Dietary Composition in the Treatment of Polycystic Ovary Syndrome: A Systematic Review to Inform Evidence-Based Guidelines

Moran, Lisa J.; Ko, Henry; Misso, Marie; Marsh, Kate; Noakes, Manny; Talbot, Mac; Frearson, Meredith; Thondan, Mala; Stepto, Nigel K.; Teede, Helena

doi:10.1016/j.jand.2012.11.018

Cited by 200 publications

(134 citation statements)

References 58 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…These parameters tended to improve in the FF-Exercise group (TG (K30%), apoB48 (K28%) and apoB100 (K11.5%)) but did not reach statistical significance compared to the FF-Sedentary group, indicating that a low exercise level in free-feeding obese PCOS animals may potentiate improvements in blood lipids if intervened for a longer duration. These findings are consistent with clinical reports that show low to moderate physical activity improves dyslipidemia in women with PCOS in the absence of changes in body weight and body composition (Moran et al 2013a,b, Sprung et al 2013 The obese PCOS-prone animals exhibit severe IR (Shi et al 2009). ER-Exercise tended to reduce (although not significantly) fasting plasma insulin (22%) and total insulin secretion (50%) in response to a meal challenge compared to FF-Sedentary animals.…”

Section: Hypothalamic Arc Neuropeptide and Peptide Expressionsupporting

confidence: 84%

“…In adulthood (O12 weeks of age), when animals have developed obesity and a PCOS-like phenotype, the use of enforced treadmill exercise may be more effective to improve cardiometabolic and reproductive indices. Similarly, in the clinical setting strong encouragement of high-intensity exercise may provide additional health benefits to dietary caloric restriction (Altieri et al 2013, Moran et al 2013a. The findings of this current study may further translate to lifestage-epigenetic modulation of the hypothalamic-pituitary-gonadal axis via dietary energy restriction and exercise programs to target young adolescent girls diagnosed with PCOS.…”

Section: Hypothalamic Arc Neuropeptide and Peptide Expressionmentioning

confidence: 72%

“…PCOS patients have a high incidence of IR and this has been shown to be independent of body weight; however, IR is more common and exacerbated in obese PCOS patients (Marcondes et al 2007, Hart et al 2011, Mehrabian et al 2011. Lifestyle interventions focusing on diet and exercise are considered first-line treatments to target reductions in total body weight in the overweight-obese PCOS phenotype (Moran et al 2011(Moran et al , 2013a. Several studies implementing dietary caloric restriction in overweight-obese women with PCOS have shown some improvements in hyperinsulinemia, hyperlipidemia, menstrual cyclicity and fertility (Thomson et al 2008, Hamayeli Mehrabani et al 2010, Altieri et al 2013.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model

Diané

Kupreeva

Borthwick

et al. 2015

Journal of Endocrinology

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) is one of the most common endocrine-metabolic disorders in women of reproductive age characterized by ovulatory dysfunction, hyperandrogenism and cardiometabolic risk. The overweight-obese PCOS phenotype appears to have exacerbated reproductive dysfunction and cardiometabolic risk. In overweight-obese adult women with PCOS, exercise and energy restricted diets have shown limited and inconsistent effects on both cardiometabolic indices and reproductive outcomes. We hypothesized that an early lifestyle intervention involving exercise and dietary energy restriction to prevent or reduce the propensity for adiposity would modulate reproductive indices and cardiometabolic risk in an obese PCOS-prone rodent model. Weanling obese PCOS-prone and Lean-Control JCR:LA-cp rodents were given a chow diet ad libitum or an energyrestricted diet combined with or without voluntary exercise (4 h/day) for 8 weeks. Dietary energy restriction and exercise lowered total body weight gain and body fat mass by 30% compared to free-fed sedentary or exercising obese PCOS-prone animals (P!0.01). Energy restriction induced an increase in exercise intensity compared to free-feeding plus exercise conditions. Energy restriction and exercise decreased fasting plasma triglycerides and apoB48 concentrations in obese PCOS-prone animals compared to free-fed and exercise or sedentary groups. The energy restriction and exercise combination in obese PCOS-prone animals significantly increased plasma sex-hormone binding globulin, hypothalamic cocaine-and amphetamine-regulated transcript (CART) and Kisspeptin mRNA expression to levels of the Lean-Control group, and this was further associated with improvements in estrous cyclicity. The combination of exercise and dietary energy restriction when initiated in early life exerts beneficial effects on cardiometabolic and reproductive indices in an obese PCOS-prone rodent model, and this may be associated with normalization of the hypothalamic neuropeptides, Kisspeptin and CART.

show abstract

Section: Hypothalamic Arc Neuropeptide and Peptide Expressionsupporting

confidence: 84%

Section: Hypothalamic Arc Neuropeptide and Peptide Expressionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model

Diané

Kupreeva

Borthwick

et al. 2015

Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…Along these lines, a meta-analysis has demonstrated the benefits of dietary modification in young women with PCOS [209]. Increasing physical activity from moderate to vigorous is effective in reducing the development of metabolic syndrome in normal-weight girls [209].…”

Section: Treatment Of Pcosmentioning

confidence: 99%

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Ibáñez¹,

et al. 2017

View full text Add to dashboard Cite

This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)¹. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

show abstract

“…In addition there were associated improvements in serum biochemistry, blood pressure and self-esteem scores 37 38. It is important to highlight diet, with an emphasis on developing a weight maintenance/weight loss cycle involving regular small healthy meals, not skipping meals and avoiding refined carbohydrate 39. However, increased physical activity should always be a key message in weight management.…”

Section: A Framework For the Management Of Pcosmentioning

confidence: 99%

A guide to understanding polycystic ovary syndrome (PCOS)

Duncan

2014

J Fam Plann Reprod Health Care

View full text Add to dashboard Cite

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder affecting women of reproductive age. Some 20% of women will have polycystic ovaries on an ultrasound scan and around 7% of women have the additional clinical or biochemical features of PCOS. As a complex multisystem disorder its background can be confusing to understand. They key feature, however, is an increased production of androgen by the ovaries. This review uses ovarian biology to describe a strategy to aid understanding and explanation of PCOS. This framework can be also be used to teach about PCOS and to inform different approaches to its management. INTRODUCTIONPolycystic ovary syndrome (PCOS) is the commonest endocrine disorder to affect women in their reproductive years. Around 20% of women have the characteristic appearance of polycystic ovaries on ultrasound scans 1 and 7-8% have the additional clinical and biochemical features of PCOS itself.2 As obesity increases the proportion of women with polycystic ovaries who develop the syndrome, the current epidemic of obesity is likely to make PCOS even more common.

show abstract

Dietary Composition in the Treatment of Polycystic Ovary Syndrome: A Systematic Review to Inform Evidence-Based Guidelines

Cited by 200 publications

References 58 publications

Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model

Cardiometabolic and reproductive benefits of early dietary energy restriction and voluntary exercise in an obese PCOS-prone rodent model

An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

A guide to understanding polycystic ovary syndrome (PCOS)

Contact Info

Product

Resources

About