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A Pilot Study of a Low-Carbohydrate, Ketogenic Diet for Obesity-Related Polycystic Ovary Syndrome

Westman, E.C., Yancy, W.S., Hepburn, J., et al., "A Pilot Study of a Low-Carbohydrate, Ketogenic Diet for Obesity-Related Polycystic Ovary Syndrome," Journal of General Internal Medicine, 19(1S), 2004, page 111.

The following information was not written by Atkins professionals.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, and is frequently associated with central obesity, insulin resistance, and dyslipidemia. Because recent evidence demonstrates that a low carbohydrate ketogenic diet (LCKD) leads to weight loss and improvements in insulin sensitivity, we conducted this uncontrolled trial of the diet for PCOS.

METHODS: Subjects were recruited from the community. Inclusion criteria were signs or symptoms suggestive of PCOS (chronic anovulation, hyperandrogenemia, hirsuitism), age 18–45 years, body mass index >27 kg/m2, and motivation to lose weight. Subjects received LCKD counseling, with an initial goal of <20 grams of carbohydrate per day, gradually increased as tolerated. Subjects were instructed to take a multivitamin and to drink 6–8 glasses of water daily. Fasting blood samples were obtained at weeks 0, 10 and 24.

RESULTS: Eleven women were enrolled; 5 (45%) completed the 24-week study. In the 5 adherent subjects, there were significant reductions from baseline to 24 weeks in body weight (101.5 to 89.2 kg, P = .01) and percent free testosterone (2.2 to 1.7%, P = .04). There were non-significant changes in insulin (23.7 to 8.2 mg/dl), glucose (97.4 to 79.2 mg/dl), testosterone (51.8 to 48.0 mg/dl), hgbA1c (6.0 to 5.4%), perceived body hair (3.8 to 2.4 on a 7-point scale), LDL (120.0 to 131.8 mg/dl), and triglycerides (101.8 to 73.2 mg/dl). Two women who had previous difficulty becoming pregnant, became pregnant during the study.

CONCLUSION: In women with obesity and a clinical diagnosis of PCOS, a LCKD led to weight loss and a reduction in percent free testosterone over a 24-week period in those able to adhere to the diet. Further controlled studies are needed to determine whether this approach is superior to other weight loss methods for the treatment of PCOS.

The following information was written by Atkins professionals.

Polycystic ovary syndrome (PCOS), an endocrine disorder characterized by central obesity, insulin resistance, and abnormal blood lipid levels, is common in women of reproductive age. Researchers studied the effects of a low carbohydrate ketogenic diet (LCKD) on PCOS. Women between the ages of 18-45 with PCOS were counseled to follow Induction (less than 20 grams of carbohydrate per day) and proceed onto On-Going Weight Loss (increasing carbohydrates as tolerated). They were also instructed to take a multivitamin and consume 6-8 glasses of water a day. After 24 weeks, the five women who completed the study (45% retention) lost a significant amount of weight (average loss of 27 pounds) and percent free testosterone decreased. Although not significant, there were improvements in insulin, glucose, testosterone, HbA1c, perceived body hair, and triglycerides. These results indicate that a LCKD may be beneficial for women with PCOS who are motivated to adhere to the diet.