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Cited by 69Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsNutritional Studies and Diet

Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study

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Cutler, Dylan A., Pride, Sheila M., Cheung, Anthony P.·2019·Food Science & Nutrition
DOI 10.1002/fsn3.977PMC PMC6475723
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Abstract

Background: Women with polycystic ovary syndrome (PCOS) often have insulin resistance (IR) which may be worsened by obesity. The roles of dietary intake and activity are unclear. Our objectives were to determine whether (a) high caloric intake or inactivity explains obesity in PCOS, and (b) dietary composition is associated with PCOS phenotypes. Methods: Eighty‐seven women with PCOS and 50 women without PCOS participated in this cohort study at a reproductive medicine center. Data collected included 3‐day food and physical activity records, anthropometrics, and metabolic and hormonal assays. Results: Women with PCOS had increased body mass index (BMI) but similar caloric intake and activity to women without PCOS. There were no differences in protein, carbohydrates, fat, or glycemic load consumption, but women with PCOS consumed less fiber (medians: 19.6 vs. 24.7 g) and less magnesium (medians: 238.9 vs. 273.9 mg). In women with PCOS, those with IR consumed less fiber, less magnesium, and greater glycemic load than those without IR (medians: 18.2 vs. 22.1 g, 208.4 vs. 264.5 mg, 89.6 vs. 83.5). Fiber intake of women with PCOS was negatively correlated with IR, fasting insulin, glucose tolerance, testosterone, and dehydroepiandrosterone sulfate. Magnesium intake was negatively correlated with IR, C‐reactive protein, and testosterone, but positively correlated with HDL cholesterol. Fiber intake and BMI accounted for 54.0% of the variance observed in IR. Conclusions: Obesity in women with PCOS could not be explained by overeating or inactivity. Increasing dietary fiber and magnesium intakes may assist in reducing IR and hyperandrogenemia in women with PCOS.

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  • A recent cohort study from Canada found that obese women with PCOS consumed significantly less dietary fiber than normal weight women without PCOS.

    “A recent cohort study from Canada found that obese women with PCOS consumed significantly less dietary fiber than normal weight women without PCOS [219].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [219]

    The Results (All participants; page not available) report significantly lower fiber intake among women with PCOS than among women without PCOS, and the study recruited participants in Vancouver, Canada (Materials and Methods; page not available). The reported significant comparison is between the full PCOS and non-PCOS groups, not specifically obese women with PCOS and normal-weight women without PCOS. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Observational studies including individuals with PCOS with a healthy BMI still identified a higher prevalence of cardiometabolic risk factors between individuals with and without PCOS.

    “observational studies that have included individuals with PCOS with a healthy BMI (18.5–24.9 kg/m2) still identified a higher prevalence of cardiometabolic risk factors between individuals with and without PCOS [10,11,21,22,23,25,28,30,31,33].”

    From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [23]

    The Results (Participants with PCOS, Table 2; page unavailable) include 25 women with PCOS in the normal-BMI category. The Results (All participants; page unavailable) report higher BMI and waist-to-hip ratio in women with PCOS than in women without PCOS, but do not compare cardiometabolic risk-factor prevalence between the normal-BMI PCOS group and controls. Thus the healthy-BMI inclusion and an overall risk-factor difference are supported, but the claimed prevalence finding in that context is not. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Individuals with PCOS have lower intakes of complex carbohydrates, fiber, unsaturated fatty acids, omega-3 polyunsaturated fatty acids, vitamin A, folate, vitamin C, vitamin D, and magnesium compared to individuals without PCOS.

    “Lower intakes of key nutrients associated with health, such as complex carbohydrates [21], fiber [11,21,23,25,28], unsaturated fatty acids [21], omega-3 polyunsaturated fatty acids [15,21], vitamin A, folate, vitamin C [11], vitamin D, and magnesium [39], have been reported for individuals with PCOS compared to individuals without.”

    From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [23]

    The Results (All participants; page unavailable) report significantly lower fiber and vitamin A intakes in women with PCOS. The citing sentence also attaches this source’s citation to folate and vitamin C, but the Results do not establish lower folate intake or a significant vitamin C difference. The other nutrients in the sentence have different citations and are not judged here. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Fiber intake of women with PCOS was negatively correlated with insulin resistance, fasting insulin, glucose tolerance and serum androgens.

    “In addition, fiber intake of women with PCOS was negatively correlated with IR, fasting insulin, glucose tolerance and serum androgens [219].”

    From Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment (2022) · cites this paper as [219]

  • Women with PCOS who consumed less dietary fiber had higher HOMA-IR scores, fasting insulin levels, and raised triglycerides.

    “Cutler et al. (2019) noticed that women with PCOS who resorted to less consumption of dietary fiber had more HOMA-IR scores, fasting insulin levels, as well as raised triglycerides [122].”

    From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [122]

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Cited by

Sorted by citations

Authors
Cutler, D. A., Pride, S. M., & Cheung, A. P.
Affiliations
University of British Columbia Hospital (CA)
Corresponding author
Cheung, Anthony P.
ORCID
Venue
Food Science & Nutrition
Publisher
Wiley
Published
2019-02-27
Volume
7
Issue
4
Pages
1426-1437
ISSN
2048-7177 (ISSN-L)
DOI
10.1002/fsn3.977
PMC
PMC6475723
OpenAlex
W2919044080
Cited by
69
References
10
Citations by year
2026: 4 · 2025: 7 · 2024: 6 · 2023: 9 · 2022: 19 · 2021: 14 · 2020: 6 · 2019: 3
FWCI
10.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Food Science & Nutrition (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
polycystic ovary syndrome, insulin resistance, hyperandrogenism, dietary fiber, dietary magnesium, glycemic load, obesity, PCOS phenotypes, testosterone, dehydroepiandrosterone sulfate, C-reactive protein, HDL cholesterol, energy intake, physical activity

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