Fig 1 - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Flowchart of study design and participant enrollment. HSDF: hypocaloric standardized diet + fennel; HHPF: hypocaloric high-protein diet + fennel; HSDP: hypocaloric standardized diet + placebo; HHPP: hypocaloric high-protein diet + placebo; ITT: intention-to-treat.
Source publication
Objective
The aim of this study was to evaluate the effect of hypocaloric high-protein, low-carbohydrate weight loss diet supplemented with fennel on anthropometric and androgen indices in overweight and obese women with polycystic ovary syndrome (PCOS).
Methods
A randomized controlled trial with a factorial design was performed on sixty-four over...
Context in source publication
Context 1
... n = 16). Among these 64 individuals enrolled, data from 56 patients (87.5 %) were available at 12 weeks. Eight subjects dropped out from the study because of pregnancy (n = 1), surgery (n = 1), personal reason (n = 1) and failure to continue treatment (n = 5). More details of study design, recruitment and lost to follow-up are demonstrated in Fig. 1. The compliance with treatment was measured as percentage of consuming 2 fennel capsules or placebo per day which varied from 93 to 95%, with no significant difference ...
Citations
... The intervention measures in the treatment groups include the Mediterranean diet in one study, 21 a restricted-energy diet in one study, 22 a lowcalorie combined with a low-carbohydrate diet in one study, 23 a low-calorie-extract combined diets in three studies, 24,25,29 a lowcalorie and low-carbohydrate diet combined with an extract diet in one study, 26 a very low-calorie diet in one study, 28 and a lowcarbohydrate combined with an extract diet in one study. 27 The intervention measures in the control groups include Western medicine in two studies, 22,23 general dietary guidance in one study, 21 an intervention plus placebo in five studies, [24][25][26][27]29 and a moderate energy-deficient diet in one study. 28 The basic information of the included studies, such as the disease duration, participant age, specific intervention measures, and outcome indicators, are shown in Table 1. ...
... Regarding the randomization aspect, eight studies [21][22][23][24][25][26][27]29 used randomization for grouping and were evaluated as having a low risk of bias; one study 28 did not provide detailed information on the specific randomization method and was evaluated as having an unknown risk ...
... of bias. Regarding the blinding aspect, four studies[25][26][27]29 mentioned specific blinding and were evaluated as having a low risk of bias, while one study28 explicitly stated that an open randomization scheme without blinding was used and was evaluated as having a high risk of bias. The remaining four studies 21-24 did not report the use of a blinding scheme and were evaluated as having an unknown risk of bias. ...
Background
Dietary interventions, recommended as a primary approach globally, benefit women with polycystic ovary syndrome (PCOS) by inducing weight loss and improving clinical symptoms, metabolism, and pregnancy results. However, the impact of diet on PCOS in individuals with BMI ≥ 25 kg/m² is unclear. The aim of this review was to offer dietary guidance for these patients.
Methods
Six databases, CNKI, Wanfang, VIP, PubMed, Cochrane Library, and Web of Science, were searched systematically from inception to December 2023 for clinical randomized controlled trials (RCT) on dietary interventions for PCOS. Two researchers independently screened and extracted data following pre‐defined inclusion criteria, with bias assessment using the Cochrane Handbook and Review Manager (version 5.4) software.
Results
Nine RCTs with 559 participants were included. Among women with PCOS and obesity, compared to the control group, individuals who underwent dietary interventions experienced improvements in weight‐related Indicators, glycolipid metabolism, hormone‐related indicators, and fertility‐related outcomes. Subgroup analysis indicated that calorie‐restricted diets (CRDs) and low‐energy–low‐carb combined diets had advantages over other dietary interventions. Moreover, the overweight period was the optimal intervention period.
Conclusions
Dietary interventions can improve the clinical manifestations of PCOS and pregnancy rates in patients with a BMI ≥ 25 kg/m². Particularly, CRDs, low‐calorie–low‐carb combined diets, and low‐calorie–extract combined diets are recommended.
