Eating frequency and snacking habits in women with polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) affects up to 10% of women of reproductive age in the UK and obesity is a common feature. Food craving has been anecdotally reported by women with PCOS (Herriot et al., 2008) and some studies suggest that increased eating frequency (EF) and snacking may contribute to increased energy intake (Hampl et al., 2003). This study aimed to describe the EF of women with PCOS and investigate the impact of EF on energy intake and body mass index (BMI). Methods:
Seven-day food diaries were posted to and completed by 131 women diagnosed with PCOS, who were also asked to report their age, weight and height. Eating episodes were categorised as drinks, mixed meals, and savoury or sweet snacks (foods consumed between meals). BMI was estimated using self-reported weight and height and categorised into <25, 25–29.9 and >30 kg m−2. Results:
All participants completed a food diary, with 122 providing self-reported height and weight. Mean (SD) age was 32.0 (6.1) years, and mean (SD) BMI was 27.9 (7.9) kg m−2. Of those who provided details of height and weight, 57% (47%) women had a BMI <25 kg m−2, 24% (20%) had a BMI 25–29.9 kg m−2 and 41% (33%) had a BMI of >30 kg m−2. Mean (SD) energy intake was 8259 (1644) kJ day−1 [1974 (393) kcal day−1] and mean carbohydrate intake was 226 (58) g/day. A paired t-test was used to compare consumption of sweet and savoury snacks. A one-way analysis of variance was used to analyse differences in energy intake, and to compare stratified BMI groups and EF including drinks. Assumption of homogeneity of variance was violated when analysing differences in stratified BMI and mean total EF excluding drinks; therefore, a robust test of equality of means was used instead. A Pearson product–moment correlation was used to explore correlations between energy or macronutrient intake and EF.
Significantly more sweet snacks, compared to savoury snacks, were consumed per day (P < 0.001). There was no significant differences in EF day−1 between BMI groups (P > 0.05). There was a weak positive correlation between energy intake and EF (r = 0.238, P < 0.05), and a weak positive correlation between percentage energy (%E) from carbohydrate intake and EF (r = 0.268, P < 0.005). There was no relationship between EF and %E from protein, nor between EF and %E from fat. Discussion:
This is the first study to report the EF and snacking habits of women with PCOS. The positive association between EF and energy and carbohydrate intake may indicate a link between carbohydrate craving and increased energy intake, although other factors will also be involved. Both energy and carbohydrate intake were higher than the National Diet and Nutrition Survey (NDNS) values (Ruston et al., 2004); however, it has been acknowledged that under-reporting was common in the NDNS. The EF of BMI categories did not differ. This is in agreement with a study in healthy adults conducted by Hampl et al. (2003). Conclusions:
Identification of sub-optimal dietary patterns in women with PCOS may contribute to improving the success of dietary and lifestyle interventions for this population group. References
Hampl, J.S., Heaton, C.L.B. & Taylor, C.A. (2003) Snacking patterns influence energy and nutrient intakes but not body mass index. J. Hum. Nutr. Diet. 16, 3–11.
Herriot, A., Whitcroft, S. & Jeanes, Y. (2008) A retrospective audit of patients with polycystic ovary syndrome: the effects of a reduced glycaemic load diet. J. Hum. Nutr. Diet.21, 337–345.
Ruston, D., Hoare, J., Henderson, L., Gregory, J., Bates, C.J., Prentice, A., Birch, M., Swan, G. & Farron, M. (2004) The National Diet and Nutrition Survey: Adults Aged 19 to 64 years, 4. London: The Stationery Office.