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Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines.

Abstract

While lifestyle management is recommended as first-line treatment of polycystic ovary syndrome (PCOS), the optimal dietary composition is unclear. The aim of this study was to compare the effect of different diet compositions on anthropometric, reproductive, metabolic, and psychological outcomes in PCOS. A literature search was conducted (Australasian Medical Index, CINAHL, EMBASE, Medline, PsycInfo, and EBM reviews; most recent search was performed January 19, 2012). Inclusion criteria were women with PCOS not taking anti-obesity medications and all weight-loss or maintenance diets comparing different dietary compositions. Studies were assessed for risk of bias. A total of 4,154 articles were retrieved and six articles from five studies met the a priori selection criteria, with 137 women included. A meta-analysis was not performed due to clinical heterogeneity for factors including participants, dietary intervention composition, duration, and outcomes. There were subtle differences between diets, with greater weight loss for a monounsaturated fat-enriched diet; improved menstrual regularity for a low-glycemic index diet; increased free androgen index for a high-carbohydrate diet; greater reductions in insulin resistance, fibrinogen, total, and high-density lipoprotein cholesterol for a low-carbohydrate or low-glycemic index diet; improved quality of life for a low-glycemic index diet; and improved depression and self-esteem for a high-protein diet. Weight loss improved the presentation of PCOS regardless of dietary composition in the majority of studies. Weight loss should be targeted in all overweight women with PCOS through reducing caloric intake in the setting of adequate nutritional intake and healthy food choices irrespective of diet composition.

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  • Authors+Show Affiliations

    ,

    The Robinson Institute, Research Centre for Reproductive Health, School of Paediatrics and Reproductive Health, University of Adelaide, Australia. lisa.moran@adelaide.edu.au

    , , , , , , , ,

    Source

    MeSH

    Androgens
    Diet
    Dietary Carbohydrates
    Dietary Fats
    Dietary Proteins
    Energy Intake
    Female
    Glycemic Index
    Guidelines as Topic
    Humans
    Obesity
    Overweight
    Polycystic Ovary Syndrome
    Quality of Life
    Treatment Outcome
    United States
    Weight Loss

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23420000

    Citation

    Moran, Lisa J., et al. "Dietary Composition in the Treatment of Polycystic Ovary Syndrome: a Systematic Review to Inform Evidence-based Guidelines." Journal of the Academy of Nutrition and Dietetics, vol. 113, no. 4, 2013, pp. 520-45.
    Moran LJ, Ko H, Misso M, et al. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. J Acad Nutr Diet. 2013;113(4):520-45.
    Moran, L. J., Ko, H., Misso, M., Marsh, K., Noakes, M., Talbot, M., ... Teede, H. J. (2013). Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. Journal of the Academy of Nutrition and Dietetics, 113(4), pp. 520-45. doi:10.1016/j.jand.2012.11.018.
    Moran LJ, et al. Dietary Composition in the Treatment of Polycystic Ovary Syndrome: a Systematic Review to Inform Evidence-based Guidelines. J Acad Nutr Diet. 2013;113(4):520-45. PubMed PMID: 23420000.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. AU - Moran,Lisa J, AU - Ko,Henry, AU - Misso,Marie, AU - Marsh,Kate, AU - Noakes,Manny, AU - Talbot,Mac, AU - Frearson,Meredith, AU - Thondan,Mala, AU - Stepto,Nigel, AU - Teede,Helena J, Y1 - 2013/02/16/ PY - 2012/07/13/received PY - 2012/11/08/accepted PY - 2013/2/20/entrez PY - 2013/2/20/pubmed PY - 2013/5/10/medline SP - 520 EP - 45 JF - Journal of the Academy of Nutrition and Dietetics JO - J Acad Nutr Diet VL - 113 IS - 4 N2 - While lifestyle management is recommended as first-line treatment of polycystic ovary syndrome (PCOS), the optimal dietary composition is unclear. The aim of this study was to compare the effect of different diet compositions on anthropometric, reproductive, metabolic, and psychological outcomes in PCOS. A literature search was conducted (Australasian Medical Index, CINAHL, EMBASE, Medline, PsycInfo, and EBM reviews; most recent search was performed January 19, 2012). Inclusion criteria were women with PCOS not taking anti-obesity medications and all weight-loss or maintenance diets comparing different dietary compositions. Studies were assessed for risk of bias. A total of 4,154 articles were retrieved and six articles from five studies met the a priori selection criteria, with 137 women included. A meta-analysis was not performed due to clinical heterogeneity for factors including participants, dietary intervention composition, duration, and outcomes. There were subtle differences between diets, with greater weight loss for a monounsaturated fat-enriched diet; improved menstrual regularity for a low-glycemic index diet; increased free androgen index for a high-carbohydrate diet; greater reductions in insulin resistance, fibrinogen, total, and high-density lipoprotein cholesterol for a low-carbohydrate or low-glycemic index diet; improved quality of life for a low-glycemic index diet; and improved depression and self-esteem for a high-protein diet. Weight loss improved the presentation of PCOS regardless of dietary composition in the majority of studies. Weight loss should be targeted in all overweight women with PCOS through reducing caloric intake in the setting of adequate nutritional intake and healthy food choices irrespective of diet composition. SN - 2212-2672 UR - https://www.unboundmedicine.com/medline/citation/23420000/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-2672(12)01925-9 DB - PRIME DP - Unbound Medicine ER -