Plain language summary
Polycystic ovary syndrome (PCOS) is a common group of endocrine metabolic disorders in women of reproductive age, characterised by polycystic ovarian changes, sporadic ovulation and menstrual disorders. The aim of this study was to combine the Mediterranean diet (MED) model with a low-carbohydrates (LC) dietary model based on energy restriction, compared with a low-fat (LF) dietary model, in order to investigate whether this novel dietary model could provide significant improvements in reproductive endocrine and metabolic levels in overweight patients with PCOS. This study is an open-label, parallel-group randomised controlled trial design for a 12-week intervention with a 4-week follow-up. Seventy-two participants were enrolled for the study. Results showed that the LF and MED/LC dietary models were effective in modifying anthropometric parameters, reproductive endocrine levels, insulin resistance levels and lipid levels in patients with PCOS, with the MED/LC dietary model being more effective and the recovery of menstrual cycles being approximately the same in both groups. Authors conclude that the MED/LC diet model is recommended for the treatment of overweight patients with PCOS.
Abstract
OBJECTIVES To determine the therapeutic effect of a Mediterranean diet (MED) combined with a low-carbohydrate (LC) dietary model in overweight polycystic ovary syndrome (PCOS) patients. METHODS In this 12-week randomized controlled clinical trial, 72 overweight patients with PCOS were randomly assigned to one of two energy-restricted dietary models: the MED/LC diet or the Low fat (LF) diet. After the intervention, the number of the two groups returned to normal menstruation was counted. Body weight, body mass index (BMI), waist circumference, waist-hip ratio (WHR), body fat percentage (BF%), serum fasting insulin(FINS), fasting plasma glucose(FPG), insulin resistance index (HOMA-IR), quantitative insulin sensitivity index (QUIKI), total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total testosterone (TT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin (PRL) were compared between 2 groups before and after intervention. RESULTS MED/LC group had more significant reduction trend in weight (-6.10 ± 1.52 kg vs -4.79 ± 0.97 kg, P < 0.05), BMI (-2.12 ± 0.57 kg/m2 vs -1.78 ± 0.36 kg/m2, P < 0.05), WC (-6.12 ± 5.95 cm vs -3.90 ± 1.58 cm, P < 0.05), WHR (-0.06 ± 0.02 vs -0.03 ± 0.02, P < 0.05), BF% (-2.97% ± 1.78% vs -1.19% ± 0.91%, P < 0.05), TT (-0.20 ± 0.24 ng/mL vs 0.08 ± 0.11 ng/Ml, P < 0.001), LH (-5.28 ± 3.31 mIU/mL vs -3.39 ± 3.64 mIU/mL, P < 0.05), and LH/FSH (-1.18 ± 0.75 vs -0.66 ± 1.05, P < 0.05) compared with the LF group. In addition, FPG (0.05 ± 0.38 mmol/mL vs -0.50 ± 1.01 mmol/mL, P < 0.001), FINS (-4.88 ± 6.11 μU/mL vs -8.53 ± 5.61 μU/mL, P < 0.01), HOMA-IR index (-1.11 ± 1.51 vs -2.23 ± 0.25, P < 0.05), and QUIKI index (0.014 ± 0.016 vs 0.028 ± 0.019, P < 0.05) decreased significantly in the MED/LC group compared with the LF group. Comparing the changes in lipid parameters between the two groups (LF vs MED/LC), significant differences in TG (-0.33 ± 0.32 mmol vs -0.76 ± 0.97 mmol, P < 0.05), TC (-0.40 ± 1.00 mmol vs -1.45 ± 2.00 mmol, P < 0.05), and LDL-C (-0.41 ± 1.05 mmol vs -0.73 ± 0.76 mmol, P < 0.05) were observed. CONCLUSION The results of this study suggest that the MED/LC diet model is a good treatment for overweight PCOS patients, significantly restoring their menstrual cycle, improving their anthropometric parameters and correcting their disturbed endocrine levels, and its overall effectiveness is significantly better than the LF diet model. Therefore, this study recommends that the MED/LC diet model can be used in the clinical treatment of patients with overweight PCOS.
Methodological quality
Jadad score
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3
Allocation concealment
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Yes
