Effectiveness of Dietary Interventions on Metabolic Profile and Hormonal Profiles in Women with Polycystic Ovary Syndrome (PCOS): A Systematic Review Study

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, characterized by insulin resistance, visceral fat accumulation, dyslipidemia, and hyperandrogenism. The combination of metabolic and hormonal disorders worsens reproductive function, increases the risk of cardiometabolic disease, and decreases quality of life. Dietary interventions have become a promising non-pharmacological strategy for improving metabolic and hormonal regulation in PCOS patients. This systematic review was prepared following the guidelines of PRISMA 2020. Literature searches were conducted on PubMed, ScienceDirect, and the Cochrane Library until August 2025. Inclusion criteria included randomized controlled trials (RCTs) in PCOS women with a BMI ≥ 25 kg/m², which evaluated the effects of dietary interventions on metabolic and hormonal profiles. Of the 437 articles screened, seven studies (n = 406 participants) met the eligibility criteria and were critically analyzed. A review of seven RCT studies showed that dietary interventions such as ketogenic, VLCKD, Mediterranean, and low-calorie diets had a positive impact on metabolic and hormonal profiles in women with PCOS. The combination of licorice + a low-calorie diet is effective in lowering insulin resistance while the PMCD diet is more effective in lowering LDL and TG. Hormonal improvements were reflected in increased SHBG (p = 0.042) and decreased LH (p < 0.05), especially in PMCD and ketogenic diets. The low-AGEs diet also helps with weight loss, waist circumference, and HOMA-IR, although data are still limited. The KEMEPHY diet and Low-AGEs showed that both diets had a significant impact on VAT and VFL (p<0.005), with only two studies explicitly describing these outcomes, so more research is needed. Dietary interventions are effective in lowering metabolic profiles, balancing hormonal regulation, and having a positive impact on visceral fat, in women with PCOS. KD and VLCKD are the most promising strategies, while PMCD and low-AGEs diets are beneficial for specific metabolic phenotypes. The principle of personal nutrition needs to be prioritized, although long-term clinical trials are still needed to confirm the effects on reproductive outcomes.