Ketogenic diet may improve reproductive hormone levels in women with PCOS
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Key takeaways:
- Women with PCOS had reductions in luteinizing hormone to FSH ratio and free testosterone after a ketogenic diet intervention.
- Participants also had an increase in SHBG and a decrease in body weight.
Women with polycystic ovary syndrome could improve some reproduction hormone levels if they switch to a ketogenic diet, according to systematic review and meta-analysis published in the Journal of the Endocrine Society.
In an analysis of seven studies in which women with PCOS were enrolled in a ketogenic diet for at least 6 weeks, participants had lower levels of luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio and serum free testosterone as well as an increase in sex hormone-binding globulin at the end of the intervention compared with baseline.
“To the best of our knowledge, the present study is the first systematic review with meta-analysis that evaluated all available clinical studies on the effects of ketogenic diet on the reproductive hormone levels among women with PCOS,” Karniza Khalid, MBBS, MMedSc, medical officer in the endocrine unit of the Institute for Medical Research, Ministry of Health Malaysia, and colleagues wrote. “The pooled analysis of clinical studies also showed a possible improvement in selected anthropometric measures, such as weight and BMI. These results, although interesting and useful to formulate a hypothesis, must be interpreted with caution due to the small number of subjects investigated.”
Researchers conducted a search of the MEDLINE, ScienceDirect, Scopus and Web of Science databases for studies in which women with PCOS received a ketogenic diet for at least 6 weeks and had reproductive hormones and anthropometric parameters reported. Included studies could be randomized or nonrandomized trials and did not require a reference group. Databases were searched from inception until Jan. 20.
There were seven studies included in the meta-analysis, of which four were conducted in Italy, two in China and one in the U.S. The seven studies included 170 participants.
In a pooled random-effects model that included 112 women with data available, participants receiving a ketogenic diet had a reduction in LH:FSH ratio (Cohen’s d = –0.851; 95% CI, –1.015 to –0.686; P < .001) and free testosterone (Cohen’s d = –0.223; 95% CI, –0.328 to –0.119; P < .001) from baseline to the end of the intervention. Women receiving a ketogenic diet had an increase in serum SHBG from baseline to the end of the study (Cohen’s d = 9.086; 95% CI, 3.379-14.792; P = .002). Serum progesterone did not change following a ketogenic diet. Women with PCOS lost weight after participating in a ketogenic diet intervention (Cohen’s d = –11.56; 95% CI, –14.97 to –8.15; P < .001).
“The accessible literature still has several limitations necessitating careful review, reducing the applicability and transferability of these results to the general PCOS population,” the researchers wrote. “However, these findings have important clinical implications, especially for endocrinologists, gynecologists and dieticians, who should carefully plan and customize individual diet recommendations for women with PCOS.”
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