title: The Effect of Low Carbohydrate Diets on Fertility Hormones and Outcomes in Overweight and Obese Women: A Systematic Review.
abstract: (1) Background: Medical interventions including assisted reproductive technologies have improved fertility outcomes for many sub-fertile couples. Increasing research interest has investigated the effect of low carbohydrate diets, with or without energy restriction. We aimed to systematically review the published literature to determine the extent to which low carbohydrate diets can affect fertility outcomes; (2) Methods: The review protocol was registered prospectively with Prospective Register for Systematic Reviews (registration number CRD42016042669) and followed Preferred Reporting Items For Systematic Reviews and Meta-Analyses guidelines. Infertile women were the population of interest, the intervention was low carbohydrate diets (less than 45% total energy from carbohydrates), compared to usual diet (with or without co-treatments). Four databases were searched from date of commencement until April 2016; a supplementary Google scholar search was also undertaken. Title and abstract, then full text review, were undertaken independently and in duplicate. Reference lists of included studies and relevant systematic reviews were checked to ensure that all relevant studies were identified for inclusion. Quality assessment was undertaken independently by both authors using the Quality Criteria Checklist for Primary Research. Outcome measures were improved fertility outcomes defined by an improvement in reproductive hormones, ovulation rates and/or pregnancy rates; (3) Results: Seven studies fulfilled the inclusion criteria and were included in the evidence synthesis. Interventions were diverse and included a combination of low carbohydrate diets with energy deficit or other co-treatments. Study quality was rated as positive for six studies, suggesting a low risk of bias, with one study rated as neutral. Of the six studies which reported changes in reproductive hormones, five reported significant improvements post intervention; (4) Conclusion: The findings of these studies suggest that low carbohydrate diets warrant further research to determine their effect. These randomised controlled trials should consider the effect of carbohydrates (with or without energy deficit) on hormonal and fertility outcomes.
authors.affiliation: Dietetics Department, Eastern Health, 5 Arnold Street, Box Hill VIC 3128, Australia. melanie@nutritionplus.com.au.|Nutrition Plus Enterprises, 1004/1 Queens Road, Melbourne VIC 3004, Australia. melanie@nutritionplus.com.au.
authors.forename: Melanie
authors.initials: M
authors.lastname: McGrice
authors.affiliation: Allied Health Research Office, 5 Arnold Street, Box Hill VIC 3128, Australia. Judi.Porter@easternhealth.org.au.|Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill VIC 3168, Australia. Judi.Porter@easternhealth.org.au.
authors.forename: Judi
authors.initials: J
authors.lastname: Porter
mesh_terms: D016208:Databases, Factual; D050528:Diet, Carbohydrate-Restricted; D019317:Evidence-Based Medicine; D005260:Female; D005298:Fertility; D042341:Gonadal Hormones / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000178:diet therapy*; D015201:Meta-Analysis as Topic; D009765:Obesity / Q000097:blood*; D050177:Overweight / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
chemical_list: D042341:Gonadal Hormones
keywords: infertile; ketogenic; low carbohydrate; obese; overweight; polycystic ovarian syndrome; systematic review