Changes in diet composition with urbanization and its effect on the polycystic ovarian syndrome phenotype in a western Indian population

The clinical and biochemical features of polycystic ovary syndrome are associated with increasingly prosperous diet composition in a cohort of women from Maharashtra.

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Volume 112, Issue 4, Pages 758–763


Sachin D. Kulkarni, M.D., Ajit N. Patil, D.I.C.O.G., Anil Gudi, M.R.C.O.G., Roy Homburg, F.R.C.O.G., Gerard S. Conway, F.R.C.P.



To study the effects of increasingly prosperous diet content on clinical features of polycystic ovary syndrome (PCOS).


A cross-sectional cohort study of 711 women with PCOS from a heterogeneous population spanning a wide spectrum of socioeconomic strata.


Independent hospital.


A total of 711 women with PCOS in whom the diagnosis was based on Rotterdam criteria. Results were compared with a locally recruited reference group.


Clinical assessment of women with PCOS.

Main Outcome Measure(s)

Clinical characteristics were assessed with particular reference to diet composition. Four diet groups were identified: simple rice with vegetables, vegetarian with mixed carbohydrates, nonvegetarian with mixed carbohydrates, and an urban diet of processed foods.


Women with PCOS showed the characteristic features of raised LH and androstenedione concentrations and increased ovarian volume and antral follicle count. There was a notable association between an increasingly affluent diet, the presence of hirsutism, raised body mass index, insulin resistance, and higher serum antimüllerian hormone concentrations. The positive association between antimüllerian hormone and body mass index is an unusual feature possibly explained by the wide spectrum of lifestyles in this cohort.


Urbanization of women in India is associated with increasingly severe phenotype of PCOS, which is likely to have implications on fertility outcomes.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.