Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome—Substudy of randomized trial between diet, exercise and diet plus exercise for weight control
Abstract
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 body mass index (BMI >27 kg/m 2, 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/d. The E group received an ambulatory exercise regimen from a physiotherapist. The DE group had both interventions. Measurements: Self‐reported food intake over 4 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 low‐density lipoprotein and Homeostasis Model of Assessment 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 = .03), while a decrease in trans fatty acid intake predicted reduced insulinogenic index (0.44, P < .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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The combination of dietary changes with exercise appears to confer an additional cardiometabolic benefit than just one component alone, and at times even in the absence of changes in weight or anthropometric measures.
“the combination of dietary changes with exercise appears to confer an additional cardiometabolic benefit than just one component alone [101,102,103,109], and at times, even in the absence of changes in weight or anthropometric measures [103,109]”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [102]
Cites
Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates
Sacks, F. M., Bray, G. A., Carey, V. J., Smith, S. R., Ryan, D. H., Anton, S. D., McManus, K., Champagne, C. M., Bishop, L. M., Laranjo, N., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0804748 · Cited by 1,966 · see citing works
Dumesic, D. A., Oberfield, S. E., Stener-Victorin, E., Marshall, J. C., Laven, J. S., & Legro, R. S. (2015) · Endocrine Reviews · doi:10.1210/er.2015-1018 · Cited by 1,020 · see citing works
Protein, weight management, and satiety
Paddon-Jones, D., Westman, E., Mattes, R. D., Wolfe, R. R., Astrup, A., & Westerterp-Plantenga, M. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.5.1558s · Cited by 549 · see citing works
Legro, R. S., Dodson, W. C., Kris-Etherton, P. M., Kunselman, A. R., Stetter, C. M., Williams, N. I., Gnatuk, C. L., Estes, S. J., Fleming, J., Allison, K. C., et al. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-2778 · Cited by 242 · see citing works
Dietary fatty acid intakes and the risk of ovulatory infertility
Chavarro, J. E., Rich-Edwards, J. W., Rosner, B. A., & Willett, W. C. (2007) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.1.231 · Cited by 203 · see citing works
Lifestyle Modification Programs in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis
Domecq, J. P., Prutsky, G., Mullan, R. J., Hazem, A., Sundaresh, V., Elamin, M. B., Phung, O. J., Wang, A., Hoeger, K., Pasquali, R., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2385 · Cited by 184 · see citing works
Difference in dietary intake between women with polycystic ovary syndrome and healthy controls
Douglas, C. C., Norris, L. E., Oster, R. A., Darnell, B. E., Azziz, R., & Gower, B. A. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.12.054 · Cited by 147 · see citing works
Mehrabani, H. H., Salehpour, S., Amiri, Z., Farahani, S. J., Meyer, B. J., & Tahbaz, F. (2012) · Journal of the American College of Nutrition · doi:10.1080/07315724.2012.10720017 · Cited by 141 · see citing works
Hyperandrogenism may explain reproductive dysfunction in Olympic athletes
HAGMAR, M., BERGLUND, B., BRISMAR, K., & HIRSCHBERG, A. L. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318195a21a · Cited by 114 · see citing works
Self-citationGoss, A. M., Chandler-Laney, P. C., Ovalle, F., Goree, L. L., Azziz, R., Desmond, R. A., Wright Bates, G., & Gower, B. A. (2014) · Metabolism · doi:10.1016/j.metabol.2014.07.007 · Cited by 85 · see citing works
Karabulut, A., Yaylali, G. F., Demirlenk, S., Sevket, O., & Acun, A. (2012) · Gynecological Endocrinology · doi:10.3109/09513590.2011.589929 · Cited by 61 · see citing works
Schmidt, J., Dahlgren, E., Brännström, M., & Landin‐Wilhelmsen, K. (2012) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2012.04378.x · Cited by 48 · see citing works
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Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome
Shang, Y., Zhou, H., Hu, M., & Feng, H. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa425 · Cited by 171 · see citing works
The Role of Lifestyle Interventions in PCOS Management: A Systematic Review
Gautam, R., Maan, P., Jyoti, A., Kumar, A., Malhotra, N., & Arora, T. (2025) · Nutrients · doi:10.3390/nu17020310 · Cited by 115 · see citing works
Dietary intake, body composition and metabolic parameters in women with polycystic ovary syndrome
Cunha, N. B. D., Ribeiro, C. T., Silva, C. M., Rosa-e-Silva, A. C. J. D. S., & De-Souza, D. A. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.10.012 · Cited by 22 · see citing works
Herbert, S., & Woolf, K. (2023) · Nutrients · doi:10.3390/nu15245069 · Cited by 15 · see citing works
“Overall, energy restriction plus exercise has been shown to decrease weight [104–106], BMI [101,102,104,105], WC [101,102,104,106,107], hip circumference [104], body fat [105], fat-free mass [105], lean body mass [101,102], blood pressure [104,106], HOMA-IR [106,107], glucose [106], insulin [106],…”
BackgroundInfluential
- Authors
- Nybacka, Å., Hellström, P. M., & Hirschberg, A. L.
- Affiliations
- Karolinska University Hospital (SE)
- Uppsala University (SE)
- Corresponding author
- Hellström, Per M.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2017-08-18
- Volume
- 87
- Issue
- 6
- Pages
- 680-688
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2739112346
- Cited by
- 50
- References
- 12
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 1 · 2023: 4 · 2022: 17 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 2 · 2017: 1
- FWCI
- 4.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stockholms Läns Landsting
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- polycystic ovary syndrome, overweight, obesity, dietary fiber, trans fatty acids, insulin resistance, insulinogenic index, weight management, lifestyle intervention, nutrition counseling, physical activity, dyslipidemia, waist-to-hip ratio, metabolic biomarkers
- MeSH terms
- Adolescent, Adult, Dietary Fiber, Female, Humans, Polycystic Ovary Syndrome, Exercise, Absorptiometry, Photon, Trans Fatty Acids, Overweight, Young Adult
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