... In the preliminary search, 853 studies were identified. We identified 10 articles reporting on 8 RCTs that involved a total of 300 participants (154 in the intervention group and 146 in the control group) as eligible for meta-analysis [31][32][33][34][35][36][37][38][39][40]. Further details regarding the selection process are provided in the PRISMA flow diagram in Fig. 1. ...
... Table 1 presents the general characteristics of the included studies, which were published between 2003 and 2021. These studies were parallel-design, single-centre trials conducted in the United States [32,37], Australia [33,34], Brazil [31], Iran [35,36,38], and China [38,39]. All studies included women with overweight and obesity (BMI ≥ 24 kg/m 2 ), except one [31] recruited patients without BMI limitations. ...
... Table 1 presents the general characteristics of the included studies, which were published between 2003 and 2021. These studies were parallel-design, single-centre trials conducted in the United States [32,37], Australia [33,34], Brazil [31], Iran [35,36,38], and China [38,39]. All studies included women with overweight and obesity (BMI ≥ 24 kg/m 2 ), except one [31] recruited patients without BMI limitations. ...
The optimal dietary regimen for polycystic ovary syndrome (PCOS) has not been identified. High-protein diets (HPDs) are effective for weight control in individuals with metabolic abnormalities, but no systematic meta-analyses have yet summarised the effects of HPDs on PCOS. Seven electronic databases were searched from inception to 30 April 2023, and studies comparing the effects of HPDs and other diets on the anthropometrics, metabolic factors, and hormonal profiles for PCOS were identified. Data were pooled using random-effects models and expressed as weighted mean differences and 95% confidence intervals. The risk of bias was assessed by Cochrane Collaboration tool. Eight trials involving 300 women with PCOS were included. Compared with isocaloric balanced diets (BDs), HPDs significantly reduced fasting insulin (−2.69 μIU/mL, 95% CI [−3.81, −1.57], P < 0.0001, I ² = 46%) and homoeostatic model assessment for insulin resistance (HOMA-IR−0.41, 95% CI [−0.80, −0.02], P = 0.04, I ² = 94%) in women with PCOS. However, HPDs and BDs had comparable effects on weight loss, abdominal adiposity, lipid profiles, and reproductive hormones (all P ≥ 0.05). HPDs may benefit women with PCOS in terms of improving insulin resistance, supporting for their use as one of the dietary management options for PCOS, however further RCTs in larger and broader settings are required to confirm these observations and investigate the mechanism behind it.
... The low carbohydrate and high protein content of the RESMENA diet may reduce appetite and energy intake [13,16 ]. In addition, high dietary protein compared to carbohydrate may provide greater weight loss by increasing protein-induced thermogenesis and satiety due to increased insulin sensitivity and increased cholecystokinin production, as well as preservation of lean body mass [7,31]. The Mediterranean diet may protect against diseases associated with insulin resistance such as obesity [3]. ...
... In our study, although the amount of daily carbohydrate intake increased in the control group, the decrease in fasting insulin levels, total cholesterol and ALT levels suggests that the decrease in daily total and saturated fat ratios and this decrease may provide some improvement in insulin sensitivity in this group. It has been reported that dietary proteins stimulate insulin secretion, lower blood glucose levels, and relieve hyperglycemia and insulin resistance by changing the intestinal flora [9,31]. İnsulin resistance is recognized to play an important role in the pathogenesis of dyslipidemia [37]. ...
