Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cb9f654ff-rkzlw Total loading time: 0 Render date: 2025-08-08T22:28:01.270Z Has data issue: false hasContentIssue false

20 - Nutritional aspects of polycystic ovary syndrome

Published online by Cambridge University Press:  29 September 2009

By
Morey Schachter ,
Carmela Rotem ,
Arieh Raziel ,
Raphael Ron-El  and
Shevach Friedler
Edited by
Gabor T. Kovacs  and
Robert Norman
Morey Schachter
Affiliation:
Tel Aviv University, Israel
Carmela Rotem
Affiliation:
Israel
Arieh Raziel
Affiliation:
Tel Aviv University, Israel
Raphael Ron-El
Affiliation:
Tel Aviv University, Israel
Shevach Friedler
Affiliation:
Tel Aviv University, Israel
Gabor T. Kovacs
Affiliation:
Monash University, Victoria
Robert Norman
Affiliation:
University of Adelaide
Get access

Summary

Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting women of reproductive age, with varying signs and symptoms. Its various manifestations will bring PCOS patients to healthcare providers from different backgrounds, for differing reasons. The metabolic, endocrine, and reproductive aspects of PCOS interact and intertwine, and all may be influenced by nutrition and alternative metabolic pathways. These have been highlighted by research in recent years, which will be reviewed in this chapter. Treatment of PCOS may be enhanced by this evolving knowledge, in all aspects of the syndrome, including short-term problems such as acne or infertility, and long-term problems such as obesity, diabetes mellitus, atherosclerosis, and even possibly breast cancer (Kaaks 1996).

Pathogenesis of PCOS and nutrition

Polycystic ovary syndrome is a syndrome whose appearance depends on a combination of genetic and environmental factors. Environmental/nutritional factors may come into play even before birth, as birthweight depends both on genetic factors and maternal nutrition and uteroplacental function (Armitage et al. 2004). A positive correlation has been found between birthweight and subsequent presentation of polycystic ovaries (Michelmore et al. 2001). Conversely, large population-based studies in the United Kingdom clearly correlated low birthweight to subsequent markers of metabolic syndrome (Godfrey and Barker 2000). Rapid early postnatal weight gain (possibly following maternal–uterine restraint) strongly predicts later childhood obesity and insulin resistance (Ong and Dunger 2004). It is becoming clear that nutrition in early life has an immense impact on adult health.

