Effects of a eucaloric reduced carbohydrate diet on body composition and fat distribution in women with PCOS

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SAT 532-553-Hyperandrogenic Disorders
Saturday, June 15, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SAT-548
Amy Miskimon Goss*1, Paula C Chandler-Laney2, Fernando Ovalle2, Laura Lee Thompson Goree3, Ricardo Azziz4, Renee Desmond5, Wesley Granger5, G. Wright Bates5 and Barbara Ann Gower6
1University of Alabama at Birmingham, Birmingham, AL, 2Univ of Alabama at Birmingham, Birmingham, AL, 3The Univeristy of Alabama at Bir, Birmingham, AL, 4Georgia Regents University, Augusta, GA, 5Univ. Alabama at Birmingham, 6Univ of AL at Birmingham, Birmingham, AL
Elevated insulin and obesity are common features of women with Polycystic Ovary Syndrome (PCOS). These features may be mechanistically linked, as insulin promotes fat deposition and limits its mobilization and oxidation. In turn, obesity may contribute to the severity of symptoms and progression of comorbidities associated with PCOS. Non-pharmacological interventions to limit adiposity in the PCOS population are needed. Diets low in carbohydrate (CHO) may decrease fasting and/or postprandial insulin concentrations, and thereby promote mobilization and oxidation of fatty acids. The objectives of this study were to determine: 1) if consumption of a moderately reduced CHO diet would result in preferential loss of adipose tissue under eucaloric (weight maintenance) conditions; and 2) whether changes in adiposity were associated with changes in fasting or postprandial insulin concentration. In a crossover diet intervention, 30 women with PCOS consumed a reduced CHO diet (41:19:40 % energy from CHO:protein:fat, resp.) for 8 weeks and a standard (STD) diet (55:18:27) for 8 weeks. All food was provided for both diet phases. Body composition by DXA, fat distribution by CT scan, and fasting insulin were assessed at baseline and after 8 weeks of each diet phase. Insulin area-under-the-curve (AUC) was obtained during a solid meal test at the midpoint of each diet phase. Results indicate that participants lost 4.8% total body fat mass following the 8 week reduced CHO diet phase and lost 2.2% total fat mass following the 8 week STD diet phase. The reduced CHO diet induced a decrease in subcutaneous abdominal adipose tissue (SAAT), intra-abdominal adipose tissue, and thigh intermuscular adipose tissue (-7.1%, -9.1%, and -11%, resp.), whereas the STD diet induced a decrease in total lean mass (-2.2%). Loss of fat mass during the reduced CHO diet was associated with lower insulin AUC (P<0.05) during the solid meal test. Change in SAAT following the reduced CHO diet was positively associated with changes in fasting insulin (P<0.05). In conclusion, in PCOS, consumption of a weight-maintaining diet moderately lower in CHO (41%) resulted in preferential loss of abdominal and intermuscular fat mass. In contrast, a eucaloric diet higher in CHO (55%) appeared to promote repartitioning of lean to fat mass. Lower fasting and/or postprandial insulin observed with the lower CHO, but not the STD diet, may have permitted depletion of adipose tissue.

Nothing to Disclose: AMG, PCC, FO, LLTG, RA, RD, WG, GWB, BAG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm