Diet Habits and Their Relationship With Metabolism in PCOS
Diet Habits and Their Relationship With Metabolism in PCOS
Objective This study investigates energy intake, macronutrient composition and habitual food choices in overweight/obese women with polycystic ovary syndrome (PCOS) and controls similar for age and body mass index (BMI), and their relationship with hormonal and metabolic parameters.
Design Case–control study carried out in an academic hospital in Bologna, Italy.
Patients One-hundred obese or overweight (BMI >25 kg/m) women with PCOS, diagnosed according to Rotterdam criteria, and 100 age- and BMI-matched controls.
Measurements Dietary habits were investigated by means of the 7 days food diary. Fasting hormones and metabolic parameters were investigated in all subjects.
Results We showed that diet does not differ between the two groups as regards energy, macronutrient and advanced glycosylated end product intake, except for a lower percentage of energy from lipids and a higher intake of fibres by PCOS women. PCOS women were characterized by a higher consumption of cheese and high-glycaemic index starchy sweets and a preference for raw oil rather than other cooked fats, compared to controls. The PCOS or control status influenced some of the relationships between dietary components, food choices and metabolic parameters, particularly insulinAUC and HDL-cholesterol.
Conclusions This study did not find major differences in dietary habits between PCOS and normoandrogenic control women. Our findings support the hypothesis that specific foods may influence metabolic and hormonal pattern and that this relationship may be differently regulated in PCOS and normoandrogenic women; however, they give little support to the hypothesis of a strong dependence of PCOS status on nutritional factors.
Adequate nutritional status is a critical determinant of the onset and maintenance of normal reproductive function. Obesity is encountered in 30–70% of women affected by polycystic ovary syndrome (PCOS), one of the most common endocrinopathies in women of fertile age, and its presence significantly modifies both clinical and laboratory expression of the syndrome. Moreover, women with PCOS have been shown to have higher amounts of visceral fat compared to healthy controls, even when they are normal weight. The importance of obesity in the pathophysiology of PCOS is definitely confirmed by the fact that even modest to moderate weight loss may improve all features of PCOS, including insulin resistance, lipid abnormalities, androgen excess, menses and ovulatory rates, and favour the complete recovery of the PCOS phenotype in some of them.
The association between abnormal dietary habits and history and risk for PCOS has not been widely examined, and available data are still sparse and contradictory. Most researchers found that daily energy intake and diet composition did not differ in the majority of PCOS women compared to controls, although minor discrepancies, regarding specific nutrients and food categories, or subgroups of women, were reported. Interestingly, an increased risk of anovulatory infertility has been associated with a higher consumption of animal proteins, total carbohydrates and foods with a high glycaemic index, low-fat dairy foods and cola beverages in different reports from the Nurses' Health Study cohort. However, whether women with PCOS have different patterns of dietary intake and food preferences with respect to the unaffected population is far from being established.
Diet is also a major source of advanced glycosylated end products (AGEs) and other oxidants. Meals cooked at high temperatures and under dry conditions have the highest AGE content, especially if the fat content is high. Dietary AGEs contribute to a state of elevated oxidative stress and inflammation and have been shown to play a role in promoting diabetes, insulin resistance and atherosclerosis in mice. Recent data have shown that oxidative stress may also be involved in the pathophysiology of PCOS. Both AGEs and advanced oxidation protein products were in fact found to be higher in women with PCOS than in healthy controls, and a positive correlation between androgen and AGE levels was reported.
With this background, we performed a case–control study in overweight or obese women with PCOS to investigate their dietary intake (including AGEs) and habitual food choices, the relationship with hormones and metabolism and the potential interaction by PCOS or control status.
Abstract and Introduction
Abstract
Objective This study investigates energy intake, macronutrient composition and habitual food choices in overweight/obese women with polycystic ovary syndrome (PCOS) and controls similar for age and body mass index (BMI), and their relationship with hormonal and metabolic parameters.
Design Case–control study carried out in an academic hospital in Bologna, Italy.
Patients One-hundred obese or overweight (BMI >25 kg/m) women with PCOS, diagnosed according to Rotterdam criteria, and 100 age- and BMI-matched controls.
Measurements Dietary habits were investigated by means of the 7 days food diary. Fasting hormones and metabolic parameters were investigated in all subjects.
Results We showed that diet does not differ between the two groups as regards energy, macronutrient and advanced glycosylated end product intake, except for a lower percentage of energy from lipids and a higher intake of fibres by PCOS women. PCOS women were characterized by a higher consumption of cheese and high-glycaemic index starchy sweets and a preference for raw oil rather than other cooked fats, compared to controls. The PCOS or control status influenced some of the relationships between dietary components, food choices and metabolic parameters, particularly insulinAUC and HDL-cholesterol.
Conclusions This study did not find major differences in dietary habits between PCOS and normoandrogenic control women. Our findings support the hypothesis that specific foods may influence metabolic and hormonal pattern and that this relationship may be differently regulated in PCOS and normoandrogenic women; however, they give little support to the hypothesis of a strong dependence of PCOS status on nutritional factors.
Introduction
Adequate nutritional status is a critical determinant of the onset and maintenance of normal reproductive function. Obesity is encountered in 30–70% of women affected by polycystic ovary syndrome (PCOS), one of the most common endocrinopathies in women of fertile age, and its presence significantly modifies both clinical and laboratory expression of the syndrome. Moreover, women with PCOS have been shown to have higher amounts of visceral fat compared to healthy controls, even when they are normal weight. The importance of obesity in the pathophysiology of PCOS is definitely confirmed by the fact that even modest to moderate weight loss may improve all features of PCOS, including insulin resistance, lipid abnormalities, androgen excess, menses and ovulatory rates, and favour the complete recovery of the PCOS phenotype in some of them.
The association between abnormal dietary habits and history and risk for PCOS has not been widely examined, and available data are still sparse and contradictory. Most researchers found that daily energy intake and diet composition did not differ in the majority of PCOS women compared to controls, although minor discrepancies, regarding specific nutrients and food categories, or subgroups of women, were reported. Interestingly, an increased risk of anovulatory infertility has been associated with a higher consumption of animal proteins, total carbohydrates and foods with a high glycaemic index, low-fat dairy foods and cola beverages in different reports from the Nurses' Health Study cohort. However, whether women with PCOS have different patterns of dietary intake and food preferences with respect to the unaffected population is far from being established.
Diet is also a major source of advanced glycosylated end products (AGEs) and other oxidants. Meals cooked at high temperatures and under dry conditions have the highest AGE content, especially if the fat content is high. Dietary AGEs contribute to a state of elevated oxidative stress and inflammation and have been shown to play a role in promoting diabetes, insulin resistance and atherosclerosis in mice. Recent data have shown that oxidative stress may also be involved in the pathophysiology of PCOS. Both AGEs and advanced oxidation protein products were in fact found to be higher in women with PCOS than in healthy controls, and a positive correlation between androgen and AGE levels was reported.
With this background, we performed a case–control study in overweight or obese women with PCOS to investigate their dietary intake (including AGEs) and habitual food choices, the relationship with hormones and metabolism and the potential interaction by PCOS or control status.
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