Effectiveness of a 6-Month Lifestyle Intervention on Diet, Physical Activity, Quality of Life, and Markers of Cardiometabolic Health in Women with PCOS and Obesity and Non-PCOS Obese Controls: One Size Fits All?
Open accessAbstract
Little is known about the difference in effectiveness of lifestyle intervention between women with PCOS and non-PCOS women. In a post hoc longitudinal analysis of a randomized, controlled trial, we aimed to investigate whether infertile women with PCOS and obesity (N = 87) responded differently to a 6-month lifestyle intervention program than infertile non-PCOS obese controls (N = 172). We evaluated several aspects of the intervention such as changes in diet, physical activity, and dropout rate, as well as the effect on weight, quality of life (QoL), and cardiometabolic outcomes. Multilevel analyses were used, and analyses were adjusted for baseline characteristics such as age, education, and smoking. Although BMI in both groups significantly decreased at 3 months and 6 months, there were no significant differences between the groups at 3 months (adjusted B: −0.3, 95% CI: −0.9 to 0.3, p = 0.35) and 6 months (adjusted B: 0.5, 95% CI: −0.4 to 1.4, p = 0.29). Women with PCOS and non-PCOS women had similar compliance with the lifestyle intervention in terms of actual change in diet and physical activity. Mental QoL scores were not different at either 3 or 6 months. Physical QoL scores were lower in women with PCOS compared with non-PCOS women at 3 months (adjusted B: −2.4, 95% CI: −4.8 to −0.06, p = 0.045) but not at 6 months. Cardiometabolic parameters did not differ between the groups. Our results showed that infertile women with PCOS and obesity and non-PCOS obese controls responded largely similarly to our lifestyle intervention and achieved the same level of improvement in markers of cardiometabolic health.
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After three months of an energy-restricted and physical activity intervention, individuals with PCOS had significantly lower body weight, BMI, WC, hip circumference, WHR, HOMA-IR, LDL-C, and insulin concentrations compared to baseline.
“After three months of an energy-restricted (600 kcal/day deficit) and physical activity (30 min, two to three times per week) intervention, individuals with PCOS had significantly lower body weight, BMI, WC, hip circumference, WHR, HOMA-IR, LDL-C, and insulin concentrations compared to baseline [104]”
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 [104]
Methods §2.2 describes an approximately 600 kcal/day reduction and at least 30 minutes of moderate activity two to three times weekly. Results §3 reports statistically significant weight or BMI decreases at three months and says cardiometabolic markers improved from baseline in both groups. It does not establish statistically significant three-month decreases in each listed measure for women with PCOS, particularly waist and hip circumference, WHR, LDL-C, insulin, and HOMA-IR; the cited supplementary table is not present in the supplied passages. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAt six months, changes in insulin concentrations and HOMA-IR were no longer significant, while significant decreases in systolic blood pressure and triglyceride concentrations emerged.
“at six months, the changes in insulin concentrations and HOMA-IR were no longer significant, while significant decreases in systolic blood pressure and triglyceride concentrations emerged [104]”
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 [104]
The Results (page not available) report that cardiometabolic markers improved at three and six months in both groups. They do not establish the claimed pattern: that insulin and HOMA-IR changes lost significance while significant decreases in systolic blood pressure and triglycerides emerged at six months. The reported blood-pressure difference between groups concerns diastolic, not systolic, pressure. (LLM, conf=0.76)
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References 27 · Cited by 19
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- Authors
- Wang, Z., Groen, H., Cantineau, A. E. P., van Elten, T. M., Karsten, M. D. A., van Oers, A. M., Mol, B. W. J., Roseboom, T. J., & Hoek, A.
- Affiliations
- University Medical Center Groningen (NL)
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1105 AZ Amsterdam, The Netherlands
- Amsterdam UMC Location University of Amsterdam (NL)
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, 9700 RB Groningen, The Netherlands
- Monash University (AU)
- Corresponding author
- Hoek, Annemieke
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-09-28
- Volume
- 13
- Issue
- 10
- Pages
- 3425
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC8538637
- OpenAlex
- W3203844591
- Cited by
- 19
- References
- 27
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 1
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Netherlands Organisation for Health Research and Development (50-50110-96-518)
- 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, obesity, lifestyle intervention, infertility, weight loss, quality of life, cardiometabolic health, diet, physical activity, women
- MeSH terms
- Cardiovascular Diseases, Diet, Disease Susceptibility, Female, Humans, Life Style, Netherlands, Obesity, Polycystic Ovary Syndrome, Quality of Life, Registries, Biomarkers, Exercise, Public Health Surveillance, Health Impact Assessment
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