Polycystic Ovary Syndrome Part II: Nutritional Strategies of Management

Polycystic Ovary Syndrome Part II: Nutritional Strategies of Management

  August 03, 2020    AVisenMD

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Dietary management of Polycystic Ovary Syndrome (PCOS) should focus on weight loss and modification in insulin levels.

In this article:

• Ketogenic diets and insulin management

• Mediterranean diet and risk reduction of metabolic syndrome and type 2 diabetes

• Polyphenols and their role in blood sugar levels

• Curcumin and its properties

• Role of omega-3 fatty acids

• Coenzyme Q10 health benefits

• Most powerful antioxidants

• Relationship between gut health and PCOS
  

Read: Polycystic Ovary Syndrome Part I: The Science Behind It

Ketogenic Diets

Insulin signalling is key in the management of insulin resistance that gives rise to metabolic syndrome and type 2 diabetes. Research has shown that low-carb ketogenic diets have resulted in greater improvement of blood sugar levels in obese patients with type 2 diabetes. Additional benefits of these diets include better hormonal control, significant weight loss and improvement of fatty liver disease.

Mediterranean Diet

Mediterranean diet is composed of cereals, nuts, legumes, vegetables, fruits with significant use of extra virgin olive oil. This food composition enhances the intake of complex carbs like fiber & whole grains, minerals like selenium, iron, potassium, magnesium & calcium, vegetable proteins & polyphenols, which are micronutrients present in plant-based foods. All these together lead to better control of blood sugar levels & aim at reducing the blood pressure. The unsaturated fatty acids of healthy oils and polyphenols together work to increase HDL (good cholesterol) and decrease chronic inflammation. These effects lead to lower cholesterol and triglyceride levels and reduced fat storage, which significantly reduces the risk of metabolic syndrome and type 2 diabetes.

Polyphenols:

A research study comprising of 1133 subjects has shown that the consumption of green tea lead to decreased fasting glucose and HbA1c levels. Eleven other studies on 388 subjects have concluded that the consumption of resveratrol (plant-based polyphenol that is a strong antioxidant) significantly reduced fasting glucose, insulin, HbA1c levels in the diabetic population.

(Read the effects of green tea on sleep and stress: What is the Relationship Between Sleep, Stress and Nutrition?)

Curcumin:

Curcumin has long been known for its strong anti-inflammatory and antioxidant properties and has been widely practiced since ancient times in Indian Ayurvedic medicine. Turmeric contains roughly 10% curcuminoids that are a potent combination of curcumin, demethoxycurcumin, bis-demethoxycurcumin.In a 30-day research trial, daily supplementation with 400mg curcumin in healthy individuals lead to reduced brain aging, lowered triglyceride levels, reduced stress levels, improved liver function and an increase in antioxidant enzymes.

Omega-3 Fatty Acids:

Two comprehensive studies have shown that taking 1200-1500mg of omega-3 fatty acids over the period of 2-6 months significantly reduced free testosterone levels and lead to a better hormonal control of PCOS in obese and non-obese women. Long-term effects included lower insulin resistance, blood glucose and triglyceride levels. Other equally significant benefits of omega-3 fatty acids are: improved symptoms of chronic depression, lower inflammatory markers in blood, low cortisol (stress hormone) levels and increased brain function.

Coenzyme Q10 (CoQ10):

 In a clinical trial conducted on 60 women with PCOS that were given 100mg CoQ10 for 12 weeks, it was concluded that CoQ10 supplementation significantly reduced blood glucose levels with well-controlled insulin levels and reduced cholesterol levels with enhanced heart health.

Strong antioxidants to include in diet:

• Vitamins A, C, D, E
• Alpha-lipoic acid
  
• Polyphenols
  
• Selenium
• Copper
• Magnesium
• Zinc
  

Antioxidants stabilize free radicals and essentially stop their damaging effects on cells and their metabolic activities. They further support detoxification, reduce fatigue and tiredness, boost mental health and are very important elements for proper functioning of the nervous system.

Gut Health:

In humans, around 90% of gut bacteria are represented by two major strains: Firmicutes (60-80%) and Bacteriodetes (15-30%). In obese women with PCOS, this ratio is imbalanced with a reduced microbial diversity. This imbalance and compromised gut health is linked with increased risk of type 2 diabetes in PCOS. Other risk factors include inflammatory bowel disease, irritable bowel syndrome, celiac disease, colorectal cancer, gut-brain axis disorders like depression, anxiety, chronic pain, fatigue, and compromised immune system (gut houses around 80% of the total immune system). In order to improve gut health, it is recommended to: increase fiber content in diet, which is naturally fermented in the gut that strengthens and diversifies gut bacteria; increase natural prebiotic intake in forms of cereals, fruits and vegetables; incorporate fermented foods like sauerkraut, kimchi, yogurt, kefir.

The nutritional strategies mentioned above are interventions that can be used in combination to synergistically enhance the health benefits while significantly reducing the health risk factors and hormonal disturbances associated with PCOS. Targeting multiple health factors with the combination of diverse nutrients mentioned above eases the challenging task of clinical management of PCOS.

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Read: Polycystic Ovary Syndrome Part I: The Science Behind It

References:

1. DiSilvestro et al. Diverse effects of a low dose supplement of lipidated currcumin in healthy middle aged people. Nutr J. 2012. 11(79). doi: 10.1186/1475-2891-11-79.

2. Gholnari et al. The effects of coenzyme Q10 supplementation on glucose metabolism, lipid profiles, inflammation, and oxidative stress in patients with diabetic nephropathy: A randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 2018. 37(3):188-193.

3. Gokalp et al. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. Journal of Obstetrics and Gynecology 2012. 33:289-291.

4. Liu et al. Effect of green tea on glucose control and insulin sensitivity: a meta-analysis of 17 randomized  controlled trials. Am J Clin Nutr. 2013. 98(2):340-348.

5. Liu et al. Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized  controlled trials. Al J Clin Nutr. 2014. 99(6):1510-1519.

6. Mohammadi et al. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac J Clin Nutr 2012. 21(4): 511-518.

7. Salas-Salvado et al. Protective Effects of the Mediterranean Diet on Type  Diabetes and Metabolic Syndrome. The Journal of Nutrition 2016. 146(4): 920S-927S.

8. Dr. Nina Bailey, PhD. Igennus Healthcare Nutrition.