{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:55:37Z","timestamp":1781844937949,"version":"3.54.5"},"reference-count":137,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Polyendocrine Metabolic Ovarian Syndrome (PMOS) is recognized as the most prevalent endocrine disorder among women of reproductive age, with an estimated prevalence of approximately 18% according to current Rotterdam diagnostic criteria. Conditions such as dyslipidemia, insulin resistance, hyperandrogenism, central adiposity, and chronic inflammation are frequently observed in women diagnosed with PMOS. These conditions predispose such individuals to an increased risk of developing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), which is the most prevalent chronic liver disease worldwide, affecting approximately 25% of the global population. PMOS and MASLD represent two interconnected metabolic disorders that share overlapping risk factors. Objective: The purpose of this narrative review is to investigate the underlying pathophysiological connections between PMOS and MASLD and to assess the efficacy of targeted nutritional interventions. Methods: An analysis of nearly 30 articles concerning nutritional strategies for PMOS and MASLD was conducted, including studies on dietary patterns, macronutrient-focused dietary strategies, and dietary supplement interventions. Results and Conclusions: The review concludes that a combined approach\u2014comprising an anti-inflammatory dietary pattern, omega-3 supplementation, and myo-inositol\u2014serves as a good evidence-based initial strategy for clinicians and dietitians managing women with coexisting PMOS and MASLD. It is noteworthy that most of the evidence for these recommendations comes from studies that focus solely on either PMOS or MASLD populations. Studies involving individuals with both conditions are currently lacking. Future research should prioritize long-term randomized controlled trials involving women from diverse backgrounds diagnosed with both PMOS and MASLD. These conditions, whether independently or concurrently, are imposing an increasing burden on women of reproductive age worldwide. As further research is conducted, nutritional interventions may serve as primary rather than supplementary therapeutic strategies for the management of PMOS and MASLD.<\/jats:p>","DOI":"10.3390\/nu18121948","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:58:38Z","timestamp":1781661518000},"page":"1948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Interplay Between PMOS and MASLD: Pathophysiology and Evidence-Based Nutritional Interventions"],"prefix":"10.3390","volume":"18","author":[{"given":"Ashley","family":"Graef","sequence":"first","affiliation":[{"name":"Nutrition and Food Sciences Department, Texas Woman\u2019s University, Denton, TX 76204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4594-5484","authenticated-orcid":false,"given":"Monique J.","family":"LeMieux","sequence":"additional","affiliation":[{"name":"Nutrition and Food Sciences Department, Texas Woman\u2019s University, Denton, TX 76204, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.fertnstert.2016.05.003","article-title":"Criteria, Prevalence, and Phenotypes of Polycystic Ovary Syndrome","volume":"106","author":"Lizneva","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J.S.E., Legro, R.S., Lizneva, D., Natterson-Horowtiz, B., Teede, H.J., and Yildiz, B.O. (2016). Polycystic Ovary Syndrome. Nat. Rev. Dis. Primers, 2.","DOI":"10.1038\/nrdp.2016.57"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Siddiqui, S., Mateen, S., Ahmad, R., and Moin, S. (2022). A Brief Insight into the Etiology, Genetics, and Immunology of Polycystic Ovarian Syndrome (PCOS). J. Assist. Reprod. Genet., 39.","DOI":"10.1007\/s10815-022-02625-7"},{"key":"ref_4","unstructured":"(2026, March 11). Diagnostic Criteria for Polycystic Ovary Syndrome|Ugeskriftet.Dk. Available online: https:\/\/ugeskriftet.dk\/videnskab\/diagnostiske-kriterier-polycystisk-ovariesyndrom."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"14172","DOI":"10.3748\/wjg.v20.i39.14172","article-title":"Review of Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome","volume":"20","author":"Kelley","year":"2014","journal-title":"World J. Gastroenetrol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Yang, M., Khoukaz, L., Qi, X., Kimchi, E.T., Staveley-O\u2019carroll, K.F., and Li, G. (2021). Diet and Gut Microbiota Interaction-Derived Metabolites and Intrahepatic Immune Response in NAFLD Development and Treatment. Biomedicines, 9.","DOI":"10.3390\/biomedicines9121893"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Rinella, M.E., and Sookoian, S. (2023). From NAFLD to MASLD: Updated Naming and Diagnosis Criteria for Fatty Liver Disease. J. Lipid Res., 65.","DOI":"10.1016\/j.jlr.2023.100485"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S4","DOI":"10.1016\/S1665-2681(19)31820-4","article-title":"Epidemiology and Natural History of Non-Alcoholic Fatty Liver Disease (NAFLD)","volume":"8","author":"Bellentani","year":"2009","journal-title":"Ann. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.jhep.2014.12.012","article-title":"NAFLD: A Multisystem Disease","volume":"62","author":"Byrne","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"941","DOI":"10.5604\/16652681.1171803","article-title":"Nonalcoholic Fatty Liver Disease and Polycystic Ovary Syndrome","volume":"14","author":"Polyzos","year":"2015","journal-title":"Ann. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"40","DOI":"10.18370\/2309-4117.2023.70.40-45","article-title":"Relationships between Nonalcoholic Fatty Liver Disease and Polycystic Ovary Syndrome","volume":"70","author":"Manzhalii","year":"2023","journal-title":"Reprod. Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12020-019-02085-7","article-title":"Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome","volume":"67","author":"Paschou","year":"2019","journal-title":"Endocrine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E214","DOI":"10.1152\/ajpendo.1979.237.3.E214","article-title":"Glucose Clamp Technique: A Method for Quantifying Insulin Secretion and Resistance","volume":"27","author":"DeFronzo","year":"1979","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.2337\/diab.38.9.1165","article-title":"Profound Peripheral Insulin Resistance, Independent of Obesity, in Polycystic Ovary Syndrome","volume":"38","author":"Dunaif","year":"1989","journal-title":"Diabetes"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Gambineri, A., Patton, L., Altieri, P., Pagotto, U., Pizzi, C., Manzoli, L., and Pasquali, R. (2012). Polycystic Ovary Syndrome Is a Risk Factor for Type 2 Diabetes: Results from a Long-Term Prospective Study. Diabetes, 61.","DOI":"10.2337\/db11-1360"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jsbmb.2009.12.010","article-title":"Insulin and Hyperandrogenism in Women with Polycystic Ovary Syndrome","volume":"122","author":"Baptiste","year":"2010","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","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":"ref_18","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.bpobgyn.2013.02.007","article-title":"Glucose Homeostasis, Obesity and Diabetes","volume":"27","author":"Bano","year":"2013","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"887","DOI":"10.2337\/dc09-1525","article-title":"Determinants of Impaired Fasting Glucose versus Glucose Intolerance in Polycystic Ovary Syndrome","volume":"33","author":"Karakas","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wu, J., Yao, X.Y., Shi, R.X., Liu, S.F., and Wang, X.Y. (2018). A Potential Link between Polycystic Ovary Syndrome and Non-Alcoholic Fatty Liver Disease: An Update Meta-Analysis. Reprod. Health, 15.","DOI":"10.1186\/s12978-018-0519-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3332","DOI":"10.1210\/jc.2009-2698","article-title":"Hyperandrogenemia Is Independently Associated with Elevated Alanine Aminotransferase Activity in Young Women with Polycystic Ovary Syndrome","volume":"95","author":"Chen","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.steroids.2011.12.003","article-title":"Inflammation in Polycystic Ovary Syndrome: Underpinning of Insulin Resistance and Ovarian Dysfunction","volume":"77","year":"2012","journal-title":"Steroids"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Vassilatou, E. (2014). Nonalcoholic Fatty Liver Disease and Polycystic Ovary Syndrome. World J. Gastroenterol., 20.","DOI":"10.3748\/wjg.v20.i26.8351"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Zhang, T., Gao, H., Fan, Y., Chen, S., Li, Y., Liu, R., Li, T., and Yin, C. (2023). Gut Microbiota Disorder Induces Liver Dysfunction in Polycystic Ovary Syndrome Rats\u2019 Model by Regulating Metabolite Rosmarinic Acid. Life Sci., 330.","DOI":"10.1016\/j.lfs.2023.121912"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kelley, S.T., Skarra, D.V., Rivera, A.J., and Thackray, V.G. (2016). The Gut Microbiome Is Altered in a Letrozole-Induced Mouse Model of Polycystic Ovary Syndrome. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146509"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Zhao, X., Jiang, Y., Xi, H., Chen, L., and Feng, X. (2020). Exploration of the Relationship Between Gut Microbiota and Polycystic Ovary Syndrome (PCOS): A Review. Geburtshilfe Frauenheilkd., 80.","DOI":"10.1055\/a-1081-2036"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1007\/s12602-024-10262-y","article-title":"Gut Microbes in Polycystic Ovary Syndrome and Associated Comorbidities; Type 2 Diabetes, Non-Alcoholic Fatty Liver Disease (NAFLD), Cardiovascular Disease (CVD), and the Potential of Microbial Therapeutics","volume":"16","author":"Singh","year":"2024","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Mei, Y., Li, W., Wang, B., Chen, Z., Wu, X., Lin, Y., and Wang, M. (2025). Gut Microbiota: An Emerging Target Connecting Polycystic Ovarian Syndrome and Insulin Resistance. