Predictors of Body Mass Index among Women with Polycystic Ovarian Syndrome (PCOS) in Jordan

Ahlam Rawashdeh (1) , Divya Vanoh (2) , Hafzan Yusoff (2) , Badrasawi Manal (3)
(1) Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia, Jordan,
(2) Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia, Malaysia,
(3) Faculty of Agriculture, An-Najah National University, PO. Box 7 Nablus, Palestine, Palestine, State of

Abstract

The objective of this study is to assess the possibles determinants of body mass index among women with Polycystic Ovary Syndrome (PCOS) in Jordan. A cross-sectional study was conducted among 120 PCOS women aged between 18 to 45 years old in Jordan. The study included a structured questionnaire divided into six sections: demographic data, anthropometric measurements, medical history, dietary habits, physical activity, quality of life and mental health status. Binary logistic regression has been used to identify the predictors of body mass index.  Among 120 participants, 37.5% were underweight or had normal weight, while 62.5% were overweight or obese. The median age was 28.0 years for the overweight/obese group and 27.0 years for the underweight/normal-weight group (p<0.001). Women with higher income and education levels were at lower risk of  being overweight or obese (p<0.05). Overweight/obese women reported significantly lower levels of physical activity (p<0.05). Higher consumption of sugar, vitamin D, vitamin C, selenium, and iron was observed in underweight/normal-weight women compared to the overweight/obese group (p<0.001) based on Mann-Whitney test. Binary logistic regression analysis revealed that low education level  (OR=0.359, 95% CI:0.142−0.908),  good mental health status (OR=0.627, 95% CI:0.438−0.898) and greater waist circumference  (OR=1.352, 95% CI:1.145−1.596) increased the risk of being overweight or obese. These findings suggest that socioeconomic, psychological, and central adiposity factors play important roles in the weight status of this population, highlighting the need for multifaceted approaches in obesity prevention and management.

Full text article

Generated from XML file

References

Alessa A, Aleid D, Almutairi S, AlGhamdi R, Huaidi N, Almansour E, Youns S. 2017. Awareness of polycystic ovarian syndrome among Saudi females. Int J Med Sci Public Health 6(6):1013–1019. https://doi.org/10.5455/ijmsph.2017.0202507022017

Alam Z, Alseari S, Alameemi M, Alzaabi M, Alkhoori R, Östlundh L, Melhem O, Abdalla MA, Al-Rifai, RH. 2024. Prevalence of polycystic ovary syndrome among infertile women in the Gulf Cooperation Council (GCC) countries: A systematic review and meta-analysis. Heliyon 10(24). https://doi.org/10.1016/j.heliyon.2024.e40603

Alshdaifat E, Sindiani A, Amarin Z, Absy N, AlOsta N, Abuhayyeh HA, Alwani M. 2021. Awareness of polycystic ovary syndrome: A university students' perspective. Ann Med Surg 72:103−123. https://doi.org/10.1016/j.amsu.2021.103123

Ajorlouie Z, Moshkian P, Baghdadi G, Amiri R, Biglari F, Rahimlou M. 2025. The association between the Mediterranean diet and the prime diet quality score and polycystic ovary syndrome: A case control study. BMC Nutr 11(1):80. https://doi.org/10.1186/s40795-025-01067-5

Argano C, Miarchi L, Amodeo S, Orlando V, Torres A, Corrao S. 2023. The role of vitamin D and its molecular bases in insulin resistance, diabetes, metabolic syndrome, and cardiovascular disease: State of the art. Int J Mol Sci 24(20):15485. https://doi.org/10.3390/ijms242015485

Argano C, Orlando V, Maggio D, Pollicino C, Torres A, Cangialosi V, Manno SB, Corrao S. 2025. Pathophysiological role and therapeutic potential of vitamin C in metabolic syndrome and type 2 diabetes mellitus. Metabolites 15(12):773. https://doi.org/10.3390/metabo15120773

Awoke MA, Earnest A, Joham AE, Hodge AM, Teede HJ, Brown WJ, Moran LJ. 2022. Weight gain and lifestyle factors in women with and without polycystic ovary syndrome. Hum Reprod 37(1):129–141. https://doi.org/10.1093/humrep/deab239

Barber TM, Franks S. Genetics of polycystic ovary syndrome. 2013. Front Horm Res 40:28–39. https://doi.org/10.1159/000341682

Barber TM, Franks S. Obesity and polycystic ovary syndrome. 2021. Clin Endocrinol (Oxford) 95(4):531–541. https://doi.org/10.1111/cen.14421

Barber TM, Hanson P, Weickert MO, Franks S. 2019. Obesity and polycystic ovary syndrome: Implications for pathogenesis and novel management strategies. Clin Med Insights Reprod Health 13:1179558119874042. https://doi.org/10.1177/1179558119874042