Information

Type
Chapter
Information
Polycystic Ovary Syndrome , pp. 343 - 362
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Anderson, R. A., Polansky, M. M., Bryden, N. A., and Canary, J. J. (1991) Supplemental chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am. J. Clin. Nutr. 54:909–916.CrossRefGoogle ScholarPubMed
Anderson, R. A., Cheng, N., Bryden, N. A., et al. (1997) Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 46:1786–1791.CrossRefGoogle ScholarPubMed
Armitage, J. A., Khan, I. Y., Taylor, P. D., Nathanielsz, P. W., and Poston, L. (2004) Developmental programming of the metabolic syndrome by maternal nutritional imbalance: how strong is the evidence from experimental models in mammals?J. Physiol. 561:355–377.CrossRefGoogle ScholarPubMed
Bayraktar, F., Dereli, D., Ozgen, A. G., and Yilmaz, C. (2004) Plasma homocysteine levels in polycystic ovary syndrome and congenital adrenal hyperplasia. Endocr. J. 51:601–608.CrossRefGoogle ScholarPubMed
Brown, B. G., Zhao, X. Q., Chait, A., et al. (2001) Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N. Engl. J. Med. 345:1583–1592.CrossRefGoogle ScholarPubMed
Bubanovic, I. (2004) 1alpha,25-dihydroxy-vitamin-D3 as new immunotherapy in treatment of recurrent spontaneous abortion. Med. Hypotheses 63:250–253.CrossRefGoogle ScholarPubMed
Carmina, E., Legro, R. S., Stamets, K., Lowell, J., and Lobo, R. A. (2003) Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet. Hum. Reprod. 18:2289–2293.CrossRefGoogle ScholarPubMed
Chen, J., Wildman, R. P., Hamm, L. L., et al. (2004) Association between inflammation and insulin resistance in US nondiabetic adults: results from the Third National Health and Nutrition Examination Survey. Diabetes Care 27:2960–2965.CrossRefGoogle Scholar
Cordain, L., Eades, M. R., and Eades, M. D. (2003) Hyperinsulinemic diseases of civilization: more than just Syndrome X. Comp. Biochem. Physiol. A Mol. Integr. Physiol. 136:95–112.CrossRefGoogle ScholarPubMed
Delarue, J., LeFoll, C., Corporeau, C., and Lucas, D. (2004) N-3 long chain polyunsaturated fatty acids: a nutritional tool to prevent insulin resistance associated to type 2 diabetes and obesity?Reprod. Nutr. Dev. 44:289–299.CrossRefGoogle ScholarPubMed
Diamanti-Kandarakis, E., Spina, G., Kouli, C., and Migdalis, I. (2001) Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy. J. Clin. Endocrinol. Metab. 86:4666–4673.CrossRefGoogle ScholarPubMed
Duleba, A. J., Foyouzi, N., Karaca, M., et al. (2004) Proliferation of ovarian theca-interstitial cells is modulated by antioxidants and oxidative stress. Hum. Reprod. 19:1519–1524.CrossRefGoogle ScholarPubMed
Dunaif, A., Segal, K. R., Shelley, D. R., et al. (1992) Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes 41:1257–1266.CrossRefGoogle ScholarPubMed
Dunger, D B., Ong, K. K., Huxtable, S. J., et al. (1998) Association of the INS VNTR with size at birth: ALSPAC Study Team – Avon Longitudinal Study of Pregnancy and Childhood. Nat. Genet. 19:98–100.CrossRefGoogle ScholarPubMed
Ek, I., Arner, P., Ryden, M., et al. (2002) A unique defect in the regulation of visceral fat cell lipolysis in the polycystic ovary syndrome as an early link to insulin resistance. Diabetes 51:484–492.CrossRefGoogle ScholarPubMed
Esposito, K., Marfella, R., Ciotola, M., et al. (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. J. Am. Med. Assoc. 292:1440–1446.CrossRefGoogle ScholarPubMed
Facchini, F., Coulston, A. M., and Reaven, G. M. (1996) Relation between dietary vitamin intake and resistance to insulin-mediated glucose disposal in healthy volunteers. Am. J. Clin. Nutr. 63:946–949.CrossRefGoogle ScholarPubMed
Facchini, F. S., Humphreys, M. H., DoNascimento, C. A., Abbasi, F., and Reaven, G. M. (2000) Relation between insulin resistance and plasma concentrations of lipid hydroperoxides, carotenoids, and tocopherols. Am. J. Clin. Nutr. 72:776–779.CrossRefGoogle ScholarPubMed
Felipe, F., Bonet, M. L., Ribot, J., and Palou, A. (2004) Modulation of resistin expression by retinoic acid and vitamin A status. Diabetes 53:882–889.CrossRefGoogle ScholarPubMed
