The Effect of Calorie-Restriction along with Thylakoid Membranes of Spinach on the Gut-Brain Axis Pathway and Oxidative Stress Biomarkers in Obese Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Open accessAbstract
BACKGROUND: Women with polycystic ovary syndrome (PCOS) have higher intestinal mucosal permeability, leading to the lipopolysaccharide (LPS) leakage and endotoxemia. This, in turn, leads to oxidative stress (OS) and neuro-inflammation caused by the gut-brain axis, affecting the neurotrophic factors levels such as brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100 B) levels. In this study, it was hypothesized that the thylakoid membranes of spinach supplementation along with a hypocaloric diet may have improved the LPS levels, neurotrophic factors, and OS in PCOS patients. METHODS: In this double-blind, randomized, placebo-controlled, and clinical trial, 48 women with obesity and diagnosed with PCOS based on Rotterdam criteria were randomly assigned to thylakoid (N = 21) and placebo groups (N = 23). A personalized hypocaloric diet with 500 calories less than the total energy expenditure was prescribed to all patients. The participants were daily supplemented with either a 5 g/day thylakoid-rich spinach extract or a placebo (5 g cornstarch) for 12 weeks along with a prescribed low-calorie diet. Anthropometric measurements and biochemical parameters were assessed at baseline and after the 12-week intervention. RESULTS: A statistically significant decrease in the LPS levels (P < 0.001) and an increase in the BDNF levels (P < 0.001) were recorded for the participants receiving the oral thylakoid supplements and a low-calorie diet. Furthermore, significant decreases were observed in fasting blood glucose, insulin, homeostatic model of assessment for insulin resistance, free testosterone index, and follicle-stimulating hormone / luteinizing hormone ratio in both groups (P < 0.05). No significant differences were detected between the two groups regarding the changes in malondialdehyde, catalase, total antioxidant capacity, and S100B levels (P > 0.05). CONCLUSIONS: In sum, the thylakoid membranes of spinach supplemented with a hypocaloric diet reduced the LPS levels, increased the BDNF levels, and improved the glycemic profile and sex-hormone levels; however, they had no effects on the OS markers levels after 12 weeks of intervention.
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Consumption of spinach is not associated with adverse effects.
“Furthermore, the consumption of spinach is not associated with adverse effects [162,171,172,173,174,175,176,177,178].”
From Ecdysterone and Turkesterone—Compounds with Prominent Potential in Sport and Healthy Nutrition (2024) · cites this paper as [173]
The Results (Participant’s characteristics and Biochemical parameters; page not provided) report no negative side effects, symptoms, or harm during 12 weeks of supplementation. This supports the claim for the spinach-derived thylakoid supplement tested in women with PCOS, but not the broader assertion that consuming spinach generally has no adverse effects. (LLM, conf=0.86)
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The Role of Lifestyle Interventions in PCOS Management: A Systematic Review
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- Authors
- Nikrad, N., Farhangi, M. A., Fard Tabrizi, F. P., Vaezi, M., Mahmoudpour, A., & Mesgari-Abbasi, M.
- Affiliations
- Tabriz University of Medical Sciences (IR)
- Corresponding author
- Farhangi, Mahdieh Abbasalizad
- Venue
- Journal of Ovarian Research
- Published
- 2023-11-16
- Volume
- 16
- Issue
- 1
- Pages
- 216-216
- ISSN
- 1757-2215 (ISSN-L)
- PMC
- PMC10652637
- OpenAlex
- W4388733497
- Cited by
- 12
- References
- 38
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 2
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Ovarian Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Tabriz University of Medical Sciences
- University of Tabriz
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- polycystic ovary syndrome, thylakoid membranes, spinach extract, caloric restriction, hypocaloric diet, gut-brain axis, lipopolysaccharide, endotoxemia, intestinal permeability, brain-derived neurotrophic factor, oxidative stress, insulin resistance, obesity, sex hormones, testosterone, fasting blood glucose, S100B, neuroinflammation
- MeSH terms
- Brain-Gut Axis, Diet, Reducing, Female, Humans, Insulin Resistance, Lipopolysaccharides, Obesity, Polycystic Ovary Syndrome, Biomarkers, Oxidative Stress, Spinacia oleracea, Brain-Derived Neurotrophic Factor, Thylakoids, Caloric Restriction
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