The effects of exercise and lifestyle management in overweight women with polycystic ovary syndrome /
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(Published version)
Date
2009
Authors
Thomson, Rebecca,
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thesis
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Abstract
Polycystic ovary syndrome (PCOS) is characterised by the presence of polycystic ovaries, menstrual dysfunction, infertility and hyperandrogenism and is associated with an increased prevalence of cardiovascular disease (CVD) risk factors and psychological problems. The benefits of combining exercise and energy restriction for improving these associated PCOS problems have not been extensively studied. This thesis evaluated exercise tolerance in overweight and obese women with PCOS and the effects of aerobic and aerobic-resistance exercise when combined with an energy-restricted diet on body composition, CVD risk factors, reproductive function, hormonal profile and PCOS-related psychological problems.Exercise tolerance was assessed in a sample of overweight/obese women with PCOS and age- and weight-matched controls by evaluating maximal aerobic capacity and muscle strength. No differences were observed in aerobic exercise capacity, perceptions of exertion during exercise and muscle strength between women with PCOS and controls, suggesting that PCOS did not impact the ability to undertake exercise.Overweight/obese women with PCOS were subsequently randomised to one of three 20-week weight loss programs: diet only (DO), diet and aerobic exercise (DA) or diet and combined aerobic-resistance exercise (DC). All treatments resulted in significant weight loss, with no differences between groups; however exercising groups had enhanced improvements in body composition, with greater reductions in fat mass and preservation of fat-free mass compared with DO. There were similar improvements in cardiometabolic risk factors and hormonal profile for all treatments and ~50% of women improved reproductive function. Following the weight loss interventions, depression and health-related quality of life scores also improved similarly in all groups with no additional benefit of exercise training observed.Heart rate recovery (HRR), an independent predictor of CVD, was also measured following a graded treadmill test to exhaustion in a subgroup of women who completed exercise testing at baseline and Week 10. Following weight loss HRR improved, demonstrating that HRR is another modifiable CVD risk factor in overweight and obese women with PCOS.Anti-müllerian hormone (AMH), a possible predictor of reproductive responsiveness to weight loss, was assessed in a subgroup of women with PCOS and reproductive impairment. Women who improved reproductive function had lower baseline AMH levels and greater weight loss compared with women who did not improve. However, despite improvements in reproductive function, AMH levels did not change with weight loss.This thesis work also showed good absolute and relative agreement between changes in body composition during weight loss assessed by dual energy x-ray absorptiometry (DXA) and two bioelectrical impedance analysis methods (BIA), suggesting that BIA may provide a viable alternative to DXA to assess changes in body composition during weight loss in obese women with PCOS.In summary, the addition of aerobic or aerobic-resistance exercise to an energy-restricted diet improved body composition but had no additional effect on improvements in cardiovascular, hormonal, reproductive and psychological outcomes compared with diet alone. Improvements in reproductive function were associated with low baseline AMH and greater weight loss. As a result lifestyle modifications that combine energy restriction and regular exercise would appear to be an effective treatment strategy in overweight women with PCOS.
School/Discipline
University of South Australia. School of Health Sciences.
School of Health Sciences.
School of Health Sciences.
Dissertation Note
Thesis (PhD)--University of South Australia, 2009.
Provenance
Copyright 2009 Rebecca Thomson.
Description
EN-AUS
1 ethesis (xix, 235 pages) :
illustrations
Includes bibliographical references.
1 ethesis (xix, 235 pages) :
illustrations
Includes bibliographical references.
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