Abstract
Summary
Background: Obesity is associated with increased risk for cardiovascular disease, type 2 diabetes mellitus, sleep apnea and some cancer types. In women, obesity may play a role in the development of polycystic ovary syndrome (PCOS). Obesity develops when a human s energy intake exceeds its energy expenditure, and choice of food is an important factor in the development of excessive fat tissue. However, the actual diet composition to obese compared to normal weight women are difficult to obtain. Reported information about food habits and dietary pattern, tend to be misreported, both among lean and obese women. Furthermore, diet, physical activity and adipositas status affect risk markers for cardiovascular disease; as dyslipidemia and adipokine profile. A common metabolic abnormality in women with PCOS is dyslipidemia, and these women also tend to have a more abdominal fat distribution than other women, making them more vulnerable for cardiovascular disease. Weight reduction and thereby improved body composition, improve the risk factors for cardiovascular disease, and might be induced by low-calorie-diets, which consist of either traditional food items or meal replacements.
Method: Part one: Dietary interview, from 116 morbidly obese women and 20 normal weight control women, based on a FFQ, were utilised in the MOBIL-study. The reported food and energy intake among obese women were compared to normal weight women, with regard to dietary composition, food choices and accuracy in energy intake reporting. Part two: Preliminary results from a randomized controlled prospective diet intervention study (FEMIN), including 9 morbidly obese women diagnosed with PCOS, where the effect of eight weeks intake of two different low-calorie-diets; the crisp bread diet and the powder diet, on anthropometric measures, body composition, blood pressure, lipid and adipokine profile were investigated.
Results: Part one: Morbidly obese women had a more unfavourable lipid profile, body composition and expression of adipokines compared to the control women. Obese women reported almost the same energy and macronutrient intake as normal weight women. The intake of fat and saturated fat tended to be higher, while the consumption of alcohol was lower among the obese women than among the control women. There were more under-reporters among obese than the normal weight women, and the amount of underreported kcal was higher. Part two: Eight weeks on a low-calorie-diet lead to significant improvement in anthropometric measures together with an improved body composition among women with PCOS.
Conclusion: Obese women and normal weight controls reported the same energy and macronutrients intake; however the intake of fat and saturated fat tended to be higher among the obese. Our results may suggest that obese women have a diet consisting of more fat containing food items compared to the normal weight women, whose fat intake is restricted to fewer particularly fatty food items. Obese women with pre-PCOS status consumed more potatoes, meat products and forcemeat, butter, margarine and oil, light squash/soft drinks and artificially sweetened soft drinks than women with lower FTI score. However, since the obese women underreported more than normal weight controls, it is difficult to state what the actual differences between the diets of obese and normal weight women are. Furthermore, morbidly obese women with PCOS have favourable effects of low-calorie-diets, improving several of their enhanced cardiovascular risk factors.