Short-time effects of ketogenic diet or modestly hypocaloric Mediterranean diet on overweight and obese women with polycystic ovary syndrome

J Endocrinol Invest. 2023 Apr;46(4):769-777. doi: 10.1007/s40618-022-01943-y. Epub 2022 Nov 19.


Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during reproductive age. It is characterized clinically by oligo-ovulation or anovulation, hyper-androgenism, and the presence of polycystic ovaries. Often comorbid with insulin resistance, dyslipidemia, and obesity, it also carries significant risk for the development of cardio-vascular and metabolic sequelae, including diabetes and metabolic syndrome. In light of these evidences, the most therapeutic option prescribed to PCOS women with obesity, regardless of the phenotype from the severity of clinical expression, is lifestyle correction by diet and physical activity.

Purpose: The aim of this study was to evaluate the association between PCOS with KD in overweight and/or obese women with PCOS, and evaluate the possible beneficial effects on metabolic and endocrine parameters, compared to a standard, balanced hypocaloric diet such as Mediterranean diet (MD).

Methods: Participants were assigned to receive, in a 1:1 ratio, one of the two following dietary sequences: KD or MD. In all subjects anthropometric parameters, body composition and metabolic and endocrine parameters were obtained at baseline and after dietetic treatment.

Results: Our results showed a significant change in the anthropometric and biochemical parameters in both groups after both diet therapies, with statistically significant differences (p < 0.001). Though, the reductions of all parameters were significantly greater in KD group than in MD group.

Conclusion: Our results suggest that a reduction of dietary intake of carbohydrates by KD may be considered as a valuable non-pharmacological treatment for PCOS.

Keywords: Insulin resistance; Ketogenic diet; Nutrition; Obesity; PCOS.

MeSH terms

  • Diet, Ketogenic*
  • Diet, Mediterranean*
  • Diet, Reducing
  • Female
  • Humans
  • Insulin Resistance*
  • Obesity / complications
  • Obesity / therapy
  • Overweight / complications
  • Overweight / therapy
  • Polycystic Ovary Syndrome* / complications
  • Polycystic Ovary Syndrome* / metabolism
  • Polycystic Ovary Syndrome* / therapy