Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS

Barbara A. Gower, Paula C. Chandler-Laney, Fernando Ovalle, Laura Lee Goree, Ricardo Azziz, Renee A. Desmond, Wesley M. Granger, Amy M. Goss, G. Wright Bates

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objective Diet-induced reduction in circulating insulin may be an attractive nonpharmacological treatment for women with polycystic ovary syndrome (PCOS) among whom elevated insulin may exacerbate symptoms by stimulating testosterone synthesis. This study was designed to determine whether a modest reduction in dietary carbohydrate (CHO) content affects β-cell responsiveness, serum testosterone concentration and insulin sensitivity in women with PCOS. Design In a crossover design, two diets ('Standard,' STD, 55:18:27% energy from carbohydrate/protein/fat; lower-carbohydrate, 41:19:40) were provided for 8 weeks in random order with a 4-week washout between. Patients Thirty women with PCOS. Measurements β-cell responsiveness assessed as the C-peptide response to glucose during a liquid meal test; insulin sensitivity from insulin and glucose values throughout the test; insulin resistance (HOMA-IR); and total testosterone by immunoassay. Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic ('first-phase') β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC (P < 0·05). Conclusions In women with PCOS, modest reduction in dietary CHO in the context of a weight-maintaining diet has numerous beneficial effects on the metabolic profile that may lead to a decrease in circulating testosterone.

Original languageEnglish (US)
Pages (from-to)550-557
Number of pages8
JournalClinical Endocrinology
Volume79
Issue number4
DOIs
StatePublished - Oct 1 2013

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Polycystic Ovary Syndrome
Testosterone
Carbohydrates
Insulin
Diet
Insulin Resistance
Fasting
Sexually Transmitted Diseases
Glucose
Dietary Carbohydrates
Metabolome
C-Peptide
Immunoassay
Cross-Over Studies
HDL Cholesterol
Area Under Curve
Meals
Fats
Cholesterol
Weights and Measures

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Gower, B. A., Chandler-Laney, P. C., Ovalle, F., Goree, L. L., Azziz, R., Desmond, R. A., ... Bates, G. W. (2013). Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. Clinical Endocrinology, 79(4), 550-557. https://doi.org/10.1111/cen.12175

Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. / Gower, Barbara A.; Chandler-Laney, Paula C.; Ovalle, Fernando; Goree, Laura Lee; Azziz, Ricardo; Desmond, Renee A.; Granger, Wesley M.; Goss, Amy M.; Bates, G. Wright.

In: Clinical Endocrinology, Vol. 79, No. 4, 01.10.2013, p. 550-557.

Research output: Contribution to journalArticle

Gower, BA, Chandler-Laney, PC, Ovalle, F, Goree, LL, Azziz, R, Desmond, RA, Granger, WM, Goss, AM & Bates, GW 2013, 'Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS', Clinical Endocrinology, vol. 79, no. 4, pp. 550-557. https://doi.org/10.1111/cen.12175
Gower BA, Chandler-Laney PC, Ovalle F, Goree LL, Azziz R, Desmond RA et al. Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. Clinical Endocrinology. 2013 Oct 1;79(4):550-557. https://doi.org/10.1111/cen.12175
Gower, Barbara A. ; Chandler-Laney, Paula C. ; Ovalle, Fernando ; Goree, Laura Lee ; Azziz, Ricardo ; Desmond, Renee A. ; Granger, Wesley M. ; Goss, Amy M. ; Bates, G. Wright. / Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. In: Clinical Endocrinology. 2013 ; Vol. 79, No. 4. pp. 550-557.
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abstract = "Objective Diet-induced reduction in circulating insulin may be an attractive nonpharmacological treatment for women with polycystic ovary syndrome (PCOS) among whom elevated insulin may exacerbate symptoms by stimulating testosterone synthesis. This study was designed to determine whether a modest reduction in dietary carbohydrate (CHO) content affects β-cell responsiveness, serum testosterone concentration and insulin sensitivity in women with PCOS. Design In a crossover design, two diets ('Standard,' STD, 55:18:27{\%} energy from carbohydrate/protein/fat; lower-carbohydrate, 41:19:40) were provided for 8 weeks in random order with a 4-week washout between. Patients Thirty women with PCOS. Measurements β-cell responsiveness assessed as the C-peptide response to glucose during a liquid meal test; insulin sensitivity from insulin and glucose values throughout the test; insulin resistance (HOMA-IR); and total testosterone by immunoassay. Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic ('first-phase') β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC (P < 0·05). Conclusions In women with PCOS, modest reduction in dietary CHO in the context of a weight-maintaining diet has numerous beneficial effects on the metabolic profile that may lead to a decrease in circulating testosterone.",
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N2 - Objective Diet-induced reduction in circulating insulin may be an attractive nonpharmacological treatment for women with polycystic ovary syndrome (PCOS) among whom elevated insulin may exacerbate symptoms by stimulating testosterone synthesis. This study was designed to determine whether a modest reduction in dietary carbohydrate (CHO) content affects β-cell responsiveness, serum testosterone concentration and insulin sensitivity in women with PCOS. Design In a crossover design, two diets ('Standard,' STD, 55:18:27% energy from carbohydrate/protein/fat; lower-carbohydrate, 41:19:40) were provided for 8 weeks in random order with a 4-week washout between. Patients Thirty women with PCOS. Measurements β-cell responsiveness assessed as the C-peptide response to glucose during a liquid meal test; insulin sensitivity from insulin and glucose values throughout the test; insulin resistance (HOMA-IR); and total testosterone by immunoassay. Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic ('first-phase') β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC (P < 0·05). Conclusions In women with PCOS, modest reduction in dietary CHO in the context of a weight-maintaining diet has numerous beneficial effects on the metabolic profile that may lead to a decrease in circulating testosterone.

AB - Objective Diet-induced reduction in circulating insulin may be an attractive nonpharmacological treatment for women with polycystic ovary syndrome (PCOS) among whom elevated insulin may exacerbate symptoms by stimulating testosterone synthesis. This study was designed to determine whether a modest reduction in dietary carbohydrate (CHO) content affects β-cell responsiveness, serum testosterone concentration and insulin sensitivity in women with PCOS. Design In a crossover design, two diets ('Standard,' STD, 55:18:27% energy from carbohydrate/protein/fat; lower-carbohydrate, 41:19:40) were provided for 8 weeks in random order with a 4-week washout between. Patients Thirty women with PCOS. Measurements β-cell responsiveness assessed as the C-peptide response to glucose during a liquid meal test; insulin sensitivity from insulin and glucose values throughout the test; insulin resistance (HOMA-IR); and total testosterone by immunoassay. Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic ('first-phase') β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC (P < 0·05). Conclusions In women with PCOS, modest reduction in dietary CHO in the context of a weight-maintaining diet has numerous beneficial effects on the metabolic profile that may lead to a decrease in circulating testosterone.

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