Assessment of Dietary Inflammatory Index and Antioxidant Capacity in Women with Polycystic Ovary Syndrome: A Case–Control Study
Abstract
TThis study aimed to assess dietary inflammatory potential and total dietary antioxidant capacity (TDAC) in women with polycystic ovary syndrome (PCOS) and to examine their associations with body composition compared with non-PCOS group. This case–control study included 57 women (mean age 22.4 ± 1.44 years), comprising 28 women with PCOS and 29 the non-PCOS women. Anthropometric measurements and body composition were assessed using standard procedures. The Dietary Inflammatory Index (DII) and TDAC were calculated based on diet. Waist circumference, hip circumference, and body fat percentage were significantly higher in the PCOS group than in the non-PCOS group (p < 0.05). Median DII values were -2.5 (-8.9 to -1.5) in the PCOS group and -4.5 (-8.5 to -1.5) in the non-PCOS group, with no statistically significant difference between the groups (p > 0.05), whereas TDAC was significantly lower in the women with PCOS whose TDAC score was 5.1 mmol/day (3.9 to 7.6) compared to the non-PCOS women whose TDAC score was 7.5 mmol/day (5.1 to 13.5) (p = 0.019). In the PCOS group, TDAC was positively correlated with total body water percentage (r = 0.487, p = 0.009) and negatively correlated with bone mass (r = −0.489, p = 0.008). In the non-PCOS group, DII showed a strong positive correlation with hip circumference (r = 0.637, p < 0.001). These findings suggest that women with PCOS have lower dietary antioxidant capacity, which may be associated with alterations in body composition. Additionally, pro-inflammatory dietary patterns may be linked to fat distribution even in healthy individuals. Nutritional strategies in PCOS management should, therefore, emphasize improving dietary antioxidant quality alongside energy balance.
Keywords
antioxidants, body composition, diet, inflammation, polycystic ovary syndrome
Ethical Statement
This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Gazi University Non-Interventional Clinical Research Ethics Committee (Approval No: 2025-857; Date: May 13, 2025). Written informed consent was obtained from all participants prior to their inclusion in the study.
References
- Alpar, R. (2018). Uygulamalı istatistik ve geçerlik-güvenirlik (5. baskı). Detay Yayıncılık.
- Amanpour, A., Çelebi, F., Kahraman, I. G., & Çelik, F. (2022). Diyet inflamatuar indeksi, inflamasyon ve beslenme. Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi, 5(3), 59–80. https://doi.org/10.51536/tusbad.1133247
- Azarbayjani, K., Sadatmahalleh, S. J., Mottaghi, A., & Nasiri, M. (2025). Association of the dietary antioxidant index with inflammatory markers such as interleukin-6 in women with and without polycystic ovary syndrome: A comparative case-control study. BMC Nutrition, 11, 219. https://doi.org/10.1186/s40795-025-01205-z
- Azziz, R., Woods, K. S., Reyna, R., Key, T. J., Knochenhauer, E. S., & Yildiz, B. O. (2004). The prevalence and features of the polycystic ovary syndrome in an unselected population. The Journal of Clinical Endocrinology & Metabolism, 89(6), 2745–2749. https://doi.org/10.1210/jc.2003-032046
- Barrea, L., Marzullo, P., Muscogiuri, G., Di Somma, C., Scacchi, M., Orio, F., & Savastano, S. (2018). Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutrition Research Reviews, 31(2), 291–301. https://doi.org/10.1017/S0954422418000136
- Baysal, A., Aksoy, M., Besler, H. T., Bozkurt, N., Keçecioğlu, S., Mercanlıgil, S. M., & Yıldız, E. (2008). Beslenme (12. baskı). Hatiboğlu Yayınları
- Carlsen, M. H., Halvorsen, B. L., Holte, K., Bøhn, S. K., Dragland, S., Sampson, L., Willey, C., Senoo, H., Umezono, Y., Sanada, C., Barikmo, I., Berhe, N., Willett, W. C., Phillips, K. M., Jacobs, D. R., Jr., & Blomhoff, R. (2010). The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutrition Journal, 9(1), 3. https://doi.org/10.1186/1475-2891-9-3
- da Silva, B. R., Orsso, C. E., Gonzalez, M. C., Barbosa-Silva, T. G., Prado, C. M., & Heymsfield, S. B. (2023). Phase angle and cellular health: Inflammation and oxidative damage. Reviews in Endocrine and Metabolic Disorders, 24(3), 543–562. https://doi.org/10.1007/s11154-022-09775-0
- Eyceöz, M. (2022). Hafif şişman ve şişman bireylerin diyetlerinin diyet inflamatuar indeksinin araştırılması (Master’s thesis). Hasan Kalyoncu University, Institute of Health Sciences.
- Gezmen Karadağ, M., Navruz Varlı, S., & Bayazıt, A. D. (2024). Yemeklerin standart tarifeleri: Besin ögeleri açısından değerlendirilmesi. Pegem Akademi.