NCT01079845

Brief Summary

Background. The polycystic ovary syndrome (PCOS) is a complex hormonal disorder that presents in susceptible girls around the time of menarche. Females with PCOS have high levels of androgens (e.g., testosterone). While cosmetic appearance (excess facial hair and acne) and menstrual disturbances were once considered the primary concerns, emerging data indicate that many adolescents and young adults with PCOS are insulin resistant and at increased risk for metabolic syndrome and diabetes. The majority of females with PCOS are obese, and excess body fat amplifies the severity of the syndrome. Dietary intervention is considered an important component of treatment for PCOS. However, a consensus statement regarding optimal nutrient composition for treating adolescents and young adults with PCOS has not been published because data are lacking to provide a foundation for such a statement. Recognizing increased risk for diabetes in patients with PCOS, many practitioners employ a low-fat diet as prescribed in the Diabetes Prevention Program (DPP) for weight loss and control of symptoms. Objective and Hypothesis. The purpose of this research study is to compare different diets for treating PCOS. We hypothesize that a low-glycemic load diet - designed to lower blood levels of glucose and insulin - will be more beneficial than a low-fat diet in obese adolescents and young adults with PCOS. Design. We propose a 6-month study in which 50 obese females with PCOS (ages 13 to 21 years) will be assigned to receive one of two dietary treatments, with the goal of retaining 40 participants. Group assignment will be at random. One of the treatments will be a low-glycemic load diet, and the other treatment will be a low-fat diet (modeled after the DPP diet). Participants in both groups will receive individual nutrition education and dietary counseling with a registered dietitian (clinic visits, telephone calls) and cooking workshops with a chef. The purpose of the cooking workshops will be to enhance compliance with diet prescriptions, beyond what can be achieved by nutrition education and dietary counseling in a conventional clinic setting. The primary outcome will be bioavailable testosterone (form of testosterone that causes symptoms of PCOS). Secondary outcomes will include other blood tests to evaluate further high androgen levels (total testosterone, free testosterone, sex hormone binding globulin, dehydroepiandrosterone sulfate), clinical signs of high androgen levels (excess facial hair, acne), glucose tolerance and risk for diabetes (determined by blood sugar and insulin measurements), risk for cardiovascular disease (based on blood cholesterol and C-reactive protein levels and blood pressure), body fat percentage and distribution (measured using state-of-the-art dual energy x-ray absorptiometry and waist circumference), menstrual cyclicity, and health-related quality of life (evaluated by questionnaire).

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
19

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Jul 2010

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 2, 2010

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 3, 2010

Completed
4 months until next milestone

Study Start

First participant enrolled

July 1, 2010

Completed
3.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2013

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2013

Completed
Last Updated

February 5, 2015

Status Verified

February 1, 2015

Enrollment Period

3.3 years

First QC Date

March 2, 2010

Last Update Submit

February 4, 2015

Conditions

Keywords

DietNutritionAdolescentYoung AdultOverweightObesity

Outcome Measures

Primary Outcomes (1)

  • Bioavailable Testosterone

    Baseline, 6 months

Secondary Outcomes (6)

  • Other Biochemical and Clinical Signs of Hyperandrogenism

    Baseline, 6 months

  • Insulin Sensitivity and Beta-cell Function

    Baseline, 6 months

  • Risk for Cardiovascular Disease

    Baseline, 6 months

  • Body Weight and Composition

    Baseline, 6 months

  • Cyclicity of Menstrual Periods

    Monthly

  • +1 more secondary outcomes

Study Arms (2)

Low-glycemic Load Diet

EXPERIMENTAL
Behavioral: Nutrition Education, Dietary Counseling, and Cooking

Low-fat Diet

ACTIVE COMPARATOR
Behavioral: Nutrition Education, Dietary Counseling, and Cooking

Interventions

Monthly clinic visits with a dietitian, Monthly telephone calls with a dietitian, Three cooking workshops with a chef

Low-fat DietLow-glycemic Load Diet

Eligibility Criteria

Age13 Years - 21 Years
Sexfemale
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Diagnosis of PCOS.
  • Aged 13 to 21 years (and living at home with a parent, only for those \<18 years old).
  • Body mass index (BMI) at or above the 85th percentile.
  • Access to a working telephone.
  • At least one parent willing and able to participate in the intervention, only for those \<18 years old.
  • Residing in predominately one household (no more than one weekend every two weeks in a secondary household).
  • Medical clearance from the physician who is treating PCOS.

You may not qualify if:

  • Physician diagnosis of a major medical illness or eating disorder.
  • Fasting blood glucose at or above 126 mg/dL, indicating diabetes mellitus.
  • Chronic use of any medication that may affect study outcomes.
  • Current smoking.
  • Physical, mental, or cognitive handicaps that prevent participation.
  • Sister participating in the study.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Children's Hospital Boston

Boston, Massachusetts, 02115, United States

Location

Related Publications (3)

  • Ebbeling CB, Leidig MM, Feldman HA, Lovesky MM, Ludwig DS. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA. 2007 May 16;297(19):2092-102. doi: 10.1001/jama.297.19.2092.

    PMID: 17507345BACKGROUND
  • Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced-glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003 Aug;157(8):773-9. doi: 10.1001/archpedi.157.8.773.

    PMID: 12912783BACKGROUND
  • Palmert MR, Gordon CM, Kartashov AI, Legro RS, Emans SJ, Dunaif A. Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome. J Clin Endocrinol Metab. 2002 Mar;87(3):1017-23. doi: 10.1210/jcem.87.3.8305.

    PMID: 11889155BACKGROUND

MeSH Terms

Conditions

Polycystic Ovary SyndromeOverweightObesity

Interventions

Nutrition AssessmentCooking

Condition Hierarchy (Ancestors)

Ovarian CystsCystsNeoplasmsOvarian DiseasesAdnexal DiseasesGenital Diseases, FemaleFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGenital DiseasesGonadal DisordersEndocrine System DiseasesOvernutritionNutrition DisordersNutritional and Metabolic DiseasesBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Data CollectionEpidemiologic MethodsInvestigative TechniquesHealth Care Evaluation MechanismsQuality of Health CareHealth Care Quality, Access, and EvaluationEpidemiologic MeasurementsPublic HealthEnvironment and Public HealthFood HandlingFood IndustryIndustryTechnology, Industry, and Agriculture

Study Officials

  • Cara B. Ebbeling, PhD, MS

    Boston Children's Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Director, Obesity Prevention Center

Study Record Dates

First Submitted

March 2, 2010

First Posted

March 3, 2010

Study Start

July 1, 2010

Primary Completion

November 1, 2013

Study Completion

November 1, 2013

Last Updated

February 5, 2015

Record last verified: 2015-02

Locations