Impact of Ultra-Processed Food on Hormonal and Insulin Signalling in Polycystic Ovary Syndrome (PCOS)

Abstract

Polycystic Ovary Syndrome (PCOS) is among the most prevalent endocrine disorders in young women of reproductive age that is characterized with hyperandrogenisms, oligo-anovulation, and insulin resistance. The consumption of ultra-processed food (UPF) should be considered to be one of the major, but under-estimated, causes of hormonal and metabolic imbalance in PCOS, on the basis of the increasingly, but not officially, acknowledged nutritional evidence. This systematic review aims to critically summarise and discuss published evidence that investigated the association between UPF intake with hormonal imbalance namely androgens excess, gonadotropin imbalance and insulin signalling impairment in PCOS women. They had inclusion criteria based on PCOS diagnosis according to Rotterdam or NIH criteria, data on dietary exposure, and hormonal or metabolic results. It has always been shown that large doses of UPF increase androgens, interfere with LH: FSH, and inhibit insulin receptor signalling through the IRS-1/PI3K-Akt. Mechanistic connections entail the dysbiosis of gut microbiota, low-grade inflammation in the body, oxidative stress, and dysregulation of HPO axis. The intake of ultra-processed food is a modifiable diet-related risk factor that increases the severity of the hormonal and insulin signalling dysfunctions in PCOS. Reduction of ultra-processed food intake represents a significant and meaningful dietary intervention in PCOS management.