EVALUATION OF EFFECTIVENESS OF TRAINING IN OBESE ADOLESCENT ABOUT NUTRITION, PHYSICAL ACTIVITY AND MENSTRUAL SYMPTOMS ON HEALTH LIFESTYLE BEHAVIOURS AND MENSTRUAL SYMPTOMS

Öz

ÖZ Giriş: Belirli bir sağlık sorununa odaklanan planlı eğitimler, sağlık davranışlarını teşvik edebilir ve hastalık semptomlarını iyileştirebilir. Amaç: Bu çalışma, adölesan obez kızların menstrüel semptomlarını iyileştirmek amacıyla Sağlığı Geliştirme Modeli'ne (HPM) göre verilen "Sağlıklı yaşam biçimi davranışları ve menstürasyon (HLB-MENS)" eğitiminin etkisini değerlendirmek amacıyla yapılmıştır. Metod: Bu randomize kontrollü çalışma 1 eylül 2017 - 21 ocak 2018 tarihleri arasında gerçekleştirilmiştir. Obez grup duyarlı bireylerden oluştuğu için ilk aşamada olasılık dışı rastgele örnekleme yöntemi kullanılmıştır. ikinci aşamada, gönüllülerden rastgele atama yapılmıştır. Araştırmaya liselerde okuyan 9., 10. ve 11. sınıf obez kız çocukları (vücut kitle indeksi > 26,7 kg/m2) dahil edilmiştir. Müdahale (n=63) ve kontrol (n=65) olarak iki grupla çalışılmıştır. Etki büyüklüğü = 0,80 (%80,1 ve p = ,05,)dir. Müdahale grubu 16 haftalık planlı eğitim almış, kontrol grubu katılmamıştır. Eğitim üç farklı başlıktan oluşuyordu. Dersler temel eğitim ve pekiştirme eğitimi olmak üzere iki aşamada gerçekleştirilmiştir. Katılımcılar her bir konuda toplam 7 saat ders aldılar. Sonuç: Sağlıklı yaşam tarzı davranışlarındaki olumlu gelişmeler, obez kızların ruhsal semptomlarını iyileştirdi. Müdahale grubunda MSQ toplam puanları (p<0,007) ve menstrüel ağrı azaldı (p<0,001). HLBS-II toplam puanları (p<0.001) ve fiziksel aktivite alt ölçek puanları (p<0.026.) arttı. Yürüme oranları, fiziksel aktivite davranışları ve fiziksel aktivite süreleri 4 saatin üzerine çıktı, (p<0,001). Günlük aktivitelerden yürüme güçlüğü (p<0,004) ve fast food tüketimi (p<0,002) azaldı.

Anahtar Kelimeler

• Planlı eğitim
• Obez kızlar
• Menstürel Semptomlar
• Sağlıklı Yaşam Tarzı Davranışları

Kaynakça

1. 1. Seif MW, Diamond K, Nickkho-Amiry M. Obesity and menstrual disorders. (2015) Best Pract Res Clin Obstet Gynaecol 29:516-27. doi: 10.1016/j.bpobgyn.2014.10.010.
2. 2. Lainez Nancy M.; Coss Djurdjica. (2019) Obesity, neuroinflammation, and reproductive function. Endocrinology 11: 2719-2736
3. 3. Tauqeer Z, Gomez G, Stanford FC. (2018) Obesity in women: insights for the clinician. J Womens Health 27:444-57. doi: 10.1089/jwh.2016.6196
4. 4. Moeini B, Rezapur-Shahkolai F, Bashirian S, Doosti-Irani A, Afshari M, Geravandi A. (2121) Effect of interventions based on regular physical activity on weight management in adolescents: a systematic review and a meta-analysis. Syst Rev 2021;1-13. 5. Mustaqeem M, Sadullah S, Waqar W, Farooq M. Z, Khan A, & Fraz T. R. (2015). Obesity with irregular menstrual cycle in young girls. Mymensingh medical journal: MMJ, 24(1), 161-167.
