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Cutting Calories Alone Eases PCOS
Regardless of Diet, Losing Weight Helps Polycystic Ovary Syndrome

By Jennifer Warner
WebMD Medical News Reviewed By Brunilda Nazario, MD
on Thursday, January 23, 2003

Jan. 23, 2003 -- No matter how you choose to do it, cutting back on calories and exercising to lose extra weight is bound to help women lessen the health problems associated with polycystic ovary syndrome (PCOS), according to new research.

PCOS is a common hormonal disorder that affects about 5-10% of women in their reproductive years, is a frequent cause of infertility, and is the most common endocrine disorder in women in this age group. A new study found that women who reduce their overall calorie intake --regardless of the type of diet they follow -- can improve their chances at conceiving a child as well as improve their overall health.

Until now, researchers say there was no scientific evidence that following a particular type of diet, such as a high-protein, low-carbohydrate one or a low-protein, high-carbohydrate one, would provide greater benefits for women with PCOS by reducing symptoms like insulin resistance, elevated cholesterol, and obesity. These symptoms can eventually lead to more serious health problems, such as heart disease, type 2 diabetes, and infertility.

In their study, researchers at the University of Adelaide in Australia compared the impacts of high- and low-protein diets in 28 overweight women with PCOS and found both diets were equally effective at stimulating weight loss and improving symptoms of the disease.

"This study shows that the diet type is much less important that the actual restriction of calories," says Sarah Berga, MD, director of the division of reproductive endocrinology and infertility at the University of Pittsburgh School of Medicine.

The study appears in the February 2003 issue of The Journal of Clinical Endocrinology & Metabolism. Berga commented on it today in New York at a hormonal disorders briefing sponsored by the American Medical Association in association with the Pituitary Network Association.

Each of the women was randomly assigned to follow either a low-protein diet that consisted of 55% carbohydrates, 15% protein, and 30% fat or a high-protein diet of 40% carbohydrates, 30% protein, and 30% fat for 16 weeks. The first 12 weeks of the program restricted intake to about 1,400 calories to promote weight loss; the last four weeks focused on weight maintenance.

The women were also expected to exercise at least three times a week.

By the end of the study period, the women who followed either diet lost an average of 14.4% of their total body fat and 12.5% of abdominal fat, which is a frequent symptom of PCOS and a high risk factor for heart disease.

Both groups of women also saw improvements in their insulin resistance, and their fasting glucose levels decreased by about 20%. These benefits began during the diet phase of the study and continued during the maintenance phase.

In addition, nearly half of the women experienced an improvement in their menstruation cycle, which can improve the chances of conception. Skipped or missed periods is a common problem caused by PCOS.

The only difference between the two diet groups was in the area of cholesterol levels. Women who followed the low-protein diet had a 10% decrease in HDL or "good" cholesterol levels, but women on the high-protein diet were protected from this drop.

Berga says this study shows that it's not really the amount of weight or type of diet women follow that makes the biggest difference in improving the symptoms of PCOS, but it's how those lifestyle changes affect insulin resistance that counts. Researchers found women who experienced a drop in their insulin levels also had the biggest improvement in their PCOS symptoms.

"These findings hint that women with PCOS should lose enough weight to improve their insulin action," says Berga. "It gives us something to shoot for. You can get away with restricting whatever you want to restrict, but it's the actual calorie restriction that matters for improving insulin resistance."
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SOURCES: The Journal of Clinical Endocrinology & Metabolism, February 2003 • Sarah Berga, MD, director of the division of reproductive endocrinology and infertility at the University of Pittsburgh School of Medicine.

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