Lower Fiber Consumption in Women with Polycystic Ovary Syndrome: A Meta-Analysis of Observational Studies
Open accessAbstract
Polycystic ovary syndrome is a common endocrine disorder associated with metabolic abnormalities and gut microbiota dysbiosis. The deficiency of dietary fiber, a crucial nutrient in the daily diet, is also associated with a wide range of metabolic and reproductive abnormalities, as well as an altered gut microbial ecosystem. This study is a meta-analysis to summarize the available evidence on the dietary fiber intake level in PCOS patients. Databases of PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched for observational studies, and 13 studies were finally included. The pooled standardized mean difference (SMD) with the 95% confidence interval (CI) of daily dietary fiber intake and total energy intake were calculated using the random-effects model. The pooled result (12 studies) on absolute dietary fiber intake showed that while there was no significant difference in the total energy intake [−0.17 (−0.44, 0.09), p = 0.208], the dietary fiber intake was significantly lower in PCOS women than those of controls [−0.32 (−0.50, −0.14), p < 0.001]. However, significant heterogeneity was detected across the studies (I2 = 65.6%, p = 0.001). Meta-regression suggested that geographic region and dietary assessment method may confer borderline significance of influence on the heterogeneity. The pooled result (two studies) on dietary fiber intake which adjusted for total energy intake, however, showed no significant difference [−2.11 (−4.77, 0.56), p = 0.122]. In subgroup analyses based on absolute dietary fiber intake, a lower dietary fiber intake in PCOS was observed in studies conducted in Asia, adopted food diary or records or food recall as the dietary assessment method, had a case–control study design, or used Rotterdam criteria for PCOS diagnosis. The difference in SMD was still significant in the adult subgroup or in studies matched or unmatched for age.
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Women with PCOS eat less dietary fiber than controls, with a pooled standardized mean difference of -0.32 (p < 0.001) in daily fiber intake across 13 studies.
“A pooling of 13 studies led to a standardized mean difference (SMD) of -0.32 (p < 0.001) in daily fiber intake of PCOS patients compared to controls, which underlines this in difficulties across different geographical regions [123].”
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 [123]
The Results (§3.2) report significantly lower daily fiber intake in women with PCOS, with SMD −0.32 and p < 0.001, but that estimate pooled unadjusted data from 12 studies, not 13. The paper included 13 studies overall; its geographic subgroup analysis (§3.3) found a significant difference in Asia but not in the other continents examined. (LLM, conf=0.94)
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Zhou, Q., Huang, B., Wei, Y., Wang, R., Lei, X., Chen, X., & Huang, K. (2025) · Middle East Fertility Society Journal · doi:10.1186/s43043-025-00264-3 · Cited by 1 · see citing works
Dietary Pattern, Physical, and Behavioral Trends in Women with Polycystic Ovary Syndrome
Acharya, A., Shetty, S. S., Shetty, P. K., & Kumari, S. (2024) · Journal of Datta Meghe Institute of Medical Sciences University · doi:10.4103/jdmimsu.jdmimsu_708_23 · Cited by 1 · see citing works
Macronutrients and Disease: Polycystic Ovary Syndrome
Tehrani, F. R., & Naz, M. S. G. (2025) · Springer eBooks · doi:10.1007/978-3-031-32047-7_28-1
Polyzystisches Ovarialsyndrom und Endometriose – Komplementäre Therapien
Müller, T. (2026) · Springer eBooks · doi:10.1007/978-3-662-68171-8_28
Kaur, R., KAUR, M., & Suri, V. (2026) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20262117
- Authors
- Leung, W. T., Tang, Z., Feng, Y., Guan, H., Huang, Z., & Zhang, W.
- Affiliations
- Fudan University (CN)
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
- Corresponding author
- Zhang, Wei
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2022-12-12
- Volume
- 14
- Issue
- 24
- Pages
- 5285
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC9785338
- OpenAlex
- W4312126163
- Cited by
- 17
- References
- 74
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 3 · 2023: 1
- FWCI
- 0.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Natural Science Foundation of China (81771587)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
- Keywords
- polycystic ovary syndrome, dietary fiber intake, women, energy intake, gut dysbiosis, metabolic abnormalities, reproductive abnormalities, dietary assessment, Rotterdam criteria
- MeSH terms
- Adult, Diet, Dietary Fiber, Female, Humans, Polycystic Ovary Syndrome, Case-Control Studies, Ecosystem
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