Fenkci, V., Fenkci, S., Yilmazer, M., and Serteser, M. (2003) Decreased total antioxidant status and increased oxidative stress in women with polycystic ovary syndrome may contribute to the risk of cardiovascular disease. Fertil. Steril. 80:123–127.CrossRefGoogle ScholarPubMed
Fulghesu, A. M., Ciampelli, M., Muzj, G., et al. (2002) N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil. Steril. 77:1128–1135.CrossRefGoogle ScholarPubMed
Gennarelli, G., Holte, J., Berglund, L., et al. (2000) Prediction models for insulin resistance in the polycystic ovary syndrome. Hum. Reprod. 15:2098–2102.CrossRefGoogle ScholarPubMed
Gerli, S., Mignosa, M., and DiRenzo, G. C. (2003) Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur. Rev. Med. Pharmacol. Sci. 7:151–159.Google ScholarPubMed
Giltay, E. J., Hoogeven, E. K., Elbers, J. M., et al. (1998) Insulin resistance is associated with elevated plasma total homocysteine levels in healthy, non-obese subjects (letter). Atherosclerosis 139:197–198.Google Scholar
Godfrey, K. M. and Barker, D. J. (2000) Fetal nutrition and adult disease. Am. J. Clin. Nutr. 71(5 Suppl.):1344S–1352S.CrossRefGoogle ScholarPubMed
Goodarzi, M. O., Erickson, S., Port, S. C., Jennrich, R. I., and Korenman, S. G. (2005) Beta-cell function: a key pathologic determinant in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 90:310–315.CrossRefGoogle Scholar
Holte, J. (1998) Polycystic ovary syndrome and insulin resistance: thrifty genes struggling with over-feeding and sedentary life style?J. Endocrinol. Invest. 21:589–601.CrossRefGoogle ScholarPubMed
House, J. D., Jacobs, R. L., Stead, L. M., Brosnan, M. E., and Brosnan, J. T. (1999) Regulation of homocysteine metabolism. Adv. Enzyme Regul. 39:69–91.CrossRefGoogle ScholarPubMed
Huber-Buchholz, M. M., Carey, D. G. P., and Norman, R. J. (1999) Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J. Clin. Endocrinol. Metab. 84:1470–1474.Google ScholarPubMed
Hung, T., Sievenpiper, J. L., Marchie, A., Kendall, C. W., and Jenkins, D. J. (2003) Fat versus carbohydrate in insulin resistance, obesity, diabetes and cardiovascular disease. Curr. Opin. Clin. Nutr. Metab. Care 6:165–176.CrossRefGoogle ScholarPubMed
Joseph, L. J., Farrell, P. A., Davey, S. L., Evans, W. J., and Campbell, W. W. (1999) Effect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and women. Metabolism 48:546–553.CrossRefGoogle ScholarPubMed
Kaaks, R. (1996) Nutrition, hormones and breast cancer: is insulin the missing link?Cancer Causes Control 7:605–625.CrossRefGoogle ScholarPubMed
Kahleova, R., Palyzova, D., Zvara, K., et al. (2002) Essential hypertension in adolescents: association with insulin resistance and with metabolism of homocysteine and vitamins. Am. J. Hypertens. 15:857–864.CrossRefGoogle ScholarPubMed
Kao, Y. H., Hiipakka, R. A., and Liao, S. (2000) Modulation of endocrine systems and food intake by green tea epigallocatechin gallate. Endocrinology 141:980–987.CrossRefGoogle ScholarPubMed
Kasim-Karakas, S. E., Almario, R. U., Gregory, L., et al. (2004) Metabolic and endocrine effects of a polyunsaturated fatty acid-rich diet in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 89:615–620.CrossRefGoogle Scholar
Kelly, C. J., Speirs, A., Gould, G. W., et al. (2002) Altered vascular function in young women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 87:742–746.CrossRefGoogle ScholarPubMed
Kelly, G. S. (2000) Insulin resistance: lifestyle and nutritional interventions. Altern. Med. Rev. 5:109–132.Google ScholarPubMed
Kilic-Okman, T. and Kucuk, M. (2004) N-acetyl-cysteine treatment for polycystic ovary syndrome. Int. J. Gynaecol. Obstet. 85:296–297.CrossRefGoogle ScholarPubMed
Kim, J. I., Kim, J. C., Kang, M. J., et al. (2004) Effects of pinitol isolated from soybeans on glycaemic control and cardiovascular risk factors in Korean patients with type II diabetes mellitus: a randomized controlled study. Eur. J. Clin. Nutr. 59:456–458.CrossRefGoogle Scholar
