title: Focus on metabolic and nutritional correlates of polycystic ovary syndrome and update on nutritional management of these critical phenomena.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is associated with numerous metabolic morbidities (insulin resistance (IR), central obesity) and various nutritional abnormalities (vitamin D deficit, mineral milieu alterations, omega6/omega3 PUFA ratio unbalance).
  
  
  METHODS
  We performed a systematic literature review to evaluate the till-now evidence regarding: (1) the metabolic and nutritional correlates of PCOS; (2) the optimum diet therapy for the treatment of these abnormalities. This review included 127 eligible studies.
  
  
  RESULTS
  In addition to the well-recognized link between PCOS and IR, the recent literature underlines that in PCOS there is an unbalance in adipokines (adiponectin, leptin, visfatin) production and in omega6/omega3 PUFA ratio. Given the detrimental effect of overweight on these metabolic abnormalities, a change in the lifestyle must be the cornerstone in the treatment of PCOS patients. The optimum diet therapy for the PCOS treatment must aim at achieving specific metabolic goals, such as IR improvement, adipokines secretion and reproductive function. These goals must be reached through: accession of the patient to hypocaloric dietary program aimed at achieving and/or maintaining body weight; limiting the consumption of sugar and refined carbohydrates, preferring those with lower glycemic index; dividing the food intake in small and frequent meals, with high caloric intake at breakfast; increasing their intake of fish (4 times/week) or taking omega3 PUFA supplements; taking Vitamin D and chromium supplementation, if there are low serum levels.
  
  
  CONCLUSIONS
  Lifestyle intervention remains the optimal treatment strategy for PCOS women. A relatively small weight loss (5 %) can improve IR, hyperandrogenism, menstrual function, fertility.
authors.affiliation: Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, University of Pavia, Azienda di Servizi alla Persona, Pavia, Italy, mariangela.rondanelli@unipv.it.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Rondanelli
authors.forename: Simone
authors.initials: S
authors.lastname: Perna
authors.forename: Milena
authors.initials: M
authors.lastname: Faliva
authors.forename: Francesca
authors.initials: F
authors.lastname: Monteferrario
authors.forename: Erica
authors.initials: E
authors.lastname: Repaci
authors.forename: Francesca
authors.initials: F
authors.lastname: Allieri
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D004032:Diet; D002149:Energy Intake; D005260:Female; D038321:Glycemic Index; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications; D007333:Insulin Resistance; D008019:Life Style; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D050177:Overweight / Q000178:diet therapy / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000178:diet therapy* / Q000523:psychology; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology*
chemical_list: D054392:Adipokines