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1508893"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Sun, Y., Gao, S., Ye, C., and Zhao, W. (2023). Gut Microbiota Dysbiosis in Polycystic Ovary Syndrome: Mechanisms of Progression and Clinical Applications. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1142041"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Kassi, E., Pervanidou, P., Kaltsas, G., and Chrousos, G. (2011). Metabolic Syndrome: Definitions and Controversies. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-48"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1517\/14656566.2011.585462","article-title":"Metabolic Syndrome: Nature, Therapeutic Solutions and Options","volume":"12","author":"Onat","year":"2011","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Lavor, C.B.H., Viana, A.B., and Medeiros, F.D.C. (2022). Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography. RBGO Gynecol. Obstet., 44.","DOI":"10.1055\/s-0041-1741032"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Giri, A., Joshi, A., Shrestha, S., and Chaudhary, A. (2022). Metabolic Syndrome among Patients with Polycystic Ovarian Syndrome Presenting to a Tertiary Care Hospital: A Descriptive Cross-Sectional Study. J. Nepal. Med. Assoc., 60.","DOI":"10.31729\/jnma.7221"},{"key":"ref_34","unstructured":"Zahiri, Z., Sharami, S.H., Milani, F., Mohammadi, F., Kazemnejad, E., Ebrahimi, H., and Dalil Heirati, S.F. (2015). Metabolic Syndrome in Patients with Polycystic Ovary Syndrome in Iran. Int. J. Fertil. Steril., 9."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2747","DOI":"10.1016\/j.dsx.2019.06.008","article-title":"The Prevalence of Metabolic Syndrome in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","volume":"13","author":"Khorshidi","year":"2019","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_36","unstructured":"Shruthi, S., Lakshmi, G., S, M.T., and Washington, J.K. (2025). Prevalence and Predictors of Metabolic Syndrome in Women with Polycystic Ovarian Syndrome: A Cross-Sectional Study. Cureus, 17."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Anjum, S., Askari, S., Riaz, M., and Basit, A. (2020). Clinical Presentation and Frequency of Metabolic Syndrome in Women with Polycystic Ovary Syndrome: An Experience from a Tertiary Care Hospital in Pakistan. Cureus, 12.","DOI":"10.7759\/cureus.11860"},{"key":"ref_38","unstructured":"Glass, L.M., Hunt, C.M., Fuchs, M., and Su, G.L. (2019). Comorbidities and Nonalcoholic Fatty Liver Disease: The Chicken, the Egg, or Both?. Fed. Pract., 36."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Godoy-Matos, A.F., Silva J\u00fanior, W.S., and Valerio, C.M. (2020). NAFLD as a Continuum: From Obesity to Metabolic Syndrome and Diabetes. Diabetol. Metab. Syndr., 12.","DOI":"10.1186\/s13098-020-00570-y"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Jinjuvadia, R., Antaki, F., Lohia, P., and Liangpunsakul, S. (2017). The Association between Nonalcoholic Fatty Liver Disease and Metabolic Abnormalities in United States Population. J. Clin. Gastroenterol., 51.","DOI":"10.1097\/MCG.0000000000000666"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Wang, D., and He, B. (2022). Current Perspectives on Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome. Diabetes Metab. Syndr. Obes., 15.","DOI":"10.2147\/DMSO.S362424"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.cmet.2012.04.004","article-title":"Increased Hepatic Synthesis and Dysregulation of Cholesterol Metabolism Is Associated with the Severity of Nonalcoholic Fatty Liver Disease","volume":"15","author":"Min","year":"2012","journal-title":"Cell Metab."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Liu, D., Gao, X., Pan, X.F., Zhou, T., Zhu, C., Li, F., Fan, J.G., Targher, G., and Zhao, J. (2023). The Hepato-Ovarian Axis: Genetic Evidence for a Causal Association between Non-Alcoholic Fatty Liver Disease and Polycystic Ovary Syndrome. BMC Med., 21.","DOI":"10.1186\/s12916-023-02775-0"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Chen, Y., Ma, L., Ge, Z., Pan, Y., and Xie, L. (2022). Key Genes Associated with Non-Alcoholic Fatty Liver Disease and Polycystic Ovary Syndrome. Front. Mol. Biosci., 9.","DOI":"10.3389\/fmolb.2022.888194"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Asfari, M.M., Sarmini, M.T., Baidoun, F., Al-Khadra, Y., Ezzaizi, Y., Dasarathy, S., and McCullough, A. (2020). Association of Non-Alcoholic Fatty Liver Disease and Polycystic Ovarian Syndrome. BMJ Open Gastroenterol., 7.","DOI":"10.1136\/bmjgast-2019-000352"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Ra\u0111enovi\u0107, S.S., Pupovac, M., Andji\u0107, M., Bila, J., Sre\u0107kovi\u0107, S., Gudovi\u0107, A., Draga\u0161, B., and Radunovi\u0107, N. (2022). Prevalence, Risk Factors, and Pathophysiology of Nonalcoholic Fatty Liver Disease (NAFLD) in Women with Polycystic Ovary Syndrome (PCOS). Biomedicines, 10.","DOI":"10.3390\/biomedicines10010131"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Shahbaz, M., Almatooq, H., Foucambert, P., Esbrand, F.D., Zafar, S., Panthangi, V., Cyril