Role of dietary habits in menstrual disorders among adolescent girls in Western Maharashtra Navi Mumbai

doi:10.21203/rs.3.rs-1862668/v1

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Role of dietary habits in menstrual disorders among adolescent girls in Western Maharashtra Navi Mumbai

https://doi.org/10.21203/rs.3.rs-1862668/v1

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Objectives: 1. To assess the menstrual disorders of adolescent girls of selected schools of Navi Mumbai. 2.To identify the dietary habits of adolescent girls of selected schools of Navi Mumbai. 3.To findout the association between dietary habits and menstrual disorders among the adolescent girls.

Materials and Method: A descriptive study was conducted among the adolescent girls at MGM School of Navi Mumbai, India from Oct.2021 to Dec. 2021 to analyze the association of dietary habits & menstrual disorders among adolescent girls. Numerical pain scale, modified women's health questionnaire and daily diary were used to collect data from 100 adolescent girls. Non probability purposive sampling technique was used to select adolescent girls.

Result: The mean age of menarche was 12.9±2.7 years. The study showed that girls were experienced moderate menstrual pain 54%, severe menstrual pain 21% and premenstrual symptoms were identified in 36% adolescence girls. More than 42% of the participants eat fast food and many of the girls were habits of skipping the meals in the afternoon. It was found that, there was a significant association between dietary habits and menstrual problems (p= <0.0001). The correlation coefficient between dietary habits and menstrual disorders was identified as r=0.7 with p<0.05.

Conclusion: The menstrual disorders were emerging problems in the adolescent girls of schools of Navi Mumbai. Daily intake of appropriate amount of protein, CHO, Fat, Vitamins and Minerals can help to reduce menstrual problems facing by adolescent girls.

Dietary Habits

Menstrual Disorders

Adolescence Girls

Association etc

Total World population of adolescent girls is 16%. In India, Adolescent girls (10–19 years) constitute 21.3%¹. Adolescent girls are the window of opportunity to mold and prepare for a healthy female life. We should ensure the nutrition, health and education needs of adolescents.²

In view point of Gynecologist, menstruation is one of the physiological sign of the health status among adolescent females. In current scenario, menstrual problems influenced the health of the females and also affect the high cost of societies; again it affects the quality of life, psychology of females, physiology of reproduction as well as families’ income & their community.³

Menstrual irregularities commonly observed during early stage of menstruation due to immature of hypothalamic pituitary ovarian axis. Due to this reason most of the adolescent girls have bleeding for 2–7 days during menstruation, 90% menstrual period occurs 21–45 days of ranges, or may have short cycle each after 20 days around interval between two cycles. 60–80% of cycle may long to 21–34 days of interval and this may long for 2–3 years of after the menarche.⁴

Diet plays important role in growth and development and it is fundamental factors that affect female lifestyle and quality of life.⁵ During adolescent age group, nutritional need is increased due to physical and physiological growth. Behaviour and daily habits develop during adolescent age and have a lifelong impact. So there is need to develop healthy eating habit is important for the physical growth.⁶

Amagin & Neupane (2019) conducted study on effects of food habits on menstrual cycle among adolescent girls. Result revealed that the poor eating habits (eat fast food 68.6%& meal skipping 50%) was significantly associated with menstrual problems.⁷

Important issue of adolescent life is menstrual health and some factors associated with menstrual health. Above study suggest food plays very important role in development, sustenance, reproduction & termination of life.

Hormone has an important factor for reproductive function. Eating disorders may lead to menstrual disorders and it is multifaceted and this result in weight loss, decreased body fat, hypoeptinemia, abnormal eating attitudes, behaviours, exercise and psychological stressors.⁸

In research context few studies are done on their association with menstrual abnormalities. Investigator interested to find the association between dietary habits and menstrual disorders.

