Skip to main content
Top
Published in: BMC Endocrine Disorders 1/2019

Open Access 01-12-2019 | Obesity | Research article

Does a restricted energy low glycemic index diet have a different effect on overweight women with or without polycystic ovary syndrome?

Authors: Farnaz Shishehgar, Parvin Mirmiran, Maryam Rahmati, Maryam Tohidi, Fahimeh Ramezani Tehrani

Published in: BMC Endocrine Disorders | Issue 1/2019

Login to get access

Abstract

Background

Obese women with polycystic ovary syndrome (PCOS) may face additional barriers in achieving weight loss. We aimed to compare the effects of the hypocaloric low glycemic index (LGI) diet on anthropometric variables and insulin resistance in women with and without PCOS and investigate the effect of this diet on the clinical and hormonal features of PCOS women.

Methods

This interventional study was carried out at the Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Of 108 women invited for the purpose of the present study, 62 participants (PCOS = 28, non-PCOS = 34) followed a 24-week energy restricted LGI diet. Anthropometric, biochemical, hormonal and clinical measurements were documented at baseline, 12 weeks and 24 weeks with intervention.

Results

The percentages of weight loss achieved by both the PCOS and non-PCOS groups did not differ significantly (PCOS: -8.04% vs. non-PCOS: -8.09%). No significant difference in decrease of homeostatic model assessment of insulin resistance (HOMA-IR) was observed between the two groups (PCOS = − 0.83 ± 0.33, non PCOS = − 0.79 ± 0.28, P = 0.83). In PCOS women, significant reduction in total testosterone (− 0.91 ± 0.33 nmol/L, P = 0.006), FAI (− 4.47 ± 1.1, P < 0.001) and increase in SHBG (38.98 ± 11.02 nmol/L, P < 0.001) were observed. Menstrual irregularity was improved in 80% of women with PCOS and a significant decrease (32.1%) in occurrence of acne was reported.

Conclusions

This diet has equally beneficial effects on anthropometric and metabolic characteristics of overweight women with and without PCOS.

