Slow metabolism maybe related to PCOS or Insulin Resistance

EvgeniZyntx

I just came across an article touching on the subject of Metabolism and PCOS. Apparently, the measured BMR was significantly lower in a group of women with PCOS (and further impacted by Insulin Resistance).

full article not available for free - here is my abstract summary:

Study: Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance
https://www.ncbi.nlm.nih.gov/pubmed/18678372

The study included 91 Greek women with PCOS and biochemical hyperandrogenemia, young and reasonable BMI (mean age 24.03 ± 0.55 years, mean BMI 26.67 ± 0.69 kg/m2) and 48 matched regularly menstruating women, with mean age 26.33 ± 0.93 years and mean BMI 23.35 ± 0.85 kg/m2, as control subjects.

Study showed Reduced BMR in PCOS with or without IR. Adjusted BMR was 1,868 ± 41 kcal/day in the control group, 1,445.57 ± 76 in all PCOS women, 1,590 ± 130 in PCOS women without IR and 1,116 ± 106 in PCOS women with IR. Adjusted BMR showed a statistically significant difference between women with PCOS and control subjects, with lowest values in the group of PCOS women with IR, even after adjusting all groups for age and BMI.

Women with PCOS, particularly those with IR, present a significantly decreased BMR.

Based on this, as a suggestion, I would recommend a rough 200 calorie decrease for PCOS alone and rough 400 calorie decrease for PCOS+IR in using a TDEE calculator for women with the confirmed condition or the consideration that the presence of a lower BMR might be related to this.

Which suggests not that someone with PCOS should necessarily be eating a lot less (because basic micro nutritional needs still must be met), rather that their daily activity level might/should be higher. Perhaps 20/30+ minutes of activity will cover this difference.

Hope the info helps.

eric_sg61

Good info. It should also put to rest the argument that CICO doesn't work for these individuals with medical condition and/ or on certain medications. These individuals have an altered calories out part of the equation that needs adjusting.

xesixb

Thanks for the info! Most women with PCOS suffer from insulin resistance,so we have to watch our carbs. It's how two people can eat the same every day but are affected by it differently. Usually women with PCOS are prescribed to take metformin daily in order to cope with insulin resistance.

Delicate

Being a women with PCOS and IR, this is thoroughly depressing, but I always kinda knew it. (i've always exercised too)

Screwed hormones, less efficient, it makes sense somewhat.

xesixb

Being a women with PCOS and IR, this is thoroughly depressing, but I always kinda knew it. (i've always exercised too)

Screwed hormones, less efficient, it makes sense somewhat.

I hear you. Our hormones are truly screwed.

shorshabae

Pretty small cohort don't you think? Has this study been replicated by anyone else?

nancy10272004

Maybe I'm the lucky exception. I have insulin resistance and am on medications that may cause a slowdown in the ability to lose weight but CICO/IIFYM has worked for me. I also have serious hormone issues due to peri-menopause.

I'm down 32 lbs in 106 days. That's not bad considering that I am only allowed to use 5000 steps on my FitBit as exercise and I'm set at 1540 calories/day. Yes. I have a closed diary. I don't really feel like getting spoken to about going to Chipotle or eating at the company cafeteria at work.

I think the study (limited as it is) might be true for a lot of women with PCOS and insulin resistance but I also think that sometimes articles like this give people an excuse to use to explain why they're not losing weight. Flame away. Tell me I'm the exception not the rule but I just don't want people to think they're doomed.

Delicate

I'm down 32 lbs in 106 days. That's not bad considering that I am only allowed to use 5000 steps on my FitBit as exercise and I'm set at 1540 calories/day.

You are doing well, however it took me 5 years to lose the weight I have, that was going through the recommended diets for pcos (GI diet, low fat diet, both with calorie restriction etc) and all it did was make me lethargic, skin horrible and hair fall out, and the sugar ups and downs (literally collapsing due to sugar crashes), I've always walked to work, exercised 3-5 times a week, but have switched to low carb/keto lost the weight, keeping it off and not getting cravings (granted its slow but atleast my meds have went down from 1500mg to 500mg metformin and im not fainting and havent since 2009).

PCOS is a very personal thing, i've put myself up for a few pcos studies but they have very strict criteria '4 mensis within a year' 'not have your latest mensis within a week of start of trial' 'not have the pill within 8 weeks of trial' (ironic considering most are taking the pill to control hormones cause of the pcos, but cant take part of a study cause they are on it, lol!)

What i'd give to be normal (but i got diagnosed over 10 years ago so have had time to get used to it, its my body its the only one i will have, i may aswell love it :flowerforyou: )

yarwell

"Adjusted BMR was 1,868 +/- 41 kcal/day in the control group, 1,445.57 +/- 76 in all PCOS women, 1,590 +/- 130 in PCOS women without IR and 1,116 +/- 106 in PCOS women with IR."

The "adjusted" caught my eye..

For each subject the predicted BMR was obtained by substituting the individual lean body mass, fat mass, gender, and age in the linear regression equation generated by the data of all patients. The prediction was then used to do an adjustment..

Adjusted BMR = BMR for sub-group + (measured BMR - predicted BMR)

As it happens the adjustment is around 50 cals so not a big deal either way. Does make you wonder what the effect of IR in the absence of PCOS is, the high insulin inhibiting the availability of fat from storage etc.

EvgeniZyntx

Pretty small cohort don't you think? Has this study been replicated by anyone else?