5. 6. Ko KM, Han K, Chung YJ, Yoon KH, Park YG, Lee SH. (2010) Association between body weight changes and menstrual irregularity: the Korea national health and nutrition examination survey 2010 to 2012. Endocrinol Metab 2017;32:248-56. doi: 10.3803/EnM.2017.32.2.248
6. 7. Silvestris E, de Pergola G, Rosania R, Loverro G. (2018) Obesity as disruptor of the female fertility. Reprod Biol Endocrinol 16:22. doi:10.1186/s12958-018-0336-z
7. 8. Staiano AE, Beyl RA, Hsia DS, Katzmarzyk PT, Newton Jr RL. (2017) Twelve weeks of dance exergaming in overweight and obese adolescent girls: transfer effects on physical activity, screen time, and self-efficacy. J Sport Health Sci 6:4-10.
8. 9. Najafabadi MG, Memari AH, Kordi R, Shayestehfar M, Eshghi MA. (2017) Mental training can improve physical activity behavior in adolescent girls. J Sport Health Sci 2017;6:327-32. doi: 10.1016/j.jshs.2015.09.011.

9. 10. Herbert C, Meixner F, Wiebking C, Gilg V. (2020) Regular physical activity, short-term exercise, mental health, and well-being among university students: the results of an online and a laboratory study. Frontiers in psychology 11:509.
10. 11. Lyngsø J, Toft G, Høyer BB, Guldbrandsen K, Olsen J, Ramlau-Hansen CH. (2014) Moderate alcohol intake and menstrual cycle characteristics. Hum Reprod 2014;29:351-8.
11. 12. Najafi N, Khalkhali H, Tabrizi FM, Zarrin R. (2018) Major dietary patterns in relation to menstrual pain: a nested case control study. BMC Womens Health 1-7.
12. 13. Fernández-M. E, Fernández-V. T, Amezcua-P.C, Suárez-V. M. M, Mateos-C. R, Ayán-P.C, et al. (2020) Menstrual problems and lifestyle among Spanish university women. Int J Environ Res Public Health 17:7425. https://doi.org/10.3390/ijerph17207425
13. 14. Martin A, Booth JN, Laird Y, Sproule J, Reilly JJ, Saunders DH. (2018) Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Cochrane Database Syst Rev 2018;3:CD009728. doi: 10.1002/14651858.CD009728.
14. 15. Barnard ND, Scialli AR, Hurlock D, Bertron P. (2000) Diet and sex-hormone binding globulin, dysmenorrhea, and premenstrual symptoms, Obstet Gynecol 2000, 95:245-50.
15. 16. Helwa HAA, Mitaeb AA, Al-Hamshri S, Sweileh WM. (2018) Prevalence of dysmenorrhea and predictors of its pain intensity among Palestinian female university students. BMC women's health 18:1-11.
16. 17. Mehrpooya M, Eshraghi A, Rabiee S, Larki-Harchegani A, Ataei S. (2017) Comparison the effect of fish-oil and calcium supplementation on treatment of primary dysmenorrhea. Rev Recent Clin Trials 12:148-53.
17. 18. Çay B, Saka S. (2020) The effect of short term aerobic exercise on dysmenorrhea in young adults. J Health Pro Res 2: 94-101
18. 19. Dehnavi ZM, Jafarnejad F, Goghary SS. (2018) The effect of 8 weeks aerobic exercise on severity of physical symptoms of premenstrual syndrome: a clinical trial study. BMC Women's Health 18: 1-7.
19. 20. Orio F, Muscogiuri G, Ascione A, et al. (2013) Effects of physical exercise on the female reproductive system. Minerva Endocrinol 38:305-19.
20. 21. Pender, N. J. (2011). Health promotion model manual.
21. 22. Vaziri F, Hoseini A, Kamali F, Abdali K, Hadianfard M, Sayadi M. (2015) Comparing the effects of aerobic and stretching exercises on the intensity of primary dysmenorrhea in the students of universities of Bushehr. J Fam Reprod Health 9:23-8.
22. 23. Nowak PF, Bożek A, Blukacz M. (2019) Physical activity, sedentary behavior, and quality of life among university students. Biomed Res Int 9791281. doi: 10.1155/2019/9791281.
