globulin (SHBG), and androgenic profile (testosterone-T, free androgen index-FAI), while the outcome variables included premenstrual symptoms (PMS), menstrual volume, body composition parameters, glycemic parameters (fasting blood sugar-FBS, insulin, HOMA-IR), sleep duration, perceived stress, and nutrient intake.. Results: There were no significant differences in primary outcome variables (MCI, SHBG, T, and FAI). In the variables, there were no significant differences except for the partial domain of PMS (symptoms of depression and anxiety) and sleep duration. Conclusions: The study was significant in that it demonstrated the importance of lifestyle, which could provide ordinary young adult women with healthy menstruation. The College-based LMP needs to be elaborated with further studies.
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Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance.
Nedeltcheva, AV, Kessler, L, Imperial, J, Penev, PD
The Journal of clinical endocrinology and metabolism. 2009;94(9):3242-50
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Type-2 diabetes (T2D) is a complex disease influenced by genetic, environmental, metabolic and behavioural factors and is a rising burden in Westernised societies. Whether reduced sleep duration, in the context of a Western lifestyle, is associated with an increased incidence of T2D is unclear and available evidence is limited. The aim of this crossover study was to determine whether sleep restriction may result in a decreased glucose tolerance and reduced insulin secretion in 11 healthy middle-aged adults. Participants were restricted to 5.5 hours of sleep per night and glucose challenges and circulating plasma concentrations were used to measure hormonal and metabolic parameters. This study showed that recurrent short sleep times may facilitate the development of insulin resistance and reduced glucose tolerance. These findings suggest that combining the adverse metabolic effects of a Western lifestyle with chronically reduced sleep duration may increase the long-term risk of developing T2D.
Abstract
CONTEXT Epidemiological data indicate that reduced sleep duration is associated with increased incidence of type-2 diabetes. OBJECTIVE The aim of the study was to test the hypothesis that, when part of a Western-like lifestyle, recurrent bedtime restriction may result in decreased glucose tolerance and reduced insulin secretion and action. DESIGN AND SETTING We conducted a randomized crossover study at a university clinical research center and sleep research laboratory. PARTICIPANTS Eleven healthy volunteers (five females and six males) with a mean (+/-sd) age of 39 +/- 5 yr and body mass index of 26.5 +/- 1.5 kg/m(2) participated in the study. INTERVENTION The study included two 14-d periods of controlled exposure to sedentary living with ad libitum food intake and 5.5- or 8.5-h bedtimes. MAIN OUTCOME MEASURES Oral and iv glucose challenges were used to obtain measures of glucose tolerance, glucose effectiveness, insulin secretion, and insulin sensitivity at the end of each intervention. Secondary measures included circulating concentrations of the glucose counter-regulatory hormones, cortisol, GH, epinephrine, and norepinephrine. RESULTS Bedtime restriction reduced daily sleep by 122 +/- 25 min. Both study periods were associated with comparable weight gain; however, recurrent sleep restriction resulted in reduced oral glucose tolerance (2-h glucose value, 144 +/- 25 vs. 132 +/- 36 mg/dl; P < 0.01) and insulin sensitivity [3.3 +/- 1.1 vs. 4.0 +/- 1.6 (mU/liter)(-1) x min(-1); P < 0.03], and increased glucose effectiveness (0.023 +/- 0.005 vs. 0.020 +/- 0.005 min(-1); P < 0.04). Although 24-h cortisol and GH concentrations did not change, there was a modest increase in 24-h epinephrine and nighttime norepinephrine levels during the 5.5-h bedtime condition. CONCLUSIONS Experimental bedtime restriction, designed to approximate the short sleep times experienced by many individuals in Westernized societies, may facilitate the development of insulin resistance and reduced glucose tolerance.