Abstract
BackgroundPolycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance. Because low carbohydrate diets have been shown to reduce insulin resistance, this pilot study investigated the six-month metabolic and endocrine effects of a low-carbohydrate, ketogenic diet (LCKD) on overweight and obese women with PCOS.ResultsEleven women with a body mass index >27 kg/m2 and a clinical diagnosis of PCOS were recruited from the community. They were instructed to limit their carbohydrate intake to 20 grams or less per day for 24 weeks. Participants returned every two weeks to an outpatient research clinic for measurements and reinforcement of dietary instruction. In the 5 women who completed the study, there were significant reductions from baseline to 24 weeks in body weight (-12%), percent free testosterone (-22%), LH/FSH ratio (-36%), and fasting insulin (-54%). There were non-significant decreases in insulin, glucose, testosterone, HgbA1c, triglyceride, and perceived body hair. Two women became pregnant despite previous infertility problems.ConclusionIn this pilot study, a LCKD led to significant improvement in weight, percent free testosterone, LH/FSH ratio, and fasting insulin in women with obesity and PCOS over a 24 week period.
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance
PCOS is associated with medical abnormalities such as central obesity [2], insulin resistance [3], hyperinsulinemia [4], type 2 diabetes mellitus [5], and dyslipidemia [6]
Inclusion/exclusion criteria The inclusion criteria were age 18–45 years, diagnosis suggestive of PCOS based on history of chronic anovulation and/or hyperandrogenemia, no other serious medical condition requiring medical supervision, body mass index (BMI) greater than or equal to 27 kg/m2, willingness to use acceptable contraception, and a desire to lose weight
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age and is associated with obesity, hyperinsulinemia, and insulin resistance. PCOS is associated with medical abnormalities such as central obesity [2], insulin resistance [3], hyperinsulinemia [4], type 2 diabetes mellitus [5], and dyslipidemia [6]. There are no known curative therapies for PCOS, though anti-diabetic medications do improve many of the metabolic abnormalities, like insulin resistance [7,8,9,10,11], and elevated serum testosterone and total cholesterol levels.[12,13] Dietary and exercise interventions [14,15].
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