Abstract
BackgroundThere 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).MethodsIn 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.ResultsAfter 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.ConclusionsSpinach-derived thylakoid supplementation resulted in more favorable improvements in anthropometric indices and insulin sensitivity compared to the calorie restriction alone.Trial registrationThe 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: IRCT20140907019082N9).
Highlights
There is a promising outlook regarding the potential effect of spinach-derived thylakoids in the management of obesity and its associated metabolic disturbances
Spinach-derived thylakoid supplementation resulted in more favorable improvements in anthropometric indices and insulin sensitivity compared to the calorie restriction alone
Baseline characteristics of participants Forty-eight obese women with polycystic ovary syndrome (PCOS) were recruited in the present clinical trial and randomized to receive either thylakoid or placebo; out of them, forty-four participants [thylakoid (n = 21) and placebo (n = 23)] completed the trial, while 4 participants discontinued the study for reasons irrelevant to the interventions (Fig. 1)
Summary
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). It has been reported that calorie-restricted diets (350–1000 kcal/day deficit) have considerable beneficial effects on the loss of body weight and fat mass, as well as amelioration of insulin sensitivity and menstrual cycle; should be recommended as the first-line therapy in PCOS women [13, 14]. To the best of our knowledge, there is no study investigating the effects of spinach-derived thylakoid supplementation with or without a calorie-restricted diet on the hormonal parameters and metabolic status in obese women with PCOS. The evaluation of the effects of thylakoid consumption in combination with a calorierestricted diet on anthropometric parameters and metabolic profiles in obese women with PCOS was the purpose of the present study
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