Diet or Exercise? Both Effective for PCOS

December 29, 2007 at 5:23 pm 1 comment

A newly published study, Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study, in the journal Human Reproduction, finds either a structured exercise program (SET) or high-protein diet effective for obese women with PCOS.

The high-protein diet provided 35% of calories from protein and a calorie deficit of 800-calories per day. The structured exercise program (SET) was held at a facility to monitor exercise three times per week.

The researchers conducted a 24-week investigation into two different non-pharmacological interventions – exercise or diet – allowing study subjects to choose which they would prefer to follow for the course of the study. The researchers allowed patient choice so as to “improve compliance and effectiveness” rather than attempt to purely evaluate one or the other through randomization of the subjects.

Throughout the study, the women participating followed either the dietary protocol or engaged in the three-times-per-week exercise regiment at a facility that monitored them while they exercised. Each week the women also met for group education sessions to help them stay on track throughout the study.

At the end of the study, the researchers found both interventions led to statistically significant improvements – especially with regard to body weight, BMI, waist circumferance, waist-hip-ratio, insulin resistance indices and in serum SHBG, androstenedoine and DHEA-S levels. The last two were only changed from baseline in those who followed the high-protein diet.

The researchers noted that they “hypothesize in both cases insulin sensitivity improvement itself is the pivotal factor involved in the restoration of ovarian function.”

From the data itself, this appears to be a solid hypothesis. In women with PCOS who experienced a resumption of ovulation – they had significantly greater weight loss, reduction of their BMI, waist circumferance and waist-hip-ratio than those who did not ovulate.

For example, at 12-weeks, women who followed the high-protein diet and ovulated, they reduced their waist circumferance an average of 10.6cm compared to women who didn’t reducing theirs by just 2.8cm. Similar reduction in waist circumferance was noted in women following the exercise protocol – at 12 weeks those who ovulated had reduced their waist circumferance by an average of 11.7cm, where those who did not ovulate reduced theirs by just 2.8cm.

Critically important in this finding is that by 12-weeks a clinically significant improvement was noted, with no further changes at 24-weeks. This leaves open the question of whether the women in either group who did not respond favorably (ovulate) to their intervention by week 12 might have if they crossed-over to the other protocol for the remaining 12-weeks. I would think that if by 12-weeks one isn’t seeing the improvement desired, changing protocol may offer an option since the researchers noted that the two interventions seemed to work through different mechanisms – so if one doesn’t work for you, the other might.

The take home message on this one is clear – patient choice is important (in this study it led to a high rate of complicance with the intervention) since both interventions worked. If you are interested and committed to making a dietary modification to a higher-protein diet, try it….if you’re more the type to enjoy a structured exercise program, try it – this study demonstrated that both offered an effective non-pharmacological first-line intervention that was inexpensive and non-invasive for obese women with PCOS.

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