Defining the impact of dietary macronutrient balance on PCOS traits

Valentina Rodriguez Paris,Madeleine J Cox,William L Ledger,David J Handelsman,Melissa C Edwards,Kirsty A Walters,Stephen J Simpson,Reena Desai,Samantha M Solon-Biet,Alistair M Senior,Robert B Gilchrist,Nicodemus Tedla

doi:10.1038/s41467-020-19003-5

Valentina Rodriguez Paris, Madeleine J Cox + Show 10 more

Open Access

https://doi.org/10.1038/s41467-020-19003-5

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Abstract

Lifestyle, mainly dietary, interventions are first-line treatment for women with polycystic ovary syndrome (PCOS), but the optimal diet remains undefined. We combined a hyperandrogenized PCOS mouse model with a systematic macronutrient approach, to elucidate the impact of dietary macronutrients on the development of PCOS. We identify that an optimum dietary macronutrient balance of a low protein, medium carbohydrate and fat diet can ameliorate key PCOS reproductive traits. However, PCOS mice display a hindered ability for their metabolic system to respond to diet variations, and varying macronutrient balance did not have a beneficial effect on the development of metabolic PCOS traits. We reveal that PCOS traits in a hyperandrogenic PCOS mouse model are ameliorated selectively by diet, with reproductive traits displaying greater sensitivity than metabolic traits to dietary macronutrient balance. Hence, providing evidence to support the development of evidence-based dietary interventions as a promising strategy for the treatment of PCOS, especially reproductive traits.

Highlights

Lifestyle, mainly dietary, interventions are first-line treatment for women with polycystic ovary syndrome (PCOS), but the optimal diet remains undefined
We evaluated the effects of dietary macronutrient balance on the development of reproductive and metabolic features of PCOS in PCOS and control female mice with dihydrotestosterone (DHT)induced experimental PCOS
general additive statistical models (GAMs) are a form of multiple regression, which allow for the quantification of non-linear effects of multi-dimensional predictors on response variables using non-parametric smoothing functions

Summary

Introduction

Mainly dietary, interventions are first-line treatment for women with polycystic ovary syndrome (PCOS), but the optimal diet remains undefined. We identify that an optimum dietary macronutrient balance of a low protein, medium carbohydrate and fat diet can ameliorate key PCOS reproductive traits. While a modified hypocaloric diet with a high-protein, low glycaemic load results in significantly increased insulin sensitivity[16], these studies demonstrate that overall weight loss has a beneficial effect on PCOS features regardless of dietary composition. Despite their reported higher motivation to follow healthy weight management practices than women without PCOS, women with PCOS are still heavier[20] This indicated change in response to diet may be explained by factors driving PCOS, such as hyperandrogenism and insulin resistance, which can alter energy homeostasis, appetite and/or metabolism, but this remains unclear

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