OBJECTIVE: We performed this study as a pilot experiment to investigate the short term effects of two diets of varying composition on weight loss as the primary outcome in obese women with polycystic ovary syndrome (PCOS) seeking fertility. DESIGN: Randomized clinical trial. SETTING: Academic medical center. PATIENT(S): Thirty-five obese women with PCOS. INTERVENTION(S): We examined the effects of a 1-month dietary intervention on the PCOS phenotype. Participants were randomized to one of two energy-restricted diets; high protein (HP: 30% protein, 40% carbohydrate, and 30% fat) or high carbohydrate (HC: 15% protein, 55% carbohydrate, and 30% fat). The fat content was held constant in both diets. MAIN OUTCOME MEASURE(S): Primary - change in body weight; Secondary - biometric, hormonal, lipid and lipoprotein, and markers of glucose homeostasis and energy metabolism. RESULT(S): Twenty-six women completed the study. Both the HP (-3.7 +/- 1.9 kg) and HC (-4.4 +/- 1.5 kg) diets resulted in significant weight loss, but there was no significant difference in mean weight loss between the two groups. There were also no differences between diets on a variety of measures including circulating androgens, measures of glucose metabolism, and leptin. However, the effects of a hypocaloric diet per se on improving metabolic and reproductive abnormalities in a group of PCOS women were marked by a decline in circulating androgens (P=.03), fasting and area under the curve (AUC) insulins (P<.05) on a 3-hour oral glucose tolerance test (OGTT), and fasting and AUC leptin levels (P<.0001). There was a high prevalence of menstrual bleeding during the trial (14 out of 26 patients). CONCLUSION(S): Those who completed the short-term hypocaloric diet had a significant weight loss and a significant improvement in their reproductive and metabolic abnormalities. There was no increased benefit to a high-protein diet. Future diet studies evaluating the ideal composition of a hypocaloric diet in women with PCOS will require a large study population, and will most likely require a multicenter trial.
RCT Entities:
OBJECTIVE: We performed this study as a pilot experiment to investigate the short term effects of two diets of varying composition on weight loss as the primary outcome in obesewomen with polycystic ovary syndrome (PCOS) seeking fertility. DESIGN: Randomized clinical trial. SETTING: Academic medical center. PATIENT(S): Thirty-five obesewomen with PCOS. INTERVENTION(S): We examined the effects of a 1-month dietary intervention on the PCOS phenotype. Participants were randomized to one of two energy-restricted diets; high protein (HP: 30% protein, 40% carbohydrate, and 30% fat) or high carbohydrate (HC: 15% protein, 55% carbohydrate, and 30% fat). The fat content was held constant in both diets. MAIN OUTCOME MEASURE(S): Primary - change in body weight; Secondary - biometric, hormonal, lipid and lipoprotein, and markers of glucose homeostasis and energy metabolism. RESULT(S): Twenty-six women completed the study. Both the HP (-3.7 +/- 1.9 kg) and HC (-4.4 +/- 1.5 kg) diets resulted in significant weight loss, but there was no significant difference in mean weight loss between the two groups. There were also no differences between diets on a variety of measures including circulating androgens, measures of glucose metabolism, and leptin. However, the effects of a hypocaloric diet per se on improving metabolic and reproductive abnormalities in a group of PCOSwomen were marked by a decline in circulating androgens (P=.03), fasting and area under the curve (AUC) insulins (P<.05) on a 3-hour oral glucose tolerance test (OGTT), and fasting and AUC leptin levels (P<.0001). There was a high prevalence of menstrual bleeding during the trial (14 out of 26 patients). CONCLUSION(S): Those who completed the short-term hypocaloric diet had a significant weight loss and a significant improvement in their reproductive and metabolic abnormalities. There was no increased benefit to a high-protein diet. Future diet studies evaluating the ideal composition of a hypocaloric diet in women with PCOS will require a large study population, and will most likely require a multicenter trial.
Authors: Amy M Goss; Paula C Chandler-Laney; Fernando Ovalle; Laura Lee Goree; Ricardo Azziz; Renee A Desmond; G Wright Bates; Barbara A Gower Journal: Metabolism Date: 2014-07-18 Impact factor: 8.694
Authors: Crystal C Douglas; Barbara A Gower; Betty E Darnell; Fernando Ovalle; Robert A Oster; Ricardo Azziz Journal: Fertil Steril Date: 2006-03 Impact factor: 7.329
Authors: Meike A Q Mutsaerts; Henk Groen; Nancy C W ter Bogt; Johanna H T Bolster; Jolande A Land; Wanda J E Bemelmans; Walter K H Kuchenbecker; Peter G A Hompes; Nick S Macklon; Ronald P Stolk; Fulco van der Veen; Jacques W M Maas; Nicole F Klijn; Eugenie M Kaaijk; Gerrit J E Oosterhuis; Peter X J M Bouckaert; Jaap M Schierbeek; Yvonne M van Kasteren; Annemiek W Nap; Frank J Broekmans; Egbert A Brinkhuis; Carolien A M Koks; Jan M Burggraaff; Adrienne S Blankhart; Denise A M Perquin; Marie H Gerards; Robert J A B Mulder; Ed T C M Gondrie; Ben W J Mol; Annemieke Hoek Journal: BMC Womens Health Date: 2010-06-25 Impact factor: 2.809
Authors: Barbara A Gower; Paula C Chandler-Laney; Fernando Ovalle; Laura Lee Goree; Ricardo Azziz; Renee A Desmond; Wesley M Granger; Amy M Goss; G Wright Bates Journal: Clin Endocrinol (Oxf) Date: 2013-05-20 Impact factor: 3.478