Abstract
Polycystic Ovary Syndrome (PCOS) is a multifactorial endocrine–metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction and metabolic abnormalities, including insulin resistance and low-grade chronic inflammation. Although genetic predisposition contributes to its pathogenesis, accumulating evidence highlights the pivotal role of environmental and lifestyle factors, particularly dietary patterns in modulating disease onset, severity and progression. Nutrition functions not only as an energy source but also as a biological regulator influencing insulin signaling, oxidative stress, mitochondrial dynamics, adipokine secretion, gut microbiota composition and hormonal homeostasis. These interconnected metabolic pathways directly affect ovarian steroidogenesis, follicular development, menstrual regularity and fertility outcomes. Current research increasingly emphasizes overall dietary patterns rather than isolated nutrients, recognizing the complex interplay between macronutrient composition, glycemic load, inflammatory potential and metabolic flexibility. This review critically evaluates contemporary evidence regarding the influence of carbohydrate quality, dietary fats, protein intake, micronutrient status, inflammatory dietary indices, gut–endocrine interactions and meal timing on PCOS pathophysiology. Clinical implications of nutritional interventions, including low-glycemic index diets, antiinflammatory dietary models and personalized nutrition approaches, are discussed in the context of improving metabolic and reproductive outcomes. Reframing dietary management of PCOS from a solely weight-centric model to a metabolically targeted strategy may enhance therapeutic efficacy. A mechanistic understanding of diet–metabolism– ovary interactions is essential for developing precision-based nutritional interventions to modulate disease over the long term and improve reproductive health.
Keywords: Dietary Patterns, Insulin Resistance, Metabolic Dysfunction, Nutritional Regulation, Polycystic Ovary Syndrome.