Kurupp, A.R., Raju, A., Luthra, G., and Khan, S. (2022). A Systematic Review of the Risk of Non-Alcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome. Cureus, 14.","DOI":"10.7759\/cureus.29928"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e1485","DOI":"10.1210\/clinem\/dgag008","article-title":"MASLD Coexisting with PCOS Increases Cardiometabolic Risk","volume":"111","author":"Ayonrinde","year":"2026","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2634","DOI":"10.1002\/hep4.2039","article-title":"Polycystic Ovary Syndrome Is Associated with Nonalcoholic Steatohepatitis in Women of Reproductive Age","volume":"6","author":"Maldonado","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_50","unstructured":"Pandyarajan, V., Gish, R.G., Alkhouri, N., and Noureddin, M. (2019). Screening for Nonalcoholic Fatty Liver Disease in the Primary Care Clinic. Gastroenterol. Hepatol., 15."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2337\/dci24-0094","article-title":"Metabolic Dysfunction\u2013Associated Steatotic Liver Disease (MASLD) in People with Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association","volume":"48","author":"Cusi","year":"2025","journal-title":"Diabetes Care"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Ullah, R., Rauf, N., Nabi, G., Ullah, H., Shen, Y., Zhou, Y.D., and Fu, J. (2019). Role of Nutrition in the Pathogenesis and Prevention of Non-Alcoholic Fatty Liver Disease: Recent Updates. Int. J. Biol. Sci., 15.","DOI":"10.7150\/ijbs.30121"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ul-Haq, I., Nadeem, M., Sharma, A., Mugabi, R., Waseem, M., and Nayik, G.A. (2025). Beyond Medication: Unveiling the Role of Diet and Lifestyle in Fatty Liver Disease Management. Hum. Nutr. Metab., 40.","DOI":"10.1016\/j.hnm.2025.200317"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Gautam, R., Maan, P., Jyoti, A., Kumar, A., Malhotra, N., and Arora, T. (2025). The Role of Lifestyle Interventions in PCOS Management: A Systematic Review. Nutrients, 17.","DOI":"10.3390\/nu17020310"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Shishehgar, F., Mirmiran, P., Rahmati, M., Tohidi, M., and Ramezani Tehrani, F. (2019). Does a Restricted Energy Low Glycemic Index Diet Have a Different Effect on Overweight Women with or without Polycystic Ovary Syndrome?. BMC Endocr. Disord., 19.","DOI":"10.1186\/s12902-019-0420-1"},{"key":"ref_56","doi-asserted-by":"crossref","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":"ref_57","doi-asserted-by":"crossref","unstructured":"Rooholahzadegan, F., Arefhosseini, S., Tutunchi, H., Badali, T., Khoshbaten, M., and Ebrahimi-Mameghani, M. (2023). The Effect of DASH Diet on Glycemic Response, Meta-Inflammation and Serum LPS in Obese Patients with NAFLD: A Double-Blind Controlled Randomized Clinical Trial. Nutr. Metab., 20.","DOI":"10.1186\/s12986-023-00733-4"},{"key":"ref_58","doi-asserted-by":"crossref","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":"ref_59","doi-asserted-by":"crossref","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":"Fallahzadeh","year":"2017","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Khalatbari-Soltani, S., Marques-Vidal, P., Imamura, F., and Forouhi, N.G. (2020). Prospective Association between Adherence to the Mediterranean Diet and Hepatic Steatosis: The Swiss CoLaus Cohort Study. BMJ Open, 10.","DOI":"10.1136\/bmjopen-2020-040959"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., and Savastano, S. (2019). Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients, 11.","DOI":"10.3390\/nu11102278"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jhep.2013.02.012","article-title":"The Mediterranean Diet Improves Hepatic Steatosis and Insulin Sensitivity in Individuals with Non-Alcoholic Fatty Liver Disease","volume":"59","author":"Ryan","year":"2013","journal-title":"J. Hepatol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Manta, A., Paschou, S.A., Isari, G., Mavroeidi, I., Kalantaridou, S., and Peppa, M. (2023). Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome. Nutrients, 15.","DOI":"10.3390\/nu15153483"},{"key":"ref_64","unstructured":"(2026, March 10). Low-Glycemic Index Diet: What\u2019s Behind the Claims?\u2014Mayo Clinic. Available online: https:\/\/www.mayoclinic.org\/healthy-lifestyle\/nutrition-and-healthy-eating\/in-depth\/low-glycemic-index-diet\/art-20048478."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Saadati, N., Haidari, F., Barati, M., Nikbakht, R., Mirmomeni, G., and Rahim, F. (2021). The Effect of Low Glycemic Index Diet on the Reproductive and Clinical Profile in Women with Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis. Heliyon, 7.","DOI":"10.1016\/j.heliyon.2021.e08338"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/advances\/nmaa092","article-title":"Effects of Dietary Glycemic Index and Glycemic Load on Cardiometabolic and Reproductive Profiles in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Kazemi","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_67","unstructured":"(2026, March 10). DASH\u2014DASH Eating Plan|NHLBI, NIH, Available online: https:\/\/www.nhlbi.nih.gov\/health\/dash-eating-plan."