Kris-Etherton, P. M., Lichtenstein, A. H., Howard, B. V., Steinberg, D., and Witztum, J. L. (Nutrition Committee of the American Heart Association Council on Nutrition, Physical Activity, and Metabolism) (2004) Antioxidant vitamin supplements and cardiovascular disease. Circulation 110:637–641.CrossRefGoogle ScholarPubMed
Landin, K., Holm, G., Tengborn, L., and Smith, U. (1992) Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am. J. Clin. Nutr. 56:1061–1065.CrossRefGoogle ScholarPubMed
Laivuori, H., Kaaja, R., Turpeinen, U., Viinikka, L., and Ylikorkala, O. (1999) Plasma homocysteine levels elevated and inversely related to insulin sensitivity in preeclampsia. Obstet. Gynecol. 93:489–493.Google ScholarPubMed
Lee, B. J., Lin, P. T., Liaw, Y. P., et al. (2003) Homocysteine and risk of coronary artery disease: folate is the important determinant of plasma homocysteine concentration. Nutrition 19:577–583.CrossRefGoogle ScholarPubMed
Lima, M., L., Cruz, T., Pousada, J. C., et al. (1998) The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 21:682–686.CrossRefGoogle Scholar
Lopez-Garcia, E., Schulze, M. B., Manson, J. E., et al. (2004) Consumption of (n-3) fatty acids is related to plasma biomarkers of inflammation and endothelial activation in women. J. Nutr. 134:1806–1811.CrossRefGoogle ScholarPubMed
Luo, Z., Saha, A. K., Xiang, X., and Ruderman, N. B. (2005) AMPK, the metabolic syndrome and cancer. Trends Pharmacol. Sci. 26:69–76.CrossRefGoogle ScholarPubMed
Mathers, J. C. and Daly, M. E. (1998) Dietary carbohydrates and insulin sensitivity. Curr. Opin. Clin. Nutr. Metab. Care 1:553–557.CrossRefGoogle ScholarPubMed
McCarty, M. F. (2000) Insulin secretion as a potential determinant of homocysteine levels. Med. Hypotheses 55:454–455.CrossRefGoogle ScholarPubMed
McCarty, M. F. (2003a) A paradox resolved: the postprandial model of insulin resistance explains why gynoid adiposity appears to be protective. Med. Hypotheses 61:173–176.CrossRefGoogle Scholar
McCarty, M. F. (2003b) Does postprandial storage of triglycerides in endothelial cells contribute to the endothelial dysfunction associated with insulin resistance and fatty diets?Med. Hypotheses 61:167–172.CrossRefGoogle Scholar
McCarty, M. F. (2003c) A wholly nutritional “multifocal angiostatic therapy” for control of disseminated cancer. Med. Hypotheses 61:1–15.CrossRefGoogle Scholar
McCarty, M. F. (2005a) Potential utility of natural polyphenols for reversing fat-induced insulin resistance. Med. Hypotheses 64:628–635.CrossRefGoogle Scholar
McCarty, M. F. (2005b) Up-regulation of PPARgamma coactivator-1alpha as a strategy for preventing and reversing insulin resistance and obesity. Med. Hypotheses 64:399–407.CrossRefGoogle Scholar
Meigs, J. B., Jacques, P. F., Selhub, J., et al. (2001) Fasting plasma homocysteine levels in the insulin resistance syndrome. Diabetes Care 24:1403–1410.CrossRefGoogle ScholarPubMed
Merritt, J. C. (2004) Metabolic syndrome: soybean foods and serum lipids. J. Natl. Med. Assoc. 96:1032–1041.Google ScholarPubMed
Molnar, D., Decsi, T., and Koletzko, B. (2004) Reduced antioxidant status in obese children with multimetabolic syndrome. Int. J. Obes. Relat. Metab. Disord. 28:1197–1202.CrossRefGoogle ScholarPubMed
Moran, L. and Norman, R. J. (2004) Understanding and managing disturbances in insulin metabolism and body weight in women with polycystic ovary syndrome. Best Pract. Res. Clin. Obstet. Gynaecol. 18:719–736.CrossRefGoogle ScholarPubMed
Moran, L. J., Noakes, M., Clifton, P. M., et al. (2004) Ghrelin and measures of satiety are altered in polycystic ovary syndrome but not differentially affected by diet composition. J. Clin. Endocrinol. Metab. 89:3337–3344.CrossRefGoogle Scholar
Morris, B. W., MacNeil, S., Stanley, K., Gray, T. A., and Fraser, R. (1993) The inter-relationship between insulin and chromium in hyperinsulinaemic euglycaemic clamps in healthy volunteers. J. Endocrinol. 139:339–345.CrossRefGoogle ScholarPubMed
