The Effects of Time-Restricted Eating in Women with Polyendocrine Metabolic Ovarian Syndrome: A Systematic Review and Meta-Analysis

Background: Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a complex endocrine-metabolic disorder strongly associated with insulin resistance, hyperandrogenism, and obesity. Time-restricted eating (TRE) has emerged as a promising dietary strategy for improving metabolic health; however, evidence regarding its efficacy in women with PMOS remains limited. Objective: To systematically evaluate the effects of TRE on metabolic, hormonal, anthropometric, and adherence-related outcomes in women with PMOS. Methods: PubMed, Embase, Scopus, and Web of Science were systematically searched through 25 April 2026, for randomized controlled trials evaluating TRE interventions in women with PMOS. Random-effects meta-analyses were performed to pool mean differences (MD) with 95% confidence intervals for specific metabolic, hormonal, and anthropometric outcomes. Results: Four randomized controlled trials comprising 216 women with PMOS were included; three trials compared TRE with calorie restriction and one with ad libitum intake. Compared with control interventions, TRE significantly improved HOMA-IR (MD = -0.58, 95% CI: -0.87 to -0.30), QUICKI (MD = 0.08, 95% CI: 0.04 to 0.13), and HDL (MD = 1.97 mg/dL, 95% CI: 0.96 to 2.99). TRE was generally associated with high adherence across the included studies, with some trials reporting higher compliance than calorie restriction. Conclusions: Current evidence from four RCTs suggests that TRE may serve as a promising alternative dietary strategy for women with PMOS, particularly for improving insulin sensitivity. However, the evidence remains limited by the small number of available studies, modest sample sizes, and heterogeneity across interventions. Therefore, these findings should be considered preliminary and require confirmation in a larger, longer-term randomized controlled trial.