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Chiavaroli, L., Viguiliouk, E., Nishi, S.K., Mejia, S.B., Raheli\u0107, D., Kahleov\u00e1, H., Salas-Salvad\u00f3, J., Kendall, C.W.C., and Sievenpiper, J.L. (2019). DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients, 11.","DOI":"10.3390\/nu11020338"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s00394-015-1081-0","article-title":"Adherence to the DASH Diet in Relation to Psychological Profile of Iranian Adults","volume":"56","author":"Valipour","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_70","unstructured":"(2026, March 10). What Is the Mediterranean Diet?|American Heart Association. Available online: https:\/\/www.heart.org\/en\/healthy-living\/healthy-eating\/eat-smart\/nutrition-basics\/mediterranean-diet."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.amjmed.2014.10.014","article-title":"The Mediterranean Diet, Its Components, and Cardiovascular Disease","volume":"128","author":"Widmer","year":"2015","journal-title":"Am. J. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1017\/S0007114512003339","article-title":"Relationships of the Mediterranean Dietary Pattern with Insulin Resistance and Diabetes Incidence in the Multi-Ethnic Study of Atherosclerosis (MESA)","volume":"109","author":"Abiemo","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ejcn.2013.4","article-title":"Adherence to the Mediterranean Diet and Body Fat Distribution in Reproductive Aged Women","volume":"67","author":"Boghossian","year":"2013","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Estruch, R., Ros, E., Salas-Salvad\u00f3, J., Covas, M.-I., Corella, D., Ar\u00f3s, F., G\u00f3mez-Gracia, E., Ruiz-Guti\u00e9rrez, V., Fiol, M., and Lapetra, J. (2018). Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N. Engl. J. Med., 378.","DOI":"10.1056\/NEJMoa1800389"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/j.metabol.2014.04.010","article-title":"The Effect of Mediterranean Diet on the Development of Type 2 Diabetes Mellitus: A Meta-Analysis of 10 Prospective Studies and 136,846 Participants","volume":"63","author":"Koloverou","year":"2014","journal-title":"Metabolism"},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Magagnini, M.C., Condorelli, R.A., Cimino, L., Cannarella, R., Aversa, A., Calogero, A.E., and La Vignera, S. (2022). Does the Ketogenic Diet Improve the Quality of Ovarian Function in Obese Women?. Nutrients, 14.","DOI":"10.3390\/nu14194147"},{"key":"ref_77","doi-asserted-by":"crossref","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":"ref_78","doi-asserted-by":"crossref","unstructured":"Mavropoulos, J.C., Yancy, W.S., Hepburn, J., and Westman, E.C. (2005). The Effects of a Low-Carbohydrate, Ketogenic Diet on the Polycystic Ovary Syndrome: A Pilot Study. Nutr. Metab., 2.","DOI":"10.1186\/1743-7075-2-35"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7762\/cnr.2023.12.1.29","article-title":"Association Between Protein Intake from Different Animal and Plant Origins and the Risk of Non-Alcoholic Fatty Liver Disease: A Case-Control Study","volume":"12","author":"Khazaei","year":"2023","journal-title":"Clin. Nutr. Res."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.fertnstert.2008.05.065","article-title":"Effects of Protein versus Simple Sugar Intake on Weight Loss in Polycystic Ovary Syndrome (According to the National Institutes of Health Criteria)","volume":"92","author":"Almario","year":"2009","journal-title":"Fertil. Steril."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Zumbro, E.L., Rao, M., Balcom-Luker, S., Broughton, K.S., and LeMieux, M.J. (2021). Whey Protein Supplementation Improves the Glycemic Response and May Reduce Non-Alcoholic Fatty Liver Disease Related Biomarkers in Women with Polycystic Ovary Syndrome (PCOS). Nutrients, 13.","DOI":"10.3390\/nu13072451"},{"key":"ref_82","unstructured":"Khani, B., Mehrabian, F., Khalesi, E., and Eshraghid, A. (2011). Effect of Soy Phytoestrogen on Metabolic and Hormonal Disturbance of Women with Polycystic Ovary Syndrome. J. Res. Med. Sci., 16."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Yahay, M., Heidari, Z., Allameh, Z., and Amani, R. (2021). The Effects of Canola and Olive Oils Consumption Compared to Sunflower Oil, on Lipid Profile and Hepatic Steatosis in Women with Polycystic Ovarian Syndrome: A Randomized Controlled Trial. Lipids Health Dis., 20.","DOI":"10.1186\/s12944-021-01433-9"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1089\/dia.2013.0178","article-title":"Effect of a 6-Month Intervention with Cooking Oils Containing a High Concentration of Monounsaturated Fatty Acids (Olive and Canola Oils) Compared with Control Oil in Male Asian Indians with Nonalcoholic Fatty Liver Disease","volume":"16","author":"Nigam","year":"2014","journal-title":"Diabetes Technol. Ther."