Introduction: The optimal dietary strategy to improve the metabolic and reproductive endocrine profile in adolescents with obesity and polycystic ovary syndrome is undefined. This study was conducted to evaluate the efficacy of the MEtabolic Syndrome REduction in NAvarra (RESMENA) diet versus a control diet based on American Heart Association (AHA) recommendations for the treatment of PCOS in adolescents with PCOS. Methods: A total of 40 adolescents diagnosed with PCOS between the ages of 13–18 years were randomized to either a RESMENA or control diet for 6 months. Dietary status, anthropometry, body composition, biochemical parameters, and reproductive endocrine hormones were compared between the 2 groups before and after the intervention. Results: Both diet groups showed significant decreases in anthropometric parameters whereas the RESMENA diet provided a greater decrease in all these parameters except neck circumference and fat percentage (p<0.05). At the end of the study fasting insulin, ALT, and total cholesterol levels decreased in both control and RESMENA group, HbA1c, HOMA-IR, and hsCRP levels decreased and QUICKI score increased in the RESMENA group (p<0.05). There was no statistical difference in the androgen levels of the control group compared to the baseline. In the RESMENA group, there was a significant decrease in total testosterone, free testosterone, 17-OH progesterone, androstenedione, LH levels and LH/FSH ratio and free androgen index and a significant increase in SHGB levels (p<0.05). Conclusions: Both dietary patterns resulted in significant improvement in anthropometric measurements and body composition, but the RESMENA diet showed beneficial effects on insulin resistance parameters and androgen levels.
... -Low carbohydrate diet: Lowering carbohydrate intake, especially refined and processed sources, can aid in weight loss and enhance metabolic markers in women with PCOS. Nonetheless, customization is vital, as certain individuals may need more carbohydrates to maintain optimal energy levels [14,39,40]. -Mediterranean-inspired diet: Prioritizing whole grains, fruits, vegetables, healthy fats like olive oil and nuts, lean proteins such as fish and poultry, and practicing moderate consumption of dairy and red meat can potentially support weight management and enhance metabolic health in PCOS [41][42][43]. ...
Polycystic ovary syndrome (PCOS) is a multifaceted hormonal disorder that has significant ramifications for both women's reproductive and metabolic well-being. This analysis aims to offer a thorough comprehension of PCOS by investigating the various contributing factors that are crucial for its effective management. We delve into the topic of hormonal imbalances, such as elevated androgens and disrupted estrogen-progesterone dynamics, and their effects on reproductive and metabolic health. Furthermore, we explore the intricate connection between insulin resistance, hyperinsulinemia, and PCOS, highlighting their pivotal role in metabolic dysfunction. Additionally, we examine fertility challenges, irregular men-strual patterns, and metabolic complications while also reviewing current treatment methodologies. Moreover, we address the latest research concerning genetic, environmental, and epigenetic influences on PCOS. By piecing together these essential elements, healthcare professionals can attain a comprehensive understanding of PCOS and deliver optimal care for those affected by the condition.
... The findings suggest that insulin resistance causes more free fatty acids to be diverted from adipose tissue to the liver. This leads to the production of very low-density lipoproteins (VLDL), increased levels of triglycerides and apolipoprotein B, and decreased levels of HDL [28]. This alteration in lipid parameters results in a form of atherogenic dyslipidemia. ...
Women with polycystic ovary syndrome (PCOS) have a high prevalence of metabolic syndrome (MS), with rates up to 33%. This is associated with long-term consequences such as cardiovascular diseases, type 2 diabetes mellitus (T2DM), cancer, sleep apnea, and psychological issues. The prevalence of MS worldwide is often associated with obesity and T2DM, yet regional variations are reported. In this study, 122 women consulting general practice and family medicine physicians were evaluated, revealing a BMI exceeding 30 kg/m². Among MS criteria, the most common diagnoses were T2DM in 29 patients, insulin resistance (IR) in 36, arterial hypertension (AH) in 51, reduced HDL levels in 53, and elevated triglycerides in 39. Further analysis revealed 16 unique combinations of MS components in these patients, with 75% of PCOS cases exhibiting three MS components and 25% having four. Additionally, research indicated that most women with PCOS face persistent, treatment-resistant obesity, with a notably higher BMI (ρ=0.87; r=0.76). These findings highlight the multifactorial nature of PCOS and MS etiology.
