(17-06-10) Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome.

Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC.

Boden Institute of Obesity NutritionExercisethe School of Molecular Bioscience
University of Sydney Sydney Australia.
Abstract
BACKGROUND: Women with polycystic ovarian syndrome (PCOS) are intrinsically
insulin resistant and have a high risk of cardiovascular disease and type 2
diabetes. Weight loss improves risk factors, but the optimal diet composition
is unknown. Low-glycemic index (low-GI) diets are recommended without evidence
of their clinical effectiveness. OBJECTIVE: We compared changes in insulin
sensitivity and clinical outcomes after similar weight losses after consumption
of a low-GI diet compared with a conventional healthy diet in women with PCOS.
DESIGN: We assigned overweight and obese premenopausal women with PCOS (n = 96)
to consume either an ad libitum low-GI diet or a macronutrient-matched healthy
diet and followed the women for 12 mo or until they achieved a 7% weight loss.
We compared changes in whole-body insulin sensitivity, which we assessed using
the insulin sensitivity index derived from the oral-glucose-tolerance test (ISI
(OGTT)), glucose tolerance, body composition, plasma lipids, reproductive
hormones, health-related quality of life, and menstrual cycle regularity.
RESULTS: The attrition rate was high in both groups (49%). Among completers, ISI
(OGTT) improved more with the low-GI diet than with the conventional healthy
diet (mean +/- SEM: 2.2 +/- 0.7 compared with 0.7 +/- 0.6, respectively; P =
0.03). There was a significant diet-metformin interaction (P = 0.048), with
greater improvement in ISI(OGTT) among women prescribed both metformin and the
low-GI diet. Compared with women who consumed the conventional healthy diet,
more women who consumed the low-GI diet showed improved menstrual cyclicity
(95% compared with 63%, respectively; P = 0.03). Among the biochemical
measures, only serum fibrinogen concentrations showed significant differences
between diets (P < 0.05). CONCLUSION: To the best of our knowledge, this study
provides the first objective evidence to justify the use of low-GI diets in the
management of PCOS.

Source: Am J Clin Nutr. 2010 May 19. [Epub ahead of print]

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