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Role of diet in the treatment of polycystic ovary syndrome.
Douglas, CC, Gower, BA, Darnell, BE, Ovalle, F, Oster, RA, Azziz, R
Fertility and sterility. 2006;85(3):679-88
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Plain language summary
Polycystic ovary syndrome (PCOS) is an endocrine disorder found in approximately 6.5% of reproductive-age women. It is often associated with obesity, insulin resistance and menstrual irregularity. Insulin inhibits the production of sex hormone binding globulin (SHBG) and stimulates ovarian P450c17 alpha activity and androgen production. This study aimed to add to the research on dietary interventions for PCOS. The intervention was three 16 day eucaloric diets, which were either enriched with mono saturated fatty acids (MUFAs) (17% energy) or low in carbohydrate (43% energy). The three intervention periods were separated by 3 week wash out periods and included 11 women. The study found that the low carbohydrate diet decreased fasting insulin, but no impact on testosterone, LH, FSH or DHEA. The researchers concluded that a modest reduction in insulin may over time, improve endocrine outcomes in those with PCOS.
Abstract
OBJECTIVE To determine whether eucaloric diets either enriched with monounsaturated fatty acids (MUFA; 17% energy) or low in carbohydrates (Low CHO; 43% energy) would increase insulin sensitivity (Si) and decrease circulating insulin concentrations, relative to a standard diet (STD; 56% CHO, 31% fat, 16% protein), among women with polycystic ovary syndrome (PCOS). DESIGN Crossover. SETTING Academic research environment. PATIENT(S): Healthy women with PCOS not on hormonal or insulin-sensitizing therapy. INTERVENTION(S): Subjects consumed three, 16-day, eucaloric diets, each separated by a 3-week washout period. A frequently sampled, intravenous, glucose tolerance test was administered at baseline and following each diet. MAIN OUTCOME MEASURE(S): Fasting glucose, insulin, the acute insulin response to glucose (AIRg), Si, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), total testosterone (T), free T, A4, total cholesterol, high-density lipoprotein cholesterol (HDL-C), tryglycerides (TG), and free fatty acids (FFA). RESULT(S): Fasting insulin was lower following the Low CHO diet relative to the STD diet; AIRg was lower following the Low CHO diet relative to the MUFA diet. Fasting glucose, Si, and the circulating concentrations of reproductive hormones were not significantly affected by the intervention. CONCLUSION(S): A moderate reduction in dietary carbohydrate reduced the fasting and postchallenge insulin concentrations among women with PCOS, which, over time, may improve reproductive/endocrine outcomes.