Evidence-Based Lifestyle Guidelines and Self-Management Strategies Utilized by Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder, affecting 13% of reproductive-aged women. While lifestyle management is the first-line treatment for improving complications, women experience challenges with implementation. This cross-sectional study aims to identify the types and sources of dietary and physical activity (PA) interventions implemented by women with PCOS and understand how they use self-management strategies to support lifestyle change. An online questionnaire was disseminated via a consumer-based PCOS website (May 2015-2016). Women (n = 1167) were aged 18-45 years and primarily born within the United States (70%). A quarter or less of women (diet 25%, PA 14%) sought lifestyle advice from health professionals (medical clinicians or dietitians) compared to over half (diet 59%, PA 67%) using alternative sources, namely from online platforms. While only 33% and 16% of women reported following formal dietary or PA guidelines, respectively, 57% had implemented a 'special diet' to manage their condition, many of which were inconsistent with evidence-based practice in PCOS. Participants also displayed a low level of engagement with important self-management behaviors, including goal setting and positive self-talk. These findings suggest that online information may promote inaccurate and ineffective lifestyle advice and emphasize the need to increase engagement with qualified health professionals.

Almond consumption and cardiovascular risk factors in adults with prediabetes.

OBJECTIVE: The authors tested the hypothesis that in adults with prediabetes, an almond-enriched American Diabetes Association (ADA) diet improves measures of insulin sensitivity and other cardiovascular risk factors compared with an ADA nut-free diet. DESIGN: Randomized parallel-group trial. SETTING: Outpatient dietary counseling and blood analysis. SUBJECTS: Sixty-five adult participants with prediabetes. INTERVENTION: Sixteen weeks of dietary modification featuring an ADA diet containing 20% of energy from almonds (approximately 2 oz per day). MEASURES OF OUTCOME: Outcomes included fasting glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, TC:HDL-C, and HbA1c, which were measured at weeks 0, 8, and 16. Body weight, body mass index (BMI), waist circumference, blood pressure, and nutrient intake were measured at weeks 0, 4, 8, 12, and 16. RESULTS: The almond-enriched intervention group exhibited greater reductions in insulin (-1.78 µU/ml vs. +1.47 µU/ml, p  =  0.002), homeostasis model analysis for insulin resistance (-0.48 vs. +0.30, p  =  0.007), and homeostasis model analysis for beta-cell function (-13.2 vs. +22.3, p  =  0.001) compared with the nut-free control group. Clinically significant declines in LDL-C were found in the almond-enriched intervention group (-12.4 mg/dl vs. -0.4 mg/dl) as compared with the nut-free control group. No changes were observed in BMI (-0.4 vs. -0.7 kg/m(2), p  =  0.191), systolic blood pressure (-4.4 mm Hg vs. -3.5 mm Hg, p  =  0.773), or for the other measured cardiovascular risk factors. CONCLUSIONS: An ADA diet consisting of 20% of calories as almonds over a 16-week period is effective in improving markers of insulin sensitivity and yields clinically significant improvements in LDL-C in adults with prediabetes.