{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:24:55Z","timestamp":1792794295930,"version":"4.5.0"},"reference-count":197,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Division of Nutritional Sciences at Cornell University","id":[{"id":"https:\/\/ror.org\/05bnh6r87","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01-HD0937848"],"award-info":[{"award-number":["R01-HD0937848"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Heart Foundation Future Leader Fellowship"},{"name":"National Health and Medical Research Council Ideas","award":["GNT 2000905"],"award-info":[{"award-number":["GNT 2000905"]}],"id":[{"id":"https:\/\/ror.org\/011kf5r70","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Canadian Institutes of Health Research Postdoctoral Fellowship","award":["459075"],"award-info":[{"award-number":["459075"]}],"id":[{"id":"https:\/\/ror.org\/01gavpb45","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Lifestyle (dietary and\/or physical activity [PA]) modification is recommended as first-line therapy to manage polycystic ovary syndrome (PCOS). Current recommendations are based on healthy lifestyle practices for the general public since evidence for unique lifestyle approaches in PCOS is limited and low quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE AND RATIONALE<\/jats:title>\n                    <jats:p>We aimed to synthesize evidence on dietary and PA behaviors between women with PCOS and those without PCOS. Primary outcomes were overall diet quality, total energy intake and total PA, and secondary outcomes included macronutrients, micronutrients, food groups, foods, glycemic indices, sedentary time and sitting levels. We conducted this work to identify any unique lifestyle behaviors in women with PCOS that could underlie the propensity of weight gain and obesity in PCOS and be targeted for precision nutrition and PA interventions. These findings could be used to inform future practice recommendations and research that more effectively address complications (weight gain, obesity, diabetes, infertility, cardiovascular disease and mental health) in this high-risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SEARCH METHODS<\/jats:title>\n                    <jats:p>Databases of MEDLINE, Web of Science, Scopus and CINAHL were searched until 15 February 2022 to identify observational studies documenting dietary and PA behaviors between women with PCOS and without PCOS (Controls). Studies on children, adolescents (&amp;lt;18 years), pregnant or menopausal-aged women (&amp;gt;50 years) were excluded. Data were pooled by random-effects models and expressed as (standardized) mean differences (MD) and 95% CIs. The risk of bias was assessed by the Newcastle-Ottawa scale (NOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OUTCOMES<\/jats:title>\n                    <jats:p>Fifty-four studies (N\u2009=\u200939\u200a471 participants; [n\u2009=\u20098736 PCOS; 30\u200a735 Controls]) were eligible (96%; [52\/54] NOS scores\u2009\u2265\u20097). Women with PCOS had higher cholesterol (MD: 12.78, 95% CI: 1.48 to 24.08\u2009mg\/day; P\u2009=\u20090.03; I2\u2009=\u200919%), lower magnesium (MD: \u221221.46, 95% CI: \u221241.03 to \u22121.91\u2009mg\/day; P\u2009=\u20090.03; I2\u2009=\u200976%), and a tendency for lower zinc (MD: \u22121.08, 95% CI: \u22122.19 to 0.03\u2009mg\/day; P\u2009=\u20090.05; I2\u2009=\u200996%) intake, despite lower alcohol consumption (MD: \u22120.95, 95% CI: \u22121.67 to \u22120.22\u2009g\/day; P\u2009=\u20090.02; I2\u2009=\u20090%) versus Controls. Also, women with PCOS had lower total PA (standardized mean difference: \u22120.38, 95% CI: \u22120.72 to \u22120.03; P\u2009=\u20090.03; I2\u2009=\u200998%). Conversely, energy, macronutrients (carbohydrate, fat, protein, fiber), micronutrients (folic acid, iron, calcium, sodium), glycemic index and glycemic load were similar (all: P\u2009\u2265\u20090.06). Most eligible studies reported lower total adherence to healthy eating patterns or poorer consumption of major food groups (grains, fruits, vegetables, proteins, seeds, nuts, dairy) in women with PCOS, as described narratively since variable study methodology did not permit meta-analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS<\/jats:title>\n                    <jats:p>Collective evidence supports that women with PCOS have a lower overall diet quality, poorer dietary intakes (higher cholesterol, lower magnesium and zinc) and lower total PA, despite lower alcohol consumption versus those without PCOS. Considerable heterogeneity among studies reinforces the need for research to address any relative contributions of other factors (e.g. genetic, metabolic or sociodemographic) to the observed differences. These clarifications may contribute to future evidence-based guideline recommendations on monitoring and managing PCOS in the era of precision lifestyle medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humupd\/dmac023","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T23:30:05Z","timestamp":1652139005000},"page":"910-955","source":"Crossref","is-referenced-by-count":90,"title":["Comparison of dietary and physical activity behaviors in women with and without polycystic ovary syndrome: a systematic review and meta-analysis of 39\u200a471 women"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6001-7208","authenticated-orcid":false,"given":"Maryam","family":"Kazemi","sequence":"first","affiliation":[{"name":"Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University , Ithaca, NY, USA"},{"name":"Hilda and J. Lester Gabrilove Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy Y","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University , Ithaca, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Wan","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University , Ithaca, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia D","family":"Xiong","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Human Metabolic Research Unit, Cornell University , Ithaca, NY, 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