title: Substituting poly- and mono-unsaturated fat for dietary carbohydrate reduces hyperinsulinemia in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  Hyperinsulinemia is a prevalent feature of polycystic ovary syndrome (PCOS), contributing to metabolic and reproductive manifestations of the syndrome. Weight loss reduces hyperinsulinemia but weight regain is the norm, thus preventing long-term benefits. In the absence of weight loss, replacement of dietary carbohydrate (CHO) with mono/polyunsaturated fat reduces ambient insulin concentrations in non-PCOS subjects. The current study evaluated whether this dietary intervention could ameliorate hyperinsulinemia in women with PCOS.
  
  
  METHODS
  Obese women with PCOS (BMI 39 ± 7 kg/m2) and insulin resistance completed a crossover study (Stanford University Clinical Research Center) comparing two isocaloric diets, prepared by research dietitians, containing 60% CHO/25% fat versus 40% CHO/45% fat (both 15% protein and ≤7% saturated fat). After 3 weeks on each diet, daylong glucose, insulin, and fasting lipid/lipoproteins were measured.
  
  
  RESULTS
  Daylong glucose did not differ according to diet. Daylong insulin concentrations were substantially (30%) and significantly lower on the low CHO/higher fat diet. Beneficial changes in lipid profile were also observed.
  
  
  CONCLUSIONS
  Replacement of dietary CHO with mono/polyunsaturated fat yields clinically important reductions in daylong insulin concentrations, without adversely affecting lipid profile in obese, insulin-resistant women with PCOS. This simple and safe dietary intervention may constitute an important treatment for PCOS. ClinicalTrials.gov Identifier: NCT00186459.
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Dalia
authors.initials: D
authors.lastname: Perelman
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Coghlan
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Lamendola
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Carter
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Fahim
authors.initials: F
authors.lastname: Abbasi
authors.affiliation: a Division of Endocrinology , Stanford University School of Medicine , Stanford , CA , USA.
authors.forename: Tracey
authors.initials: T
authors.lastname: McLaughlin
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000178:diet therapy*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000178:diet therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004042:Dietary Fats, Unsaturated; D007328:Insulin; D008055:Lipids
keywords: Carbohydrate; PCOS; diet; insulin; insulin-resistant; obesity