Association Between Healthy Eating Patterns and Prevalence of Suspected Polycystic Ovary Syndrome: A Cross Sectional Study

The diet-PCOS relationship remains complex and requires further investigation. Among 1424 participants (12.3% suspected PCOS), dietary patterns were evaluated using NIH criteria via FFQ: exploratory factor analysis (EFA), EAT-Lancet dietary pattern (EAT-LDP), Mediterranean, plant-based indices. EFA identified four patterns: plant-forward (PFD), animal-protein (APD), red and organ meat (ROM), and fast-food (FFD). Multivariable logistic regression, adjusted for age, BMI, education attainment, marriage situation, physical activity status, frequency of ordering takeout, depression, anxiety and stress, showed: compared to the lowest adherence group, the highest APD quartile was associated with a higher prevalence of suspected PCOS (OR = 2.20, 95% CI: 1.42-3.41, P < 0.001); the highest EAT-LDP quartile was correlated with a lower prevalence of suspected PCOS (OR = 0.40, 95% CI: 0.16-0.83, P < 0.05). Mediterranean scores ≥5 are positively associated with suspected PCOS (score 5: OR = 1.63, 95% CI: 1.09-2.44; score >5: OR = 1.89, 95% CI: 1.23-2.89, both P < 0.05), while scores ≤4 are negatively associated with suspected PCOS (OR = 0.57, 95% CI: 0.33-0.95, P < 0.05). Plant-based indices showed no significant associations with suspected PCOS. Higher adherence to the EAT-LDP, lower adherence to the APD, and moderate adherence to the Mediterranean diet are associated with a reduced prevalence of suspected PCOS. Large-scale cohort studies are needed to confirm these findings and establish causality.