Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention

Loos, Alexandra L.P. Dietz de; Jiskoot, Geranne; Timman, Reinier; Beerthuizen, Annemerle; Busschbach, Jan J. V.; Laven, Joop S.E.

doi:10.1016/j.rbmo.2021.05.008

Cited by 18 publications

(16 citation statements)

References 58 publications

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“…Although several studies have reported the importance of lifestyle management among patients with PCOS, 12 13 these studies did not clearly describe multidimensional life management with PCOS. Most studies focused on only one dimension of behaviour assessment, mainly nutritional intake and physical activity.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study

et al. 2022

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ObjectiveThis study aimed to investigate health-promoting lifestyle status and associated risk factors in patients with polycystic ovary syndrome (PCOS).DesignCross-sectional study.SettingThis study was conducted at a tertiary hospital in Guizhou, China from December 2020 to June 2021.ParticipantsA total of 366 participants (18–45 years) diagnosed with PCOS were recruited from the outpatient departments.MeasuresSociodemographic characteristics were collected, and health-promoting behaviours were measured using the Health-Promoting Lifestyle Profile scale. Anxiety status was measured using the Zung’s Self-Rating Anxiety Scale, depression status using the Zung’s Self-Rating Depression Scale and self-efficacy using the Managing Chronic Disease 6-Item Scale. Multiple stepwise linear regression was conducted to assess the risk factors associated with the health-promoting behaviours of the study participants.ResultsThe participants had a poor health-promoting behaviours (88.54±17.44). The highest score in all dimensions was spiritual growth (16.68±4.98), while physical activity (12.71±2.68) was the lowest. Multiple regression analysis revealed that the main factors influencing the development and maintenance of health-promoting behaviours among participants were education (B=10.788, p<0.001), depression (B=−0.377, p<0.001), anxiety (B=−0.333, p<0.001) and self-efficacy (B=0.938, p=0.002). The model showed 74.40% variance shared between the dependent and independent variables (R2=74.40, F=264.633, p<0.001).ConclusionHealth-promoting behaviours are minimal among patients with PCOS, and improving negative emotions and enhancing behavioural awareness and self-efficacy are necessary to increase the adoption of health-promoting behaviours among patients with PCOS.Trial registration numberChiCTR2000034572.

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Section: Introductionmentioning

confidence: 99%

Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study

et al. 2022

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“…Weight [ 19 ], emotional well-being [ 24 ], phenotypical characteristics [ 25 ], and metabolic health [ 26 ] all were shown to improve more in the LSI groups compared to CAU over the course of our study. It is believed that the pre-pregnancy optimization of these factors should improve reproductive and obstetric outcomes in women with PCOS as well as in their offspring [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcomes in Women with PCOS: Follow-Up Study of a Randomized Controlled Three-Component Lifestyle Intervention

Loos

Jiskoot

Louwers

et al. 2023

JCM

Self Cite

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Women with polycystic ovary syndrome (PCOS) and excess weight often present with reproductive derangements. The first-line treatment for this population is a multi-component lifestyle intervention. This follow-up study of a randomized controlled trial based on data from the Dutch Perinatal registry was conducted to study the effect of a one-year three-component (cognitive behavioral therapy, healthy diet, and exercise) lifestyle intervention on pregnancy outcomes in women with PCOS and overweight or obesity. Women diagnosed with PCOS, a BMI ≥ 25 kg/m², and a wish to conceive were randomized to either three-component lifestyle intervention (LSI, n = 123), and care as usual (CAU, n = 60) where they were encouraged to lose weight autonomously. Conception resulting in live birth was 39.8% (49/123) within LSI and 38.3% (23/60) within CAU (p = 0.845). In total, 58.3% conceived spontaneously. Gestational diabetes (LSI: 8.2% vs. CAU: 21.7%, p = 0.133), hypertensive disorders (LSI: 8.2% vs. CAU 13.0%, p = 0.673), and preterm birth (LSI: 12.2% vs. CAU: 17.4%, p = 0.716) rates were all lower in LSI compared to CAU. This follow-up study showed no significant differences in conception resulting in live birth rates between LSI and CAU. Nonetheless, a large proportion eventually conceived spontaneously. Moreover, after LSI, the number of uneventful pregnancies was lower compared to care as usual.

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“…The between groups weight loss differences did not translate into differences in ovulation dysfunction. A post‐hoc analysis showed that greater weight loss was associated with a lower chance of ovulation dysfunction 6 …”

Section: Lifestyle Behavioural Interventionsmentioning

confidence: 99%

“…A post-hoc analysis showed that greater weight loss was associated with a lower chance of ovulation dysfunction. 6 The potential importance of macronutrient composition in diet has been extensively studied and there is currently insufficient evidence to support a particular macronutrient dietary composition in women with PCOS for weight loss. 7 Very low energy diets (VLEDs) can lead to significant weight reductions of >15% after 12 weeks in women with PCOS.…”

Section: Lifestyle Behavioural Interventionsmentioning

confidence: 99%

How to manage weight loss in women with obesity and PCOS seeking fertility?

Hazlehurst

Singh

Bhogal

et al. 2022

Clinical Endocrinology

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Obesity exacerbates the phenotype of polycystic ovarian syndrome (PCOS) including infertility as well as reducing the efficacy and access to fertility treatments. Weight management is, therefore, a key component of treatment for women with PCOS and coexistent obesity. Many women with PCOS describe significant difficulty losing weight and treatment options are limited. The first‐line treatment is lifestyle interventions though the weight loss and any impact on fertility are limited. No one dietary strategy can be preferentially recommended based on current evidence. While very low energy diets can result in significant weight loss the evidence for impact on fertility is limited. Pharmacotherapy, including a range of treatments can result in marked weight loss and there is some evidence of improved rates of conception including spontaneous and in response to assisted reproduction treatment. As with pharmacotherapy, data regarding bariatric surgery is largely from nonrandomized studies and though the significant weight loss is anticipated to improve fertility the available data prevents firm conclusions. Clinicians and patients must consider the magnitude of weight loss to be targeted as well as the anticipated fertility treatment required and the timeline of treatment when deciding upon the personalized weight loss strategy. Clinicians and patients should be confident in targeting the most appropriate treatment early in the patient's management to avoid unnecessary delays.

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Improvements in PCOS characteristics and phenotype severity during a randomized controlled lifestyle intervention

Cited by 18 publications

References 58 publications

Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study

Factors affecting the adoption of health-promoting behaviours in patients with polycystic ovary syndrome: a cross-sectional study

Pregnancy Outcomes in Women with PCOS: Follow-Up Study of a Randomized Controlled Three-Component Lifestyle Intervention

How to manage weight loss in women with obesity and PCOS seeking fertility?

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