The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome.

Abstract

In overweight women with polycystic ovary syndrome (PCOS), the benefits of the addition of exercise to an energy-restricted diet in further improving cardiometabolic risk factors and reproductive function has not been extensively studied. The objective was to evaluate the effects of aerobic and aerobic-resistance exercise when combined with an energy-restricted high protein diet (5000-6000 kJ/d) on metabolic risk factors and reproductive function in women with PCOS. A 20-wk outpatient, randomized, parallel study was conducted in a metropolitan research clinic. Ninety-four overweight and obese women with PCOS (age 29.3 +/- 0.7 yr; body mass index 36.1 +/- 0.5 kg/m2) were randomized to diet only (DO; n = 30), diet and aerobic exercise (DA; n = 31), or diet and combined aerobic-resistance exercise (DC; n = 33). Weight, body composition, cardiometabolic risk factors, hormonal status, menstrual cyclicity, and ovulatory function were assessed. All interventions reduced weight (DO 8.9 +/- 1.6%, DA 10.6 +/- 1.7%, and DC 8.7 +/- 1.7%; P < 0.001) with no difference between treatments (P = 0.7, time x treatment). Fat mass decreased more (3 kg) and fat-free mass decreased less (2 kg) in DA and DC compared with DO (P < or = 0.03). Reductions in blood pressure (5.6/2.7 mm Hg), triglycerides (0.4 mmol/liter), total cholesterol (0.5 mmol/liter), low-density lipoprotein cholesterol (0.1 mmol/liter), glucose (0.2 mmol/liter), fasting insulin (4.3 mIU/liter), testosterone (0.4 nmol/liter), and free androgen index (2.8) (P < 0.001) and improvements in SHBG (7.0 nmol/liter) and reproductive function occurred in all groups, with no difference between treatments. In overweight and obese women with PCOS, the addition of aerobic or combined aerobic-resistance exercise to an energy-restricted diet improved body composition but had no additional effect on improvements in cardiometabolic, hormonal, and reproductive outcomes relative to diet alone.