Dietary intake, resting energy expenditure, and eating behavior in women with and without polycystic ovary syndrome

Background: Data on dietary intake, meal patterns, and eating attitudes from women with polycystic ovary syndrome (PCOS) is limited despite the fact that PCOS is associated with obesity. We aimed to test the hypothesis that women with PCOS display altered dietary intakes and eating behaviors compared to controls. Methods: Women with PCOS (n = 72) as defined according to the modified Rotterdam criteria were compared with healthy controls (n = 30). Anthropometry included measurement of waist circumference and determination of the resting metabolic rate via indirect calorimetry. All women completed questionnaires regarding eating behavior; Three-Factor Eating Questionnaire (TFEQ-R21) and eating attitudes; Eating Attitudes Test (EAT). Group comparisons were done by Mann Whitney U test and logistic regression analysis was used for adjustments of age and BMI in a non-parametric way. Results: BMI was higher in women with PCOS compared to controls. Resting metabolic rate did not differ between women with women with and without PCOS after adjustment for age and BMI [1411 +/- 229 kcal/day versus 1325 193 kcal per day (P = 0.07)], whereas the respiratory exchange ratio was higher in women with PCOS than in controls [0.83 +/- 0.07 versus 0.78 +/- 0.08 (P = 0.02 after adjustments for age and BMI)]. Energy percent (E%) carbohydrates was higher in women with PCOS compared to controls (P = 0.017), but E% alcohol was lower (P = 0.036) after adjustment for age and BMI. The average total EAT scores and EAT dieting subscale scores were higher in women with PCOS compared with controls (P = 0.001 and P = 0.024, respectively) after adjustment for age and BMI. No difference was found for previous or current symptoms of bulimia nervosa. Conclusions: Independent of BMI and age, the resting metabolic rate did not differ between women with and without PCOS indicating that women with PCOS should have equal abilities in terms of energy metabolism to lose weight as women without PCOS. Women with PCOS showed greater concerns about their weight and dieting, and this indicates that anxiety about weight is one of the psychological symptoms of PCOS. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.