Meal replacements improve reproductive parameters in polycystic ovary syndrome

Asia Pac J Clin Nutr. 2004;13(Suppl):S88.

Short term energy restriction (using meal replacements) improves reproductive parameters in polycystic ovary syndrome.

Moran LJ, Noakes M, Clifton PM, Wittert G, Norman RJ.

Reproductive Medicine Unit, Dept. Obstetrics and Gynaecology, University of Adelaide, SA, Australia.

Background- Polycystic ovary syndrome (PCOS) is a common endocrine condition affecting women of reproductive age. Weight loss improves the reproductive and metabolic dysfunction associated with PCOS. However, it is unclear what extent of adiposity reduction is required to restore reproductive function.

Objective- To assess the relative effects of energy restriction and weight loss on changes in reproductive parameters and to assess the effectiveness of meal replacements as a weight loss strategy in overweight women with PCOS.

Conclusions- Reproductive parameters improved after only 2 weeks of weight loss. Therefore, these data suggest that reproductive function can be restored with either a small degree of weight loss or by acute energy restriction. The implication is that only short term energy restriction may be required to improve reproductive function. This requires further investigation.

Design- Overweight women with PCOS (n = 34; age = 32.6+/- 5.1 years; weight = 96.0+/-19.5 kg; mean+/-SD) followed a weight loss intervention (two meal replacements, low fat snacks and evening meal daily) for 8 weeks. Fasting weight, waist circumference, body composition (assessed by bioelectrical impedance analysis), blood pressure (BP) and venous testosterone, sex hormone binding globulin (SHBG) and free androgen index (FAI) were assessed fortnightly.

Outcomes- The intervention resulted in a reduction in weight (5.6+/-2.4 kg, 6%), waist circumference (6.1+/-2.5 cm), body fat (4.1+/-2.2 kg) and systolic BP (8.4+/-11.1 mmHg) (p< 0.001). There was no change in SHBG but a significant reduction in testosterone (0.3+/-0.7 nmol/L, p = 0.05) and FAI (3.1+/-4.6nmol/L, 16.8%)(p = 0.001). This change in FAI occurred from week 0 – 2 (2.4+/-4.2 nmol/L, p=0.002) and corresponded with a weight loss of 2.4+/-1.0 kg(2.5%) with no further changes in FAI occurring from week 2 – 8. The change in FAI from week 0 – 2 or week 0 – 8 did not correlate with the change in weight, waist circumference or fat mass.