23. 24. Fish C, Nies MA. (1996) Health promotion needs of students in a college environment. Public Health Nurs 13:104-11. doi:10.1111/j.1525-1446.1996.tb00227.x
24. 25. Arıöz A, Ege E. (2013) Effectiveness of education in increasing the quality of life and the control of premenstrual syndrome on university students who have premenstrual syndrome problem. Genel Tıp Dergisi 23:63-9.
25. 26. Rathod AD, Chavan RP, Pajai SP, Bhagat V, Thool P. (2016) Gynecological problems of adolescent girls attending outpatient department at tertiary care center with evaluation of cases of puberty menorrhagia requiring hospitalization. J Obstet Gynecol India 2016;66:400-6. doi:10.1007/s13224-015-0770-1
26. 27. Elizondo-Montemayor L, Hernández-Escobar C, Lara-Torre E, Nieblas B, Gómez-Carmona M. (2017) Gynecologic and obstetric consequences of obesity in adolescent girls. J Pediatr Adolesc Gynecol 30:156-68. doi:10.1016/j.jpag.2016.02.007
27. 28. Chesney MA, Tasto DL. (1975) The development of the menstrual symptom questionnaire. Behaviour Research and Therapy, 13(4), 237-244.
28. 29. Guvenc G, Seven M, Akyuz A. (2014) Adaptation of the menstrual symptom questionnaire into Turkish. TAF Prev Med Bull 13:367-74. doi:10.5455/pmb.1-1378840527
29. 30. Walker SN, Sechrist KR, Pender NJ. (1987) The health-promoting lifestyle profile: development and psychometric characteristics. Nurs Res 36:76-81. doi:10.1097/00006199-198703000-00002
30. 31. Bahar Z, Beşer A, Gördes N, Ersin F, Kıssal A. (2008) Healthy life style behavior scale II: a reliability and validity study. Cumhuriyet Univ Nurs High Sch J 12:1-13.
31. 32. Beal, T., Morris, S. S., & Tumilowicz, A. (2019). Global patterns of adolescent fruit, vegetable, carbonated soft drink, and fast-food consumption: a meta-analysis of global school-based student health surveys. Food and nutrition bulletin, 4:444-459.
32. 33. Ashdown-Franks G, Vancampfort D, Firth J, Smith L, Sabiston CM, Stubbs B, Koyanagi A. (2019)Association of leisure-time sedentary behavior with fast food and carbonated soft drink consumption among 133,555 adolescents aged 12-15 years in 44 low- and middle-income countries. Int J Behav Nutr Phys Act. 16(1):35. doi: 10.1186/s12966-019-0796-3. PMID: 31014359; PMCID: PMC6480660.
33. 34. Altun M, Kutlu Y. (2015) Ergenlerin yeme davranışları ile ilgili görüşleri: Niteliksel çalışma, Florence Nightingale Hemşirelik Dergisi 3:174-184.
34. 35. Unsal A, Ayranci U, Tozun M, Arslan G, Calik E. (2010) Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Ups J Med Sci.115:138-45. doi: 10.3109/03009730903457218. PMID: 20074018; PMCID: PMC2853792.
35. 36. Ermetici F, Zelaschi RF, Briganti S, Dozio E, Gaeta M, Ambrogi F, Pelissero G, Tettamanti G, Corsi Romanelli MM, Carruba M, Morricone L, Malavazos AE. (2016) Association between a school-based intervention and adiposity outcomes in adolescents: The Italian "EAT" project. Obesity (Silver Spring) 3:687-95. doi: 10.1002/oby.21365.
36. 37. Subak Erdem. (2021) Status of the Exercise Habits for Health in Turkish Population: A General Review of the Turkish National Publications. Res Inves Sports Med, 7(4), RISM.000669. DOI: 10.31031/RISM.2021.07.000669
37. 38. Bakır N. The effect of healthy lifestyle behavior training in university students with premenstrual complications. [dissertation]. İstanbul, Turkey: University of İstanbul; 2017.
38. 39. Sjögren, K. (2017). Increased adipose tissue aromatase activity improves insulin sensitivity and reduces adipose tissue inflammation in male mice. American Journal of Physiology-Endocrinology and Metabolism, 313(4), E450-E462.
39. 40. Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 2019 Jun;220(6):569.e1-569.e7.