Medium size cohort with strong P values, so I don't see it as too small to report. And no, I have not come across a replicated study in this population yet.

shorshabae

I don't think its too small to report but with minimum cohort being 30, this isn't far off being too small. I appreciate that the findings may be true but I would take it all with a pinch of salt until they expanded it in to a much much bigger study and managed to replicate it.

I just worry with these kind of things people take a study findings as a gospel and use it to legitimise why they can't lose weight or change their lifestyle. From working in medicine I find that patients love having something to blame for their health when in fact it makes only a small difference overall.

EvgeniZyntx

"Adjusted BMR was 1,868 +/- 41 kcal/day in the control group, 1,445.57 +/- 76 in all PCOS women, 1,590 +/- 130 in PCOS women without IR and 1,116 +/- 106 in PCOS women with IR."

The "adjusted" caught my eye..

For each subject the predicted BMR was obtained by substituting the individual lean body mass, fat mass, gender, and age in the linear regression equation generated by the data of all patients. The prediction was then used to do an adjustment..

Adjusted BMR = BMR for sub-group + (measured BMR - predicted BMR)

As it happens the adjustment is around 50 cals so not a big deal either way. Does make you wonder what the effect of IR in the absence of PCOS is, the high insulin inhibiting the availability of fat from storage etc.

Seems like a reasonable comparison method to remove lbm, age and height factors - although stronger statistical methods could have been used.

I haven't looked for IR influence in BMR - this was stumbled across as I am looking into source articles on various RMR/BMR equations methods. Frankly a mess.

SharonNehring

Thanks for posting this! It does confirm what I've already figured out. I have PCOS with IR which developed into type 2 about 6 months ago. I've been counting carbs and taking meds but one thing has become clear... If I compare 2 weeks with similar eating, one week with daily exercise and one week of 3 days of exercise, the daily exercise week helps me lose 2-3 times more.

So eating well is good but combined with daily exercise is great!

yarwell

Pretty small cohort don't you think? Has this study been replicated by anyone else?

http://www.healio.com/endocrinology/reproduction-androgen-disorders/news/online/{1299eb75-d58b-404f-8220-28d2daa086d4}/bmi-may-be-most-vital-determinant-of-basal-metabolic-rate-in-pcos

suggests BMI is a bigger factor, but I can't find the paper easily.

yarwell

Seems like a reasonable comparison method to remove lbm, age and height factors - although stronger statistical methods could have been used.

I'm not a fan of using regression through the study subjects for correction, something more population based appeals more as the small sample gives some pretty weak BMR correlations.

_Zardoz_

I'm afraid just examining study using it's abstract is pretty pointless. Without seeing the whole study it's impossible to evaluate it properly. That's the problem with this forum too many people post abstracts supporting a point of view without access to the full study. All that this abstract is is interesting

sbbhbm

I have always told anyone who asks me how I've lost and kept the weight off, that for me exercise has been key. Exercise (I'm fairly certain I read this, but anyone feel free to correct me) also has the benefit of increasing insulin response. Diagnosed PCO/IR ten years ago.

EvgeniZyntx

I don't think its too small to report but with minimum cohort being 30, this isn't far off being too small. I appreciate that the findings may be true but I would take it all with a pinch of salt until they expanded it in to a much much bigger study and managed to replicate it.

I just worry with these kind of things people take a study findings as a gospel and use it to legitimise why they can't lose weight or change their lifestyle. From working in medicine I find that patients love having something to blame for their health when in fact it makes only a small difference overall.

Not sure where you are getting that 30. Looking at that "adjusted" difference and variance, the post-hoc power of this study has to be close to 100%, if not that. Methodologically speaking, replication isn't what is needed to validate a study, it remains valid until another study shows reversal of hypothesis.

As to your interpretation, while it might be true, and some people might use it as justification one doesn't get to argue away results from the convenience of how those results might be improperly used. The data is there, I invite you to find conflicting information that shows that PCOS/IR does not influence metabolism.

EvgeniZyntx

I'm afraid just examining study using it's abstract is pretty pointless. Without seeing the whole study it's impossible to evaluate it properly. That's the problem with this forum too many people post abstracts supporting a point of view without access to the full study. All that this abstract is is interesting

I agree that it is usually more effective to review the entire article, however, not having access to it - the abstract and the conclusions presented are still of general interest. Furthermore, a study doesn't exist by itself there is a body of knowledge that supports that PCOS, as complex as it might be, has a variety of hormonal impacts that influence thermogenesis regulation and substrate utilization.

kethry70

Being a women with PCOS and IR, this is thoroughly depressing, but I always kinda knew it.....

Screwed hormones, less efficient, it makes sense somewhat.

Yeah - that.
Turns out that calories in calories out and exercise work for me... But it worked better when I restricted treats more than I have been lately. When I started in January 2013, I pretty much got all my carbs from fruits, nuts, dairy, and veggies for quite a while.... Now, I aim for 25-30% of my cals from carbs and I try to keep my treats to single measured servings and on an occasional basis. I still restrict grains to fit my macros and cause I don't really miss them.

Diagnosed PCOS/IR in march of 2003. No meds since my second pregnancy (late 2006). I'm now 44, probably peri-menopausal, and my ovaries apparently looked much improved at my last annual. Turned down having blood work done but now kicking myself since it would be nice to hopefully see what 40+ lbs has done for me even though my BMI and BF% are still high

omma_to_3

PCOS and IR. Tested RMR is consistently 10% higher than all the formula estimations.

If in doubt, get your RMR tested. I was sure mine would be low but it's actually high.