title: Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS), a common condition in women, improves with weight loss. Meal replacements in short-term weight loss and strategies for weight maintenance have not been investigated in PCOS.
  
  
  OBJECTIVE
  We compared in overweight women with PCOS the effects of meal replacements in short-term weight-loss and longer-term carbohydrate- or fat-restriction strategies on weight maintenance and improvements in reproductive and metabolic variables.
  
  
  METHODS
  Overweight women with PCOS (n = 43; x +/- SD age: 32.1 +/- 5.2 y; weight: 96.1 +/- 18.4 kg) followed an 8-wk weight-loss regimen (2 meal replacements/d, 4904.4 +/- 127 kJ; phase 1) and then a 6-mo weight-maintenance carbohydrate- (<120 g/d) or fat- (<50 g/d) restriction regimen (phase 2).
  
  
  RESULTS
  Thirty-four women completed phase 1, and 23 women completed phase 2; the proportion of dropouts was similar in the 2 groups. During phase 1, significant (P < 0.05) reductions in weight (5.6 +/- 2.4 kg), waist circumference (6.1 +/- 2.5 cm), body fat (4.1 +/- 2.2 kg), insulin (2.8 +/- 1.1 mU/L), total testosterone (0.3 +/- 0.7 nmol/L), and free androgen index (3.1 +/- 4.6) occurred; these changes were sustained during phase 2. No significant differences between diet groups were seen for any variables. At 6 mo, both approaches resulted in a net weight loss of 4.7 +/- 4.6 kg. Improvements in menstrual cyclicity occurred for 16 (57.1%) of 28 subjects.
  
  
  CONCLUSIONS
  Meal replacements are an effective strategy for the short-term management of PCOS. Advice on moderate fat or carbohydrate restriction was equally effective in maintaining weight reduction and improving reproductive and metabolic variables.
authors.affiliation: Discipline of Obstetrics and Gynaecology (Research Centre for Reproductive Health), School of Paediatrics and Reproductive Health, Adelaide, Australia. lisa.moran@csiro.au
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Moran
authors.forename: Manny
authors.initials: M
authors.lastname: Noakes
authors.forename: Peter M
authors.initials: PM
authors.lastname: Clifton
authors.forename: Gary A
authors.initials: GA
authors.lastname: Wittert
authors.forename: Gemma
authors.initials: G
authors.lastname: Williams
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Norman
mesh_terms: D000328:Adult; D050528:Diet, Carbohydrate-Restricted; D018752:Diet, Fat-Restricted; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004041:Dietary Fats / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005526:Food, Formulated; D038321:Glycemic Index; D006801:Humans; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D012098:Reproduction / Q000502:physiology*; D013739:Testosterone / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D013739:Testosterone