A cross sectional descriptive study conducted among schools of Navi Mumbai. Standardized tool used to collect data includes NPS to assess menstrual pain, PBAC score to assess menstrual bleeding, Modified women’s health questionnaire to assess the premenstrual symptoms and daily dietary pattern assess by daily diary. Total 100 adolescent girls selected by Non probability purposive sampling technique from age group of 12–19 years. Data was analysed by SPSS 24.0, IBM, India software. Ethical approval was taken from Institutional Ethical committee (IRC) and permission from MGM school of Navi Mumbai.

Table 1

Distribution of Adolescent Girls as per Age (n = 100)
Age (Years)	Frequency	Percentage
12–14	20	20
15 – 17	48	48
> 17	32	32
Total	100	100

Data in Table 1: shows that out of 100 enrolled adolescent girls age wise distribution of adolescent girls 48 was belongs to 15–17 years of age, 32 girls from > 18 years of age and 20 from 12–14 years of age.

Table 2

Distribution of Adolescent Girls as per Age at Menarche (n = 100)
Age at Menarche (Years)	Frequency	Percentage
< 12	41	41
12–13	52	52
> 13	7	7
Total	100	100

Data in Table 2 Shows out of 100 girls, age at menarche wise distribution 52 girls from 12–13 years of age, 41 from < 12 years of age and only 7 girls belongs to > 13 years of age at menarche.

Table 3

Distribution of Adolescence Girls as per Dietary Pattern (n = 100)
Dietary Pattern of adolescence Girls	Frequency	Percentage
Healthy Diet
Yes	55	55
No	45	45
Type of food
Vegetarian	25	25
Non-Vegetarian	11	11
Mixed	64	64
Tea/Coffee
Yes	87	87
No	13	13
Eating Junk Food (days/weeks)
1 to 4	56	56
> 4	44	44
Follows Meal Time
Regular	39	39
Irregular	58	58

Table 3 shows out of 100 adolescent girls, only 55% girls were taking healthy diet. 25% and 64% adolescent girls were taking vegetarian diet and mixed type of diet respectively. Out of 100 participants, 87% participants were having habit of taking tea/ coffee. 44% girls were eating junk food more than 4 days per weeks. Only 39% girls were followed regular meal patterns.

Table 4

**Distribution of Menstrual Disorders among the Adolescence Girls.** (n = 100)
Menstrual Disorders	Frequency	Percentage
Present	86	86
Absent	14	14
Lower Abdominal Pain	81	81
Backache	73	73
Headache	62	62
Body Ache	78	78
Anorexia(loss of appetite)	82	82
Malaise	54	54
Mood Swings	30	30
Nausea + vomiting	17	17

The Table 4 showed that 86 (86%) of the participants had menstrual disorders during their menstrual cycle. Similarly, among all the menstrual disorders lower abdominal pain was the main problems suffering to almost 81% of the girls. Back ache, headache, body ache, anorexia, malaise, mood swings and nausea & vomiting were the subsequently less common menstrual problems occurring during their menstrual cycle.

Table 5

Association of Heavy Menstrual Bleeding with Anemia in Adolescence Girls (n = 100)
Hemoglobin (Hb.)Level	Menstrual Disorders		χ² Value	p-value
	Present	Absent
< 7	3	0	10.58	0.0142*
7–9	5	2
10–12	27	40
> 12	5	18

This study found that the occurrence of menstrual problems were found to have more in the less Hb. score it was observed it was statistical significance with menstrual disorders with p < 0.05 (Table. 5)

Table 6

Association of Body Mass Index with Menstrual disorders in Adolescence Girls. (n = 100)
Body mass index(BMI)	Menstrual Disorders		χ² Value	p-value
	Present (f)	Absent (f)
Under Weight	13	2	45.21	< 0.0001*
Normal Weight	7	32
Over Weight	19	5
Obesity	20	2

f = frequency

This study revealed that the occurrence of menstrual disorders was found to have more in the obesity followed by overweight, underweight respectively and it was observed it was statistical significance with menstrual disorders with p < 0.05 (Table 6)

Table 7

Association of Dietary Habits with Types of Menstrual Disorders in Adolescence Girls. (n = 100)
Dietary Habits	Menstrual Disorder			χ2 value	p-value
Dietary Habits	Irregular Menstruation Cycle (f) (n = 33)	Premenstrual Syndrome (f) (n = 39)	Dysmenorrhea (f) (n = 29)	χ2 value	p-value
Healthy Diet
Yes (n = 55)	3(3%)	27(27%)	25(25%)	41.51	< 0.0001*
No (n = 45)	29(29%)	12(12%)	4(4%)	41.51	< 0.0001*
Diet/Food
Veg	9(9%)	4(4%)	1(1%)	11.096	0.0255*
Non Veg	17(17%)	28(28%)	17(17%)
Mixed	7(7%)	7(7%)	11(11%)
Eating Junk Food (days/weeks)
1 to 4	6(6%)	18(18%)	4(4%)	10.92	0.043*
> 4	27(27%)	21(21%)	25(25%)	10.92	0.043*
Follows Meal Time
Regular	13	18	11	0.55	0.76
Irregular	20	21	18	0.55	0.76
Skipped Meal
Yes	14	12	19	8.22	0.0164*
No	19	27	10	8.22	0.0164*
Amount of Meal/Calories
Sufficient	5(5%)	12(12%)	1(1%)	8.72	0.0128*
Insufficient	28(28%)	27(27%)	28(28%)	8.72	0.0128*

*Significant when p < 0.05

The Table 7 shows that the association of dietary habits with types of menstrual disorders in adolescence girls and it was observed that there was significant role of dietary pattern while comparing it with different types there we found moreover similar kind of effects of dietary pattern and found not significant (p > 0.05)

Menstrual health is the important key of adolescent girls that leads to prepare a woman for future motherhood. Diet is the important factor which works on that ( Yadav A. 2018)¹

This study was conducted with 100 adolescent girls. Among that the mean age of menarche was 12.9 ± 2.7 years. Participant’s experienced moderate menstrual pain 54%, severe menstrual pain 21% and premenstrual symptoms identified in 36% adolescence girls. More than 42% of the participants eat fast food and many of the girls were habits of skipping the meals in the afternoon. When comparing the menstrual problems and dietary pattern, there was significant association between the dietary pattern and menstrual disorders among the adolescent girls.

Amagin & Neupane (2019) found that out of 140 participants 87.9% had the menstrual problems during menstruation. Out of that 80.7% of participant suffering from lower abdominal pain, 65.7% had headache and less common 20.7% mood swings. Menstrual problems were more common in non vegetarian diet than vegetarian diet and significantly associated with menstrual problems (p < 0.001). ⁷

Similarly study conducted by P.V. Kotecha et al, found that half of the girls were taking fast food, chocolates, soft drinks and 35% had eating habit of fast food.⁸

A similar cross sectional study in Gwalior city found that the average age of menarche was 13.5 ± 0.64 years. The common problems observed among adolescent girls were Dysmenorrhea (62.75%), premenstrual syndrome (PMS) (40.42%), and irregular cycle (28.72%). The final result showed that dysmenorrhea, PMS, and menstrual irregularities were directly correlated with dietary habits and physical activities. Dysmenorrhea was correlated with eating junk food (66.10%), and PMS was correlated with lacking of physical activities (78.94%).¹⁰

Individual QOL also influenced by different type of diet. Their study revealed that breakfast skipping may affect function of ovary and may land up gynecological disorders that manifest as menstrual pain in young adolescents. Study also demonstrated that the intensity of menstrual pain is high with those result who having previous a history of dieting in adolescence¹¹.

