Status Of Young Women Research Articles

Metformin administration improves endothelial function in women with polycystic ovary syndrome

The aim of this study was to investigate the endothelial status in young women with polycystic ovary syndrome (PCOS), using a simple and easily reproducible hemodynamic method combined with a biological marker and to evaluate the effect of metformin treatment on these parameters. Descriptive clinical trial. Forty young women, 20 with PCOS and 20 normal women of similar age and body mass index were studied. Metformin (1700 mg daily) was administered for 6 months to the PCOS group. The endothelium status and the metabolic and hormonal profile were studied in both groups, as well as after metformin, by flow-mediated dilatation (FMD) on the brachial artery and by measurements of plasma endothelin-1 (ET-1) levels. FMD was impaired in the PCOS group when compared with controls (3.24+/-0.71% vs 8.81+/-1.07% respectively, P<0.0001), but this difference normalized after metformin treatment (PCOS(post-metformin) vs controls: 8.17+/-1.26 vs 8.81+/-1.07%, P = 0.70) since the values significantly improved after metformin treatment (PCOS(pre-metformin) vs PCOS(post-metformin): 3.24+/-0.71 vs 8.17+/-1.26%, P=0.003). ET-1 levels were significantly higher in the PCOS women compared with the control group (7.23+/-0.50 vs 4.99+/-0.69 fmol/l, P=0.01), they improved significantly after metformin treatment (PCOS(pre-metformin) vs PCOS(post-metformin): 7.23+/-0.50 vs 3.57+/-0.60 fmol/l, P<0.0001) and their difference compared with the control group was reversed (PCOS(post-metformin) vs controls: 3.57+/-0.60 vs 4.99+/-0.69 fmol/l, P=0.13). Metformin administration improved hyperandrogenemia. However, in this study, mathematical methods used to assess insulin resistance failed to show any detected alteration after treatment with metformin. PCOS women were found to exhibit endothelial dysfunction compared with controls, which was reversed 6 months after metformin administration.

Effect of a Synthetic Progestin on the Exercise Status of Sedentary Young Women

The impact of progestins on exercise performance in women has not been previously studied. The objective of this study was to examine the effect of a synthetic progestin on aspects of exercise status in young women. DESIGN, PATIENTS, SETTING: Twenty-three young, healthy, habitually sedentary women participated in a single-blind, randomized, counterbalanced, cross-over study in a university-based laboratory setting. Two monophasic oral contraceptive pills (OCPs) were administered in which the dose of the synthetic progestin, norethisterone, was 2-fold different but the dose of the synthetic estrogen, ethinyl estradiol, was constant. During each month of OCP aspects of exercise status were assessed during incremental exercise to exhaustion and steady-state submaximal exercise and with a performance test. The main outcome measures were peak oxygen uptake (VO(2peak)), respiratory exchange ratio (RER), time to exhaustion, lactate concentrations, and total work done. Peak heart rates were approximately 95% of age-predicted values with both OCP preparations, whereas VO(2peak) was approximately 30% above age-predicted values. Peak postincremental exercise plasma lactate concentrations exceeded those reported for males and females, whereas the RER was below expected values throughout both incremental and steady-state exercise. The effects on VO(2peak) and RER were increased with the higher dose progestin OCP, as were exercise time to exhaustion and total work done. Synthetic progestins in OCP formulations can have a significant effect on the exercise status of young, sedentary women, possibly through an effect on stroke volume and a shift in the principal energy substrate used during exercise from carbohydrate to lipid.

Secondary Amenorrhoea after Hodgkin's Lymphoma Is Influenced by Age at Treatment, Stage of Disease, Chemotherapy Regimen, and the Use of Oral Contraceptives during Therapy: A Report from the German Hodgkin Lymphoma Study Group (GHSG).