Trial registration

This study is registered in the Iranian Randomized Clinical Trials Registry (IRCT, code: IRCT201609212990​9N1).
Literature
1.
go back to reference Skiba MA, Islam RM. Bell RJ1, Davis SR. understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(6):694–709.CrossRef Skiba MA, Islam RM. Bell RJ1, Davis SR. understanding variation in prevalence estimates of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2018;24(6):694–709.CrossRef
2.
go back to reference Lim SS, Norman RJ, Davies MJ, Moran LJ. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev. 2013;14:95–109.CrossRef Lim SS, Norman RJ, Davies MJ, Moran LJ. The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Rev. 2013;14:95–109.CrossRef
3.
go back to reference Thomson RL, Buckley JD, Noakes M, Clifton PM, Norman RJ, Brinkworth GD. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93(9):3373–80.CrossRef Thomson RL, Buckley JD, Noakes M, Clifton PM, Norman RJ, Brinkworth GD. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93(9):3373–80.CrossRef
4.
go back to reference Augustin LS, Kendall CW, Jenkins DJ, Willett WC, Astrup A, Barclay AW, Björck I, Brand-Miller JC, Brighenti F, Buyken AE. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis. 2015;25:795e815.CrossRef Augustin LS, Kendall CW, Jenkins DJ, Willett WC, Astrup A, Barclay AW, Björck I, Brand-Miller JC, Brighenti F, Buyken AE. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis. 2015;25:795e815.CrossRef
5.
go back to reference Szczuko M, Zapałowska-Chwyć M, Maciejewska D, Drozd A, Starczewski A, Stachowska E. High glycemic index diet in PCOS patients. The analysis of IGF I and TNF-α pathways in metabolic disorders. Med Hypotheses. 2016;96:42–7.CrossRef Szczuko M, Zapałowska-Chwyć M, Maciejewska D, Drozd A, Starczewski A, Stachowska E. High glycemic index diet in PCOS patients. The analysis of IGF I and TNF-α pathways in metabolic disorders. Med Hypotheses. 2016;96:42–7.CrossRef
6.
go back to reference Di Pino A, Currenti W, Urbano F, Scicali R, Piro S, Purrello F, Rabuazzo AM. High intake of dietary advanced glycation end-products is associated with increased arterial stiffness and inflammation in subjects with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2017;27(11):978–84.CrossRef Di Pino A, Currenti W, Urbano F, Scicali R, Piro S, Purrello F, Rabuazzo AM. High intake of dietary advanced glycation end-products is associated with increased arterial stiffness and inflammation in subjects with type 2 diabetes. Nutr Metab Cardiovasc Dis. 2017;27(11):978–84.CrossRef
7.
go back to reference Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynaecol. 2010;31(1):24–31.CrossRef Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynaecol. 2010;31(1):24–31.CrossRef
8.
go back to reference Teede HJ, Joham AE, Paul E, Moran LJ, Loxton D, Jolley D, Lombard C. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity. 2013;21:1526–32.CrossRef Teede HJ, Joham AE, Paul E, Moran LJ, Loxton D, Jolley D, Lombard C. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity. 2013;21:1526–32.CrossRef
9.
go back to reference Japur CC, Diez-Garcia RW, Oliveira Penaforte FR. Imbalance between postprandial ghrelin and insulin responses to an ad libitum meal in obese women with polycystic ovary syndrome. Reprod Sci. 2014;21(8):1020–6.CrossRef Japur CC, Diez-Garcia RW, Oliveira Penaforte FR. Imbalance between postprandial ghrelin and insulin responses to an ad libitum meal in obese women with polycystic ovary syndrome. Reprod Sci. 2014;21(8):1020–6.CrossRef
10.
go back to reference Shishehgar F, Tehrani FR, Mirmiran P, Hajian S, Baghestani AR, Moslehi N. Comparison of dietary intake between polycystic ovary syndrome women and controls. Global J Health Sci. 2016;8(9):302–11.CrossRef Shishehgar F, Tehrani FR, Mirmiran P, Hajian S, Baghestani AR, Moslehi N. Comparison of dietary intake between polycystic ovary syndrome women and controls. Global J Health Sci. 2016;8(9):302–11.CrossRef
11.
go back to reference Jeanes Y, Barr S, Sharp K, Reeves S. Eating behaviours and BMI in women with polycystic ovary syndrome. Proc Nutr Soc. 2010;69(OCE1):E57.CrossRef Jeanes Y, Barr S, Sharp K, Reeves S. Eating behaviours and BMI in women with polycystic ovary syndrome. Proc Nutr Soc. 2010;69(OCE1):E57.CrossRef
12.
go back to reference The Rotterdam EA-SPCWG Revised. 2003 Consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.CrossRef The Rotterdam EA-SPCWG Revised. 2003 Consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25.CrossRef
13.
go back to reference Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values. Am J Clin Nutr. 2002;76:5–56.CrossRef Foster-Powell K, Holt SH, Brand-Miller JC. International table of glycemic index and glycemic load values. Am J Clin Nutr. 2002;76:5–56.CrossRef
14.
