Dietary Carbohydrate Intake Does Not Impact Insulin Resistance or Androgens in Healthy, Eumenorrheic Women

Context: Diet is proposed to contribute to androgen-related reproductive dysfunction. Objective: This study evaluated the association between dietary macronutrient intake, carbohydrate fraction intake, and overall diet quality on androgens and related hormones, including anti-Mullerian (AMH) and insulin, in healthy, regularly menstruating women. Design: This was a prospective cohort study from 2005 and 2007. Setting: The study was conducted at the University at Buffalo, western New York State, USA. Participants: Participants were 259 eumenorrheic women without a self-reported history of infertility, polycystic ovary syndrome (PCOS), or other endocrine disorder. Main Outcome Measures: A 24-hour dietary recall was administered 4 times per menstrual cycle, and hormones were measured 5 to 8 times per cycle for 1 (n = 9) or 2 (n = 250) cycles per woman (n = 509 cycles). Associations between the dietary intake of carbohydrates (starch, sugar, sucrose, and fiber), macronutrients, overall diet quality and hormones (insulin, AMH, and total and free testosterone), as well as the relationship of dietary intake with occurrences of high total testosterone combined with high AMH (fourth quartile of each), ie, the PCOS-like phenotype, were assessed. Results: No significant relationships were identified between dietary intake of carbohydrates, percent calories from any macronutrient or overall diet quality (ie, Mediterranean diet score) and relevant hormones (insulin, AMH, and total and free testosterone). Likewise, no significant relationships were identified between dietary factors and the occurrence of a subclinical PCOS-like phenotype. Conclusions: Despite evidence of a subclinical continuum of a PCOS-related phenotype of elevated androgens and AMH related to sporadic anovulation identified in previous studies, dietary carbohydrate and diet quality do not appear to relate to these subclinical endocrine characteristics in women without overt PCOS.