(21-02-06) Effective weight loss and maintenance strategies in polycystic ovary syndrome.

Moran LJ, Noakes M, Clifton PM, Wittert GA, Williams G, Norman RJ.

Research Centre for Reproductive Health, Dept. Obstetrics and Gynaecology, University of Adelaide.

Background - Polycystic ovary syndrome (PCOS), a common endocrine condition in women of reproductive age, improves with weight loss but the optimal strategy for weight maintenance is unknown. Objective - To assess the use of meal replacements as a weight loss strategy and the effects of carbohydrate or fat restriction on weight maintenance, reproductive and metabolic parameters in overweight women with PCOS. Design - Overweight women with PCOS (n=43; age=32.15.2 years; weight=96.118.4 kg; meanSD) followed an 8 week weight loss regime (2 meal replacements daily) followed by a carbohydrate (<120 g/day) or fat restricted (<50 g/day) weight maintenance regime for 6 months. Both dietary groups were followed up monthly and received advice on reducing the glycemic index and saturated fat content of their diet. Weight, waist circumference, body composition (bioelectrical impedance analysis), insulin, testosterone, sex-hormone binding globulin and free androgen index (FAI) were assessed at the beginning and end of each study phase. Outcomes - Thirty two women completed the weight loss and 23 women completed the weight maintenance phase with similar dropouts in each diet group. During the weight loss phase, reductions in weight (5.62.4 kg), waist circumference (6.12.5 cm), body fat (4.12.2 kg), insulin (2.81.1 mU/L), testosterone (0.30.7 nmol/L) and FAI (3.14.6) (P<0.05) occurred. These changes were sustained during the weight maintenance phase with no differences between diet groups for any variables. At 6 months both approaches maintained a net weight loss of 4.74.6 kg. 2 pregnancies occurred during the weight maintenance phase (2 fat restricted) with 6.5 and 11.8 kg weight losses at estimated conception time. Conclusions - In conclusion, meal replacements are an effective strategy for the short-term management of PCOS. Fat and carbohydrate restriction were equally effective in maintaining weight reduction.

Asia Pac J Clin Nutr. 2005;14 Suppl:S94.

PMID: 16326590 [PubMed - in process]

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