Purpose: Long term survivors of successfully treated Hodgkin's disease (HD) are at risk for late complications. Among these, infertility for female patients is of major importance affecting many young women. The subject of this analysis is to evaluate the menstrual status in young women after HD therapy.Patients and methods: From 1994–1998, the German Hodgkin Lymphoma Study Group (GHSG) conducted clinical trials for early, intermediate and advanced-stage HD (HD7-HD9) involving a total of 3186 patients. A questionnaire was used to evaluate the menstrual status of young female patients after therapy. The following factors were assessed by multivariate analysis for their influence on amenorrhoea: age, treatment, stage, and the use of oral contraceptives during chemotherapy.Results: The data presented were last updated in May 2004. A total of 405 women aged <40 years answered the questionnaire referring the menstrual status after HD therapy. For most women (89.6%), menstruation before the beginning of therapy was regular. After a median follow-up of 3.2 years, 51.6% of the women receiving 8 cycles of dose-escalated BEACOPP had continuous amenorrhoea. Amenorrhoea was significantly more frequent in women receiving 8 cycles of dose-escalated BEACOPP compared to women treated with ABVD alone, COPP/ABVD or standard BEACOPP (p=0.0066). Moreover, amenorrhoea after therapy was most pronounced in women with advanced-stage HD (p<0.0001), in those older than 30 years at treatment (p= 0.0065), and in women who did not take oral contraceptives during chemotherapy (p=0.0002).Conclusion: Most women who are treated for advanced-stage HD experience amenorrhoea after therapy. Amenorrhoea is significantly more frequent in women with advanced-stage HD receiving 8 cycles of dose-escalated BEACOPP and in women older than 30 years at treatment. Furthermore, the present data suggest a possible protection of oral contraceptives against amenorrhoea.

Smoking and Passive Smoking as Conditioners of Folate Status in Young Women

Objective: For women of fertile age, an adequate supply of folate is important for preventing a range of health problems, especially congenital malformations in their offspring. Since congenital deformities are more common in children of mothers who smoke, the objective was to analyse the folate status of smokers, passive smokers and non-smokers.Methods: Folate intake was monitored in 319 women aged 18–35 (112 smokers, 100 passive smokers and 107 non-smokers) using a three day food record. Serum and erythrocyte folate concentrations were measured by radioimmunoassay. Exposure to tobacco smoke was established by a questionnaire on present and past tobacco consumption, the number of hours in contact with smokers, and by assessing urine cotinine concentrations.Results: The folate intake of smokers (S) (159.1 ± 65.7 μg/day) and passive smokers (PS) (165.2 ± 66.6 μg/day) was lower than that of non-smokers (N) (181.7 ± 72.4 μg/day) (p < 0.05 between S and N). No subject fully met the recommended intake of the vitamin, but S and PS subjects both took less than N subjects (39.8 ± 16.4% and 41.3 ± 16.6% compared to 45.4 ± 18.1% respectively). Serum folate concentrations were also lower in S and PS subjects grouped together (16.6 ± 5.9 nmol/L) compared to N subjects (18.4 ± 6.7 nmol/L) (p < 0.05).Conclusions: None of the studied women took the 400 μg/day of folate recommended. 6.7% had serum folate concentrations of <9.2 nmol/L. The situation was worse in S and PS subjects, which might contribute to an increased risk of developing certain diseases and to giving birth to children with congenital deformations.

Supplemental Zinc Lowers Measures of Iron Status in Young Women with Low Iron Reserves

Zinc and iron compete during intestinal absorption, but postabsorptive interactions between these nutrients are less clear. Understanding these interactions is important to determine when supplementation with iron or zinc is proposed. The effect of zinc supplementation (22 mg Zn/d as zinc gluconate) or of iron supplementation (100 mg Fe/d as ferrous sulfate) for 6 wk on iron and zinc metabolism and absorption was evaluated in young women with low iron reserves. Young adult women (ages 20-28 y), nonanemic but with low iron stores (plasma ferritin< 20 microg/L), participated in the 70-d study. The women were divided in two groups (zinc-supplemented, n = 11; iron-supplemented, n = 12). The supplements were taken at bedtime. Iron and zinc biochemical indices and intestinal absorption were measured on d 1 and 56. Radioiron and stable isotopes of zinc were used to measure iron and zinc absorption from a test meal. In the iron-supplemented group, blood hemoglobin, plasma ferritin and the percentage of transferrin saturation increased (P < 0.01). Zinc indices did not change. In the zinc-supplemented group, plasma ferritin and the percentage of transferrin saturation decreased (P < 0.05), whereas the plasma transferrin receptor and erythrocyte zinc protoprophyrin levels increased (P < 0.05). Plasma and urinary zinc also increased (P < 0.01). Iron absorption (%) from the test meal increased (P < 0.01), whereas zinc absorption (%) decreased (P < 0.01) compared with baseline in the Zn-supplemented women. Our results indicate that the use of iron supplements in women with marginal iron status improves iron indices with no effect on zinc status. However, use of a modest zinc supplement improves zinc indices, but also appears to induce a cellular iron deficiency and, possibly, further reduce iron status.

