CCRC: The Effects of Walnuts, Walnut-Oil, Almonds and Fish Oils on Glucose Homeostasis in Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is a common disease that affects 1 out of 16 women. Metabolic and
endocrine abnormalities seen in PCOS include insulin resistance, androgen excess and
infertility. This study focuses on the insulin resistance aspect because increased insulin
resistance leads to premature onset of impaired glucose tolerance or diabetes whereas
decreased insulin resistance reduces androgen excess, improves the ovarian function and
increases fertility. Although insulin resistance can be treated with insulin-sensitizing
drugs, PCOS clinically manifests during adolescence and the long-term safety of the
drug-treatment can be a concern. Thus, improving insulin resistance with effective
nutritional approaches would be very desirable. Epidemiological studies and animal
experiments suggest that replacement of dietary saturated fats with monounsaturated (MUFA)
and polyunsaturated (PUFA) fats improves insulin resistance.

Inclusion Criteria:

- Clinical diagnosis of polycystic ovary syndrome

- Body mass index (BMI) 22-52

Exclusion Criteria:

- Habitual dietary intake of less than 30% fat

- Use of oral contraceptives, insulin sensitizers, d-chiro inositol, or any other
supplements affecting weight or insulin sensitivity during the preceding two months

- Impaired glucose tolerance

- Diabetes mellitus

- Other system illnesses such as renal, hepatic, gastrointestinal, severe
hyperlipidemia and hypertension that require medication

- Smoking, alcohol intake (more than 2 drinks/week)

- The laboratory values used for exclusion of subjects will be fasting glucose > 110
mg/dl, glycosylated hemoglobin (HgBA1) > 6.5%, serum creatinine > 1.5 mg/dl, ALT or
AST > 2x the upper limit of normal, cholesterol > 250 mg/dl. The investigators will
also exclude subjects with hematocrit < 30%.