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A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome.

Abstract

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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of obstetrics and Gynecology, Pennsylvania State University, Hershey, Pennsylvania 17033, USA.

    , , , ,

    Source

    Fertility and sterility 81:3 2004 Mar pg 630-7

    MeSH

    Adult
    Diet, Reducing
    Dietary Carbohydrates
    Dietary Proteins
    Female
    Humans
    Infertility, Female
    Obesity
    Pilot Projects
    Polycystic Ovary Syndrome
    Reproduction
    Time Factors
    Weight Loss

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    15037413

    Citation

    Stamets, Kelly, et al. "A Randomized Trial of the Effects of Two Types of Short-term Hypocaloric Diets On Weight Loss in Women With Polycystic Ovary Syndrome." Fertility and Sterility, vol. 81, no. 3, 2004, pp. 630-7.
    Stamets K, Taylor DS, Kunselman A, et al. A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertil Steril. 2004;81(3):630-7.
    Stamets, K., Taylor, D. S., Kunselman, A., Demers, L. M., Pelkman, C. L., & Legro, R. S. (2004). A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertility and Sterility, 81(3), pp. 630-7.
    Stamets K, et al. A Randomized Trial of the Effects of Two Types of Short-term Hypocaloric Diets On Weight Loss in Women With Polycystic Ovary Syndrome. Fertil Steril. 2004;81(3):630-7. PubMed PMID: 15037413.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. AU - Stamets,Kelly, AU - Taylor,Denise S, AU - Kunselman,Allen, AU - Demers,Laurence M, AU - Pelkman,Christine L, AU - Legro,Richard S, PY - 2003/03/25/received PY - 2003/08/04/revised PY - 2003/08/04/accepted PY - 2004/3/24/pubmed PY - 2004/4/29/medline PY - 2004/3/24/entrez SP - 630 EP - 7 JF - Fertility and sterility JO - Fertil. Steril. VL - 81 IS - 3 N2 - 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. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/15037413/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015028203030231 DB - PRIME DP - Unbound Medicine ER -