... 'Employs a range of treatment modalities' promotes continuity of care across health disciplines, and while it may include traditional, complementary and integrative medicine (TCIM), TCIM is not holistic if used in isolation and without adequate integration into conventional healthcare [16] Low GI diets followed for ≥ 12 weeks: ↓ BW [76,77], BMI [76,77], BFM [77], WC [77], WHR [77], FINS [76,77], FGL [77], TC [77], LDL-C [77], TAG [77], T [77], LH [77], androstenedione [77], prolactin [77] ↑ insulin sensitivity (HOMA2-IS) [61], synthesis of predominantly antiinflammatory eicosanoid mediators (e.g. 16(R)/16(S)-HETE, 13(S)-HODE, 9(S)-HODE, 15(S)-HETE, 12(S)-HETE, 5(S)-oxoETE, 5(S)-HETE)) [118], fasting glucagon (higher glucagon levels associated with lower levels of self-reported hunger) [ High protein 1 SR (5 RCT total -3 RCT using high protein diet) [16] 2 Pre-post prospective [73,74] 6 RCT [92,[94][95][96][97] 11; 308 High protein diets improve depression and self-esteem [16] ↓ BFM [74,97], BW [73,74,97], BMI [73,74], WC [73,74,97], WHR [73], FINS [74,98], FGL [97], HOMA-IR [73,98], TAG [73], VLDL-C [73], T [73,98], Ferriman-Gallway scores [73] High protein and standard/low protein diet ↓ BW [92,94,95], BMI [92,94,95], BFM [95], WC [92,94], WHR [94], FINS [95,96], HOMA-IR [95], TAG [96], LDL-C [98] CRP [96], MPA [96], leptin [95], T [98], DHEAS [98], FAI [98] and there was ↔ between high and standard/low protein diets 23:14 Although weight loss has shown clear benefits to PCOS outcomes, including not only on reproductive function, but also glucoregulatory status, androgen status and lipid profiles [42][43][44][45][46][47][48][49][50][51][52], there are varying degrees of responsiveness to weight loss in terms of improvement of PCOS symptoms. One study by Pasquali et al. [53] found that when women achieved similar levels of weight loss (>5% weight) only one-third displayed a full recovery from PCOS, with the remainder showing only partial or no recovery. ...
... 'Employs a range of treatment modalities' promotes continuity of care across health disciplines, and while it may include traditional, complementary and integrative medicine (TCIM), TCIM is not holistic if used in isolation and without adequate integration into conventional healthcare [16] Low GI diets followed for ≥ 12 weeks: ↓ BW [76,77], BMI [76,77], BFM [77], WC [77], WHR [77], FINS [76,77], FGL [77], TC [77], LDL-C [77], TAG [77], T [77], LH [77], androstenedione [77], prolactin [77] ↑ insulin sensitivity (HOMA2-IS) [61], synthesis of predominantly antiinflammatory eicosanoid mediators (e.g. 16(R)/16(S)-HETE, 13(S)-HODE, 9(S)-HODE, 15(S)-HETE, 12(S)-HETE, 5(S)-oxoETE, 5(S)-HETE)) [118], fasting glucagon (higher glucagon levels associated with lower levels of self-reported hunger) [ High protein 1 SR (5 RCT total -3 RCT using high protein diet) [16] 2 Pre-post prospective [73,74] 6 RCT [92,[94][95][96][97] 11; 308 High protein diets improve depression and self-esteem [16] ↓ BFM [74,97], BW [73,74,97], BMI [73,74], WC [73,74,97], WHR [73], FINS [74,98], FGL [97], HOMA-IR [73,98], TAG [73], VLDL-C [73], T [73,98], Ferriman-Gallway scores [73] High protein and standard/low protein diet ↓ BW [92,94,95], BMI [92,94,95], BFM [95], WC [92,94], WHR [94], FINS [95,96], HOMA-IR [95], TAG [96], LDL-C [98] CRP [96], MPA [96], leptin [95], T [98], DHEAS [98], FAI [98] and there was ↔ between high and standard/low protein diets 23:14 Although weight loss has shown clear benefits to PCOS outcomes, including not only on reproductive function, but also glucoregulatory status, androgen status and lipid profiles [42][43][44][45][46][47][48][49][50][51][52], there are varying degrees of responsiveness to weight loss in terms of improvement of PCOS symptoms. One study by Pasquali et al. [53] found that when women achieved similar levels of weight loss (>5% weight) only one-third displayed a full recovery from PCOS, with the remainder showing only partial or no recovery. ...