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1002\/hep.27289","article-title":"Effects of Purified Eicosapentaenoic and Docosahexaenoic Acids in Nonalcoholic Fatty Liver Disease: Results from the WELCOME* Study","volume":"60","author":"Scorletti","year":"2014","journal-title":"Hepatology"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3842","DOI":"10.1210\/jc.2009-0870","article-title":"Omega-3 Fatty Acid Supplementation Decreases Liver Fat Content in Polycystic Ovary Syndrome: A Randomized Controlled Trial Employing Proton Magnetic Resonance Spectroscopy","volume":"94","author":"Cussons","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Khani, B., Mardanian, F., and Fesharaki, S.J. (2017). Omega-3 Supplementation Effects on Polycystic Ovary Syndrome Symptoms and Metabolic Syndrome. J. Res. Med. Sci., 22.","DOI":"10.4103\/jrms.JRMS_644_16"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Soltani, S., Jayedi, A., Abdollahi, S., Vasmehjani, A.A., Meshkini, F., and Shab-Bidar, S. (2023). Effect of Carbohydrate Restriction on Body Weight in Overweight and Obese Adults: A Systematic Review and Dose\u2013Response Meta-Analysis of 110 Randomized Controlled Trials. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1287987"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1093\/nutrit\/nuae229","article-title":"The Role of Dietary Protein in Mitigating the Risk of Nonalcoholic Fatty Liver Disease","volume":"83","author":"Shariq","year":"2025","journal-title":"Nutr. Rev."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s00394-015-0974-2","article-title":"Food Protein-Derived Bioactive Peptides in Management of Type 2 Diabetes","volume":"54","author":"Patil","year":"2015","journal-title":"Eur. J. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.foodres.2015.01.016","article-title":"Whey as a Source of Peptides with Remarkable Biological Activities","volume":"73","author":"Brandelli","year":"2015","journal-title":"Food Res. Int."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.jnutbio.2012.12.013","article-title":"Modulation of Adipose Tissue Inflammation by Bioactive Food Compounds","volume":"24","author":"Siriwardhana","year":"2013","journal-title":"J. Nutr. Biochem."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1016\/j.jnutbio.2011.11.009","article-title":"N-3 and n-6 Polyunsaturated Fatty Acids Differentially Regulate Adipose Angiotensinogen and Other Inflammatory Adipokines in Part via NF-\u039aB-Dependent Mechanisms","volume":"23","author":"Siriwardhana","year":"2012","journal-title":"J. Nutr. Biochem."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/B978-0-12-416003-3.00013-5","article-title":"Health Benefits of N-3 Polyunsaturated Fatty Acids: Eicosapentaenoic Acid and Docosahexaenoic Acid","volume":"65","author":"Siriwardhana","year":"2012","journal-title":"Adv. Food Nutr. Res."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1042\/CS20070456","article-title":"Cellular and Molecular Effects of N-3 Polyunsaturated Fatty Acids on Adipose Tissue Biology and Metabolism","volume":"116","author":"Flachs","year":"2009","journal-title":"Clin. Sci."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.mam.2011.10.011","article-title":"Immunity as a Link between Obesity and Insulin Resistance","volume":"33","author":"Kalupahana","year":"2012","journal-title":"Mol. Asp. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1111\/j.1753-4887.2010.00272.x","article-title":"Long-Chain Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid Dose-Dependently Reduce Fasting Serum Triglycerides","volume":"68","author":"Binns","year":"2010","journal-title":"Nutr. Rev."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"808","DOI":"10.3945\/ajcn.2009.28374","article-title":"Effects of n\u20133 Fatty Acids on Macro- and Microvascular Function in Subjects with Type 2 Diabetes Mellitus","volume":"91","author":"Stirban","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1089\/met.2011.0081","article-title":"Docosahexaenoic Acid Supplementation Improved Lipocentric but Not Glucocentric Markers of Insulin Sensitivity in Hypertriglyceridemic Men","volume":"10","author":"Kelley","year":"2012","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"387","DOI":"10.11622\/smedj.2013139","article-title":"Eicosapentaenoic Acid Improves Insulin Sensitivity and Blood Sugar in Overweight Type 2 Diabetes Mellitus Patients: A Double-Blind Randomised Clinical Trial","volume":"54","author":"Sarbolouki","year":"2013","journal-title":"Singap. Med. J."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.2337\/diacare.19.11.1207","article-title":"Long-Term Effects of Fish Oil on Insulin Resistance and Plasma Lipoproteins in NIDDM Patients with Hypertriglyceridemia","volume":"19","author":"Rivellese","year":"1996","journal-title":"Diabetes Care"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1093\/ajcn\/86.5.1670","article-title":"Treatment for 2 Mo with N-3 Polyunsaturated Fatty Acids Reduces Adiposity and Some Atherogenic Factors but Does Not Improve Insulin Sensitivity in Women with Type 2 Diabetes: A Randomized Controlled Study","volume":"86","author":"Kabir","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3945\/an.110.1003","article-title":"(N-3) Fatty Acids: Clinical Trials in People with Type 2 Diabetes","volume":"1","author":"Hendrich","year":"2010","journal-title":"Adv. Nutr."