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, 7 (4), 1426-1437
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Low Intakes of Dietary Fiber and Magnesium Are Associated With Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome: A Cohort Study

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Low Intakes of Dietary Fiber and Magnesium Are Associated With Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome: A Cohort Study

Dylan A Cutler et al. Food Sci Nutr.

Abstract

Background: Women with polycystic ovary syndrome (PCOS) often have insulin resistance (IR) which may be worsened by obesity. The roles of dietary intake and activity are unclear. Our objectives were to determine whether (a) high caloric intake or inactivity explains obesity in PCOS, and (b) dietary composition is associated with PCOS phenotypes.

Methods: Eighty-seven women with PCOS and 50 women without PCOS participated in this cohort study at a reproductive medicine center. Data collected included 3-day food and physical activity records, anthropometrics, and metabolic and hormonal assays.

Results: Women with PCOS had increased body mass index (BMI) but similar caloric intake and activity to women without PCOS. There were no differences in protein, carbohydrates, fat, or glycemic load consumption, but women with PCOS consumed less fiber (medians: 19.6 vs. 24.7 g) and less magnesium (medians: 238.9 vs. 273.9 mg). In women with PCOS, those with IR consumed less fiber, less magnesium, and greater glycemic load than those without IR (medians: 18.2 vs. 22.1 g, 208.4 vs. 264.5 mg, 89.6 vs. 83.5). Fiber intake of women with PCOS was negatively correlated with IR, fasting insulin, glucose tolerance, testosterone, and dehydroepiandrosterone sulfate. Magnesium intake was negatively correlated with IR, C-reactive protein, and testosterone, but positively correlated with HDL cholesterol. Fiber intake and BMI accounted for 54.0% of the variance observed in IR.

Conclusions: Obesity in women with PCOS could not be explained by overeating or inactivity. Increasing dietary fiber and magnesium intakes may assist in reducing IR and hyperandrogenemia in women with PCOS.

Keywords: PCOS; diet; hyperandrogenism; insulin resistance; lifestyle; obesity.

Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Figure 1
Figure 1
Insulin resistance and dietary intake. (a), HOMA‐IR of women with PCOS categorized by tertile of fiber intake (energy adjusted). (b), Glycemic load intake (energy adjusted) in women with PCOS categorized by insulin resistance diagnosis (based on HOMA‐IR ≥3.8). HOMA‐IR: homeostasis model assessment of insulin resistance
Figure 2
Figure 2
Fiber intake and androgen levels. Correlations between fiber intake (energy adjusted) in women with PCOS and (a) testosterone, and (b) DHEAS. Fiber intake (energy adjusted) categorized by tertiles and corresponding (a) testosterone and (b) DHEAS (low fiber = 6.9–17.4 g, medium fiber = 17.5–22.9 g, high fiber = 23.0–68.0 g). DHEAS: dehydroepiandrosterone sulfate

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