Mulberry species (Morus spp.) provide phytochemically distinct plant materials in which leaves are typically characterized by high levels of iminosugars (notably 1-deoxynojirimycin), flavonols/flavones, and polysaccharides, whereas fruits—especially Morus nigra—contain substantial amounts of anthocyanins alongside other phenolic compounds and polysaccharides. Importantly, the composition and biological properties of mulberry-derived products depend not only on species and plant part (leaf vs. fruit), but also on preparation and processing variables, including drying, maceration, fermentation, and extraction, or fractionation strategy (e.g., aqueous vs. hydroalcoholic extracts or enriched fractions). Such technological factors may substantially influence the chemical composition, bioavailability, and functionality of mulberry-derived preparations and thereby modify their interactions with gut microbiota and host metabolic processes. Available preclinical studies indicate that mulberry leaf- and fruit-derived preparations can affect gut microbial composition or activity in experimental models of metabolic dysfunction. Reported findings frequently include enrichment of microbial taxa commonly regarded as beneficial, such as Bifidobacterium, Lactobacillus, and Akkermansia, normalization of dysbiosis-associated microbial patterns, and increased production of short-chain fatty acids, particularly acetate, propionate, and butyrate. These microbial changes are sometimes observed alongside improvements in metabolic parameters such as glucose regulation, lipid profile, adiposity, or inflammatory markers. However, reported responses differ across plant parts, species, and preparation approaches, indicating that phytochemical composition and processing strategy are likely to influence biological outcomes. Interpretation of the current evidence is limited by the predominance of non-human studies and by incomplete or inconsistent reporting of extract composition, processing conditions, and standardization procedures. These factors reduce comparability between studies and complicate mechanistic interpretation of microbiome-related effects. Overall, existing preclinical data support the possibility that mulberry-derived preparations may influence metabolic health through microbiota-associated pathways shaped by both botanical origin and preparative technology. Well-designed human intervention studies using chemically characterized and standardized preparations, together with comprehensive gut microbiome analyses, are needed to determine the translational relevance of these observations and to identify which mulberry-derived preparations offer the greatest potential for supporting gut and metabolic health.

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a heterogeneous endocrine and metabolic disorder associated with reproductive dysfunction, hyperandrogenism, insulin resistance, chronic low-grade inflammation and an increased risk of long-term cardiometabolic disease. Lifestyle intervention remains the cornerstone of management; however, the optimal nutritional strategy continues to be debated. This narrative review summarizes current evidence on nutritional management of PMOS, including dietary approaches, the role of the gut microbiota, dietary supplementation and complementary lifestyle interventions. Current evidence indicates that no single dietary model is universally superior for all women with PMOS. Instead, different dietary approaches may improve selected anthropometric, metabolic, endocrine, and reproductive outcomes, although the consistency of these effects varies across interventions and outcomes. The most consistent benefits are observed for body weight, insulin resistance, glycolipid metabolism and cardiometabolic risk, whereas improvements in reproductive and hyperandrogenic outcomes are generally more variable. Gut microbiota modulation represents a biologically plausible mechanism linking diet with metabolic and reproductive function, although its role as a mediator of dietary effects remains insufficiently established. Adjunctive supplementation, particularly with inositols, vitamin D, omega-3 fatty acids, and selected probiotics or synbiotics, may improve selected metabolic and reproductive outcomes, although the certainty and consistency of these effects vary across supplements. Such approaches should be considered complementary to, rather than a replacement for, lifestyle management. Physical activity, behavioural support, adequate sleep and stress management further contribute to comprehensive care, although evidence is strongest for structured exercise interventions. Lifestyle approaches may also have a role in early risk modification, particularly through the prevention of excess weight gain and promotion of physical activity, although direct evidence for primary prevention of PMOS remains limited. Overall the findings support individualized and sustainable nutritional and lifestyle strategies rather than a universal therapeutic approach. Future research should focus on well-designed long-term randomized trials and the development of personalized approaches that account for clinical and metabolic heterogeneity in PMOS.