Abstract

Abstract Study question This study aims to assess the efficacy of, design, and implement a public health nutrition intervention designed to enhance healthy eating and life style management among PCOS patients. Summary answer After 6 months, this intervention decreased initial body weight by 5%-10%, increased pregnancy rate by 70%, and significantly improved psychological, metabolic and endocrine profiles. What is known already Polycystic ovary syndrome (PCOS) is a common endocrinopathy among women in their reproductive age and is characterized by imbalanced hormones, irregular menses, and fertility problems. PCOS has been linked to obesity and insulin resistance in many studies and this association suggests that a weight management intervention consisting of a lifestyle modification (LSM) program might improve the metabolic, reproductive and biochemical profiles of PCOS patients, especially that studies showed that weight loss among PCOS women reduces hyperandrogenism and thus improve ovulation. Study design, size, duration The study is a randomized control trial studying the effect of a 6 month weight management program with nutritional guidelines. 588 female participants attending the obstetrics/gynecology clinic, aged between 18 and 45 years old, were recruited. There were two obese/overweight (experimental and control) and two lean subgroups (experimental and control). Experimental groups received the intervention under study while the controls were given the usual programs (except for the non-PCOS lean group that received no intervention). Participants/materials, setting, methods Data on socio-demographic variables, nutritional status, physical activity, psychological and medical status were collected using a pre-validated questionnaire. Data on biochemical variables were collected from blood analysis. Data collection took place at baseline, after 3 and 6 months from intervention. Patients who were in the intervention groups were subject to nutritional education/counseling (following the proposed guidelines) as well as the structural weight loss program for obese patients. Main results and the role of chance After 6 months, PCOS women lost 8.2 kg (P = 0.001), non-PCOS women lost 11.6kg among while controls gained weight. The biochemical, psychological and reproductive profile showed significant improvements among PCOS women. In fact, the percentage weight loss of 10 % in the overweight/obese intervention group showed significant changes in some of the biochemical markers (total cholesterol FBS, CRP, LDL, and testosterone) (P < 0.001). PCOS patients who got the intervention had a shorter time to ovulation, than those who didn’t and had more average number of cycles during the 6 months study duration (P < 0.001). Regarding the pregnancy rate for PCOS patients, it was shown that it increased significantly with intervention patients in all groups compared to controls (from 0% to 70% compared from 0% to 15 % respectively). Limitations, reasons for caution Limitations of the study includes inability to objectively assess patient compliance with innervation and inability to follow up with the participants for a longer period of time (12 months or more) for long term outcomes. Wider implications of the findings The findings of our study are in synchrony with previous studies that implied that nutritional and life style interventions improved PCOS outcome. This suggests the need for nutritional interventions and guidelines on additional to the traditioned gynecological treatment to improve PCOS outcome. Trial registration number Not applicable

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