{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:08:57Z","timestamp":1791994137250,"version":"4.4.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The rising global prevalence of polycystic ovary syndrome (PCOS) poses a significant threat to women\u2019s metabolic and reproductive health. The carbohydrate quality\u2014particularly dietary fiber, glycemic index (GI), and glycemic load (GL)\u2014in addressing metabolic and reproductive abnormalities remains debated due to the condition\u2019s heterogeneity. \u201cThe ongoing debate regarding PCOS arises from its complexity and heterogeneity, including variations in clinical symptoms, underlying causes, and treatment responses.\u201d This study aimed to perform a meta-analysis of randomized clinical trials to examine the effects of high fiber and low glycemic index (LGI)\/low glycemic load (LGL) dietary interventions on metabolic parameters in women with PCOS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic literature search was conducted using PubMed, EMBASE, the Cochrane Library, Web of Science, Ovid MEDLINE, and Scopus to identify eligible studies. The outcomes were reported as standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity among studies was evaluated using the chi-square test and the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study showed high dietary fiber and LGI significantly reduced fasting glucose and insulin resistance. Both high fiber and the LGI diet significantly reduced triglycerides and Low-density lipoprotein cholesterol (LDL-C), with fiber also increasing High-density lipoprotein cholesterol (HDL-C). High-fiber and LGI diets increased Sex Hormone-Binding Globulin (SHBG) and reduced Free androgen index (FAI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This meta-analysis highlights the significant benefits of optimizing dietary carbohydrate quality on glycolipid metabolism, sex hormone levels, and weight in women with PCOS. While further high-quality studies are needed, the findings suggest that dietary fiber and LGI\/LGL consumption have distinct effects on metabolic parameters. Therefore, treatment strategies should incorporate personalized dietary interventions tailored to the specific needs of women with PCOS within a shared decision-making framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>www.crd.york.ac.uk<\/jats:uri>\n                      , identifier PROSPERO CRD42024579681.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2025.1578459","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T01:45:41Z","timestamp":1750211141000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Optimizing carbohydrate quality: a path to better health for women with PCOS"],"prefix":"10.3389","volume":"12","author":[{"given":"Li","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aili","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinwen","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunni","family":"Heng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/S2213-8587(19)30289-X","article-title":"Empowering women with PCOS.","volume":"7","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1016\/S0140-6736(18)31809-9","article-title":"Carbohydrate quality and human health: A series of systematic reviews and meta-analyses.","volume":"393","author":"Reynolds","year":"2019","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1017\/S0954422418000136","article-title":"Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome.","volume":"31","author":"Barrea","year":"2018","journal-title":"Nutr Res Rev."},{"key":"B4","doi-asserted-by":"publisher","first-page":"876620","DOI":"10.3389\/fnut.2022.876620","article-title":"Mediterranean diet combined with a low-carbohydrate dietary pattern in the treatment of overweight polycystic ovary syndrome patients.","volume":"9","author":"Mei","year":"2022","journal-title":"Front Nutr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1186\/s13063-023-07569-6","article-title":"A comparison of the portfolio low-carbohydrate diet and the ketogenic diet in overweight and obese women with polycystic ovary syndrome: Study protocol for a randomized controlled trial.","volume":"24","author":"Najafabadi","year":"2023","journal-title":"Trials."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1016\/j.metabol.2014.07.007","article-title":"Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS.","volume":"63","author":"Goss","year":"2014","journal-title":"Metabolism."},{"key":"B7","doi-asserted-by":"publisher","first-page":"4386401","DOI":"10.1155\/2019\/4386401","article-title":"The effect of low carbohydrate diet on polycystic ovary syndrome: A meta-analysis of randomized controlled trials.","volume":"2019","author":"Zhang","year":"2019","journal-title":"Int J Endocrinol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"5262","DOI":"10.1038\/s41467-020-19003-5","article-title":"Defining the impact of dietary macronutrient balance on PCOS traits.","volume":"11","author":"Rodriguez Paris","year":"2020","journal-title":"Nat Commun."},{"key":"B9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.Metabol.2017.09.016","article-title":"Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences.","volume":"86","author":"Anagnostis","year":"2018","journal-title":"Metabolism."