Fructose content of low calorie diets: effect on cardiometabolic risk factors in obese women with polycystic ovarian syndrome: a randomized controlled trial

Line K Johnson, Kirsten B Holven, Njord Nordstrand, Jan R Mellembakken, Tom Tanbo, Jøran Hjelmesæth, Line K Johnson, Kirsten B Holven, Njord Nordstrand, Jan R Mellembakken, Tom Tanbo, Jøran Hjelmesæth

Abstract

We aimed to examine whether a whole-grain crispbread (CB) low-fructose, low-calorie diet (LCD) might be superior to a traditional LCD based on fructose-rich liquid meal replacements (LMRs) with respect to improvement of various cardiometabolic risk factors and reproductive hormones. Parallel-group randomised controlled clinical trial. Morbidly obese women with polycystic ovarian syndrome (PCOS) were randomised to either an 8-week CB-LCD or LMR-LCD (900-1100 kcal/day, fructose 17 g/day or 85 g/day). A total of 51 women completed the study. Body weight, fat mass and waist circumference reduced by mean (s.d.) 10.0 (4.8) kg, 7.4 (4.2) kg and 8.5 (4.4) cm, with no significant differences between groups. Total-cholesterol, HDL-cholesterol and Apo-A1 were significantly reduced within both groups (all P values <0.01), with no significant between-group differences. The triacylglycerol and LDL-cholesterol levels were reduced within the LMR group only, with no significant between-group differences. Blood pressure and most measures of glucose metabolism improved significantly in both diet groups, with no significant between-group difference. Uric acid levels rose by 17.7 (46.4) and 30.6 (71.5) μmol/l in the CB and LMR group, respectively, with no significant difference between groups. Gastrointestinal discomfort was significantly and equally reduced in both intervention groups. Free testosterone index was reduced in both groups, with no significant difference between groups. Morbidly obese women with PCOS who underwent either an 8-week low or high-fructose LCD-diet had similar changes in various cardiometabolic risk factors and reproductive hormones. Registration at ClinicalTrials.gov: NCT00779571.

Keywords: PCOS; cardiometabolic risk-factors; fructose; low calorie diets; obesity; weight loss.

© 2015 The authors.

Figures

Figure 1
Figure 1
Participant flow. Four participants switched from the liquid meal replacement (LMR) to the crispbread (CB) diet during the first 2 weeks. These four patients were categorised to their originally allocated group (LMR). All results are based on a modified intention-to-treat analysis.
Figure 2
Figure 2
Prevalence of metabolic syndrome (MS) in the two diet groups at baseline and after 8 weeks. Y-axis indicates prevalence of MS (%). Dark grey bars indicate prevalence of MS at baseline and light grey bars indicate prevalence of MS after 8 weeks. P values are for comparison of prevalence of MS before and after intervention within each diet group (McNemar test).
Figure 3
Figure 3
Participants with weight loss ≥5 and ≥10% after 8 weeks in the two diet groups. Y-axis indicates percentage of subjects. Dark grey bars indicate weight loss ≥5% and light grey bars indicate weight loss ≥10%.

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