Assessment of Vitamin B-6 Status in Young Women Consuming a Controlled Diet Containing Four Levels of Vitamin B-6 Provides an Estimated Average Requirement and Recommended Dietary Allowance

The Recommended Dietary Allowance (RDA) of vitamin B-6 for young women was recently reduced from 1.6 to 1.3 mg/d based on an adequate plasma pyridoxal phosphate (PLP) concentration of 20 nmol/L. To assess vitamin B-6 requirements and suggest recommendations for intake, seven healthy young women consumed a controlled diet providing 1.2 g protein/kg body weight for a 7-d adjustment period (1.0 mg vitamin B-6/d) and three successive 14-d experimental periods (1.5, 2.1 and 2.7 mg/d, respectively). Direct and indirect vitamin B-6 status indicators were measured in plasma, erythrocytes and urine. Indicators most strongly correlated with vitamin B-6 intake [i.e., plasma and erythrocyte PLP, urinary 4-pyridoxic acid (4-PA) and total vitamin B-6] were regressed on vitamin B-6 intake and the dietary vitamin B-6 to protein ratio. Inverse prediction using adequate and baseline values estimated vitamin B-6 requirement. Adequate values were determined for plasma PLP and urinary 4-PA from baseline values of 60 previous subjects, using the statistical method suggested by Sauberlich. The current study suggests a vitamin B-6 Estimated Average Requirement (EAR) for young women of 1.1 mg/d or 0.016 mg/g protein, and a RDA of 1.5 mg/d or 0.020 mg/g protein. When results from this study are combined with data from four other recent studies, the combined data predict an EAR of 1.2 mg/d or 0.015 mg/g protein, and a RDA of 1.7 mg/d or 0.018 mg/g protein. This study suggests that the current vitamin B-6 RDA may not be adequate.

Rural women earning income in Indonesian factories: The impact on gender relations

In 1997 and 1998, the international economic crisis widely known as the 'Asian crisis' caused massive inflation and currency devaluation in Indonesia. This paper highlights the effects of the economic crisis on rural Indonesian women and their families. After the crisis, young women who were employed in factories began to contribute a significantly greater amount of their wages to family budgets. This cash contribution seems not only to have altered the nature of household livelihood strategies, but also to have raised young women's status within the household.

Fortification With Low Amounts of Folic Acid Makes a Significant Difference in Folate Status in Young Women: Implications for the Prevention of Neural Tube Defects

The recent advent of fortifying grain products with folic acid is expected to provide an average added daily intake of 100 μg. The present study attempted to estimate the efficacy of this measure by removing a similar amount from the diet of young women choosing to eat folate-fortified food on a regular basis. Twenty-one women who claimed to take fortified foods at least once a week (“consumers”) were compared with 30 others (“nonconsumers”). None of the women were pregnant or planning a pregnancy. The participants were instructed to replace fortified foods with equivalent amounts of isoenergetic, unfortified foods for 12 weeks. Consumers had significantly higher total folate intakes than nonconsumers (265 vs. 197 μg/d) and higher red blood cell folate concentrations (403 vs. 342 μg/liter). Excluding folate-fortified foods led to significant reductions in average total folate intake and red cell folate levels in consumers but not in nonconsumers. Serum folate levels did not differ significantly in the two groups. These findings seem to indicate that providing an extra 100 μg of folate per day will significantly improve red cell folate status in women and that fortified foods are an effective way of doing this. Hopefully, a substantial reduction in neural tube defects will result. Am J Clin Nutr 1999;70:234–239