Michelmore, K., Ong, K., Mason, S., et al. (2001) Clinical features in women with polycystic ovaries: relationships to insulin sensitivity, insulin gene VNTR and birth weight. Clin. Endocrinol. (Oxf.) 55:439–446.CrossRefGoogle ScholarPubMed
Muneyyirci-Delale, O., Nacharaju, V. L., Dalloul, M., et al. (2001) Divalent cations in women with PCOS: implications for cardiovascular disease. Gynecol. Endocrinol. 15:198–201.CrossRefGoogle ScholarPubMed
Nestler, J. E., Jakubowicz, D. J., Reamer, P., Gunn, R. D., and Allan, G. (1999) Ovulatory and metabolic effects of d-chiro-inositol in the polycystic ovary syndrome. N. Engl. J. Med. 340:1314–1320.CrossRefGoogle ScholarPubMed
Ong, K. K. and Dunger, D. B. (2004) Birth weight, infant growth and insulin resistance. Eur. J. Endocrinol. 151(Suppl. 3):U131–139.CrossRefGoogle ScholarPubMed
Orio, F. Jr, Palomba, S., Di Biase, S., et al. (2003) Homocysteine levels and C677T polymorphism of methylenetetrahydrofolate reductase in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 88:673–679.CrossRefGoogle ScholarPubMed
Orio, F., JrPalomba, S., Cascella, T., et al. (2004) Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 89:4588–4593.CrossRefGoogle ScholarPubMed
Ostlund, R. E. JrSeemayer, R., Gupta, S., et al. (1996) A stereospecific myo-inositol/d-chiro-inositol transporter in HepG2 liver cells: identification with d-chiro-[3–3H]inositol. J. Biol. Chem. 271:10073–10078.CrossRefGoogle ScholarPubMed
Paolisso, G. and Ravussin, E. (1995) Intracellular magnesium and insulin resistance: results in Pima Indians and Caucasians. J. Clin. Endocrinol. Metab. 80:1382–1385.Google ScholarPubMed
Paradisi, G., Steinberg, H. O., Hempfling, A., et al. (2001) Polycystic ovary syndrome is associated with endothelial dysfunction. Circulation 103:1410–1415.CrossRefGoogle ScholarPubMed
Qin, B., Nagasaki, M., Ren, M., et al. (2004) Cinnamon extract prevents the insulin resistance induced by a high-fructose diet. Horm. Metab. Res. 36:119–125.Google ScholarPubMed
Rabinovitz, H., Friedensohn, A., Leibovitz, A., et al. (2004) Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. Int. J. Vitam. Nutr. Res. 74:178–182.CrossRefGoogle ScholarPubMed
Riccardi, G. and Rivellese, A. A. (2000) Dietary treatment of the metabolic syndrome: the optimal diet. Br. J. Nutr. 83(Suppl. 1):S143–148.CrossRefGoogle ScholarPubMed
Rivellese, A. A., Maffettone, A., Iovine, C., et al. (1996) Long-term effects of fish oil on insulin resistance and plasma lipoproteins in NIDDM patients with hypertriglyceridemia. Diabetes Care 19:1207–1213.CrossRefGoogle ScholarPubMed
Rizk, A. Y., Bedaiwy, M. A., and Al-Inany, H. G. (2005) N-acetyl-cysteine is a novel adjuvant to clomiphene citrate in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil. Steril. 83:367–370.CrossRefGoogle ScholarPubMed
Roy, M., Chakrabarty, S., Sinha, D., Bhattacharya, R. K., and Siddiqi, M. (2003) Anticlastogenic, antigenotoxic and apoptotic activity of epigallocatechin gallate: a green tea polyphenol. Mutat. Res. 523/4:33–41.CrossRefGoogle Scholar
Sabuncu, T., Vural, H., Harma, M., and Harma, M. (2001) Oxidative stress in polycystic ovary syndrome and its contribution to the risk of cardiovascular disease. Clin. Biochem. 34:407–413.CrossRefGoogle ScholarPubMed
Sakura, N., Ono, H., Nomura, S., Ueda, H., and Fujita, N. (1998) Betaine dose and treatment intervals in therapy for homocystinuria due to 5,10-methylenetetrahydrofolate reductase deficiency. J. Inherit. Metab. Dis. 21:84–85.CrossRefGoogle ScholarPubMed
San Millan, J. L., Corton, M., Villuendas, G., et al. (2004) Association of the polycystic ovary syndrome with genomic variants related to insulin resistance, type 2 diabetes mellitus, and obesity. J. Clin. Endocrinol. Metab. 89:2640–2646.CrossRefGoogle ScholarPubMed
Sanchez, M., Sierra, A., Coca, A., et al. (1997) Oral calcium supplementation reduces intraplatelet free calcium concentration and insulin resistance in essential hypertensive patients. Hypertension 29:531–536.CrossRefGoogle ScholarPubMed
