Dietary under-reporting in women affected by Polycystic Ovary Syndrome: A Pilot Study.

Aim: The first-line therapy for polycystic ovary syndrome (PCOS) is weight loss focussing on diet and regular exercise;
measurement of diet and energy intake (EI) is important to determine associations between nutrients and health
in women with PCOS. The EI underreporting (UR) is a condition characterised by reports of habitual EI that is implausibly
low, compared with estimated requirements. This case–control study aims to evaluate UR in women with PCOS.
Methods: Thirty-six women with PCOS were enrolled according to the Rotterdam criteria; 37 healthy women were
enrolled as controls. Inclusion criteria: age range 18–45 and body mass index ≥18.5 kg/m2 in subjects without eating
disorders and/or diabetes mellitus. Nutritional assessment includes: anthropometric, basal metabolic rate (BMR),
weight history and physical activity assessment. Subjects filled a three-day non-consecutive dietary diary to identify
energy and macronutrient intake. UR was calculated (Goldberg Index: EI/BMR).
Results: Although women with PCOS reported a significantly higher mean BMR than controls (P < 0.0001), their EI
was lower (P < 0.001), suggesting an UR in 47.2% of women with PCOS versus 2.7% of controls (P < 0.0001). The EI
from simple sugars was lower in women with PCOS than controls (P < 0.01). The protein intake was increased in controls
than women with PCOS (P < 0.0001). Weight cycling was more frequent in women with PCOS (P < 0.001). Logistic
regression analysis identified UR associated with PCOS (P = 0.001).
Conclusions: Women with PCOS underreport foods rich in simple sugars rather than underreport their total dietary
intake. These results may have implications for the interpretation of diet and health correlations in this patient
population.