40. 41. Wang D, Stewart D, Yuan Y, Chang C. (2015) Do health-promoting schools improve nutrition in China? Health Promot Int 30:359-68. doi:10.1093/heapro/dat047
41. 42. Potur D. C, Kömürcü N. (2014) The effects of local low-dose heat application on dysmenorrhea, Journal of pediatric and adolescent gynecology 4:216-221.
42. 43. Sönmezer E. Primer Dismenorede Konnektif Doku Masajı Ve Kinezyobantlama Uygulamalarının Ağrı Ve Yaşam Kalitesi Üzerine Etkilerinin Karşılaştırılması. Sağlık Bilimleri Enstitüsü, Fizyoterapi ve Rehabilitasyon Ana Bilim Dalı, Doktora Tezi, Ankara: Hacettepe Üniversitesi, 2014
43. 44. De Almeida Santos Reis C.A, Hardy E, De Sousa H. (2010) The effectiveness of connective tissue massage in the treatment of primary dysmenorrhea among young women, Rev. Bras. Saúde Matern Infant Recife 2:247-256
44. 45. Chiou MH, Wang HH, Yang YH. (2007) Effect of systematic menstrual health education on dysmenorrheic female adolescents’ knowledge, attitudes, and self-care behavior. Kaohsiung J Med Sci 23:183-90. doi:10.1016/s1607-551x(09)70395-x
45. 46. Dipali N, Seema A, Rupali G. (2009) Impact of health education on knowledge and practices about menstruation among adolescent school girls of Kalamboli, Navi-Mumbai. Health Popul Perspect Issues 32:167-75.
46. 47. El-Lassy RB, Madian AAA. (2013) Impact of health educational program on menstrual beliefs and practices of adolescent Egyptian girls at secondary technical nursing school. Life Sci J 10:335-45.
47. 48. Arora A, Mittal A, Pathania D, Singh J, Mehta C, Bunger R. (2013) Impact of health education on knowledge and practices about menstruation among adolescent school girls of rural part of district Ambala, Haryana. Indian J Commun Health 25:492-7.
48. 49. Haque SE, Rahman M, Itsuko K, Mutahara M, Sakisaka K. (2014) The effect of a school-based educational intervention on menstrual health: an intervention study among adolescent girls in Bangladesh. BMJ Open 4:e004607. doi: 10.1136/bmjopen-2013-004607
49. 50. Wahyuni AM. (2016) The effect of pilates exercise to hamper primary dysmenorrhea in 18-21 years old adolescents. In Proceedings of the ICHWB (International Conference on Health Well-Being) 413-417. Surakarta, Indonesia.
50. 51. Kokiwar PR, Nikitha P. (2020) Efficacy of focused group discussion on knowledge and practices related to menstruation among adolescent girls of rural areas of rhtc of a medical college: an interventional study. Indian J Community Med 45: 32-5. doi: 10.4103/ijcm.IJCM_134_1
51. 52. Gupta R, Kaur S, Singh A. (2013) Comparison to assess the effectiveness of active exercise and dietary ginger vs active exercises on primary dysmenorrhea among adolescent girls. Nurs Midwifery Res 9:167-77.
52. 53. Caballero-Guzmán A, Lafaurie-Villamil MM. (2020) Swimming and menstruation: a qualitative study in elite female swimmers. Rev Fac Med Univ Nac Colomb 68:356-62.
53. 54. El-Mowafy RI, Moussa MMM, El-Ezaby HH. (2014) Effect of health education program on knowledge and practices about menstrual hygiene among adolescents girls at orphanage home. IOSR-JNHS 3:48-55. doi:10.9790/1959-03614855
54. 55. Tang J, Xu H. (2016) Analysis of self-management education on improving the symptoms of female college students with primary dysmenorrhea in Shaoyang. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2016;41:434-9. doi: 10.11817/j.issn.1672-7347.2016.04.016
55. 56. Daşıkan Z, Çay Taş G, Sözen G. (2014) Perimenstrual complaints and related affecting factors in women in ödemiş. J Turk Soc Obstet Gynecol 2014;11:98-104. doi:10.4274/tjod.48726
56. 57. Martín-García M, Alegre LM, García-Cuartero B, Bryant EJ, Gutin B, Ara I. (2019) Effects of a 3-month vigorous physical activity intervention on eating behaviors and body composition in overweight and obese boys and girls. J Sport Health Sci 2019;8:170-6.