},{"key":"B10","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/cen.12175","article-title":"Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS.","volume":"79","author":"Gower","year":"2013","journal-title":"Clin Endocrinol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1016\/j.jand.2012.11.018","article-title":"Dietary composition in the treatment of polycystic ovary syndrome: A systematic review to inform evidence-based guidelines.","volume":"113","author":"Moran","year":"2013","journal-title":"J Acad Nutr Diet."},{"key":"B12","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3945\/ajcn.2010.29261","article-title":"Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome.","volume":"92","author":"Marsh","year":"2010","journal-title":"Am J Clin Nutr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.fertnstert.2005.12.054","article-title":"Difference in dietary intake between women with polycystic ovary syndrome and healthy controls.","volume":"86","author":"Douglas","year":"2006","journal-title":"Fertil Steril."},{"key":"B14","doi-asserted-by":"publisher","first-page":"9847","DOI":"10.1039\/d2fo01539k","article-title":"Effect of sodium alginate supplementation on weight management and reproductive hormones in polycystic females.","volume":"13","author":"Manzoor","year":"2022","journal-title":"Food Funct."},{"key":"B15","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1111\/j.1753-4887.2001.tb07001.x","article-title":"Dietary fiber and weight regulation.","volume":"59","author":"Howarth","year":"2001","journal-title":"Nutr Rev."},{"key":"B16","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1093\/ajcn\/55.2.436","article-title":"Physical properties of dietary fiber that influence physiological function: A model for polymers along the gastrointestinal tract.","volume":"55","author":"Eastwood","year":"1992","journal-title":"Am J Clin Nutr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2139","DOI":"10.1017\/S0007114516004153","article-title":"Effects of whole-grain rye porridge with added inulin and wheat gluten on appetite, gut fermentation and postprandial glucose metabolism: A randomised, cross-over, breakfast study.","volume":"116","author":"Lee","year":"2016","journal-title":"Br J Nutr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.nutres.2015.03.004","article-title":"Soluble dietary fiber (Fibersol-2) decreased hunger and increased satiety hormones in humans when ingested with a meal.","volume":"35","author":"Ye","year":"2015","journal-title":"Nutr Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.3390\/nu7021245","article-title":"Effects of two dietary fibers as part of ready-to-eat cereal (RTEC) breakfasts on perceived appetite and gut hormones in overweight women.","volume":"7","author":"Lafond","year":"2015","journal-title":"Nutrients."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1038\/ijo.2015.84","article-title":"The role of short chain fatty acids in appetite regulation and energy homeostasis.","volume":"39","author":"Byrne","year":"2015","journal-title":"Int J Obes."},{"key":"B21","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1017\/S0029665114001657","article-title":"Control of appetite and energy intake by SCFA: What are the potential underlying mechanisms?","volume":"74","author":"Chambers","year":"2015","journal-title":"Proc Nutr Soc."},{"key":"B22","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1089\/jmf.2011.0072","article-title":"Dietary fiber, gut peptides, and adipocytokines.","volume":"15","author":"S\u00e1nchez","year":"2012","journal-title":"J Med Food."},{"key":"B23","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.tifs.2016.11.001","article-title":"Impact of dietary fiber and fat on gut microbiota re-modeling and metabolic health.","volume":"57","author":"Ben\u00edtez-P\u00e1ez","year":"2016","journal-title":"Trends Food Sci Technol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1016\/S0002-8223(01)00194-8","article-title":"The role of whole grains in disease prevention.","volume":"101","author":"Slavin","year":"2001","journal-title":"J Am Diet Assoc."},{"key":"B25","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1111\/cen.14179","article-title":"A randomized controlled trial of a lifestyle intervention with longitudinal follow-up on ovarian dysmorphology in women with polycystic ovary syndrome.","volume":"92","author":"Kazemi","year":"2020","journal-title":"Clin Endocrinol."},{"key":"B26","first-page":"1421","article-title":"Reducing HIV\/AIDS transmission among African-American females: Is the female condom a solution?","volume":"97","author":"Brown","year":"2005","journal-title":"J Natl Med Assoc."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cbi.2015.11.033","article-title":"Protective effect of thymol on high fat diet induced diabetic nephropathy in C57BL\/6J mice.","volume":"245","author":"Saravanan","year":"2016","journal-title":"Chem Biol Interact."},{"key":"B28","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1093\/nutrit\/nuz082","article-title":"Low-carbohydrate diets and cardiometabolic health: The importance of carbohydrate quality over quantity.","volume":"78","author":"Sievenpiper","year":"2020","journal-title":"Nutr Rev."},{"key":"B29","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1038\/s41574-019-0190-x","article-title":"Carbohydrate quality is key for a healthy and sustainable diet.","volume":"15","author":"Riccardi","year":"2019","journal-title":"Nat Rev Endocrinol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s12916-024-03325-y","article-title":"Carbohydrate quality, not quantity, linked to reduced colorectal cancer incidence and mortality in US populations: Evidence from a prospective study.","volume":"22","author":"Xiao","year":"2024","journal-title":"BMC Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"giz113","DOI":"10.1093\/gigascience\/giz113","article-title":"Genome sequence of the Chinese white wax scale insect Ericerus pela: the first draft genome for the Coccidae family of scale insects.","volume":"8","author":"Yang","year":"2019","journal-title":"Gigascience."},{"key":"B32","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1111\/cen.13333","article-title":"The effects of dietary approaches to stop hypertension diet on weight loss, anti-M\u00fcllerian hormone and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial.","volume":"87","author":"Foroozanfard","year":"2017","journal-title":"Clin Endocrinol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1055\/s-0034-1376990","article-title":"DASH diet, insulin resistance, and serum hs-CRP in polycystic ovary syndrome: A randomized controlled clinical trial.","volume":"47","author":"Asemi","year":"2015","journal-title":"Horm Metab Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1016\/j.nutres.2014.04.011","article-title":"Low glycemic index vegan or low-calorie weight loss diets for women with polycystic ovary syndrome: A randomized controlled feasibility study.","volume":"34","author":"Turner-McGrievy","year":"2014","journal-title":"Nutr Res."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1016\/j.nut.2014.03.008","article-title":"Effects of DASH diet on lipid profiles and biomarkers of oxidative stress in overweight and obese women with polycystic ovary syndrome: A randomized clinical trial.","volume":"30","author":"Asemi","year":"2014","journal-title":"Nutrition."},{"key":"B36","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/jhn.12433","article-title":"Effects of dietary approach to stop hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: A randomised controlled trial.","volume":"30","author":"Azadi-Yazdi","year":"2017","journal-title":"J Hum Nutr Diet."},{"key":"B37","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.cct.2009.05.001","article-title":"Local recruitment experience in a study comparing the effectiveness of a low glycaemic index diet with a low calorie healthy eating approach at achieving weight loss and reducing the risk of endometrial cancer in women with polycystic ovary syndrome (PCOS).","volume":"30","author":"Atiomo","year":"2009","journal-title":"Contemp Clin Trials."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.3760\/cma.j.cn112137-20220930-02066","article-title":"[Effects of three medical nutrition therapies for weight loss on metabolic parameters and androgen level in overweight\/obese patients with polycystic ovary syndrome].","volume":"103","author":"Dou","year":"2023","journal-title":"Zhonghua Yi Xue Za Zhi."},{"key":"B39","doi-asserted-by":"crossref","first-page":"85","DOI":"10.5301\/NTM.2014.12407","article-title":"Effects of an isocaloric low-glycemic-load diet in polycystic ovary syndrome.","volume":"32","author":"Panico","year":"2014","journal-title":"Nutritional Therapy Metab."},{"key":"B40","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/07315724.2012.10720017","article-title":"Beneficial effects of a high-protein, low-glycemic-load hypocaloric diet in overweight and obese women with polycystic ovary syndrome: A randomized controlled intervention study.","volume":"31","author":"Mehrabani","year":"2012","journal-title":"J Am Coll Nutr."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e2151","DOI":"10.1210\/clinem\/dgab028","article-title":"Changes in ghrelin and glucagon following a low glycemic load diet in women with PCOS.","volume":"106","author":"Hoover","year":"2021","journal-title":"J Clin Endocrinol Metab."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.3390\/nu10101387","article-title":"A comparison of a pulse-based diet and the therapeutic lifestyle changes diet in combination with exercise and health counselling on the cardio-metabolic risk profile in women with polycystic ovary syndrome: A randomized controlled trial.","volume":"10","author":"Kazemi","year":"2018","journal-title":"Nutrients"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1016\/j.fertnstert.2008.01.035","article-title":"Comparison of hormonal and metabolic markers after a high-fat, Western meal versus a low-fat, high-fiber meal in women with polycystic ovary syndrome.","volume":"91","author":"Katcher","year":"2009","journal-title":"Fertil Steril."},{"key":"B44","doi-asserted-by":"publisher","first-page":"dgaa425","DOI":"10.1210\/clinem\/dgaa425","article-title":"Effect of diet on insulin resistance in polycystic ovary syndrome.","volume":"105","author":"Shang","year":"2020","journal-title":"J Clin Endocrinol Metab."},{"key":"B45","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1093\/ajcn\/63.1.47","article-title":"Types of carbohydrate in an ordinary diet affect insulin action and muscle substrates in humans.","volume":"63","author":"Kiens","year":"1996","journal-title":"Am J Clin Nutr."},{"key":"B46","doi-asserted-by":"publisher","first-page":"n1651","DOI":"10.1136\/bmj.n1651","article-title":"Effect of low glycaemic index or load dietary patterns on glycaemic control and cardiometabolic risk factors in diabetes: Systematic review and meta-analysis of randomised controlled trials.","volume":"374","author":"Chiavaroli","year":"2021","journal-title":"Bmj."