Scannell Nicole, Villani Anthony, Moran Lisa, Mantzioris Evangeline
School of Health, University of the Sunshine Coast, Sippy Downs, QLD, Australia.
Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Proc Nutr Soc. 2024 Nov 19:1-12. doi: 10.1017/S0029665124007584.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder amongst reproductive-aged women associated with cardiometabolic, reproductive and psychological abnormalities. Lifestyle modification, including a healthy diet, is considered first-line treatment for management of clinical symptoms. However, there is limited high-quality evidence to support one superior therapeutic dietary intervention for PCOS management that is beyond general population-based dietary guidelines. Adherence to a Mediterranean diet (MedDiet) has been shown to decrease cardiometabolic disease risk and attenuate depressive symptoms, particularly in patients with metabolic perturbations. This narrative review summarises the proposed biological mechanisms underpinning the potential therapeutic benefits of a MedDiet for the management of cardiometabolic, reproductive and psychological features related to PCOS. Observational evidence suggests an inverse relationship between MedDiet adherence and PCOS features, particularly insulin resistance and hyperandrogenemia. Although the exact mechanisms are complex and multifaceted, they are likely related to the anti-inflammatory potential of the dietary pattern. These mechanisms are underpinned by anti-inflammatory bioactive constituents present in the MedDiet, including carotenoids, polyphenols and n-3 polyunsaturated fatty acids (PUFAs). Synthesis of the available literature suggests the MedDiet could be a promising therapeutic dietary intervention to attenuate short and long-term symptoms associated with PCOS and may aid in reducing the longer-term risks associated with cardiometabolic diseases and reproductive and psychological dysfunction. Nevertheless, current evidence remains insufficient to inform clinical practice and well-designed clinical trials are needed. As such, we provide recommendations for the design and delivery of future MedDiet interventions in women with PCOS, including exploring the acceptability, and feasibility to enhance adherence.
多囊卵巢综合征（PCOS）是育龄女性中常见的内分泌紊乱疾病，与心脏代谢、生殖及心理异常有关。生活方式的改变，包括健康饮食，被视为管理临床症状的一线治疗方法。然而，高质量证据有限，无法支持一种优于基于普通人群饮食指南的PCOS管理治疗性饮食干预措施。已证明坚持地中海饮食（MedDiet）可降低心脏代谢疾病风险并减轻抑郁症状，尤其是在有代谢紊乱的患者中。本叙述性综述总结了MedDiet对与PCOS相关的心脏代谢、生殖及心理特征进行管理的潜在治疗益处背后的生物学机制。观察性证据表明，坚持MedDiet与PCOS特征之间存在负相关，尤其是胰岛素抵抗和高雄激素血症。尽管确切机制复杂且多方面，但它们可能与这种饮食模式的抗炎潜力有关。这些机制由MedDiet中存在的抗炎生物活性成分支撑，包括类胡萝卜素、多酚和n-3多不饱和脂肪酸（PUFAs）。现有文献的综合表明，MedDiet可能是一种有前景的治疗性饮食干预措施，可减轻与PCOS相关的短期和长期症状，并可能有助于降低与心脏代谢疾病以及生殖和心理功能障碍相关的长期风险。然而，目前的证据仍不足以指导临床实践，需要设计良好的临床试验。因此，我们为未来针对PCOS女性的MedDiet干预措施的设计和实施提供建议，包括探索可接受性和可行性以提高依从性。
