The ketogenic diet is promising as a non-pharmacological treatment for PCOS

With a higher treatment recommendation for obese women with polycystic ovary syndrome (PCOS) that includes lifestyle changes through changes in diet and physical activity, the researchers in this study evaluated the effects of a keto diet among this patient population.

As a first-stage non-pharmacological treatment for women with polycystic ovary syndrome (PCOS) classified as obese, the ketogenic diet, in particular caloric restriction, is very promising as an adjunct treatment along with pharmacological therapy. , observe the new results of the study in the International Journal. of Environmental Research and Public Health.

Common comorbidities in PCOS are insulin resistance, dyslipidemia, and obesity, the authors noted, which may increase the risk of diabetes and metabolic syndrome among women with endocrine disorder. Seventeen women whose mean age (SD) was 28.5 (5.38) years (fertile age, according to the researchers) with PCOS and who were classified as obese (body mass index). [BMI] > 25) were included in this study; all were enrolled in the University Medical Service for Dietary and Metabolic Diseases of the Faculty of Medicine and Surgery of the University of Foggia, Italy.

“In light of this evidence, the most therapeutic option prescribed to obese women with PCOS, regardless of phenotype and severity of clinical expression, is lifestyle correction,” they wrote. “This is the first study on the effects of ketogenic diet on PCOS.” This type of diet consists of an increase in fat intake, a reduction in carbohydrate intake and adequate protein. For this study, the daily intake was set at 600 kcal for calories, 1.1 to 1.2 g of protein per kilogram of body weight, 30 g for carbohydrates and 30 g for fat.

After a 45-day dietary protocol, the results of the initial / first visit were compared with the results of the 45-day / final visit for the gynecological evaluation of oligo / amenorrhea. nutritional status, body composition, biochemical measurements and dietary administration. The initial mean overall total body weight was 81.5 (13.56) kg and the initial BMI was 31.84 (5.85) kg / m2.

Decreases have been observed in all the following measures:

Average weight: 9.4 kg (P <0.0001) Average BMI: 3.6 kg / m2 (P <0.001) Waist circumference: 9.4 cm (P <0.001) Hip circumference: 8.1 cm (P < 0.001) Fat mass: 7.90 kg (P <0.001) Free fat mass: 1.41 kg (P <0.05) Muscle mass: 1.32 kg (P <0.05) Total body water: 1.32 kg (P <0.01) Basal metabolic rate: 67 kcal (P <.001)

Improvements were also observed in several metabolic parameters (all P <0.001):

Mean ketone blood and urinary concentrations increased to 1.7 (0.58) mmol / L and 83 (54.34) mg / dL, respectively, from zero at baseline for both. decreased 0.87 ng / ml Triglycerides decreased 70 mg / dL Total cholesterol decreased 40 mg / dLLDL Cholesterol decreased 35 mg / dLHDL Cholesterol increased 15 md / dL

For endocrine parameters, these changes were observed:

Luteinizing hormone (LH) decreased 4.6 mIU / mL (P <0.001) Free and total testosterone decreased 0.17 and 7.34 ng / dL, respectively (P <0.001) The LH / stimulating hormone ratio of follicle (FSH) decreased to 1.32, from 2.72 to baseline (P <0.01) FSH value increased 1.46 mIU / ml (P <0.05) Globulins d sex hormone binding 12.43 nmol / L (P <0.001) Positive correlations were observed between LH / FSH and weight, BMI and fat mass Negative correlations were observed between LH / FSH and weight, BMI and fat mass. Positive correlations were observed between blood glucose and LH and FSH. Negative correlations were observed between LH / FSH and blood glucose.

In addition, regular menstrual cycles reappeared in 5 patients, “after years of amenorrhea,” the authors noted, while regular menstrual cycles were restored for the other 12 patients, 5 of whom when they became pregnant naturally.

“The results show that mixed dietary ketogenic medical intervention, by reducing the amount of carbohydrates and inducing therapeutic ketosis, acts favorably and effectively in the management of PCOS,” they wrote. “These data are very interesting and show that this pathology is a multifactorial disease influenced by lifestyle.”

The authors also concluded that their results are affected by the fact that their intervention in the ketogenic diet had such positive results in such a short period of time and that this was seen without the addition of foods intended for induce weight loss. And while they recommend a ketogenic diet as adjuvant treatment with pharmacological therapy for PCOS, they do suggest that further studies are needed on the mechanisms that drive the benefits of this diet.


Cincione RI, Losavio F, Ciolli, et al. Effects of the mixed diet of a ketogenic diet on overweight and obese women with polycystic ovary syndrome. Int J Environ Res Public Health. Published online November 27, 2021. doi:10.3390/ijerph182312490

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