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"6425","DOI":"10.21037\/apm-21-1050","article-title":"Efficacy of Omega-3 Fatty Acid Supplementation on Cardiovascular Risk Factors in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","volume":"10","author":"Xia","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Javed, Z., Papageorgiou, M., Deshmukh, H., Kilpatrick, E.S., Mann, V., Corless, L., Abouda, G., Rigby, A.S., Atkin, S.L., and Sathyapalan, T. (2019). A Randomized, Controlled Trial of Vitamin D Supplementation on Cardiovascular Risk Factors, Hormones, and Liver Markers in Women with Polycystic Ovary Syndrome. Nutrients, 11.","DOI":"10.3390\/nu11010188"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s12020-014-0336-5","article-title":"Does Vitamin D Improve Liver Enzymes, Oxidative Stress, and Inflammatory Biomarkers in Adults with Non-Alcoholic Fatty Liver Disease? A Randomized Clinical Trial","volume":"47","author":"Sharifi","year":"2014","journal-title":"Endocrine"},{"key":"ref_107","first-page":"5512","article-title":"The 40:1 Myo-Inositol\/D-Chiro-Inositol Plasma Ratio Is Able to Restore Ovulation in PCOS Patients: Comparison with Other Ratios","volume":"23","author":"Nordio","year":"2019","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_108","unstructured":"Mellonie, P., Manivannan, A., Thangaraj, P., and Logeswari, B.M. (2024). The Effectiveness of Myo-Inositol in Women with Polycystic Ovary Syndrome: A Prospective Clinical Study. Cureus, 16."},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Arefhosseini, S., Roshanravan, N., Asghari, S., Tutunchi, H., and Ebrahimi-Mameghani, M. (2023). Expression of Inflammatory Genes, WBC-Derived Inflammatory Biomarkers and Liver Function Indices: Effects of Myo-Inositol Supplementation in Obese Patients with NAFLD. J. Funct. Foods, 104.","DOI":"10.1016\/j.jff.2023.105524"},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Arefhosseini, S., Roshanravan, N., Tutunchi, H., Rostami, S., Khoshbaten, M., and Ebrahimi-Mameghani, M. (2023). Myo-Inositol Supplementation Improves Cardiometabolic Factors, Anthropometric Measures, and Liver Function in Obese Patients with Non-Alcoholic Fatty Liver Disease. Front. Nutr., 10.","DOI":"10.3389\/fnut.2023.1092544"},{"key":"ref_111","first-page":"319","article-title":"Hormonal and Metabolic Effects of Coenzyme Q10 and\/or Vitamin E in Patients with Polycystic Ovary Syndrome","volume":"104","author":"Izadi","year":"2019","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.arcmed.2019.04.004","article-title":"Independent and Additive Effects of Coenzyme Q10 and Vitamin E on Cardiometabolic Outcomes and Visceral Adiposity in Women with Polycystic Ovary Syndrome","volume":"50","author":"Izadi","year":"2019","journal-title":"Arch. Med. Res."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1056\/NEJMoa0907929","article-title":"Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis","volume":"362","author":"Sanyal","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_114","unstructured":"Stipanuk, M., and Caudill, M. (2012). Biochemical, Physiological, and Molecular Aspects of Human Nutrition, Elsevier. [3rd ed.]."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Comerford, K.B., and Pasin, G. (2016). Emerging Evidence for the Importance of Dietary Protein Source on Glucoregulatory Markers and Type 2 Diabetes: Different Effects of Dairy, Meat, Fish, Egg, and Plant Protein Foods. Nutrients, 8.","DOI":"10.3390\/nu8080446"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Chhetri, D.R. (2019). Myo-Inositol and Its Derivatives: Their Emerging Role in the Treatment of Human Diseases. Front. Pharmacol., 10.","DOI":"10.3389\/fphar.2019.01172"},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Roseff, S., and Montenegro, M. (2020). Inositol Treatment for PCOS Should Be Science-Based and Not Arbitrary. Int. J. Endocrinol., 2020.","DOI":"10.1155\/2020\/6461254"},{"key":"ref_118","unstructured":"(2026, March 10). Vitamin E\u2014Mayo Clinic. Available online: https:\/\/www.mayoclinic.org\/drugs-supplements-vitamin-e\/art-20364144."},{"key":"ref_119","unstructured":"(2026, March 10). Vitamin E\u2014Health Professional Fact Sheet, Available online: https:\/\/ods.od.nih.gov\/factsheets\/VitaminE-HealthProfessional\/."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"76","DOI":"10.56782\/pps.256","article-title":"The Vitamin E: Overview of History of Discovery, Mechanism of Action, Role and Deficiency","volume":"22","author":"Kowalska","year":"2024","journal-title":"Prospect. Pharm. Sci."