Fortification with low amounts of folic acid makes a significant difference in folate status in young women: implications for the prevention of neural tube defects

Mandatory fortification of grain products with folic acid was introduced recently in the United States, a policy expected to result in a mean additional intake of 100 microgram/d. One way of predicting the effectiveness of this measure is to determine the effect of removing a similar amount of folic acid as fortified food from the diets of young women who had been electively exposed to chronic fortification. The objective was to examine the effect on folate status of foods fortified with low amounts of folic acid. We investigated the changes in dietary intakes and in red blood cell and serum concentrations of folate in response to removing folic acid-fortified foods for 12 wk from the diets of women who reportedly consumed such foods at least once weekly (consumers). Consumers (n = 21) had higher total folate intakes (P = 0.002) and red blood cell folate concentrations (P = 0.023) than nonconsumers (women who consumed folic acid-fortified foods less than once weekly; n = 30). Of greater interest, a 12-wk intervention involving the exclusion of these foods resulted in a decrease in folate intake of 78 +/- 56 microgram/d (P < 0.001), which was reflected in a significant reduction in red blood cell folate concentrations (P < 0.05). Cessation of eating folic acid-fortified foods resulted in removing 78 microgram folic acid/d from the diet. Over 12 wk this resulted in a lowering of red blood cell folate concentrations by 111 nmol/L (49 microgram/L). This magnitude of change in folate status in women can be anticipated as a result of the new US fortification legislation and is predicted to have a significant, although not optimal, effect in preventing neural tube defects.

Menstrual history and bone density in young women.

Adequate levels of reproductive and pituitary hormones are needed for the initiation and maintenance of regular menstrual cycles as well as for the achievement of peak bone mineral density (BMD). Therefore, in the absence of direct hormone measures, menstrual history may serve as a surrogate for the adequacy of hormonal functioning and be a marker for bone status in young women. In our cross-sectional study of white college women aged 19-26 years, we examined the association of six characteristics of menstrual history with bone density at the lumbar spine and the femoral neck. To characterize associations, we used multiple linear regression models that also accounted for the contribution of body mass index, dietary calcium intake, height, level of physical activity, smoking, and alcohol use. The associations between each of the six menstrual characteristics and BMD were stronger at the lumbar spine than at the femoral neck. Age at menarche explained the most variance at both the lumbar spine (partial r2 x 100 = 5.9%) and the femoral neck (partial r2 x 100 = 2.1%). For each year that menarche was delayed, bone density was lower by -0.023 g/cm2 (p = 0.0024) at the lumbar spine and -0.0129 g/cm2 (p = 0.0565) at the femoral neck. At the lumbar spine, a higher number of lifetime menstrual cycles was also significantly associated with increased bone density (adjusted beta = 0.0010, p = 0.0052, partial r2 x 100 = 4.4%). This association was not significant after adjusting for age at menarche. Neither reproductive years (age - age at menarche) nor a history of irregular cycles (either at menarche, in the past year, or ever) was associated with bone density at either site. Menstrual function appears to affect the bone density of these young women. Studies that include measures of reproductive and pituitary hormones are needed to further explore the role of hormones in the potential link between menstrual history and bone density.