Schachter, M., Raziel, A., Friedler, S., et al. (2003) Insulin resistance in patients with polycystic ovary syndrome is associated with elevated plasma homocysteine. Hum. Reprod. 18:721–727.CrossRefGoogle ScholarPubMed
Schoppee, P. D., Garmey, J. C., and Veldhuis, J. D. (2002) Putative activation of the peroxisome proliferator-activated receptor gamma impairs androgen and enhances progesterone biosynthesis in primary cultures of porcine theca cells. Biol. Reprod. 66:190–198.CrossRefGoogle ScholarPubMed
Schwab, U., Torronen, A., Toppinen, L., et al. (2002) Betaine supplementation decreases plasma homocysteine concentrations but does not affect body weight, body composition, or resting energy expenditure in human subjects. Am. J. Clin. Nutr. 76:961–967.CrossRefGoogle ScholarPubMed
Setola, E., Monti, L. D., Galluccio, E., et al. (2004) Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia. Eur. J. Endocrinol. 151:483–489.CrossRefGoogle ScholarPubMed
Singh, R. H., Kruger, W. D., Wang, L., Pasquali, M., and Elsas, L. J. II (2004) Cystathionine beta-synthase deficiency: effects of betaine supplementation after methionine restriction in B6-nonresponsive homocystinuria. Genet. Med. 6:90–95.CrossRefGoogle ScholarPubMed
Skov, A. R., Toubro, S., and Ronn, B. (1999) Randomized trial on protein vs. carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int. J. Obes. Relat. Metab. Disord. 23:528–536.CrossRefGoogle ScholarPubMed
Sonmez, A. S., Yasar, L., Savan, K., et al. (2005) Comparison of the effects of acarbose and metformin use on ovulation rates in clomiphene citrate-resistant polycystic ovary syndrome. Hum. Reprod. 20:175–179.CrossRefGoogle ScholarPubMed
Stamets, K., Taylor, D. S., Kunselman, A., et al. (2004) A randomized trial of the effects of two types of short-term hypocaloric diets on weight loss in women with polycystic ovary syndrome. Fertil. Steril. 81:630–637.CrossRefGoogle ScholarPubMed
Strobel, P., Allard, C., Perez-Acle, T., et al. (2005) Myricetin, quercetin and catechin-gallate inhibit glucose uptake in isolated rat adipocytes. Biochem. J. 386:471–478.CrossRefGoogle ScholarPubMed
Szczecinski, P., Gryff-Keller, A., Horbowicz, M., and Lahuta, L. B. (2000) Galactosylpinitols isolated from vetch (Vicia villosa Roth.) seeds. J. Agric. Food Chem. 48:2717–2720.CrossRefGoogle ScholarPubMed
Thirunavukkarasu, V. and Anuradha, C. V. (2004) Influence of alpha-lipoic acid on lipid peroxidation and antioxidant defence system in blood of insulin-resistant rats. Diabetes Obes. Metab. 6:200–207.CrossRefGoogle ScholarPubMed
Thys-Jacobs, S., Donovan, D., Papadopoulos, A., Sarrel, P., and Bilezikian, J. P. (1999) Vitamin D and calcium dysregulation in the polycystic ovarian syndrome. Steroids 64:430–435.CrossRefGoogle ScholarPubMed
Vuksan, V., Sievenpiper, J. L., Owen, R., et al. (2000) Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 23:9–14.CrossRefGoogle ScholarPubMed
Walker, K. Z., O'Dea, K., and Johnsohn, L. (1996) Body fat distribution and non-insulin dependent diabetes: comparison of a fiber-rich, high carbohydrate, low fat (23%) and a 35% fat diet high in monounsaturated fat. Am. J. Clin. Nutr. 63:254–260.CrossRefGoogle Scholar
Yarali, H., Yildirir, A., Aybar, F., et al. (2001) Diastolic dysfunction and increased serum homocysteine concentrations may contribute to increased cardiovascular risk in patients with polycystic ovary syndrome. Fertil. Steril. 76:511–516.CrossRefGoogle ScholarPubMed
Yildirim, B., Sabir, N., and Kaleli, B. (2003) Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil. Steril. 79:1358–1364.CrossRefGoogle ScholarPubMed
Yokozawa, T., Nakagawa, T., and Kitani, K. (2002) Antioxidative activity of green tea polyphenol in cholesterol-fed rats. J. Agric. Food Chem. 50:3549–3552.CrossRefGoogle ScholarPubMed

Accessibility standard: Unknown

Accessibility compliance for the PDF of this book is currently unknown and may be updated in the future.

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×