Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of childbearing age. This study aimed to compare the effects of lifestyle interventions on anthropometric, clinical, and biochemical parameters in adolescent girls with PCOS. Methods: PubMed, Scopus, and Web of Science was systematically searched to retrieve studies investigating the effects of lifestyle modifications in adolescent girls with PCOS, which were published up to December 2019. The primary outcome was Body Mass Index (BMI) and secondary outcomes were all manifestations of PCOS, including clinical, metabolic, and hormonal parameters. Random effect meta-analysis was applied for significant results. Publication bias was assessed using the Egger test. Results: This study showed significant improvements in luteinizing hormone (LH) (Pooled SMD = − 0.1.23; 95% CI, − 2.44 to − 0.03), and Free Androgen Index (FAI) levels (Pooled SMD = − 0.78 95% CI, − 0.1.42 to − 0.13) in adolescent girls receiving lifestyle intervention compared to baseline. This study also revealed that diet modifications alone were associated with a significant decrease in Body Mass Index (BMI) (Pooled SMD = − 0.45; 95% CI, − 0.76 to − 0.13), and FG score (Pooled SMD = − 0.81; 95% CI, − 1.33 to − 0.28). Exercise interventions were associated with significant changes in the menstrual cycles (Pooled SMD = 1.16; 95% CI, 0.72 to 1.61), Ferriman-Gallwey (FG) score (Pooled SMD = − 0.57; 95% CI, − 0.99 to − 0.15), LH (Pooled SMD = − 056; 95% CI, − 0.98 to − 0.14), Anti-Müllerian Hormone (AMH) (Pooled SMD = − 0.81; 95% CI, − 0.1.24 to − 0.38), and Triglyceride (TG) levels (Pooled SMD = − 0.32; 95% CI, − 0.62 to − 0.02).
Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.
Background: Nutrition labelling is a strategy to promote healthy eating and combat non-communicable diseases (NCDs). The present study aimed to provide an analysis of the nutrition labelling policy and its opportunities to improve in Iran.Methods: Data were collected by 1) reviewing relevant documents and 2) semi-structured interviews with stakeholders through purposive and snowball sampling, continued until data saturation was achieved. A deductive content analysis was used by applying the policy triangulation framework and the Kingdon multiple stream theory. MAXQDA software was used to manage data analysis.Results: Iran, is the first country in the Eastern Mediterranean region which has accomplished to implement nutrition traffic light labelling. The main contextual factors that affected nutrition labelling policy to become a national included health, political commitment, and international factors. Poor involvement of media for public awareness of nutrition traffic labeling, the inconsistency of nutrition traffic light color ranking using food standard guidelines, lack of consistency between nutrition traffic light colors and the healthy/unhealthy nature of some food products and the absence of a comprehensive evaluation plan were among the policy challenges identified.Conclusions: Strengthening the governance for a healthy food environment is recommended to improve the program.Also, establishing national portion sizes for food labelling,
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