ASSOCIATIONS AMONG COGNITIVE DIETARY RESTRAINT, EXERCISE AND BONE STATUS IN YOUNG WOMEN

1415 High levels of cognitive dietary restraint (conscious limitation of food intake to regulate body weight) are associated with ovulatory disturbances, which in turn have been linked to bone loss. This study assessed whether restraint was associated with bone status in young women who reported exercising minimally (<2hrs/wk) or moderately (2-7 hrs/wk). Sixty-one women, 21.6 ± 2.5 yrs old, with high (n=32) or low (n=29) restraint levels completed this cross-sectional study. All reported regular menstrual cycles. Body composition and bone were assessed by DEXA, exercise level by questionnaire, and cortisol by 24-hr urine collection. Women with high and low restraint did not differ in age, ht, wt, fat mass or non-bone lean tissue, although those with high restraint exercised more (3.4 ± 1.7 vs 2.2 ± 1.8 hr/wk; p<0.05) and had higher cortisol/creatinine (42.92 ± 12.92 vs 36.34 ± 8.90; p<0.05). Compared to women who exercised minimally (n=20), those exercising moderately (n=41) had significantly higher whole body bone mineral density (BMD) and content (BMC), and spinal BMD. Among moderate exercisers (n=41), whole body BMC (2553.86 ± 301.64 g vs 2315.30 ± 263.65 g; p<.05) and spinal BMC (65.61 ± 11.21 vs 55.73 ± 14.13 g; p<.05) were higher in women with low than with high restraint, and the difference in spinal BMD approached significance (1.224 ± .150 vs 1.146 ± .097 g/cm2; p=.061). Although several variables correlated with whole body BMC, after controlling for weight, only restraint level and cortisol/creatinine were significant predictors in multiple regression analysis. Whole body BMD, spinal BMD and BMC were predicted only by restraint. These results suggest that high dietary restraint may offset some of the benefits of exercise on bone. The inverse relationship between dietary restraint and bone status may be associated in part with higher cortisol levels, which are known to impact negatively on bone.

Association between human papillomavirus (HPV) infection, HPV-related disease, and HIV status in young women

Association between human papillomavirus (HPV) infection, HPV-related disease, and HIV status in young women

Nutritional characteristics, eating pathology, and hormonal status in young women

Ovulatory dysfunction is common in patients with eating disorders. However, many women engage in pathologic dieting behaviors without meeting the current diagnostic criteria for anorexia or bulimia nervosa. Clinical eating disorders are only the most extreme form of pathologic eating attitudes and behaviors that are present in many young women. Specific food choices and nutrient intakes may be associated with altered gonadal hormone status of these dieters. This cross-sectional study was conducted to describe the nutritional characteristics of college-aged women defined by their eating attitudes and behaviors with a previously described questionnaire. We evaluated dietary intake, body composition, and selected biochemical indicators in 76 undergraduate women. Serum concentrations of estradiol, progesterone, lipids, and carotenoids were measured on days 6, 21, and 28 of one menstrual cycle. Dietary assessment was based on food records at two 3-d intervals during the cycle. Ovulatory status was definitively determined on the basis of biochemical data for 46 of the women. Increased degree of pathologic dieting was associated with a significantly lower intake of dietary fat (P < 0.02), despite similar mean body mass index and body composition across the eating pathology groups. Serum concentration of alpha-carotene was significantly greater (P < 0.005) in association with a greater degree of eating pathology. With ovulation as a between-group factor, serum lutein concentration and dietary intake of energy and fat differed significantly between groups (P < 0.003). Nutritional characteristics associated with pathologic dieting behavior may also be associated with menstrual irregularities in young women.

Clinical investigations Effects of long-term moderate exercise on iron status in young women

The impact of long-term (6-month) moderate exercise on the iron status of previously sedentary women was determined by randomly assigning 62 college-age women into one of the following four groups: 1) 50 mg.d-1 iron supplement, low iron diet (N = 16); 2) Placebo, free choice diet (N = 13); 3) Meat supplement to achieve 15 mg.d-1 iron intake (N = 13); and 4) Control, free choice diet (N = 20). All groups except the Control group exercised 3 d.wk-1 at 60%–75% of their heart rate reserve. VO2max was measured at baseline and week 24. Blood was sampled at baseline and every 4 wk thereafter for 24 wk to measure iron status and to elucidate the causes for alterations in iron status. Subjects had depleted iron stores throughout the study as indicated by their serum ferritin levels (<15 ng.ml-1). Serum iron, total iron binding capacity and transferrin saturation were not compromised with exercise. Mean hemoglobin level in the Placebo/Ex group was significantly (P < 0.05) lower than the 50 Fe/Ex and the Meat/Ex groups by week 24. However, changes in serum albumin, haptoglobin, and erythropoietin data from the study cannot explain these changes.