go back to reference Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Position statement: utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab. 2007;92:405–13.CrossRef Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Position statement: utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab. 2007;92:405–13.CrossRef
15.
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef
16.
go back to reference Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol. 1981;140(7):815–30.CrossRef Hatch R, Rosenfield RL, Kim MH, Tredway D. Hirsutism: implications, etiology, and management. Am J Obstet Gynecol. 1981;140(7):815–30.CrossRef
17.
go back to reference International Physical Activity Questionnaire. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire - Short and Long Forms. Retrieved 18 Jan 2014, from http://www.ipaq.ki.se. 2005. International Physical Activity Questionnaire. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire - Short and Long Forms. Retrieved 18 Jan 2014, from http://​www.​ipaq.​ki.​se. 2005.
18.
go back to reference Robinson S, Chan SP, Spacey S, Anyaoku V, Johnston DG, Franks S. Postprandial thermogenesis is reduced in polycystic ovary syndrome and is associated with increased insulin resistance. Clin Endocrinol. 1992;36:537–43.CrossRef Robinson S, Chan SP, Spacey S, Anyaoku V, Johnston DG, Franks S. Postprandial thermogenesis is reduced in polycystic ovary syndrome and is associated with increased insulin resistance. Clin Endocrinol. 1992;36:537–43.CrossRef
19.
go back to reference Blay SL, Aguiar JV, Passos IC. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Europsychiatr Dis Treat. 2016;8(12):2895–903.CrossRef Blay SL, Aguiar JV, Passos IC. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Europsychiatr Dis Treat. 2016;8(12):2895–903.CrossRef
20.
go back to reference Churchill SJ, Wang ET, Bhasin G, Alexander C, Bresee C, Pall M, Azziz R, Mathur R, Pisarska MD. Basal metabolic rate in women with PCOS compared to eumenorrheic controls. Clin Endocrinol. 2015;83(3):384–8.CrossRef Churchill SJ, Wang ET, Bhasin G, Alexander C, Bresee C, Pall M, Azziz R, Mathur R, Pisarska MD. Basal metabolic rate in women with PCOS compared to eumenorrheic controls. Clin Endocrinol. 2015;83(3):384–8.CrossRef
21.
go back to reference Radulian G, Rusu E, Dragomir A, Posea M. Metabolic effects of low glycaemic index diets. Nutr J. 2009;8:5.CrossRef Radulian G, Rusu E, Dragomir A, Posea M. Metabolic effects of low glycaemic index diets. Nutr J. 2009;8:5.CrossRef
22.
go back to reference Venn BJ, Green TJ. Glycemic index and glycemic load: measurement issues and their effect on diet-disease relationships. Eur J Clin Nutr. 2007;61(Suppl 1):S122–31.CrossRef Venn BJ, Green TJ. Glycemic index and glycemic load: measurement issues and their effect on diet-disease relationships. Eur J Clin Nutr. 2007;61(Suppl 1):S122–31.CrossRef
23.
go back to reference Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92:83–92.CrossRef Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92:83–92.CrossRef
24.
go back to reference Tiikkainen M, Bergholm R, Vehkavaara S, Rissanen A, Hakkinen AM, Tamminen M, Teramo K, YkiJarvinen H. Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content. Diabetes. 2003;52:701–7.CrossRef Tiikkainen M, Bergholm R, Vehkavaara S, Rissanen A, Hakkinen AM, Tamminen M, Teramo K, YkiJarvinen H. Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content. Diabetes. 2003;52:701–7.CrossRef
25.
go back to reference Reaven G, Segal K, Hauptman J, Boldrin M, Lucas C. Effect of orlistat assisted weight loss in decreasing coronary heart disease risk in patients with syndrome X. Am J Cardiol. 2001;87:827–31.CrossRef Reaven G, Segal K, Hauptman J, Boldrin M, Lucas C. Effect of orlistat assisted weight loss in decreasing coronary heart disease risk in patients with syndrome X. Am J Cardiol. 2001;87:827–31.CrossRef
26.
go back to reference Herriot AM, Whitcroft S, Jeanes Y. An retrospective audit of patients with polycystic ovary syndrome: the effects of a reduced glycaemic load diet. J Hum Nutr Diet. 2008;21:337–45.CrossRef Herriot AM, Whitcroft S, Jeanes Y. An retrospective audit of patients with polycystic ovary syndrome: the effects of a reduced glycaemic load diet. J Hum Nutr Diet. 2008;21:337–45.CrossRef
27.
go back to reference Moran LJ, Noakes M, Wittert GA, Clifton PM, Norman RJ. Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome. Reprod Biomed. 2012;25(5):500–3.CrossRef Moran LJ, Noakes M, Wittert GA, Clifton PM, Norman RJ. Weight loss and vascular inflammatory markers in overweight women with and without polycystic ovary syndrome. Reprod Biomed. 2012;25(5):500–3.CrossRef
28.
go back to reference Lo JC, Feigenbaum SL, Yang J, Pressman AR, Selby JV, Go AS. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357–63.CrossRef Lo JC, Feigenbaum SL, Yang J, Pressman AR, Selby JV, Go AS. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357–63.CrossRef
29.
go back to reference Rouhani MH, Kelishadi R, Hashemipour M, Esmaillzadeh A, Azadbakht L. The effect of low glycemic index diet on body weight status and blood pressure in overweight adolescent girls: a randomized clinical trial. Nutr Res Pract. 2013;7(5):385–92.CrossRef Rouhani MH, Kelishadi R, Hashemipour M, Esmaillzadeh A, Azadbakht L. The effect of low glycemic index diet on body weight status and blood pressure in overweight adolescent girls: a randomized clinical trial. Nutr Res Pract. 2013;7(5):385–92.CrossRef
30.
go back to reference Phy JL, Pohlmeier AM, Cooper JA, Watkins P, Spallholz J, Harris KS, Berenson AB, Boylan M. Low starch/low dairy diet results in successful treatment of obesity and co-morbidities linked to polycystic ovary syndrome (PCOS). Obes Weight Loss Ther. 2015;5:2. Phy JL, Pohlmeier AM, Cooper JA, Watkins P, Spallholz J, Harris KS, Berenson AB, Boylan M. Low starch/low dairy diet results in successful treatment of obesity and co-morbidities linked to polycystic ovary syndrome (PCOS). Obes Weight Loss Ther. 2015;5:2.
31.
go back to reference Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33:981–103.CrossRef Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33:981–103.CrossRef
32.
go back to reference Ornstein RM, Copperman NM, Jacobson MS. Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2011;24:161–5.CrossRef Ornstein RM, Copperman NM, Jacobson MS. Effect of weight loss on menstrual function in adolescents with polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2011;24:161–5.CrossRef
33.
go back to reference Lass N, Kleber M, Winkel K, Wunsch R, Reinehr TH. Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls. J Clin Endocrinol Metab. 2011;96(11):3533–40.CrossRef Lass N, Kleber M, Winkel K, Wunsch R, Reinehr TH. Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls. J Clin Endocrinol Metab. 2011;96(11):3533–40.CrossRef
34.
go back to reference Moran LJ, Noakes M, Clifton PM, Tomlinson L, Norman RJ. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(2):812–9.CrossRef Moran LJ, Noakes M, Clifton PM, Tomlinson L, Norman RJ. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88(2):812–9.CrossRef
35.
go back to reference Kwon HH, Yoon JY, Hong JS, Jung JY, Park MS, Suh DH. Clinical and histological effect of a low Glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial. Acta Derm Venereol. 2012;92:241–6.CrossRef Kwon HH, Yoon JY, Hong JS, Jung JY, Park MS, Suh DH. Clinical and histological effect of a low Glycaemic load diet in treatment of acne vulgaris in Korean patients: a randomized, controlled trial. Acta Derm Venereol. 2012;92:241–6.CrossRef
36.
go back to reference Melnik BC, John SM, Plewig G. Acne: risk Indicator for increased body mass index and insulin resistance. Acta Derm Venereol. 2013;93:644–9.CrossRef Melnik BC, John SM, Plewig G. Acne: risk Indicator for increased body mass index and insulin resistance. Acta Derm Venereol. 2013;93:644–9.CrossRef
37.
go back to reference Seyam E, Hefzy E. Long-term effects of combined simvastatin and metformin treatment on the clinical abnormalities and ovulation dysfunction in single young women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34(12):1073–80.CrossRef Seyam E, Hefzy E. Long-term effects of combined simvastatin and metformin treatment on the clinical abnormalities and ovulation dysfunction in single young women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34(12):1073–80.CrossRef
38.
go back to reference Seyam E, Al Gelany S, Abd A, Ghaney A, Mohamed MAA, Youseff AM, Ibrahim EM, Khalifa EM, Hefzy E. Evaluation of prolonged use of statins on the clinical and biochemical abnormalities and ovulation dysfunction in single young women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34(7):589–96.CrossRef Seyam E, Al Gelany S, Abd A, Ghaney A, Mohamed MAA, Youseff AM, Ibrahim EM, Khalifa EM, Hefzy E. Evaluation of prolonged use of statins on the clinical and biochemical abnormalities and ovulation dysfunction in single young women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34(7):589–96.CrossRef
39.
go back to reference Scicali R, Di Pino A, Ferrara V, Urbano F, Piro S, Rabuazzo AM, Purrello F. New treatment options for lipid-lowering therapy in subjects with type 2 diabetes. Acta Diabetol. 2018;55(3):209–18.CrossRef Scicali R, Di Pino A, Ferrara V, Urbano F, Piro S, Rabuazzo AM, Purrello F. New treatment options for lipid-lowering therapy in subjects with type 2 diabetes. Acta Diabetol. 2018;55(3):209–18.CrossRef
Metadata
Title
Does a restricted energy low glycemic index diet have a different effect on overweight women with or without polycystic ovary syndrome?
Authors
Farnaz Shishehgar
Parvin Mirmiran
Maryam Rahmati
Maryam Tohidi
Fahimeh Ramezani Tehrani
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2019
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/s12902-019-0420-1

Other articles of this Issue 1/2019

BMC Endocrine Disorders 1/2019 Go to the issue