Comparison of hormonal and metabolic markers after a high-fat, Western meal versus a low-fat, high-fiber meal in women with polycystic ovary syndrome

Objective: To determine the effect of meal composition on postprandial T levels in women with polycystic ovary syndrome (PCOS). Design: Randomized, crossover design. Setting: Academic research center. Patient(s): Fifteen women with PCOS. Intervention(s): We evaluated changes in T, sex hormone binding globulin (SHBG), DHEAS, cortisol, glucose, and insulin for 6 hours after a high-fat, Western meal (HIFAT) (62% fat, 24% carbohydrate, I g fiber) and an isocaloric low-fat, high-fiber meal (HIFIB) (6% fat, 81% carbohydrate, 27 g fiber). Main Outcome Measure(s): Change in T levels. Result(s): Testosterone decreased 27% within 2 hours after both meals. However, T remained below premeal values for 4 hours after the HIFIB meal and 6 hours after the HIFAT meal. Insulin was twofold higher for 2 hours after the HIFIB meal compared with the HIFAT meal. Glucose was higher for I hour after the HIFIB meal comp pared with the HIFAT meal. DHEAS decreased 8%-10% within 2-3 hours after both meals, then increased during the remainder of the study period. Cortisol decreased during the 6-hour period after both meals. Conclusions: Diet plays a role in the regulation of T levels in women with PCOS. Further studies are needed to determine the role of diet composition in the treatment of PCOS. (Fertil Steril (R) 2009;91:1175-82. (C) 2009 by American Society for Reproductive Medicine.)