Green recovery of antioxidants from “Cẩm” purple rice bran by microwave-assisted extraction: Optimization and evaluation of its antioxidant and anti-diabetic properties

Background.Polycystic ovary syndrome (PCOS) is a common condition that affects up to 15% of women of reproductive age.Recently, the ketogenic diet (KD) has gained popularity in the treatment of PCOS.The aim of this meta-analysis was to assess evidence from randomised controlled trials (RCTs) on the effects of KD on changes in body weight, glycaemic control, lipid parameters, and reproductive hormone levels among women with PCOS.Materials and methods.The PubMed, Cochrane Library, and Google Scholar were searched to identify RCTs examining the effects of KD (very low caloric ketogenic diet [VLCKD] and low caloric ketogenic diet [LCKD]) on anthropometric, metabolic and hormonal parameters in women with PCOS through March 2025.Five RCTs involving 313 patients with PCOS were included in this systematic review.Results.Three studies reported changes in anthropometric, metabolic, and hormonal parameters following a VLCKD compared to a hypocaloric Mediterranean diet, while two RCTs compared an LCKD to a typical diet.Pooled findings indicated that several anthropometric (body weight index [BMI], and waist circumference [WC]), metabolic (fasting plasma glucose [FPG], insulin, homeostatic model assessment for insulin resistance [HOMA-IR]), and hormonal (luteinizing hormone [LH], sex hormone-binding globulin [SHBG]) parameters significantly decreased following KD intervention.Furthermore, subgroup analyses revealed that VLCKD significantly improved BMI, FPG, total cholesterol (TC), low-density cholesterol (LDL), high--density cholesterol (HDL), and LH, while LCKD significantly improved LDL, HDL and LH. Conclusion.A VLCKD appears effective in improving select anthropometric and metabolic parameters in women with PCOS.However, larger and longer-duration RCTs are needed to evaluate the long-term safety and efficacy of KD in relation to weight loss, cardiometabolic health, and hormonal regulation in this population.PROSPERO registration no.CRD 42024503878.