An Isocaloric Low Glycemic Index Diet Improves Insulin Sensitivity in Women with Polycystic Ovary Syndrome

Barr, Suzanne; Reeves, Sue; Sharp, Kay; Jeanes, Yvonne

doi:10.1016/j.jand.2013.06.347

Cited by 44 publications

(47 citation statements)

References 36 publications

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“…Beneficial effect on birth weight was already observed in non-GDM pregnant patients after a low GI diet (42). It has been shown that a low GI diet improves insulin sensitivity (43) and reduces the insulin requirement possibly due to its ability to reduce postprandial glucose excursions (44). Noteworthy, the GI in intervention groups was really low (47-49), which could be an indirect measure of dietary compliance in GDM patients.…”

Section: Discussionmentioning

confidence: 99%

Dietary Intervention in Patients With Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Clinical Trials on Maternal and Newborn Outcomes

2014

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OBJECTIVEDiet is the cornerstone treatment of patients with gestational diabetes mellitus (GDM), but its role in maternal and newborn outcomes has been scarcely studied. The purpose of this study was to analyze the efficacy of dietary interventions on maternal or newborn outcomes in patients with GDM. RESEARCH DESIGN AND METHODSA systematic review and meta-analysis of randomized clinical trials (RCTs) of dietary intervention in GDM or pregnancy with hyperglycemia was performed. MEDLINE, Embase, ClinicalTrials.gov, Cochrane, and Scopus were searched through to March 2014. The main evaluated maternal outcomes were proportion of patients using insulin and proportion of cesarean delivery; the newborn outcomes were proportion of macrosomia and hypoglycemia and newborn weight. RESULTSFrom 1,170 studies, nine RCTs, including 884 women aged 31.5 years (28.7-33.2) with 27.4 weeks (24.1-30.3) of gestation, were eligible. We divided the RCTs according to the type of dietary intervention: low glycemic index (GI) (n = 4; 257 patients), total energy restriction (n = 2; 425 patients), low carbohydrates (n = 2; 182 patients), and others (n = 1; 20 patients). Diet with low GI reduced the proportion of patients who used insulin (relative risk 0.767 [95% CI 0.597, 0.986]; P = 0.039) and the newborn birth weight (weight mean differences 2161.9 g [95% CI 2246.4, 277.4]; P = 0.000) as compared with control diet. Total restriction and low carbohydrate diets did not change either maternal or newborn outcomes. CONCLUSIONSA low GI diet was associated with less frequent insulin use and lower birth weight than control diets, suggesting that it is the most appropriate dietary intervention to be prescribed to patients with GDM.

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Section: Discussionmentioning

confidence: 99%

Dietary Intervention in Patients With Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Clinical Trials on Maternal and Newborn Outcomes

2014

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“…A number of studies have demonstrated that weight loss and diet quality may contribute to improvement of symptoms associated with PCOS 6–9 . However, whether qualitative aspects of the diet affect weight or body composition and fat distribution independent of energy restriction among women with PCOS is unclear.…”

Section: Introductionmentioning

confidence: 99%

Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS

et al. 2014

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Objective To determine if consumption of a reduced-carbohydrate (CHO) diet would result in preferential loss of adipose tissue under eucaloric conditions, and whether changes in adiposity were associated with changes in postprandial insulin concentration. Methods In a crossover-diet intervention, 30 women with PCOS consumed a reduced-CHO diet (41:19:40%energy from CHO:protein:fat) for 8 weeks and a standard diet (55:18:27) for 8 weeks. Body composition by DXA and fat distribution by CT were assessed at baseline and following each diet phase. Insulin AUC was obtained from a solid meal test (SMT) during each diet phase. Results Participants lost 3.7% and 2.2% total fat following the reduced-CHO diet and STD diet, resp. (p<0.05 for difference between diets). The reduced-CHO diet induced a decrease in subcutaneous-abdominal, intra-abdominal, and thigh-intermuscular adipose tissue (−7.1%, −4.6%, and −11.5%, resp.), and the STD diet induced a decrease in total lean mass. Loss of fat mass following the reduced CHO diet arm was associated with lower insulin AUC (p<0.05) during the SMT. Conclusions In women with PCOS, consumption of a diet lower in CHO resulted in preferential loss of fat mass from metabolically harmful adipose depots, whereas a diet high in CHO appeared to promote repartitioning of lean mass to fat mass.

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“…In a nonrandomized clinical trial, participants replaced high-GI and medium-GI with low-GI foods, and findings showed possible improvements in metabolic risk factors (ie, insulin sensitivity). 95 In conclusion, results from a few available studies suggest that consumption of low-GI foods may have a small additional beneficial impact on some outcome measures in women with PCOS.…”

Section: Gi Glycemic Load (Gl) and Pcosmentioning

confidence: 86%

“…77,79,83,86,95 Out of the five trials, two showed increased insulin sensitivity 79,95 and one showed decreased insulin levels, IR, DHEAS and high-sensitivity C-reactive protein (hsCRP) with adoption of low-GI diet. 83 Results from one trial showed that a high-protein, moderately low-carbohydrate with low and medium GL resulted in significant reductions in blood insulin (-4 mIU/L), IR (homeostatic model assessment for IR [HOMA-IR], -0.8) and hsCRP (-0.9 mg/L) levels compared to a conventional diet.…”

Section: Gi Glycemic Load (Gl) and Pcosmentioning

confidence: 99%

Nutritional support and dietary interventions for women with polycystic ovary syndrome

Papavasiliou¹,

Papakonstantinou²

2017

NDS

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Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductiveaged women, which leads to reproductive, metabolic and hormonal abnormalities. Hyperinsulinemia, insulin resistance, androgen excess, ovulatory dysfunction, polycystic ovaries, gonadotropin abnormalities, obesity, adipose tissue dysfunction, difficulty to conceive and high-risk pregnancy are the most common PCOS-associated complications. The aim of this review was to describe and evaluate the effects of dietary interventions on PCOS-associated outcomes and to provide some evidence-based dietary advice for use in clinical practice. There is no optimal diet or macronutrient composition for PCOS. However, lifestyle modification, including a small-to-moderate weight loss of 5-10% (combined diet with regular physical activity) with any dietary pattern of choice, depending on the individuals' preferences, culture, habits and metabolic needs (ie, Mediterranean diet, Dietary Approaches to Stop Hypertension [DASH] diet or moderately low-carbohydrate diets [30-45% of energy]), as well as alternative dietary interventions, including small, frequent meal (five to six meals daily) consumption at regular times, with the majority of carbohydrates consumed at lunch time or equally distributed throughout the day, seems to offer the evidence-based first-line strategy for the management of PCOS symptoms and insulin resistance. No conclusions can be drawn at this time for high protein diets, polyunsaturated fatty acids or micronutrient supplementation.

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An Isocaloric Low Glycemic Index Diet Improves Insulin Sensitivity in Women with Polycystic Ovary Syndrome

Cited by 44 publications

References 36 publications

Dietary Intervention in Patients With Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Clinical Trials on Maternal and Newborn Outcomes

Dietary Intervention in Patients With Gestational Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Clinical Trials on Maternal and Newborn Outcomes

Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS

Nutritional support and dietary interventions for women with polycystic ovary syndrome

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