Polycystic ovary syndrome (PCOS) is the most common endocrine and me- tabolic disorders in women of reproductive age, defined by a combination of signs and clinical or biochemical symptoms of androgen excess and ova- rian dysfunction in the absence of other specific endocrine diagnoses. The aetiology of PCOS is largely unknown, but different evidence suggests that this syndrome might be a complex multifactorial disorder with strong envi- ronmental and epigenetic influences, including lifestyle factors, such as nutri- tion. Specific nutrients per sè or via weight loss improve endocrine features, cardiometabolic risk profile, and reproductive function. Different foods and a change in dietary habits are associated with the reduction of body weight and with improvement PCOS clinical severity. Of interest, beyond obesity se- veral comorbidities, including infertility, metabolic syndrome, impaired glu- cose tolerance, insulin resistance, type 2 diabetes, and increased cardiovascu- lar risk are associated with PCOS. In this context, specific recommendations on macronutrient intake should be provided to patients with obesity and PCOS. In particular, high intake of high glycemic index carbohydrate contributes to weight gain and metabolic alterations, including insulin resistance, dysli- pidemia and metabolic syndrome, and stimulates hunger and carbohydrate craving. The nutritional approach in PCOS must be to reach specific goals including as improving insulin resistance and metabolic disorders that will be possible through an hypocaloric diet reducing the intake of simple and refined carbohydrates with a high glycemic index, limiting of saturated fatty acids (<10% of total energy intake), and attention to possible deficiencies of several micronutrients, including vitamin D, chromium and omega-3. The main aim of this narrative review is to discuss the role of diet as therapeutic treatment in management of women with obesity and PCOS.

Keywords: polycystic ovary syndrome; obesity; nutrition; diet.