Division of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Obstetrics and Gynecology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Clin Endocrinol (Oxf). 2020 Jun;92(6):525-535. doi: 10.1111/cen.14179. Epub 2020 Mar 16.
Effects of lifestyle modification on reproductive function in polycystic ovary syndrome (PCOS) remain poorly elucidated. We compared the effects of a pulse-based diet (lentils, beans, split peas and chickpeas) with Therapeutic Lifestyle Changes (TLC) diet on ultrasonographic markers of ovarian morphology, hyperandrogenism and menstrual irregularity in PCOS.
Randomized controlled trial.
Women with PCOS (18-35 years).
Thirty women randomized to the pulse-based and 31 to TLC groups completed a 16-week intervention without energy restriction. Groups performed aerobic exercise (minimum of 5 days/wk; 45 minutes/d) and received health counselling (monthly) and longitudinal follow-up. Follicle numbers per ovary (FNPO, 2-9 mm), ovarian volume (OV), free androgen index (FAI) and menstrual cycle length were measured pre- and postintervention.
Follicle numbers per ovary (mean change ± SD, -10 ± 15), OV (-2.7 ± 4.8 mL), FAI (-3 ± 2) and menstrual cycle length (-13 ± 47 days) decreased over time in both groups (All: P < .01), without group-by-time interactions (All: P ≥ .13). Attrition rate was 33.7% and comparable between groups (P = .94). Adherence to diet intervention negatively correlated with changes in FNPO (r=-0.54), OV (r=-0.35) and FAI (r = -.29) in pooled groups (All: P ≤ .04). Groups maintained reduced OV, FNPO, FAI and menstrual cycles 6 months postintervention; however, decreased FNPO and FAI at 16 weeks tended to revert to baseline levels 12 months postintervention in both groups (All: P ≤ .05).
Both interventions improved ovarian dysmorphology, hyperandrogenism and menstrual irregularity in PCOS, and no diet appeared to be superior at improving reproductive outcomes. Our observations highlight the importance of longitudinal surveillance for sustainable adherence to newly adopted healthy lifestyle behaviours and reproductive health in PCOS (ClinicalTrials.gov identifier, NCT01288638).
生活方式改变对多囊卵巢综合征（PCOS）生殖功能的影响仍不清楚。我们比较了基于脉冲的饮食（小扁豆、豆类、split peas 和鹰嘴豆）与治疗性生活方式改变（TLC）饮食对 PCOS 卵巢形态、高雄激素血症和月经不规则的超声标志物的影响。
随机对照试验。
患有 PCOS（18-35 岁）的女性。
30 名女性随机分为基于脉冲的组和 31 名 TLC 组，在不限制能量的情况下进行 16 周的干预。两组均进行有氧运动（每周至少 5 天；每天 45 分钟），并接受健康咨询（每月）和纵向随访。干预前后测量每个卵巢的卵泡数（FNPO，2-9mm）、卵巢体积（OV）、游离雄激素指数（FAI）和月经周期长度。
两组 FNPO（平均变化±SD，-10±15）、OV（-2.7±4.8mL）、FAI（-3±2）和月经周期长度（-13±47 天）均随时间减少（所有：P<0.01），无组间时间交互作用（所有：P≥0.13）。两组的失访率均为 33.7%，且相似（P=0.94）。饮食干预的依从性与两组 pooled 组的 FNPO（r=-0.54）、OV（r=-0.35）和 FAI（r=-0.29）的变化呈负相关（所有：P≤0.04）。两组在干预后 6 个月仍保持 OV、FNPO、FAI 和月经周期减少，但在 16 周时 FNPO 和 FAI 的降低在 12 个月时趋于恢复到基线水平（所有：P≤0.05）。
两种干预措施均改善了 PCOS 的卵巢畸形、高雄激素血症和月经不规则，且没有一种饮食在改善生殖结局方面表现出优势。我们的观察结果强调了纵向监测对新采用的健康生活方式行为和 PCOS 生殖健康的可持续性的重要性（ClinicalTrials.gov 标识符，NCT01288638）。