},{"key":"B47","doi-asserted-by":"publisher","first-page":"655","DOI":"10.14219\/jada.archive.1987.0142","article-title":"Ultrasonic endodontics: A clinical review.","volume":"114","author":"Johnson","year":"1987","journal-title":"J Am Dent Assoc."},{"key":"B48","doi-asserted-by":"publisher","first-page":"5060","DOI":"10.3390\/nu15245060","article-title":"The health effects of low glycemic index and low glycemic load interventions on prediabetes and type 2 diabetes mellitus: A literature review of RCTs.","volume":"15","author":"Peres","year":"2023","journal-title":"Nutrients."},{"key":"B49","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.metabol.2014.07.007","article-title":"Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: A randomized clinical trial.","volume":"17","author":"Goss","year":"2020","journal-title":"Nutr Metab."},{"key":"B50","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1210\/jcem-61-5-946","article-title":"Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome.","volume":"61","author":"Wild","year":"1985","journal-title":"J Clin Endocrinol Metab."},{"key":"B51","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/j.1365-2265.1992.tb02295.x","article-title":"Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome.","volume":"37","author":"Conway","year":"1992","journal-title":"Clin Endocrinol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1210\/jc.2002-020815","article-title":"Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome.","volume":"88","author":"Moran","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"key":"B53","doi-asserted-by":"publisher","first-page":"2258","DOI":"10.1093\/oxfordjournals.humrep.a136280","article-title":"Subjects with polycystic ovaries without hyperandrogenaemia exhibit similar disturbances in insulin and lipid profiles as those with polycystic ovary syndrome.","volume":"10","author":"Norman","year":"1995","journal-title":"Hum Reprod."},{"key":"B54","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1159\/000519302","article-title":"Dietary interventions: A promising treatment for polycystic ovary syndrome.","volume":"77","author":"Che","year":"2021","journal-title":"Ann Nutr Metab."},{"key":"B55","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1210\/er.2015-1104","article-title":"The pathogenesis of polycystic ovary syndrome (PCOS): The hypothesis of PCOS as functional ovarian hyperandrogenism revisited.","volume":"37","author":"Rosenfield","year":"2016","journal-title":"Endocr Rev."},{"key":"B56","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1016\/j.fertnstert.2022.03.014","article-title":"Heart health in polycystic ovary syndrome: Time to act on the data.","volume":"117","author":"Dokras","year":"2022","journal-title":"Fertil Steril."},{"key":"B57","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1210\/jcem-59-5-949","article-title":"Elevated production and metabolic clearance rates of androgens in morbidly obese women.","volume":"59","author":"Samojlik","year":"1984","journal-title":"J Clin Endocrinol Metab."},{"key":"B58","doi-asserted-by":"publisher","first-page":"991","DOI":"10.3390\/ijms23020991","article-title":"Inulin improves diet-induced hepatic steatosis and increases intestinal akkermansia genus level.","volume":"23","author":"P\u00e9rez-Monter","year":"2022","journal-title":"Int J Mol Sci."},{"key":"B59","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1093\/humupd\/dml017","article-title":"The origins and sequelae of abnormal neuroendocrine function in polycystic ovary syndrome.","volume":"12","author":"Blank","year":"2006","journal-title":"Hum Reprod Update."},{"key":"B60","doi-asserted-by":"publisher","first-page":"e1071","DOI":"10.1210\/clinem\/dgaa839","article-title":"Update on PCOS: Consequences, challenges, and guiding treatment.","volume":"106","author":"Hoeger","year":"2021","journal-title":"J Clin Endocrinol Metab."},{"key":"B61","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1111\/j.1365-2265.1994.tb02578.x","article-title":"The independent effects of polycystic ovary syndrome and obesity on serum concentrations of gonadotrophins and sex steroids in premenopausal women.","volume":"41","author":"Holte","year":"1994","journal-title":"Clin Endocrinol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1093\/humupd\/5.2.166","article-title":"Leptin, polycystic ovaries and polycystic ovary syndrome.","volume":"5","author":"Jacobs","year":"1999","journal-title":"Hum Reprod Update."},{"key":"B63","doi-asserted-by":"publisher","first-page":"2447","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome.","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab."},{"key":"B64","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.1093\/cvr\/cvab312","article-title":"Limitations of the glycaemic index and the need for nuance when determining carbohydrate quality.","volume":"118","author":"Kanter","year":"2022","journal-title":"Cardiovasc Res."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1578459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T01:45:43Z","timestamp":1750211143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1578459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":64,"alternative-id":["10.3389\/fnut.2025.1578459"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1578459","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,18]]},"article-number":"1578459"}}