Changes in diet composition with urbanization and its effect on the polycystic ovarian syndrome phenotype in a Western Indian population

Abstract

Objective: To study the effects of increasingly prosperous diet content on clinical features of polycystic ovary syndrome (PCOS). Design: A cross-sectional cohort study of 711 women with PCOS from a heterogeneous population spanning a wide spectrum of socioeconomic strata. Setting: Independent hospital. Patient(s): A total of 711 women with PCOS in whom the diagnosis was based on Rotterdam criteria. Results were compared with a locally recruited reference group. Intervention(s): Clinical assessment of women with PCOS. Main Outcome Measure(s): Clinical characteristics were assessed with particular reference to diet composition. Four diet groups were identified: simple rice with vegetables, vegetarian with mixed carbohydrates, nonvegetarian with mixed carbohydrates, and an urban diet of processed foods. Result(s): Women with PCOS showed the characteristic features of raised LH and androstenedione concentrations and increased ovarian volume and antral follicle count. There was a notable association between an increasingly affluent diet, the presence of hirsutism, raised body mass index, insulin resistance, and higher serum antim€ ullerian hormone concentrations. The positive association between anti-m€ ullerian hormone and body mass index is an unusual feature possibly explained by the wide spectrum of lifestyles in this cohort. Conclusion(s): Urbanization of women in India is associated with increasingly severe phenotype of PCOS, which is likely to have implications on fertility outcomes. (Fertil Steril Ò 2019;112:758-63. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Endocrine and glycolipid metabolism characteristics of diminished ovarian reserve in Chinese women with polycystic ovary syndrome

“…We used an FSH concentration of >25 IU/L as a diagnostic criterion for PCOS with DOR according to the guideline development group recommendation. 6 Kulkarni et al 7 observed associations of an increasingly affluent diet and high BMI with the incidence of PCOS. Weight management is a first-line treatment for women with PCOS.…”

The Potential for Plant-Based Diets to Promote Health Among Blacks Living in the United States

“…In a clinical trial, women with PCOS who were placed on a vegan diet (39% African-Americans) lost significantly more weight than participants on a regular diet [101]. A cohort study in 711 Indian women found that the shift from a vegetarian dietary pattern to a meat-based pattern with urbanization increased a woman's risk for PCOS [102]. However, more research is needed on the effects of plant-based diets on PCOS.…”

Polycystic ovary syndrome: is a Western diet sabotaging our best efforts at management?

“…The findings from the study by Kulkarni et al (2) demonstrate the paradoxical relationships between India's urbanization, socioeconomic classes, and health management as compared with other Westernized nations. Inconsistencies in the setting where PCOS occurs makes finding a universal resolution more difficult.…”

“…Kulkarni et al (2) found statistically significantly increased measures of antim€ ullerian hormone, obesity, and hirsutism in urban Indian women with PCOS who consumed a WSD. Overall, the PCOS phenotype was worse in urban areas; a 89% prevalence of hirsutism was found in urban women who consumed a WSD compared with 22% among rural women who ate a vegetarian diet.…”

“…As a consequence, South Asian-Indian women in urban areas may have overall higher levels of stress as compared with their rural counterparts. The study by Kulkarni et al (2), as it relates to the timing of India's urbanization, is remarkable for its potential to observe the later impacts of WSD during childhood on female reproductive development.…”