As per country Students' were taken different food patterns, there was common taking unhealthy food items frequently. Bulgarian students were reported frequently eating fast food like sweets example of cakes and different fried snacks chips. Polish students were reported the less consumption healthy foods like vegetables and fruits.¹²

Atrian KM et al done the study on menstrual irregularities among the obese adolescent girls. This study revealed that Obesity is common factors contributing cause for menstrual cycles irregularities, study was recommended when girls may modified owns lifestyle which contained exercises and nutritious diet this will maintain actual body weight as per their height that will help to reduce irregular menstrual cycles. (2014)¹¹

Dars S, Sayed K.and Yousufzai Z (2014) concluded study that out of total study population 75.51% girls belongs to BMI 14-24.9 reported regular menstrual cycle. 16 girls reported irregular menstrual cycle which belongs to a BMI of 25–29.9 kg/m². This study found that there is significant statistical relationship was identified between BMI and menstrual cycles. (df = 6, x3 = 116.5, P < 0.001).¹²

The unhealthy and inappropriate dietary pattern have impact on every womens’s quality of life not only in the present and in the upcoming era. In this study, the majority of the participants, skipping their breakfast and associated with higher eating of junk food. Dysmenorrhea was commonest in girls who were regularly eating fast food. The fast foods are rich in saturated fatty acids, and which have effect on the metabolism of progesterone in the body during menstrual cycle.¹³

Our study findings had similar findings from previous study reports. The girls who having lesser BMI they were significantly associated with irregular menstrual cycle. Nutrition is helpful among adolescent girls that emphasize on this study and that may affect on BMI. Alma Ata (1978) was declared eight essential elements which included healthy nutrition and appropriate food items essential for normal health of individual. Government of India was running the nutritional programme under the ICDS program to reduce the nutritional deficiency. There will be holistic approach to reduce menstrual disorders among adolescent girls.¹⁴

Above study was to find a relation between different lifestyle factors that are eating junk food, healthy food, and less physical activities along with the menstrual problems which faced by the adolescent girls.

In comparison, some observation-based studies revealed that participants complaining of more taking tea/ coffee, the role of caffeine during menstrual problems cause is yet unclear.¹⁵It needs further studies to prove whether consumption of caffeine is among the factors causing these signs or it is women's self-therapeutic response to the usual signs of fatigue to reduce their concentration on menstrual distress signs.¹⁶

Recommendation

Similar study can be done in larger sample.
Comparative study can be done for Effect of dietary pattern on menstrual disorders among experimental & control group of adolescent girls.
Identify the different predisposing factors associated with menstrual disorders.

The menstrual disorders were common problem among the adolescent girls of schools of Navi Mumbai. Daily intake of appropriate amount of protein, CHO, Fat, Vitamins and Minerals can help to reduce menstrual problems of adolescent girls. A healthy nutritious diet followed before your expected period will help you to ease out your pain in your next cycle.

Ethical approval and consent to participate:

Informed consent was taken by participants and their parents. All methods were carried out in accordance with relevant guidelines and regulations. The Institutional Ethics Committee of National Institute of Medical Sciences, Jaipur, Rajasthan, India had reviewed the research project and approved undertaking the study protocol vide their letter no. NIMSUNI/IEC/2019/Ph.D./109 dated 29^th July 2019.

Consent for publication: Participant’s and their parent given the consent for publication along with study participant consent.

Conflict of Interest: None

Funding: No funding sources from outside. Self-funding.

Acknowledgement: This study was approved by Nims University of Rajasthan, Jaipur. Gratitude is expressed to adolescent girls who participated in study.

Author’s contribution: Mrs Vaishali Talekar, Dr. Maharaj Singh, Dr. Kalpana Kamble, and Mr. Dhirajkumar Mane participated in the study approach and design, statistical analysis of data and tabulation, literature review, preparation and editing the manuscript.

Availability of data and materials: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

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No competing interests reported.

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Role of dietary habits in menstrual disorders among adolescent girls in Western Maharashtra Navi Mumbai

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Abstract

Introduction

Methodology

Result

f = frequency

*Significant when p < 0.05

Discussion

Conclusion

Declarations

References

Additional Declarations

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