The Process of Educational and Occupational Attainment of Adolescent Females from Low-Income, Rural Families

The AA. examine the educational and occupational attainment of young women from low-income, Appalachian families who resided in rural areas. Data from a 10-year longitudinal study from 3 southeastern states were examined. Path analysis was used to test relative contribution of family-of-origine, family life-cycle, and social psychological variables as predictors of young women's status attainment. The variables unique to women's attainment (i.e. significant other influence on marriage and fertility plans, actual marriage and fertility plans, age at mariage, number of children, and household size) were not predictive. Several finding were interpreted as resulting from traditional gender-role expectations, family socialization processes, and the structural limitations faced by low-income women from rural areas.

Effect of oral contraceptives agents on thiamin, riboflavin, and pantothenic acid status in young women

Thiamin, riboflavin, and pantothenic acid status were determined in 13 young women, ages 19-25, at the beginning and end of a 12-day confined study. 9 women were using (+OCA) oral contraceptives and the other 4 were not (-OCA). The subjects entered the metabolic unit during the 1st week of their menstrual cycle and were fed a constant formula diet containing 2.0 mg thiamin, 3.0 mg riboflavin, and 10 mg pantothenic acid. Prestudy intakes, estimated from 3-day dietary records, were about 1/2 of the thiamin, riboflavin, and pantothenic acid levels fed in the study, and were similar in both groups. Use of OCs did not appear to influence the activity of erythrocyte transketolase or erythrocyte glutahione reductase or the response of these enzymes to in vitro stimulation by their cofactors. The enzymes were responsive to the levels of thiamin and riboflavin fed during the study, however. In the +OCA group, erythrocyte transketolase and erythrocyte glutahione reductase stimulation by their cofactors was significantly decreased by day 12. At the beginning of the study, blood and urine pantothenic acid levels were significantly lower in the +OCA group than the -OCA group. These differences were no longer evident by the end of the study. The data show that when dietary intakes and times of sampling in the menstrual cycle are controlled, OCs do not cause significant changes in the biochemical parameters of thiamin, riboflavin, and pantothenic acid status.

Vitamin E status of young women on combined-type oral contraceptives

Differences in vitamin E status between young Caucasian women using oral contraceptives (OCs) for 1 yr or more and control females were obtained with regard to the following parameters: 1) hemolysis, 2) plasma total tocopherols by spectrophotometric analysis, 3) individual tocopherols by a thin-layer gas-liquid chromatographic (TLC-GLC) technique, and 4) dietary intakes of vitamin E, polyunsaturated and saturated lipids, cholesterol and kilocalories. Ten subjects were on Ortho-Novum- or Norinyl-1/50, 8 on Ortho-Novum- or Norinyl-1/80, and 10 had never taken OCs. Analyses of 24-hr recalls and 7-day dietary records revealed no significant differences among groups for intakes of nutrients listed above. No significant differences among groups were observed from hemolytic values. Plasma total tocopherol concentrations measured by spectrophotometric and TLC-GLC techniques revealed that OC-1/80 subjects had significantly lower values than controls. Marginally inadequate vitamin E status as assessed by the various techniques was observed in approximately one subject in the control and OC-1/50 groups and in 2 of the OC-1/80 women. Large individual variations in vitamin E status were observed for subjects in all groups on similar estimated vitamin E intakes. TLC-GLC measurements of total tocopherols in plasma seemed to be perhaps a more sensitive indicator of vitamin E status of subjects than spectrophotometric analysis of tocopherols.

Intake of selected nutrients compared with socioeconomic status in young women.

In this survey the aim was to investigate the relationship between the socioeconomic status of young women of child bearing age and their daily intake of calcium and other selected nutrients. Although no significant relationship was found there were other findings of nutritional interest. Further support is given to the theory that young women are a vulnerable group with respect to nutrition.