Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome
Australian Technology Network Centre for Metabolic Fitness & Nutritional Physiology Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia. Fertility and sterility
(Impact Factor: 4.59).
12/2009; 94(5):1812-6. DOI: 10.1016/j.fertnstert.2009.11.001
To assess the impact of adding exercise to dietary restriction on depressive symptoms and health-related quality of life (HRQOL) in women with polycystic ovary syndrome (PCOS).
Analysis of depression and quality of life outcomes from a randomized, controlled prospective clinical intervention that evaluated the effects on a range of health outcomes in women with PCOS.
Clinical research unit.
One hundred four overweight/obese PCOS women (aged 29.3 ± 0.7 years; body mass index [BMI] 36.1 ± 0.5 kg/m(2)).
Randomized to one of three 20-week lifestyle programs: diet only, diet and aerobic exercise, or diet and combined aerobic-resistance exercise.
Depression and PCOS-specific HRQOL.
Forty-nine women completed the intervention (diet only = 14, diet and aerobic exercise = 15, diet and combined aerobic-resistance exercise = 20). By week 20 all groups achieved weight loss and had improvements in depression and PCOS-specific HRQOL scores, except for body hair domain score. There was no difference between treatments for all outcomes.
This study demonstrated that dietary restriction alone and combined with exercise had similar benefits for improving depression and HRQOL scores in overweight and obese women with PCOS.
Available from: Remco C J Polman
- "The specific interaction between physical activity and mental health has not been explored in depth in PCOS, however, preliminary data including a recent clinic-based study of women with PCOS found physically inactive women had higher depression scores than physically active women, and there was an association between lower physical activity and mild depression . Reductions in depression and elevations in quality of life have been observed in combined physical activity and dietary interventions in PCOS  and specific physical activity interventions have been found to be effective in reducing mild-moderate depression [32,33] and anxiety  in the general population. Yet engagement and sustainability in physical activity in women with PCOS is particularly problematic. "
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ABSTRACT: Physical activity is prescribed as a component of primary management for Polycystic Ovary Syndrome (PCOS). This study investigates the association between physical activity and mental health as well as the exercise barriers, motivators and support providers for younger women with and without PCOS to assist in physical activity uptake and prescription for these women.
Women aged 18-50 years with (n = 153) and without PCOS (n = 64) completed a questionnaire at one time point. The questionnaire included the Hospital Anxiety and Depression Scale and a survey regarding levels of physical activity, physical activity barriers, motivators and supports. A MANCOVA assessed associations between physical activity, PCOS and mental health (specifically depression and anxiety). Descriptive and Chi square goodness of fit statistics assessed the differences in perceived barriers, motivators and support providers amongst women with and without PCOS.
Women with PCOS displayed higher severity of depression (F(1,210) = 8.32, p = 0.004) and anxiety (F(1,210) = 17.37, p < 0.001) symptoms compared to controls. Overall, for physically active women, depression was significantly less severe than in their inactive counterparts (F(2,210) = 13.62, p < 0.001). There were no differences in anxiety by physical activity status and no interaction effects between PCOS and activity status for depression or anxiety. Women with PCOS were more likely to report a lack of confidence about maintaining physical activity (Chi2 = 3.65; p = 0.046), fear of injury (Chi2 = 4.08; p = 0.043) and physical limitations (Chi2 = 11.92; p = 0.001) as barriers to physical activity and were more likely to be motivated to be active to control a medical condition (Chi2 = 7.48; p = 0.006). Women with PCOS identified more sources of support compared to women without PCOS.
Physical activity is associated with lower depression in women with PCOS and differences exist in the self-reported physical activity barriers, motivators and support providers, compared to controls. Being more active may offer mental health benefits in managing PCOS. Prescribing physical activity to women with PCOS should be individualized and consider both common and PCOS-specific barriers and motivators for successful engagement.
Available from: Peter M Clifton
- "The present results are consistent with those reported by Kaplan et al.11 that observed in an 18‐month follow up to the provision of a 10‐week behavior modification and education program that incorporated a caloric restricted diet, that there was no additional benefit on QOL to patients with type 2 diabetes when EX (consisting of stretching and aerobic activities) was added to the program. Similarly, Thomson et al.18 reported an overall improvement in QOL and depression symptoms in response to a 20‐week program of a hypocaloric diet prescribed either alone or combined with EX (either aerobic or combined aerobic and resistance exercise) in overweight and obese women with polycystic ovary syndrome, with no difference between treatment groups. Collectively, these data suggest that when combined with a hypocaloric dietary intervention program, EX might not offer any observable additional benefit for improving QOL scores. "
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ABSTRACT: Aims/IntroductionTo evaluate the effects of a caloric restricted weight loss program with or without supervised resistance exercise training (EX) on diabetes-related emotional distress and quality of life (QOL) in overweight and obese patients with type 2 diabetes. Materials and Methods
In a parallel design, 106 men and women with type 2 diabetes were randomized to a prescriptive 16-week caloric restricted diet (D; 6,000–7,000 kJ/day), with (n = 65) or without (n = 41) EX (three times per week). Bodyweight, glycated hemoglobin, diabetes-specific emotional distress (Problem Areas in Diabetes [PAID] questionnaire) and QOL (Diabetes-39 [D-39] questionnaire) was assessed pre- and post-intervention. ResultsA total of 84 participants completed the study (D n = 33, D + EX n = 51). Weight loss was significantly greater in D + EX compared with D (−11.4 ± 5.8 vs −8.8 ± 5.8 kg, P = 0.04 time × diet). Overall, there were significant improvements in glycated hemoglobin, PAID total score and the D-39 dimensions of ‘diabetes control’, ‘anxiety and worry’, ‘sexual functioning’, ‘energy and mobility’, ‘overall rating of QOL’ and ‘severity of diabetes’ (P ≤ 0.01 for time). The D-39 dimension, ‘social burden’, did not change (P = 0.07 for time). There was no difference between groups in the response for any of these variables (P ≥ 0.10). ConclusionA structured caloric restricted diet with or without EX improves emotional distress and QOL in overweight and obese patients with type 2 diabetes. This trial was registered with Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTR No: ACTRN12608000206325).
Available from: Ninive Sanchez
- "Researchers also increasingly recognize the relevance of mental health and psychosocial factors in the behavioral (ie, lifestyle changes)37 and therapeutic (ie, oral contraceptives, metformin) treatment of PCOS.38–40 However, much of the mental health and psychosocial research on PCOS has focused on women entering young adulthood (age 20–29 years) and in adulthood (age 30–40 years). "
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ABSTRACT: Polycystic ovary syndrome (PCOS) is a major public health problem in the US. Worldwide, the public is largely unaware of the condition and health care providers do not seem to fully understand it. Research on PCOS has primarily focused on its etiology and clinical characteristics and less on the psychosocial aspects of human development associated with PCOS. This paper posits that a life course perspective provides a framework for further understanding the psychosocial experiences of women with PCOS and the contexts in which they live. The paper discusses how life course principles of human development, constraints on agency, interdependence of lives, time and place, and timing of events and experiences are relevant to the management of PCOS and prevention of its complications.
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