Bhattacharya K, Sengupta P, Dutta S, Chaudhuri P, Das Mukhopadhyay L, Syamal AK. 2021. Waist-to-height ratio and BMI as predictive markers for insulin resistance in women with PCOS in Kolkata, India. Endocrine 72(1):86–95. https://doi.org/10.1007/s12020-020-02555-3

Bosy-Westphal A, Booke CA, Blöcker T, Kossel E, Goele K, Later W, Hitze B, Heller M, Glüer CC, Müller MJ. 2010. Measurement site for waist circumference affects its accuracy as an index of visceral and abdominal subcutaneous fat in a Caucasian population. J Nutr 140(5):954–961. https://doi.org/10.3945/jn.109.118737

Chen L, Xu WM, Zhang D. 2014. Association of abdominal obesity, insulin resistance, and oxidative stress in adipose tissue in women with polycystic ovary syndrome. Fertil Steril 102(4):1167–1174. https://doi.org/10.1016/j.fertnstert.2014.06.027

Cooney LG, Dokras A. 2017. Depression and anxiety in polycystic ovary syndrome: Etiology and treatment. Current Psychiatry Reports 19(11):83. https://doi.org/10.1007/s11920-017-0834-2

Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF et al. 2003. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB

Dobrzyńska M, Drzymała-Czyż S, Woźniak D, Drzymała S, Przysławski J. 2023. Natural sources of selenium as functional food products for chemoprevention. Foods 12(6):1247. https://doi.org/10.3390/foods12061247

El-Rufaie OE, Daradkeh TK. 1996. Validation of the Arabic versions of the thirty- and twelve-item General Health Questionnaires in primary care patients. Br J sychiatry 169(5):662–664. https://doi.org/10.1192/bjp.169.5.662

Ferdous B, Rahman MM, Akhter N, Afroj R, Morsheda KN, Afrin W. 2024. Association of socioeconomic status and lifestyle factors of polycystic ovarian disease among women in a tertiary care hospital in Dhaka. Sir Salimullah Med Coll J 32(1):29–38. https://doi.org/10.3329/ssmcj.v32i1.84503

Fernández-Cardero Á, Sierra-Cinos JL, López-Jiménez A, Beltrán B, Cuadrado C, García-Conesa MT, Bravo L, Sarriá B. 2024. Characterizing factors associated with excess body weight: A descriptive study using principal component analysis in a population with overweight and obesity. Nutr 16(8):1143. https://doi.org/10.3390/nu16081143

Guidi J, Rafanelli C, Fava GA. 2018. The clinical role of well-being therapy. Nord J Psychiatry 72(6):447–453. https://doi.org/10.1080/08039488.2018.1492013

Gupta V, Mishra S, Mishra S, Gupta VL. 2017. A ratio, insulin resistance and metabolic risk in women with polycystic ovarian syndrome. Diabetes Metab Syndr: Clin Res Rev 11:S697–S701. https://doi.org/10.1016/j.dsx.2017.05.001

Huddleston HG, Dokras A. 2022. Diagnosis and treatment of polycystic ovary syndrome. JAMA 327(3):274–275. https://doi.org/10.1001/jama.2021.23769

Jayanti SER, Widyaningsih V, Budihastuti UR. 2022. Correlations between obesity, polycystic ovary syndrome, and sleep apnea: A meta-analysis. Matern Child Health J 7:432–445. https://doi.org/10.26911/thejmch.2022.07.04.07

Khader Y, Batieha A, Jaddou H, Rawashdeh SI, El-Khateeb M, Hyassat D, Khader A, Ajlouni K. 2019. Hypertension in Jordan: Prevalence, awareness, control, and its associated factors. Int J Hypertens 3210617. https://doi.org/10.1155/2019/3210617

Liaset B, Øyen J, Jacques H, Kristiansen K, Madsen L. 2019. Seafood intake and the development of obesity, insulin resistance, and type 2 diabetes. Nutr Res Rev 32(1):146–167. https://doi.org/10.1017/S0954422418000240

Li L, Kang Z, Chen P, Niu B, Wang Y, Yang L. 2024. Association between mild depressive states in polycystic ovary syndrome and an unhealthy lifestyle. Front Public Health. 12:1361962. https://doi.org/10.3389/fpubh.2024.1361962

Mosli HH, Kutbi HA, Alhasan AH, Mosli RH. 2020. Understanding the interrelationship between education, income, and obesity among adults in Saudi Arabia. Obes Facts 13(1):77–85. https://doi.org/10.1159/000505246

Muhaidat N, Mansour S, Dardas M, Qiqieh J, Halasa Z, Al-Huneidy L, Samhouri J, Rayyan R, AlOweiwi W, AlMohtasib, Jet al. 2023. Current awareness status of and recommendations for polycystic ovarian syndrome: A national cross-sectional investigation of central Jordan. Int J Environ Res Public Health 20(5):4018. https://doi.org/10.3390/ijerph20054018

