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PCOS Studies Highlight Diet and Exercise
Two studies have highlighted the importance of diet and exercise for overweight and obese women with polycystic ovarian syndrome (PCOS). "Obesity doesn't cause PCOS, but obesity can worsen the symptoms of PCOS," says Anuja Dokras, MD, PhD, a reproductive endocrinologist with Penn Fertility Care, and director of the Penn Polycystic Ovary Syndrome Center. In the United States, approximately 70 percent of patients with PCOS are overweight or obese, according to Dr. Dokras.
In the first study, published in the The American Journal of Clinical Nutrition, Danish researchers found that women with PCOS may do better on a high protein diet with 40 percent of energy from protein, 30 percent from fat and the remainder from carbohydrates. Replacing carbohydrates with protein appeared to increase weight loss and improve glucose metabolism without restricting calorie intake.
Another study, published in the journal Fertility and Sterility, found that diet and exercise — alone and in combination — improved BMI, menstrual pattern and ovulation in 57 overweight and obese women with PCOS. Swedish researchers used calorie restriction diets and found that dietary management supervised by a dietitian reduced BMI by 6 percent; exercise supervised by a physical therapist reduced BMI by 3 percent; and both diet and exercise reduced BMI by 5 percent.
In general, Dr. Dokras has found more success with the higher protein, lower carbohydrate proportions for women with PCOS. "A higher protein, lower carbohydrate diet has been shown to help people with PCOS lose weight," Dr. Dokras says. "Having said that, any kind of nutritional counseling — you count your calories or you do the higher protein, lower carbohydrate diet, and in combination with exercise — will help women with PCOS."
Women with PCOS have insulin resistance, and often have pre-diabetes, explains Dr. Dokras. The low carbohydrate, higher protein diets are often recommended for diabetes. "We have continued to recommend that the patients have [fewer] carbohydrate cravings when they do a higher protein diet," she says. "They have [fewer] sugar dips, and it helps them to move from one meal to the other."
However, Dr. Dokras says that a diet must work for the patient's lifestyle, so if a diet has worked for a patient before, she encourages her to use it again. "There isn't one definitive diet that we're handing out and saying that you have to follow this," she says. "I think it's unrealistic in this world, and it has to be tailored a little bit to the circumstances of your patient."
Finding an exercise regimen that works within the patient's lifestyle is equally important, Dr. Dokras says. "There isn't any study telling me one kind of exercise is better than the other, but [it should be] something they can do three to four times a week consistently — be it walking the dog or joining a gym. I like them to choose and tell me what's going to work for them, but do it consistently."