Método smart: relação com a composição corporal, consumo alimentar e saúde mental em mulheres com síndrome dos ovários policísticos

Abstract

Polycystic Ovary Syndrome (PCOS) is a complex endocrine condition that affects the reproductive, metabolic, and emotional health of women of childbearing age. There is no consensus in the literature on the ideal diet for the treatment of PCOS, but lifestyle modification plays a crucial role in its management, particularly in weight control, insulin resistance, and hormonal regulation. Considering the behavioral aspects of PCOS, the application of nutritional goals based on the SMART method (Specific, Measurable, Achievable, Relevant, and Time-bound) could help in the lifestyle modification of these patients. Thus, this study aimed to evaluate the impact of nutritional guidelines based on the SMART method on body composition, dietary intake, and anxiety and depression scores in women with PCOS, compared to a healthy control group. The study included women aged 18 to 40 years with a confirmed diagnosis of PCOS, evaluated by the Rotterdam criteria. For the control group, women without a diagnosis of PCOS within the same age range were included. To reach the proposed objectives, the study was divided into two stages. The first, an observational case-control design, assessed physical activity practice using the International Physical Activity Questionnaire – Short Form, and mental health aspects using the Hospital Anxiety and Depression Scale (HADS). In the second stage, an intervention with a before-and-after design, involving only women with PCOS, clinical and nutritional evaluations were conducted, including anthropometric measurements, physical examination, and dietary intake assessment using a 24-hour dietary recall (24hR). After the initial evaluation (Ti), individualized nutritional goals based on the SMART method were established to promote healthy eating aligned with the Brazilian Dietary Guidelines and encourage lifestyle modification. The intervention lasted eight weeks, during which patients received messages every 20 days to reinforce the nutritional guidelines. At the end of the eight weeks (Tf), the patients were invited for the final evaluation, where all assessments performed at the project's admission (Ti) were repeated. The results showed that women with PCOS had a lower tendency to engage in moderate weekly physical activity compared to the control group (p=0.037). Additionally, women with PCOS had higher depression scores according to HADS data (p=0.013). A significant correlation was observed between the depression scale score and body mass index (BMI) (r=0.352, p=0.026), hip circumference (HC) (r=0.360, p=0.022), and arm circumference (AC) (r=0.329, p=0.038) among patients with PCOS at Ti. There was no significant difference in anthropometric measurements (except for a reduction in the waist-to-height ratio) and dietary intake before and after the nutritional intervention. A borderline consumption of saturated fats was evident among patients with PCOS. The results suggest that women with PCOS experienced difficulties following lifestyle modification guidelines and had lower adherence to physical activity. Furthermore, higher depression scores in women with PCOS may be related to difficulty accepting their body and appearance. The SMART goals were not able to generate changes in anthropometric parameters but should be considered a tool with potential for forming new habits in the long term, given that the intervention lasted only eight weeks.