The Effects of Thylakoid-Rich Spinach Extract Combined with the Calorie-Restricted Diet on Cardiometabolic Risk Factors in Obese Women with Polycystic Ovary Syndrome: A Randomized Controlled Clinical Trial

Abstract

Background: The polycystic ovary syndrome (PCOS) was associated with a higher risk of cardiovascular diseases, related to metabolic dysfunction, due to its peculiar hormonal pattern, dyslipidemia, and inflammatory state. This study was aimed to investigate the effects of thylakoid-rich spinach extract supplementation combined with a hypocaloric diet on cardiometabolic risk factors in obese women with PCOS. Methods: In a double-blind, placebo-controlled design, forty-eight participants (age 20–45 years) consumed in random order either a thylakoid-rich spinach extract powder (5g) or a matched placebo (5g starch), given daily combined with the hypocaloric diet for 12 weeks. The samples were collected at baseline and after the end of the supplementation. The primary outcome was the measure of anthropometric changes, glycemic indices, and lipid profile. The secondary outcomes included inflammatory status and blood pressure. Results: Thylakoid-rich spinach extract supplementation combined with the restricted-calorie diet was associated with significant reductions in abdominal obesity indicators, insulin resistance, lipid accumulation product (LAP), and diastolic blood pressure (DBP) (P< 0.05). Significant decreases were also seen in serum triglycerides (TG), insulin, high-sensitivity C-reactive protein (hs-CRP), and total testosterone compared with the placebo group (P< 0.05). However, no significant differences in systolic blood pressure (SBP) and in serum levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and fasting blood glucose were evident between groups at the end of study ( P>0.05). Conclusions: Thylakoid-rich spinach extract supplementation combined with the calorie restriction for 12 weeks may improve the cardiometabolic risk factors in obese women with PCOS.Trial registration: The study was approved by the Ethics Committee of Research Vice-chancellor of Tabriz University of Medical Sciences, Tabriz, Iran, and was registered in the Iranian Registry of Clinical Trials (IRCT20140907019082N9).

Supplementation with spinach-derived thylakoid augments the benefits of high intensity training on adipokines, insulin resistance and lipid profiles in males with obesity

“…By the same token, findings in an animal model of polycystic ovary syndrome (PCOS) indicated that thylakoid-treated rats showed reduced weight, attenuated HOMA-IR and insulin levels, and improved serum concentrations of lipids ( 58 ). There is, however, little information on spinach-derived thylakoid combined with exercise training on adipose tissue derived mediators, but other reports suggest that consumption of 5 g/day thylakoid-rich spinach extract along with calorie-restrictive diet in obese women improved abdominal obesity parameters, insulin resistance, and lipid profiles while decreasing the levels of inflammatory cytokines such as hs-CRP compared to the calorie-restrictive diet alone ( 59 ). However, some studies reported that spinach-derived thylakoid combined with calorie-restriction affect adipokine levels and caused significant downregulation of chemerin and upregulation of omentin in the obese women, likely due to decreases in body weight, fat mass, and BMI ( 22 ).…”

“…Another finding of our study is that spinach-derived thylakoid supplementation alone or in combination with HIFT modulates adipokine levels in obese men, and that consuming spinach-derived thylakoid amplified the anti-inflammatory effects of HIFT function. Thylakoids can lead to positive outcomes in overweight and obesity and their related disorders by inducing satiety and suppression of hunger sensations, lowering body fat and weight, enhancing glucose homeostasis, reducing serum lipids, attenuating oxidative stress and inflammation, and reducing the absorption of dietary fat and carbohydrate (56). Thylakoids has anti-obesity activities, stimulating insulin sensitivity and improving the lipid profile through delayed glucose and lipid absorption respectively (57).…”