Considering the direct interaction between nutritional elements and other risk factors, such as oxidative stress and gut microbes, the benefits of nutrition therapy and food supplements may also be crucial in the absence of IR. Early detection of and nutritional intervention in modifiable risk factors, such as IR, should be considered as the recommended approach to restore ovulation and to protect fertility in adolescents with obesity and PCOS. The purpose of this review is to present and discuss PCOS in adolescents with obesity, emphasizing its relationship with IR and the role of MNT and food supplements in treatment. IR is considered a metabolic precursor of PCOS development. Medical nutrition therapy (MNT) in these patients aims at improving symptoms and signs, including insulin resistance and metabolic and reproductive functions, by means of personalized dietetic treatment considering energy restriction as well as the macro- and micronutrient composition of the diet, which, regardless of weight loss, impacts insulin sensitivity.
The first-line treatment for adolescents with PCOS is lifestyle changes, including nutrition treatment, physical activity and behavioral therapy. However, early diagnosis and treatment of PCOS are crucial to restore ovulation. PCOS in adolescence still remains a great clinical issue from the diagnostic and therapeutic points of view. In adolescents with obesity, increased visceral adiposity is also associated with hormonal changes impairing the hypothalamus and the pituitary function and directly affecting ovarian function. IR is associated with consequent hyperinsulinemia, which activates excessive ovarian androgen production, leading to PCOS development.Īdditionally, obesity-related inflammation may have potential implications for ovarian physiology due to the dysregulated adipokine secretion, affecting insulin sensitivity. PCOS is often associated with obesity and impairs reproductive health.Įven though several theories have been proposed to explain the pathogenic mechanism of PCOS, the role of insulin resistance (IR), independently of (but amplified by) obesity, is a key etiological component. PCOS is a multifactorial disorder and is characterized by a combination of clinical (anovulation and hyperandrogenism), biochemical (excessive androgen and luteinizing hormone concentrations) and ovarian morphological (polycystic ovaries) features. Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in young reproductive-aged women. Appropriate early dietary intervention for the management of adolescents with obesity and PCOS should be considered as the recommended approach to restore ovulation and to protect fertility. The purpose of this narrative review is to present and discuss PCOS in adolescents with obesity, its relationship with IR and the role of MNT and food supplements in treatment. Medical nutrition therapy (MNT) and the use of specific food supplements in these patients aim at improving symptoms and signs, including insulin resistance and metabolic and reproductive functions. The first-line treatment for adolescents with obesity and PCOS includes lifestyle changes personalized dietary interventions and, when needed, weight loss. Additionally, the state of chronic inflammation related to obesity impacts ovarian physiology due to insulin sensitivity impairment.
The consequent hyperinsulinemia activates excessive ovarian androgen production, leading to PCOS. Even though several theories have been proposed to explain the pathogenic mechanism of PCOS, the role of insulin resistance (IR) as a key etiological component, independently of (but amplified by) obesity, is well recognized. PCOS is often associated with obesity and impairs reproductive health.