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Eucaloric High-fat Diet Effects on Reproductive Hormone Profiles: Mimicking Reprometabolic Syndrome in Normal Weight
Katherine Kuhn1, Andrew P Bradford1, Irene E Schauer2
1Department of Obstetrics & Gynecology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Context:
Reprometabolic syndrome is associated with relative hypogonadotropic hypogonadism, reduced fecundability, and increased pregnancy loss in women with obesity.
Objective:
Does a eucaloric, high-fat diet (HFD) decrease gonadotropins, urinary estrogen, and progesterone metabolites, characteristic of reprometabolic syndrome, in healthy women of normal body mass index (BMI)?
Design:
Interventional study.
Setting:
University medical center.
Participants:
Eighteen healthy, eumenorrheic women with normal BMI (18-24.9 kg/m²), age 29.1 ± 6.3.
Interventions:
A 4-month study including a prescribed 30-day, eucaloric HFD (48% calories from fat). Women collected daily first-voided morning urine for 4 menstrual cycles: pre-diet, on-diet, and 2 post-diet.
Main Outcome Measures:
Urinary LH, FSH, estrone conjugate (E1c), and pregnanediol-3-glucuronide (Pdg) levels were measured daily before, during, and after HFD. Cycles were aligned by LH peak and standardized to a 28-day cycle. Peak and integrated hormone levels were compared across cycles using generalized estimating equations.
Results:
Participants were weight-stable with no change in BMI. Peak E1c, Pdg, FSH, and LH were significantly lower during and after the HFD compared to pre-diet levels (P < .05). Post-diet luteal phase urinary FSH and LH (area under the curve) were also significantly lower than pre-diet (P < .01). No significant changes in menstrual cycle length were observed.
Conclusion:
Consumption of a 1-month HFD was sufficient to induce a significant and sustained reduction in LH and FSH and lower E1c and Pdg characteristic of reprometabolic syndrome of obesity in normal-weight, eumenorrheic women. This indicates that dietary intervention may be an effective strategy to mitigate reproductive hormone deficiencies in women with obesity-related subfertility.
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