Adolescent Dietary Habit-induced Obstetric and Gynecologic Disease (ADHOGD) as a New Hypothesis—Possible Involvement of Clock System

Abstract

There are growing concerns that poor dietary behaviors at young ages will increase the future risk of chronic diseases in adulthood. We found that female college students who skipped breakfast had higher incidences of dysmenorrhea and irregular menstruation, suggesting that meal skipping affects ovarian and uterine functions. Since dysmenorrhea is more prevalent in those with a past history of dieting, we proposed a novel concept that inadequate dietary habits in adolescence become a trigger for the subsequent development of organic gynecologic diseases. Since inadequate feeding that was limited during the non-active phase impaired reproductive functions in post-adolescent female rats, we hypothesize that circadian rhythm disorders due to breakfast skipping disrupts the hypothalamic–pituitary–ovarian axis, impairs the reproductive rhythm, and leads to ovarian and uterine dysfunction. To explain how reproductive dysfunction is memorized from adolescence to adulthood, we hypothesize that the peripheral clock system also plays a critical role in the latent progression of reproductive diseases together with the central system, and propose naming this concept “adolescent dietary habit-induced obstetric and gynecologic disease (ADHOGD)”. This theory will contribute to analyzing the etiologies of and developing prophylaxes for female reproductive diseases from novel aspects. In this article, we describe the precise outline of the above hypotheses with the supporting evidence in the literature.

Breakfast Skipping in Female College Students Is a Potential and Preventable Predictor of Gynecologic Disorders at Health Service Centers

“…Both food intake and the light/dark cycle are key regulators of circadian rhythms regulated by the central clock system [ 23 , 24 , 25 ]. Since skipping breakfast interferes with the start of the active phase during the circadian rhythm, we proposed that the central clock system is involved in breakfast skipping-related dysmenorrhea [ 15 ]. In the adolescent stage, abnormal uterine contraction is usually caused by ovarian dysfunction [ 26 ], and it is one of main causes of primary dysmenorrhea [ 27 , 28 ].…”

“…Ovarian immaturity in steroid hormone production leads to intrauterine elevation of prostaglandins and leukotrienes during menstruation, which in turn induces excessive uterine contractions that are associated with pain [ 28 , 29 ]. Accordingly, we suggest that the disruption of the circadian rhythm caused by breakfast skipping affects the hypothalamic–pituitary–ovarian axis and impairs the reproductive rhythm, leading to ovarian dysfunction and dysmenorrhea [ 13 , 15 ]. In our animal experiments, when the timing of food intake in post-adolescent female rats was restricted only to the daytime (fed only in the non-active phase), ovarian functions were significantly disrupted as compared with those of rats fed during the active phase, providing supporting evidence that the timing of food intake can affect the function of the hypothalamic–pituitary–ovarian axis [ 30 ].…”

“…From these findings, we hypothesize that breakfast skipping disrupts the hypothalamic–pituitary function and impairs the reproductive rhythm by disrupting central clock system, leading to ovarian and uterine dysfunction [ 13 ]. Since the incidence of dysmenorrhea is high in female college students with a history of dieting, we considered that inadequate dietary habits in adolescence induce the subsequent development of organic gynecologic diseases [ 14 ], and named this concept “adolescent dietary habit-induced obstetric and gynecologic disease (ADHOGD)” [ 15 ].…”

“…Since dietary habits in young adulthood can be managed by education, the concept of ADHOGD may contribute to developing prophylaxes for female reproductive diseases, changing the focus from a therapeutic approach in a hospital to a prophylactic one in health service centers of universities [ 15 ]. The initial step to achieve prophylaxis is to establish a convenient screening system for meal skipping that is associated with dysmenorrhea.…”

Hypertensive disorders of pregnancy are associated with dysmenorrhea in early adulthood: A cohort study

“…We previously termed this theory 'adolescent dietary habit-induced obstetric and gynecologic disease (ADHOGD)'. 8 Although functional dysmenorrhea in young adulthood is ameliorated, it may become apparent as a perinatal disease when a physical load such as pregnancy is applied.…”