The Effects of the Portfolio Low-Carbohydrate Diet versus the Ketogenic Diet on Anthropometric Indices, Metabolic Status, and Hormonal Levels in Overweight or Obese Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial

Abstract

Background Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. It is believed that excessive androgen production is primarily caused by hyperinsulinemia, making it the main factor in the development of PCOS. The portfolio low-carbohydrate diet (PLCD) is a plant-based diet with a carbohydrate content of 40% and incorporates five cholesterol-lowering foods. While, the ketogenic diet is a high-fat diet that 70% of its calories come from fat, promoting a ketosis state. However, to the best of our knowledge, no study compared the therapeutic effects of these two diets in PCOS patients. Thus, this study aimed to compare the impact of PLCD and KD on anthropometric indices, metabolic status, and hormonal levels in overweight or obese women with PCOS. Methods This randomized clinical trial was conducted on forty-six overweight or obese women diagnosed with PCOS. Participants were randomly allocated into either the PLCD or the KD group for 8 weeks. The anthropometric indices including body mass index (BMI), fat body mass (FBM), and waist circumference (WC), as well as metabolic markers including fasting blood glucose (FBG), plasma insulin levels, HOMA-IR, and plasma lipid profiles including total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), and high-density lipoproteins (HDL), were measured. Reproductive hormones including follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone, as well as Ferriman Gallwey score were assessed at the baseline and after the intervention. Results After 8 weeks, both diets demonstrated enhancements in anthropometric, metabolic, and reproductive hormonal status. However, the mean difference in weight reduction, BMI, WC, FBG, HOMA-IR, LH, and FSH was significantly greater in the KD group than in the PLCD group (P < 0.05). Nevertheless, plasma lipid profiles including TC, LDL, and HDL indicated more improvement in the PLCD compared to the KD group. There were no significant changes in the Ferriman-Gallwey score within or between the two groups. Conclusions The study findings revealed that both the PLCD and the KD diets were effective in improving PCOS manifestations. However, the KD exhibited greater effectiveness in enhancing body measurements, metabolic factors, and hormone levels compared to the PLCD in women with PCOS. Registration number of Clinical Trial: IRCT20200912048693N3, Trial registered 2022–12–14. https://www.irct.ir/trial/67548