title: Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare the influence of dietary management and/or physical exercise on ovarian function and metabolic variables in women with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Randomized 4-month trial with three interventions and a long-term follow-up.
  
  
  METHODS
  Women's health clinical research unit at a university hospital.
  
  
  METHODS
  Fifty-seven overweight/obese women with PCOS.
  
  
  METHODS
  Dietary management, physical exercise, or both, using programs individually adapted and supervised by a dietician and/or a physical therapist.
  
  
  METHODS
  Ovarian function, endocrinologic, and metabolic status and body composition.
  
  
  RESULTS
  On average, body mass index was reduced 6% by the dietary management, 3% by the exercise, and 5% by the combined interventions. Lower body fat and lean body mass were significantly decreased in the dietary groups, whereas upper body fat was lowered and lean body mass maintained by exercise alone. The menstrual pattern was significantly improved in 69% and ovulation confirmed in 34% of the patients, with no differences among the groups. The strongest predictor of resumed ovulation was a high serum level of insulin-like growth factor-binding protein 1 after the intervention. Follow-up of one-half of the patients for a median of 2.8 years revealed sustained weight reduction and improvement in menstrual pattern.
  
  
  CONCLUSIONS
  Dietary management and exercise, alone or in combination, are equally effective in improving reproductive function in overweight/obese women with PCOS. The underlying mechanisms appear to involve enhanced insulin sensitivity. Supportive individualized programs for lifestyle change could exert long-term beneficial effects.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Nybacka
authors.forename: Kjell
authors.initials: K
authors.lastname: Carlström
authors.forename: Agneta
authors.initials: A
authors.lastname: Ståhle
authors.forename: Sven
authors.initials: S
authors.lastname: Nyrén
authors.forename: Per Martin
authors.initials: PM
authors.lastname: Hellström
authors.forename: Angelica Lindén
authors.initials: AL
authors.lastname: Hirschberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D003131:Combined Modality Therapy; D004035:Diet Therapy; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055442:Metabolome; D010053:Ovary / Q000502:physiology*; D050177:Overweight / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult