Summary
Objective
Polycystic ovary syndrome (PCOS) is commonly affected by obesity. PCOS phenotypes are prone to increased waist/hip ratio, insulin resistance and dyslipidaemia. This substudy was undertaken to evaluate the effects of lifestyle interventions on metabolic biomarkers in overweight/obese PCOS women, and the interventional effects of dietary components related to metabolic outcomes.
Design
Randomized three-arm parallel study.
Patients
Fifty-seven PCOS women (BMI >27kg/m2, age 18-40) were randomly assigned to diet (D, n=19), exercise (E, n=19) or diet plus exercise (DE, n=19) in three-arm fashion over 16 weeks. The D group received nutritional counselling by a dietician to reduce their energy intake by at least 600 kcal/day. The E group received an ambulatory exercise regimen from a physiotherapist. The DE group had both interventions.
Measurements
Self-reported food intake over four days, exercise pedometers, BMI, waist/hip ratio, blood pressure, body composition, and oral glucose tolerance test were performed before and at the end of intervention.
Results
BMI, waist circumference and total cholesterol were significantly reduced in the D and DE groups, as well as LDL and HOMA index in the D group. In the E group, exercise was increased along with a decrease in BMI and waist circumference. The strongest predictor of reduced BMI was increased fibre intake (-0.44, p=0.03), while a decrease in trans fatty acid intake predicted reduced insulinogenic index (0.44, p<0.01).
Conclusions
Nutritional counselling with dieting is clearly effective to improve metabolic disturbances in overweight/obese women with PCOS. Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement and weight control.
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