The Effect of a Hypocaloric Diet With and Without Exercise Training on Body Composition, Cardiometabolic Risk Profile, and Reproductive Function in Overweight and Obese Women With Polycystic Ovary Syndrome

Abstract

Although regular exercise is the cornerstone of management of overweight women with polycystic ovary syndrome, there are little data on additional benefits of regular exercise and exercise training when combined with an energy-restricted diet. This prospective, randomized, parallel study assessed the added benefit of aerobic or aerobic-resistance exercise training when combined with a moderate hypocaloric weight-loss diet on metabolic risk factors and reproductive function in women with PCOS. Ninety-four overweight and obese women with PCOS (age, 18-41 years; body mass index, 25-55 kg/m 2 ) were randomized to receive diet only (DO), diet and aerobic exercise (DA), or diet and combined aerobic-resistance exercise (DC) for 20 weeks. All participants received the same energy-restricted, high-protein diet (5000-6000 kJ/d). Fat mass was decreased more and free fat-free mass was decreased less at 20 weeks among the women in the DA and DC groups compared with those in the DO group (all values, P < 0.05). Larger reductions occurred in systolic and diastolic blood pressure among women in the DA and DC groups than those in the DO group, but only the decrease within the DC group reached statistical significance (P < 0.01). Statistically significant reductions from baseline values occurred within both the DA and DC groups for fasting insulin, total cholesterol, low-density lipoprotein cholesterol, testosterone, and free androgen index (all values, P < 0.05). Compared with baseline values, increases were found within the DA and DC groups in levels of serum sex hormone binding globulin. With respect to reproductive function, there were improvements in ovulation and menstrual cyclicity over the 20-week study period within the 3 treatment groups. There were no statistically significant differences in these cardiometabolic, hormonal, and reproductive parameters between the treatment groups. Among women with PCOS on an energy-restricted high-protein diet, the lack of additional improvements by exercise in cardiometabolic risk factors, hormonal status, and reproductive function suggests that improvements in these parameters were primarily related to energy restriction and weight loss.