Role Of Diet In The Treatment Of Polycystic Ovary Syndrome
Crystal C. Douglas, Ph.D., R.D.,a,b Barbara A. Gower, Ph.D.,a Betty E. Darnell, M.S., R.D.,b Fernando Ovalle, M.D.,c Robert A. Oster, Ph.D.,b,c and Ricardo Azziz, M.D., M.P.H., M.B.A.d,e a Department of Nutrition Sciences, b Pittman General Clinical Research Center, and c Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; d Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California; and e Department of Obstetrics and Gynecology and Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California
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. (Fertil Steril 2006;85:679–88. ©2006 by American Society for Reproductive Medicine.)