... 'Employs a range of treatment modalities' promotes continuity of care across health disciplines, and while it may include traditional, complementary and integrative medicine (TCIM), TCIM is not holistic if used in isolation and without adequate integration into conventional healthcare [16] Low GI diets followed for ≥ 12 weeks: ↓ BW [76,77], BMI [76,77], BFM [77], WC [77], WHR [77], FINS [76,77], FGL [77], TC [77], LDL-C [77], TAG [77], T [77], LH [77], androstenedione [77], prolactin [77] ↑ insulin sensitivity (HOMA2-IS) [61], synthesis of predominantly antiinflammatory eicosanoid mediators (e.g. 16(R)/16(S)-HETE, 13(S)-HODE, 9(S)-HODE, 15(S)-HETE, 12(S)-HETE, 5(S)-oxoETE, 5(S)-HETE)) [118], fasting glucagon (higher glucagon levels associated with lower levels of self-reported hunger) [ High protein 1 SR (5 RCT total -3 RCT using high protein diet) [16] 2 Pre-post prospective [73,74] 6 RCT [92,[94][95][96][97] 11; 308 High protein diets improve depression and self-esteem [16] ↓ BFM [74,97], BW [73,74,97], BMI [73,74], WC [73,74,97], WHR [73], FINS [74,98], FGL [97], HOMA-IR [73,98], TAG [73], VLDL-C [73], T [73,98], Ferriman-Gallway scores [73] High protein and standard/low protein diet ↓ BW [92,94,95], BMI [92,94,95], BFM [95], WC [92,94], WHR [94], FINS [95,96], HOMA-IR [95], TAG [96], LDL-C [98] CRP [96], MPA [96], leptin [95], T [98], DHEAS [98], FAI [98] and there was ↔ between high and standard/low protein diets 23:14 Although weight loss has shown clear benefits to PCOS outcomes, including not only on reproductive function, but also glucoregulatory status, androgen status and lipid profiles [42][43][44][45][46][47][48][49][50][51][52], there are varying degrees of responsiveness to weight loss in terms of improvement of PCOS symptoms. One study by Pasquali et al. [53] found that when women achieved similar levels of weight loss (>5% weight) only one-third displayed a full recovery from PCOS, with the remainder showing only partial or no recovery. ...
Polycystic ovary syndrome (PCOS) is a common condition affecting reproductive-aged women with reproductive, metabolic and psychological consequences. Weight and lifestyle (diet, physical activity and behavioural) management are first-line therapy in international evidence-based guidelines for PCOS. While these recommend following population-level diet and physical activity guidelines, there is ongoing interest and research in the potential benefit of including psychological and sleep interventions, as well as a range of traditional, complimentary and integrative medicine (TCIM) approaches, for optimal management of PCOS. There is limited evidence to recommend a specific diet composition for PCOS with approaches including modifying protein, carbohydrate or fat quality or quantity generally having similar effects on the presentations of PCOS. With regards to physical activity, promising evidence supports the provision of vigorous aerobic exercise, which has been shown to improve body composition, cardiorespiratory fitness and insulin resistance. Psychological and sleep interventions are also important considerations, with women displaying poor emotional wellbeing and higher rates of clinical and subclinical sleep disturbance, potentially limiting their ability to make positive lifestyle change. While optimising sleep and emotional wellbeing may aid symptom management in PCOS, research exploring the efficacy of clinical interventions is lacking. Uptake of TCIM approaches, in particular supplement and herbal medicine use, by women with PCOS is growing. However, there is currently insufficient evidence to support integration into routine clinical practice. Research investigating inositol supplementation have produced the most promising findings, showing improved metabolic profiles and reduced hyperandrogenism. Findings for other supplements, herbal medicines, acupuncture and yoga is so far inconsistent, and to reduce heterogeneity more research in specific PCOS populations, (e.g. defined age and BMI ranges) and consistent approaches to intervention delivery, duration and comparators are needed. While there are a range of lifestyle components in addition to population-recommendations for diet and physical activity of potential benefit in PCOS, robust clinical trials are warranted to expand the relatively limited evidence-base regarding holistic lifestyle management. With consumer interest in holistic healthcare rising, healthcare providers will be required to broaden their knowledge pertaining to how these therapies can be safely and appropriately utilised as adjuncts to conventional medical management.
