The effects of ketogenic diet on the outcomes of polycystic ovary syndrome: A systematic review on clinical trials

Document Type : Review Article

Authors

1 B.Sc. Student in Nutrition Sciences, Student Research Committee, School of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 PhD candidate of Nutrition Sciences, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Cellular and Molecular Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: Polycystic ovary syndrome is a major cause of anovulation and infertility in women that is associated with chronic diseases such as obesity, insulin resistance, diabetes, cardiovascular disease, and fatty liver disease. This systematic review was performed aimed to determine the effects of ketogenic diet on the outcomes of polycystic ovary syndrome.
Methods: In this systematic review, the keywords of “polycystic ovary syndrome”, “ketogenic diet”, “low carbohydrate diet”, and “clinical trials” were searched in databases of Medline, PubMed, Science Direct, Magiran, ISD, ISC and Cochrane in English and Persian language without time restrictions. Then, the articles relevant to the study's aim were reviewed.
Results: In this research, 4 studies were examined. The results showed that following a ketogenic diet in patients with polycystic ovary syndrome may reduce the risk of cardiovascular diseases in these patients by lowering weight and body mass index, blood pressure, serum total cholesterol, and triglycerides.
Conclusion: Long-term adherence to a ketogenic diet may result in weight loss, improved insulin resistance, and serum lipid profile disorders in patients with polycystic ovary syndrome. Clinical trials are suggested to evaluate the effects of ketogenic diet on these metabolic and endocrine factors in PCOS women.
 

Keywords

References

  1. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Frontiers in bioscience (Elite edition) 2014; 6:104.
  2. Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian journal of endocrinology and metabolism 2014; 18(3):317-24.
  3. Sayehmiri F, Kiani F, Maleki F, Ahmadi M, Shohani M. Prevalence of polycystic ovary syndrome in Iranian women: a systematic review and meta-analysis. Iran J Obstet Gynecol infertil 2014; 17(115):11-21.
  4. Jalilian A, Kiani F, Sayehmiri F, Sayehmiri K, Khodaee Z, Akbari M. Prevalence of polycystic ovary syndrome and its associated complications in Iranian women: A meta-analysis. Iranian journal of reproductive medicine 2015; 13(10):591-604.
  5. Glueck CJ, Phillips H, Cameron D, Sieve-Smith L, Wang P. Continuing metformin throughout pregnancy in women with polycystic ovary syndrome appears to safely reduce first-trimester spontaneous abortion: a pilot study. Fertility and sterility 2001; 75(1):46-52.
  6. Hashemipour M, Faghihimani S, Zolfaghary B, Hovsepian S, Ahmadi F, Haghighi S. Prevalence of polycystic ovary syndrome in girls aged 14–18 years in Isfahan, Iran. Hormone Research in Paediatrics 2004; 62(6):278-82.
  7. George S, Alex A. Assessment of Symptoms and Diet Intake in Young Adult with Polycystic Ovary Syndrome (PCOS). Journal of Scientific Research 2021; 65(4).
  8. Baldauff NH, Witchel SF. Polycystic ovary syndrome in adolescent girls. Current Opinion in Endocrinology & Diabetes and Obesity 2017; 24(1):56-66.
  9. Diamanti-Kandarakis E, Kandarakis H, Legro RS. The role of genes and environment in the etiology of PCOS. Endocrine 2006; 30(1):19-26.
  10. Panda PK, Rane R, Ravichandran R, Singh S, Panchal H. Genetics of PCOS: A systematic bioinformatics approach to unveil the proteins responsible for PCOS. Genomics data 2016; 8:52-60.
  11. Sam S. Obesity and polycystic ovary syndrome. Obesity management 2007; 3(2):69-73.
  12. Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC medicine 2010; 8(1):1-0.
  13. Luscombe-Marsh ND, Noakes M, Wittert GA, Keogh JB, Foster P, Clifton PM. Carbohydrate-restricted diets high in either monounsaturated fat or protein are equally effective at promoting fat loss and improving blood lipids. The American journal of clinical nutrition 2005; 81(4):762-72.
  14. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes care 1999; 22(1):141-6.
  15. Sam S, Dunaif A. Polycystic ovary syndrome: syndrome XX?. Trends in Endocrinology & Metabolism 2003; 14(8):365-70.
  16. Laitinen J, Taponen S, Martikainen H, Pouta A, Millwood I, Hartikainen AL, et al. Body size from birth to adulthood as a predictor of self-reported polycystic ovary syndrome symptoms. International journal of obesity 2003; 27(6):710-5.
  17. Zafari Zangeneh F, Naghizadeh MM, Abedinia N, Haghollahi F. Risk factors in polycystic ovary syndrome. Iran J Obstet Gynecol infertil 2012; 15(6):1-9.
  18. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. The journal of clinical endocrinology & metabolism 1999; 84(1):165-9.
  19. Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN, et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 2006; 91(1):48-53.
  20. Sıklar Z, Berberoğlu M, Çamtosun E, Kocaay P. Diagnostic characteristics and metabolic risk factors of cases with polycystic ovary syndrome during adolescence. Journal of pediatric and adolescent gynecology 2015; 28(2):78-83.
  21. Dunaif A. Hyperandrogenic anovulation (PCOS): a unique disorder of insulin action associated with an increased risk of non-insulin-dependent diabetes mellitus. The American journal of medicine 1995; 98(1):S33-9.
  22. Noormohammadi M, Eslamian G, Malek S, Shoaibinobarian N, Mirmohammadali SN. The association between fertility diet score and polycystic ovary syndrome: A Case-Control study. Health Care for Women International 2022; 43(1-3):70-84.
  23. Eslamian G, Hekmatdoost A. Nutrient patterns and risk of polycystic ovary syndrome. Journal of Reproduction & Infertility 2019; 20(3):161-8.
  24. Eslamian G, Baghestani AR, Eghtesad S, Hekmatdoost A. Dietary carbohydrate composition is associated with polycystic ovary syndrome: a case–control study. Journal of Human Nutrition and Dietetics 2017; 30(1):90-7.
  25. Zhang X, Zheng Y, Guo Y, Lai Z. The effect of low carbohydrate diet on polycystic ovary syndrome: a meta-analysis of randomized controlled trials. International Journal of Endocrinology 2019; 2019.
  26. Barrea L, Marzullo P, Muscogiuri G, Di Somma C, Scacchi M, Orio F, et al. Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutrition research reviews 2018; 31(2):291-301.
  27. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European journal of clinical nutrition 2013; 67(8):789-96.
  28. Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of internal medicine 2005; 142(6):403-11.
  29. Alwahab UA, Pantalone KM, Burguera B. A ketogenic diet may restore fertility in women with polycystic ovary syndrome: a case series. AACE Clinical Case Reports 2018; 4(5):e427-31.
  30. Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutrition & metabolism 2005; 2(1):1-5.
  31. Paoli A, Mancin L, Giacona MC, Bianco A, Caprio M. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. Journal of translational medicine 2020; 18(1):1-11.
  32. Li J, Bai WP, Jiang B, Bai LR, Gu B, Yan SX, et al. Ketogenic diet in women with polycystic ovary syndrome and liver dysfunction who are obese: A randomized, open‐label, parallel‐group, controlled pilot trial. Journal of Obstetrics and Gynaecology Research 2021; 47(3):1145-52.
  33. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinology and Metabolism Clinics 2014; 43(1):123-47.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 7
September 2022
Pages 128-138

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