Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome-Substudy of randomized trial between diet, exercise and diet plus exercise for weight control

Clin Endocrinol (Oxf). 2017 Dec;87(6):680-688. doi: 10.1111/cen.13427. Epub 2017 Aug 18.


Objective: Polycystic ovary syndrome (PCOS) is commonly affected by obesity. PCOS phenotypes are prone to increased waist/hip ratio, insulin resistance and dyslipidaemia. This substudy was undertaken to evaluate the effects of lifestyle interventions on metabolic biomarkers in overweight/obese PCOS women and the interventional effects of dietary components related to metabolic outcomes.

Design: Randomized three-arm parallel study.

Patients: Fifty-seven PCOS women body mass index (BMI >27 kg/m2 , age 18-40) were randomly assigned to diet (D, n = 19), exercise (E, n = 19) or diet plus exercise (DE, n = 19) in three-arm fashion over 16 weeks. The D group received nutritional counselling by a dietician to reduce their energy intake by at least 600 kcal/d. The E group received an ambulatory exercise regimen from a physiotherapist. The DE group had both interventions.

Measurements: Self-reported food intake over 4 days, exercise pedometers, BMI, waist/hip ratio, blood pressure, body composition and oral glucose tolerance test were performed before and at the end of intervention.

Results: BMI, waist circumference and total cholesterol were significantly reduced in the D and DE groups, as well as low-density lipoprotein and Homeostasis Model of Assessment index in the D group. In the E group, exercise was increased along with a decrease in BMI and waist circumference. The strongest predictor of reduced BMI was increased fibre intake (-0.44, P = .03), while a decrease in trans fatty acid intake predicted reduced insulinogenic index (0.44, P < .01).

Conclusions: Nutritional counselling with dieting is clearly effective to improve metabolic disturbances in overweight/obese women with PCOS. Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement and weight control.

Keywords: body composition; insulin resistance; lifestyle intervention; obesity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Dietary Fiber / therapeutic use*
  • Exercise / physiology*
  • Female
  • Humans
  • Overweight / diet therapy*
  • Overweight / physiopathology
  • Overweight / therapy*
  • Polycystic Ovary Syndrome / diet therapy*
  • Polycystic Ovary Syndrome / physiopathology
  • Polycystic Ovary Syndrome / therapy*
  • Trans Fatty Acids / adverse effects*
  • Young Adult


  • Dietary Fiber
  • Trans Fatty Acids