... Dietary patterns have potential effects on IR and overweight [26,27] and can influence the expression of genes involved in critical metabolic pathways [28]. It is indicated that Iranian women with a higher risk of PCOS had a higher intake of western dietary patterns and less plant-based diets [8]. ...
Background
Polycystic ovary syndrome (PCOS), as one of the significant endocrine disorders, is common among women worldwide. Food insecurity (FI) and unhealthy dietary patterns can negatively affect reproductive health. The effects of the lifestyle modifications, especially dietary components, on PCOS are contradictory. The aim was the assessment of association between PCOS with food security status and dietary patterns among overweight or obese women.
Methods
This case-control study was performed on 240 overweight and obese women with and without PCOS (ratio 1:1) referred to the infertility clinic of Arash Hospital, Tehran, Iran. The general and socioeconomic characteristics, anthropometrics (weight, height, body mass index (BMI), waist circumference, hip circumference), physical activity, food security status, and dietary intakes (or patterns) were assessed using valid questionnaires, scales, stadiometer, and tape meter. The significant p -value was < 0.05.
Results
The prevalence of FI was 60% in women with PCOS and 30% in healthy women. PCOS risk was positively related to FI, quasi-western dietary patterns, low economic levels, waist circumference, and menstrual age and negatively with physical activity and healthy dietary patterns, even after controlling the potential confounders ( P < 0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B 5 , B 6 , B 12 , C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, fiber (total, insoluble, and crude), glucose, galactose, fructose, and lactose compared to the healthy women ( P < 0.05).
Conclusions
FI, quasi-western dietary patterns, low economic levels, and waist circumference were significantly associated with the higher risk of PCOS. The lifestyle changes, especially dietary patterns, may be an essential strategy for reducing PCOS. Further studies are warranted to confirm these findings and to identify the underlying mechanisms.
Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine disorders among reproductive-aged women. It is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Lifestyle changes are suggested as first-line interventions in managing PCOS. This systematic review aims to assess the scientific evidence regarding the role of lifestyle modifications (dietary changes, physical activity, and behavioral changes) in improving reproductive, anthropometric, metabolic, and psychological outcomes in women with PCOS. Dietary interventions such as foods with low glycemic index scores; caloric restrictions; high-fiber, omega three fatty acid-rich diets; ketogenic diets; Mediterranean diets; antioxidant-rich food; and anti-inflammatory diets improve insulin sensitivity and hormonal balance in women with PCOS. Physical activity, like aerobic and resistance exercise, enhances insulin sensitivity, helps weight loss, and improves metabolic and reproductive outcomes in women with PCOS. Further, behavioral and education modules can also be used to improve awareness, adherence, and the effectiveness of conventional treatment and to manage mental health issues related to PCOS. Collectively, lifestyle modifications not only improve the biochemical, hormonal, and anthropometric parameters in PCOS patients but also reduce the long-term risks of metabolic and cardiovascular diseases.
Objectives
To investigate various supplements that improve insulin resistance, hormonal status, and oxidative stress in overweight or obese women with polycystic ovarian syndrome (PCOS).
Methods
A literature search was conducted on four different databases, which led to the discovery of twenty - five randomized controlled trials (RCTs). These RCTs evaluated the efficacy of various supplements in improving insulin resistance (IR), hormonal status, and oxidative stress among overweight or obese women diagnosed with PCOS. Subsequently, data extraction and analysis were carried out to determine the quality of the study’s methodological design and the potential for bias. Moreover, a meta-analysis was performed using the data from the RCTs.
