All ETDs from UAB

Advisory Committee Chair

Amy Goss

Advisory Committee Members

Paula Chandler-Laney

Jose Fernandez

Kevin R Fontaine

Barbara A Gower

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Dysregulated appetite may contribute to weight gain and high prevalence of comorbid obesity in women with polycystic ovary syndrome (PCOS), yet dietary recommendations to promote satiety and facilitate weight maintenance in this population remain scarce. The objective of this dissertation was to determine if women with PCOS have alterations in appetite-regulating hormones that can be manipulated by low glycemic load diet habituation to improve satiety. This was tested by secondary analyses of two randomized controlled dietary intervention trials in women with and without PCOS. First, we explored differences in women with and without PCOS during a standardized liquid meal test at baseline. We observed that women with PCOS had lower postprandial glucagon-like peptide-1 (GLP-1), which was related to SHBG, and experienced greater hunger while fasted compared to women without PCOS. Next, we examined responses in appetite hormones and perceived appetite to high and low glycemic load meals following 4 weeks of diet habituation in women with PCOS. We found that ghrelin and glucagon were greater following a low compared to high glycemic load meal in women with PCOS. We also observed that greater fasting glucagon was associated with lesser feelings of hunger after a low glycemic load meal in women with PCOS. Finally, we investigated appetite responses to a standardized liquid meal test following 8-weeks of habituation to high and low glycemic load diet interventions in women with and without PCOS. We observed no changes in gut hormones in women with PCOS. Women without PCOS had iv higher fasting GLP-1 after the high GL diet intervention, and lower ghrelin iAUC and hunger iAUC following low GL diet habituation. Additionally, women with PCOS reported higher fasting hunger after the high GL diet intervention, and women without PCOS reported higher measures of perceived appetite following both diet interventions. These findings collectively indicate that women with PCOS have differences in appetite hormones and perceived appetite that may contribute to excess energy intake and weight gain. Further, habituation to a low glycemic load diet in women with PCOS may facilitate changes in homeostatic appetite regulation and perceived appetite to facilitate greater satiety.

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