},{"key":"ref_121","doi-asserted-by":"crossref","unstructured":"Banini, B.A., and Sanyal, A.J. (2019). Vitamin E in Nonalcoholic Fatty Liver Disease. Vitamin E in Human Health, Humana Press.","DOI":"10.1007\/978-3-030-05315-4_23"},{"key":"ref_122","unstructured":"(2026, March 10). Steatotic Liver Disease: Cutting Through the Fat|AASLD. Available online: https:\/\/www.aasld.org\/liver-fellow-network\/core-series\/back-basics\/steatotic-liver-disease-cutting-through-fat."},{"key":"ref_123","doi-asserted-by":"crossref","unstructured":"Tefagh, G., Payab, M., Qorbani, M., Sharifi, F., Sharifi, Y., Ebrahimnegad Shirvani, M.S., Pourghazi, F., Atlasi, R., Shadman, Z., and Rezaei, N. (2022). Effect of Vitamin E Supplementation on Cardiometabolic Risk Factors, Inflammatory and Oxidative Markers and Hormonal Functions in PCOS (Polycystic Ovary Syndrome): A Systematic Review and Meta-analysis. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-09082-3"},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Rao, M., Broughton, K.S., and LeMieux, M.J. (2020). Cross-Sectional Study on the Knowledge and Prevalence of PCOS at a Multiethnic University. Prog. Prev. Med., 5.","DOI":"10.1097\/pp9.0000000000000028"},{"key":"ref_125","first-page":"604","article-title":"Delayed Diagnosis and a Lack of Information Associated with Dissatisfaction in Women with Polycystic Ovary Syndrome","volume":"102","author":"Teede","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1016\/S0140-6736(26)00717-8","article-title":"Polyendocrine Metabolic Ovarian Syndrome, the New Name for Polycystic Ovary Syndrome: A Multistep Global Consensus Process","volume":"407","author":"Teede","year":"2026","journal-title":"Lancet"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1002\/hep.32519","article-title":"Risk of Cardiovascular Disease and Loss in Life Expectancy in NAFLD","volume":"76","author":"Shang","year":"2022","journal-title":"Hepatology"},{"key":"ref_128","unstructured":"(2026, March 12). MASLD (Nonalcoholic Fatty Liver Disease). Available online: https:\/\/my.clevelandclinic.org\/health\/diseases\/22437-non-alcoholic-fatty-liver-disease."},{"key":"ref_129","unstructured":"(2026, March 12). Fibrosis: Development. Available online: https:\/\/liverfoundation.org\/about-your-liver\/how-liver-diseases-progress\/fibrosis-scarring\/."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"493.e1","DOI":"10.1016\/j.ajog.2017.01.003","article-title":"Racial and Ethnic Differences in the Polycystic Ovary Syndrome (PCOS) Metabolic Phenotype","volume":"216","author":"Engmann","year":"2017","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.cgh.2017.09.041","article-title":"Racial and Ethnic Disparities in Non-Alcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-Analysis","volume":"16","author":"Rich","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Manoogian, E.N.C., and Laferr\u00e8re, B. (2023). Time-Restricted Eating: What We Know and Where the Field Is Going. Obesity, 31.","DOI":"10.1002\/oby.23672"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Vidya Bharathi, R., Swetha, S., Neerajaa, J., Varsha Madhavica, J., Janani, D.M., Rekha, S.N., Ramya, S., and Usha, B. (2025). The Impact of Intermittent Fasting on Fertility: A Focus on Polycystic Ovary Syndrome and Reproductive Outcomes in Women\u2014A Systematic Review. Metabol. Open, 25.","DOI":"10.1016\/j.metop.2024.100341"},{"key":"ref_134","doi-asserted-by":"crossref","unstructured":"Berciano, S., Figueiredo, J., Brisbois, T.D., Alford, S., Koecher, K., Eckhouse, S., Ciati, R., Kussmann, M., Ordovas, J.M., and Stebbins, K. (2022). Precision Nutrition: Maintaining Scientific Integrity While Realizing Market Potential. Front. Nutr., 9.","DOI":"10.3389\/fnut.2022.979665"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/j.clnu.2024.05.042","article-title":"Inflammatory Markers as Diagnostic and Precision Nutrition Tools for Metabolic Dysfunction-Associated Steatotic Liver Disease: Results from the Fatty Liver in Obesity Trial","volume":"43","author":"Milagro","year":"2024","journal-title":"Clin. Nutr."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00394-019-02033-1","article-title":"The Effect of Probiotics, Prebiotics, and Synbiotics on Hormonal and Inflammatory Indices in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","volume":"59","author":"Shamasbi","year":"2019","journal-title":"Eur. J. Nutr."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1007\/s40618-017-0708-9","article-title":"Non-Alcoholic Fatty Liver Disease in Women with Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis","volume":"40","author":"Rocha","year":"2017","journal-title":"J. Endocrinol. Investig."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/12\/1948\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:45:58Z","timestamp":1781844358000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/12\/1948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":137,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["nu18121948"],"URL":"https:\/\/doi.org\/10.3390\/nu18121948","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]}}}