Results
A total of 25 RCTs were carried out, and 1636 women were enrolled. All participants were overweight or obese. The standardized mean differences (SMD) were as follows: For fasting plasma glucose (FPG), it was -0.34 (95% confidence interval [CI], -0.49 to -0.19, p = 0.123, I² = 30.8%); for insulin, it was -0.67 (95% CI, -0.83 to -0.52, p = 0.208, I² = 24%); for fasting insulin (FI), it was -0.26 (95% CI, -0.52 to -0.00, p = 0.269, I² = 21.9%); for homeostatic model assessment-insulin resistance index (HOMA-IR), it was -0.59 (95% CI, -0.73 to -0.45, p = 0.015, I² = 48.7%); for homoeostatic model assessment beta - cell function (HOMA-B), it was -0.51 (95% CI, -0.75 to -0.27, p = 0.547, I² = 0%); for quantitative insulin sensitivity check index (QUICKI), it was 0.94 (95% CI, 0.76 to -1.12, p = 0.191, I² = 27.5%); for total testosterone, it was -0.61 (95% CI, -1.14 to -0.09, p = 0.00, I² = 78.5%); for testosterone, it was -0.38 (95% CI, -0.86 to 0.10, p = 0.03, I² = 71.5%); for follicle - stimulating hormone (FSH), it was 0.16 (95% CI, -0.08 to 0.40, p = 0.470, I² = 0%); for luteinizing hormone (LH), it was -0.56 (95% CI, -1.32 to 0.20, p = 0.000, I² = 91.1%); for sex hormone - binding globulin (SHBG), it was 0.35 (95% CI, 0.02 to 0.69, p = 0.000, I² = 78%); for dehydroepiandrosterone (DHEAS), it was -0.27 (95% CI, -0.76 to 0.21, p = 0.001, I² = 78.7%); for plasma total antioxidant capacity (TAC), it was 0.87 (95% CI, 0.45 to 1.30, p = 0.004, I² = 71.3%); for plasma malondialdehyde (MDA), it was -0.57 (95% CI, -0.79 to -0.36, p = 0.992, I² = 0.0%).
Conclusion
This study’s findings indicate that, in comparison with a placebo, supplements have a favorable effect on IR, hormonal functions, and oxidative stress in PCOS. Nevertheless, it is crucial to note that the above-drawn conclusions need to be verified by more high-quality studies, given the limitations regarding the number and quality of the included studies.
The rising incidences and prevalence of metabolic diseases, creating enormous health and economic burden worldwide, are a global healthcare challenge. Such conditions, which can be inherited or acquired, are exemplified by type II diabetes, high blood pressure, dyslipidemia, non-alcoholic fatty liver disease, obesity, etc. and are caused by dysregulated metabolism, i.e. defects in the body’s energy processing system. Increase in mortality and years of healthy life lost due to metabolic diseases calls for urgent attention to manage these diseases. Current treatment options largely involve prolonged allopathic medication which is disadvantageous because of associated adverse health effects. Moreover, these diseases often occur as a constellation of maladies requiring complex treatment regimens with multiple drugs culminating in adverse drug-drug interactions. Therefore, considering the limitations of existing therapeutic options, there is a renewed and growing interest in the use of ethnomedicines for the management of metabolic diseases. Ethnomedicine offers advantage over allopathy or chemical drugs, because these are part of indigenous traditional knowledge system and hence are time-tested, safer, economically affordable, accessible and hence sustainable in the long run. In this chapter, we discuss about ethnomedicines which are used in the treatment and management of diabetes, obesity, dyslipidemia, hypertension, fatty liver diseases, etc. in various parts of the world. We also discuss about the scientific investigations that have been performed to validate the therapeutic potential of widely used ethnomedicines against metabolic diseases. Finally, clinical trials conducted on ethnomedicinal resources for the cure of metabolic disorders and associated drawbacks will be reported.