Effects of a dietary modification intervention on menstrual pain and urinary BPA levels: a single group clinical trial

Abstract

Background Exposure to endocrine-disrupting chemicals (EDCs) occurs mainly through dietary intake. Due to current lifestyle trends, young people tend to consume fast food, to use disposable products, and to utilize convenient household items, all of which are major sources of EDCs. This study aimed to investigate the effects of a dietary modification intervention on menstrual pain and urinary bisphenol A (BPA) levels throughout three menstrual cycles in female college students who experienced severe menstrual pain. We also analyzed participants’ adherence to the intervention and examined whether their level of adherence was associated with differences in the effects of the intervention. Methods A single-group pretest and repeated posttest experimental design was employed. Thirty female college students with a score of 5 or higher on a menstrual pain scale were recruited through convenience sampling. During three menstrual cycles, menstrual pain was scored on a 10-point scale after each cycle, and urinary BPA levels were measured from the first morning urine collected after each cycle. The intervention involved three components: small-group education, follow-up monitoring, and peer support via social network communication. Statistical analyses were conducted using Friedman one-way repeated-measure analysis of variance by ranks, non-parametric two-way analysis of variance, and the Wilcoxon signed-rank test as a post-hoc test. Results The dietary modification intervention had significant effects on menstrual pain at all three time points of menstrual cycles (χ2 = 119.64, p = 0.000) and on urinary BPA levels until the 2nd menstrual cycle (χ2 = 205.42, p = 0.000). Slightly fewer than half (43.3%) of the participants were highly adherent. Menstrual pain differed according to adherence level (F = 4.67, p = 0.032) and decreased over time through the third cycle post-intervention (F = 18.30, p = 0.000). Urinary BPA levels also decreased significantly (F = 7.94, p = 0.000), but did not differ according to adherence level. Conclusions The dietary modification intervention was effective and sustainable for reducing menstrual pain and urinary BPA levels. Detailed information about EDCs and dietary experiences seemed to encourage the young women to become more concerned about EDCs and to perform self-protective actions. Further experimental research is suggested to examine the relationships of EDCs with various health indicators in women. Trial registration: KCT0005472 at 2020-9-24 retrospectively registered.

Interventions on Reducing Exposure to Endocrine Disrupting Chemicals in Human Health Care Context: A Scoping Review

“… 32–36 Considering the country where more than half of the authors were from as the country in which the study was conducted, five (38.46%) articles were conducted in the United States, 24 , 26–28 , 33 four (30.77%) from Europe (UK, 29 Poland, 31 the Netherlands, 32 Italy, 36 three (23.08%) from Korea, 25 , 34 and one (7.69%) from China. 30 When the academic domain of the study was identified through the journal title and the author’s major or affiliated institution, public health, 27 , 30 , 33 medicine, 26 , 32 , 36 nursing, 31 , 34 , 35 published three (23.08%) articles for each, and environmental science had two (15.38%) articles. 24 , 29 The rest were pharmacy 25 and kinesiology, 28 one (7.69%) for each.…”

“… 24 , 29 The rest were pharmacy 25 and kinesiology, 28 one (7.69%) for each. For study designs, seven (53.85%) articles 24 , 26 , 27 , 29 , 31 , 33 , 35 used one-group pretest-posttest design, three (23.08%) used randomized controlled trial design, 25 , 28 , 34 and there were one (7.69%) for each of randomized crossover design, 30 randomized factorial design, 32 non-equivalent control group pretest-posttest design. 36 …”

“…There were six (46.15%) studies in which dietary modification interventions were conducted, 24 , 26 , 29 , 30 , 32 , 35 five (38.46%) with replacement of household or personal products, 27 , 28 , 31 , 33 , 36 and one (7.69%) for each of supplementary food (red ginseng) intake 25 and intervention that contained both dietary modification and household or personal product replacement. 34 Among the intervention studies on diet modification, five (38.46%) provided food products that contained low levels of EDCs or restricted fast/processed food intake, 24 , 26 , 29 , 30 , 35 and one (7.69%) provided a calorie control intervention. 32 In all of the interventions on the use of household or personal products, interventions were conducted to replace existing goods by providing alternative goods with low levels of EDCs.…”

Endocrine Disrupting Chemicals and Premenstrual Syndrome in Female College Students in East Asia: A Multi-Country Study

“…An experimental study revealed that dietary modification was effective for reducing urinary EDC levels and alleviating menstrual pain. 25 Detailed information on EDCs and diet can encourage young women to perform self-protective actions and change their behaviors regarding usage of EDC sources in everyday life. 25 In community, nurses in schools and colleges should offer access to a diverse set of information on PMS, including the effects of EDCs.…”

“…25 Detailed information on EDCs and diet can encourage young women to perform self-protective actions and change their behaviors regarding usage of EDC sources in everyday life. 25 In community, nurses in schools and colleges should offer access to a diverse set of information on PMS, including the effects of EDCs. Since unmarried women visiting obstetrics and gynecology clinics in Asian countries are perceived unfavorably, voluntarily visiting such health care centers for PMS symptoms occurs rarely.…”