Women with PCOS have worse diet quality, exercise less than healthy controls
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Women with polycystic ovary syndrome have worse diet quality and engage in less physical activity than women without PCOS, according to findings from a systematic review and meta-analysis.
“To our knowledge, this is the first systematic review and meta-analysis to synthesize evidence on lifestyle behaviors in women with PCOS,” Maryam Kazemi, RD, MSc, PhD, CPT, a health researcher in genomics of human complex metabolic and reproductive traits at the Icahn School of Medicine at Mount Sinai, and colleagues wrote in Human Reproduction Update. “The most significant results of this comprehensive review ... are that women with PCOS exhibit an overall adverse lifestyle behavior, specifically poorer dietary intakes ... and lower total physical activity compared to those without PCOS, despite lower alcohol intakes. We also observed worse or similar consumption of core food groups ... for women with PCOS.”
Researchers conducted a systematic review and meta-analysis of observational studies comparing dietary and physical activity in reproductive-aged women with PCOS vs. those without PCOS. The MEDLINE, Web of Science, Scopus and the CINAHL databases were searched through Feb. 26, 2021. Demographics, study design, dietary and physical activity outcomes were collected from each study.
There were 54 studies included in the review with a total of 39,471 participants. Of the study cohort, 8,736 had PCOS and 30,735 did not have PCOS. All but five studies had either a cross-sectional or a case-control/cohort design, and 78% of the studies were deemed to be high quality.
Of 13 studies that evaluated diet quality, nine found women with PCOS had worse diet quality scores compared with controls. Of the few studies reporting on adherence to food groups, women with PCOS had worse or comparable intakes of grains, fruits, vegetables, proteins, seeds, nuts and dairy compared with those without PCOS.
In findings from the meta-analysis, women with PCOS had higher daily cholesterol intake (mean difference, 12.78 mg; 95% CI, 1.48-24.08; P = .03) and lower daily magnesium intake (mean difference, –21.46 mg; 95% CI, –41.03 to –1.91; P = .03) compared with those without PCOS. The PCOS groups consumed less alcohol per day and engaged in less physical activity than control groups. Total energy intake, carbohydrates, total fat, total protein, fiber, folic acid, vitamin D, iron, calcium, zinc, sodium, glycemic index and glycemic load were similar between the two groups.
“Our observations have implications for allied health care providers ... and physicians to prioritize the identification of suboptimal dietary and physical activity behaviors in women with PCOS and to guide evidence-based lifestyle management for this prevalent and at-risk population,” the researchers wrote. “These findings highlight the importance of early lifestyle intervention at the time of PCOS diagnosis to address modifiable extrinsic factors that can prevent or minimize longitudinal weight gain and associated health complications. Provider recommendations should target meeting daily energy intake requirements and adequate consumption of select nutrients ... and core foods ... to achieve and maintain optimal health, healthy body weight and prevent long-term weight gain.”
The researchers noted most of the findings in the meta-analysis had high heterogeneity between the studies and said more research is needed to address any potential contributions of genetic, metabolic and sociodemographic factors to the differences observed in women with PCOS vs. without PCOS.
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