57. 58. Hsiao YC, Chen MY, Gau YM, Hung LL, Chang SH, Tsai HM. (2005) Short-term effects of a health promotion course for Taiwanese nursing students. Public Health Nurs 2005;22:74-81. doi: 10.1111/j.0737-1209.2005.22111.x
58. 59. Wei CN, Harada K, Ueda K, Fukumoto K, Minamoto K, Ueda A. (2012) Assessment of health-promoting lifestyle profile in Japanese university students. Environ Health Prev Med 17:222-7. doi:10.1007/s12199-011-0244-8
59. 60. Yesilfidan D, Adana F. (2017) The impact of health behaviours development training on healthy lifestyle behaviours amongst adolescents with obesity risk: a school example in a city in Western Turkey. J Pak Med Assoc 67:1698-703.
60. 61. Yılmaz A. The effect of training provided for obese high school students based on health development model on their healthy lifestyle behaviors and life quality. [dissertation]. Erzurum, Turkey: University of Atatürk University; 2014.
61. 62. Meng Y, Manore MM, Schuna JM, Patton-Lopez MM, Branscum A, Wong SS. (2018) Promoting healthy diet, physical activity, and Life-Skills in high school athletes: results from the WAVE ripples for change childhood obesity prevention two-year intervention. Nutrients 10: 947.
62. 63. Wu XY, Han LH, Zhang JH, Luo S, Hu JW, Sun K. (2017) The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review. PLoS One 12: e0187668. doi:10.1371/journal.pone.0187668
63. 64. Steinberger J, Daniels SR, Hagberg N, et al. (2016) Cardiovascular health promotion in children: challenges and opportunities for 2020 and beyond: a scientific statement from the American Heart Association. Circulation 134:e236-55. doi: 10.1161/CIR.0000000000000441
64. 65. Omorou AY, Langlois J, Lecomte E, Briançon S, Vuillemin A. (2016) Cumulative and bidirectional association of physical activity and sedentary behaviour with health-related quality of life in adolescents. Qual Life Res 25:1169-78. doi: 10.1007/s11136-015-1172-7.
65. 66. Pengpid S, Peltzer K. (2019) Sedentary behaviour, physical activity and life satisfaction, happiness and perceived health status in university students from 24 countries. Int J Environ Res Public Health 16:2084. doi: 10.3390/ijerph16122084.
66. 67. Nowak J, Borkowska B, & Pawlowski B. (2016). Leukocyte changes across menstruation, ovulation, and mid‐luteal phase and association with sex hormone variation. American Journal of Human Biology, 28,5: 721-728.
67. 68. Silva KS, Silva JAD, Barbosa Filho VC, et al. (2020) Protocol paper for the Movimente school-based program: a cluster-randomized controlled trial targeting physical activity and sedentary behavior among Brazilian adolescents. Medicine 99:e21233. doi: 10.1097/MD.0000000000021233
68. 69. Sutherland R, Campbell E, McLaughlin M, et al. (2020) Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 12-month implementation outcomes from a cluster randomized controlled trial. Int J Behav Nutr Phys Act 17:100. doi: 10.1186/s12966-020-01000-y
69. 70. Potecha LM. A school-based intervention of adolescent obesity prevention in at-risk youth. [dissertation]. Virginia, USA: Liberty University; 2012.
70. 71. Roh HT, So WY. (2017) The effects of aerobic exercise training on oxidant–antioxidant balance, neurotrophic factor levels, and blood–brain barrier function in obese and non-obese men. J Sport Health Sci 6:447-53.
71. 72. Geçkil E, Yıldız S. (2006) The effect of nutrition and coping with stress education on adolescents’ health promotion (Turkey). Hacettepe Univ Fac Health Sci Nurs J 10:19-28.
72. 73. Eggert L, Kleinstäuber M, Hiller W, Witthöft M. (2017) Emotional interference and attentional processing in premenstrual syndrome. J Behav Ther Exp Psychiatry 54:77-87. doi:10.1016/j.jbtep.2016.07.002