Musmar S, Afaneh A, Mo'alla H. 2013. Epidemiology of polycystic ovary syndrome: a cross-sectional study of university students at An-Najah national university-Palestine. Reprod Biol Endocrinol 11(1):47. https://doi.org/10.1186/1477-7827-11-47

Ohaeri JU, Awadalla AW. 2009. The reliability and validity of the short version of the WHO Quality of Life Instrument in an Arab general population. Ann Saudi Med. 29(2):98−104. https://doi.org/10.4103/0256-4947.51790

Oliveira PS, Levy J, Carli ED, Bensenor IJ, Lotufo PA, Pereira RA, Yokoo EM, Sichieri R, Crispim SP, Marchioni DM. 2022. Estimation of underreporting of energy intake using different methods in a subsample of the ELSA-Brasil study. Cad Saúde Pública. 38:e00249821. https://doi.org/10.1590/0102-311xen249821

Passarello K, Kurian S, Villanueva V. 2019. Endometrial cancer: An overview of pathophysiology, management, and care. Semin Oncol Nurs 35(2):157–165. https://doi.org/10.1016/j.soncn.2019.02.002

Poulimeneas D, Anastasiou CA, Santos I, Hill JO, Panagiotakos DB, Yannakoulia M. 2020. Exploring the relationship between the Mediterranean diet and weight loss maintenance: The MedWeight study. British J Nutr 124:874–880. https://doi.org/10.1017/S0007114520001798

Radaideh SS, Ibrahim, M. 2024. Nutritional status of patients with Polycystic Ovary Syndrome (PCOS) in Irbid Governorate, Jordan: A case-control study. MJNAHS 39(1):107–123. https://doi.org/10.35682/mjnahs.v39i1.1121

Rowlands IJ, Teede H, Lucke J, Dobson AJ, Mishra GD. 2016. Young women’s psychological distress after a diagnosis of polycystic ovary syndrome or endometriosis. Hum Reprod 31:2072–2081. https://doi.org/10.1093/humrep/dew174

Sarwer DB, Allison KC, Wadden TA, Ashare R, Spitzer JC, McCuen-Wurst C, LaGrotte C, Williams NN, Edwards M, Tewksbury C et al. 2019. Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surg Obes Rela Dis 15:390–396. https://doi.org/10.1016/j.soard.2019.01.029

Schröder H, Fitó M, Estruch R, Martínez-González MA, Corella D, Salas-Salvadó J, Lamuela-Raventós R, Ros E, Salaverría I, Fiol M. 2011. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr 141:1140–1145. https://doi.org/10.3945/jn.110.135566

Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, Szeto K, O’Connor E, Ferguson T, Eglitis E et al. 2023. Effectiveness of physical activity interventions for improving depression, anxiety and distress: An overview of systematic reviews. Br J Sports Med 57:1203–1209. https://doi.org/10.1136/bjsports-2022-106195

Sweiss K, Naser AY, Alsharif AA. 2025. Insights on eating behaviors among adult females in Jordan: A national survey study. Medicine 104(34):e44073. https://doi.org/10.1097/MD.0000000000044073

Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran LJ, Piltonen T, Norman RJ, International PCOS Network. 2018. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod 33:1602–1618. https://doi.org/10.1093/humrep/dey256

Tóth BE, Takács I, Valkusz Z, Jakab A, Fülöp Z, Kádár K, Putz Z, Kósa JP, Lakatos P. 2025. Effects of vitamin D3 treatment on polycystic ovary symptoms: A prospective double-blind two-phase randomized controlled clinical trial. Nutr 17(7):1246. https://doi.org/10.3390/nu17071246

Toosy S, Sodi R, Pappachan JM. 2018. Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord 17(2):277–285. https://doi.org/10.1007/s40200-018-0371-5

Zeng X, Xie YJ, Liu YT, Long SL, Mo ZC. 2020. Polycystic ovarian syndrome: Correlation between hyperandrogenism, insulin resistance and obesity. Clin Chem Lab Mede 50:214–221. https://doi.org/10.1016/j.cca.2019.11.003

Authors

Ahlam Rawashdeh
Divya Vanoh
divyavanoh@usm.my (Primary Contact)
Hafzan Yusoff
Badrasawi Manal
Author Biography

Hafzan Yusoff, Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, Malaysia

Rawashdeh, A., Vanoh, D., Yusoff, H. ., & Manal, B. (2026). Predictors of Body Mass Index among Women with Polycystic Ovarian Syndrome (PCOS) in Jordan. Jurnal Gizi Dan Pangan, 21(2), 147-158. https://doi.org/10.25182/jgp.2026.21.2.147-158

Article Details

How to Cite

Rawashdeh, A., Vanoh, D., Yusoff, H. ., & Manal, B. (2026). Predictors of Body Mass Index among Women with Polycystic Ovarian Syndrome (PCOS) in Jordan. Jurnal Gizi Dan Pangan, 21(2), 147-158. https://doi.org/10.25182/jgp.2026.21.2.147-158