Objective To compare the effects of essential vs. long chain omega (n)-3 polyunsaturated fatty acids (PUFA) in polycystic ovary syndrome (PCOS). Materials/Methods In this 6-week, prospective, double-blinded, placebo (soybean oil) controlled study, 51 completers received 3.5 g n-3 PUFA/day (essential from flaxseed oil or long chain from fish oil). Anthropometric variables, cardiovascular risk factors and androgens were measured; oral glucose tolerance test (OGTT) and frequently sampled intravenous GTT (FSIVGTT) were conducted at the baseline and 6 wks. Results Between group comparisons showed significant differences in serum triglyceride response (p = 0.0368), while the changes in disposition index (DI) also tended to differ (p = 0.0621). When within group changes (after vs. before intervention) were considered, fish oil and flaxseed oil lowered serum triglyceride (p = 0.0154 and p = 0.0176, respectively). Fish oil increased glucose at 120 min of OGTT (p = 0.0355); decreased Matsuda index (p= 0.0378); and tended to decrease early insulin response during IVGTT (AIRg; p = 0.0871). Soybean oil increased glucose at 30 min (p = 0.0030) and 60 min (p = 0.0121) and AUC for glucose (p = 0.0122) during OGTT; tended to decrease AIRg during IVGTT (p= 0.0848); reduced testosterone (p = 0.0216) and tended to reduce SHBG (p = 0.0858). Fasting glucose, insulin, adiponectin, leptin or hs-CRP did not change with any intervention. Conclusions Long chain vs. essential n-3 PUFA rich oils have distinct metabolic and endocrine effects in PCOS, and therefore they should not be used inter-changeably.

Walnut supplementation may beneficially alter lipid distribution among various lipoprotein subclasses even when total plasma lipids do not change. This may be an additional mechanism underlying the antiatherogenic properties of nut intake.

Background/Objectives: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance, dyslipidemia and increased inflammation, which all benefit from dietary intake of monounsaturated and n-3 polyunsaturated fatty acids (MUFA and n-3 PUFA). Our goal was to compare the effects of MUFA-rich almonds vs n-3/n-6 PUFA-rich walnuts on metabolic and endocrine parameters in PCOS. Subjects/Methods: Thirty-one PCOS patients randomly received either walnuts or almonds containing 31 g of total fat per day for 6 weeks. At the beginning and at the end, anthropometric parameters, fasting lipids, phospholipid-fatty acids, inflammatory markers, androgens, oral glucose tolerance tests (OGTT) and frequently sampled intravenous-GTT were obtained. Results: Weight remained stable. Within group, walnuts increased the n-3/n-6 essential PUFA in the diet and plasma phospholipids. Walnuts decreased low-density lipoprotein-cholesterol by 6% from 3.76 ± 0.27 to 3.38 ± 0.22 mmol/l (P ¼ 0.05) and apoprotein B by 11% from 0.72 ± 0.04 to 0.64 ± 0.05 g/l (Po0.03). Although almonds also reduced low-density lipoprotein-cholesterol by 10% and apoprotein B by 9%, these were not significant. Walnuts increased insulin response during OGTT by 26% (Po0.02). Both walnuts and almonds increased adiponectin (walnuts from 9.5 ± 1.6 to 11.3 ± 1.8 mg per 100 ml, P ¼ 0.0241; almonds from 10.1 ± 1.5 to 12.2 ± 1.4 mg/dl, P ¼ 0.0262). Walnuts decreased HgBA1 from 5.7 ± 0.1 to 5.5 ± 0.1% (P ¼ 0.0006) with significant intergroup difference from almonds (P ¼ 0.0470). Walnuts increased sex hormone-binding globulin from 38.3±4.1 to 43.1±4.3 nmol/l (P ¼ 0.0038) and almonds reduced free androgen index from 2.6±0.4 to 1.8±0.3 (P ¼ 0.0470). Conclusion: Nut intake exerted beneficial effects on plasma lipids and androgens in PCOS.

The ad libitum 15%-fat diet resulted in significant weight loss. The euenergetic but not the ad libitum diet caused hypertriacylglycerolemia. HDL cholesterol decreased during both low-fat diets.