Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management

Farshchi, Hamid R; Rane, Ajay; Love, Aubrey; Kennedy, R. L.

doi:10.1080/01443610701667338

Cited by 72 publications

(50 citation statements)

References 114 publications

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“…It has been recognized that a significant number of PCOS patients complain of symptoms suggestive of hypoglycemia after consuming sweets and simple sugars (3, 40). Our findings indicate that symptoms like shakiness, sweating, weakness and excessive hunger are associated with increased adrenal steroid response, and emphasize the importance of questioning patients specifically for these symptoms.…”

Section: Resultsmentioning

confidence: 99%

In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake

Gurusinghe

Gill

Almario

et al. 2010

Fertility and Sterility

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Objective-To investigate adrenal steroid regulation in PCOS Design-5-hour oral glucose tolerance test (OGTT) and frequently sampled-intravenous GTT Setting-University research center Patients-Thirty patients Intervention-NoneMain outcome measures-Anthropometrics, leptin, cortisol, DHEAS, glucose, insulinResults-Morning cortisol correlated with sensitivity index (SI, r=0.540, p=0.0109), DHEAS correlated inversely with age (r=−0.6359), body mass index (BMI, r=−0.6199), fat mass (r= −0.630) and leptin (r=−0.5676) (p< 0.002 for all). Between the 2 nd and 4 th hour of OGTT, cortisol changes (Δ) exhibited 3 patterns: I. Responders (n=9, Δ:10.7±1.0μg/dL), II. Non-responders (n=10, Δ:−3.5±0.6μg/dL), III. Intermediates (n=11, Δ:4.3±1.0μg/dL). Compared to nonresponders, responders were more obese (BMI: 37.0±1.6 vs. 31.7±1.8kg/m 2 , p< 0.05); had higher leptin (28.9±1.7 vs. 24.1±1.1ng/mL, p<0.03) and lower DHEAS (133±12 vs. 236±32ng/mL, p<0.01), higher glucose at 1h of OGTT (195±13 vs. 131±12mg/dL, p< 0.05), higher AUC Glucose (332±20 vs. 265±17mg/dL, p=0.0208), higher AUC Insulin (244±50 vs. 125±30μU/mL, p=0.05) and lower nadir glucose (61±2 vs. 70±2mg/dL, p=0.0002).Conclusion-Obesity and insulin resistance are associated with lower morning cortisol and DHEAS but increased cortisol and DHEA responses after glucose ingestion. Morning steroid levels may not reflect the day-long exposure. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAnthropometric data-Subjects were seen after an overnight fast. Weight was determined in light clothing using the Tanita BWB800-P Digital Medical Scale. Height without shoes was measured using an Ayrton Model S100 stadiometer. Body composition was determined using bioelectrical impedance (Biostat, British Isles) (8). Because the fluctuations occurring in body-water during menstrual cycles can affect bioelectrical impedance, menstruating women were studied during the first ten days of their cycles. 5-h OGTT-Participantswere tested between 0600 and 0900, after an overnight fast. Water intake was permitted. An intravenous catheter was placed into the forearm and kept open with saline. At time point zero, participants drank 75 g of glucose (Glucola ™). Blood samples were obtained at baseline (time point -10 min) and then, after glucose ingestion, at 30-minute intervals for 5 hours. Subjects remained supine throughout the procedure to avoid the confounding effects of physical activity on blood glucose levels. Samples for glucose measurement were collected in N...

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Section: Resultsmentioning

confidence: 99%

In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake

Gurusinghe

Gill

Almario

et al. 2010

Fertility and Sterility

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“…Dietary interventions to improve insulin resistance and reduce hyperinsulinaemia may be of greater benefit for short‐term symptoms and long‐term disease risk compared to weight loss alone. A number of review articles have been published proposing dietary management strategies that go beyond just weight loss (Marsh & Brand‐Miller, 2005; Farshchi et al. , 2007; Liepa et al.…”

Section: Introductionmentioning

confidence: 99%

Dietary management of women with polycystic ovary syndrome in the United Kingdom: the role of dietitians

Jeanes

Barr

Smith

et al. 2009

J Human Nutrition Diet

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Background Polycystic ovary syndrome (PCOS) is a common endocrine condition associated with hyperandrogenism, infertility and metabolic dysfunction. Weight management through diet and lifestyle modifications are fundamental to its management, however, presently there are no official dietary guidelines. This study aimed to explore the dietary and lifestyle strategies followed by women with PCOS and the contribution of dietitians to its management. Methods A questionnaire was completed by 105 UK dietitians focused on the service provided and a patient questionnaire and 7-day food diary were completed by women with PCOS (n=206 and n=196 respectively). Food diaries were analysed for energy and macronutrient intake and the questionnaire focused on the dietary advice received. Results Advice provided by dietitians focused on a reduction in energy intake (78%) and dietary glycaemic index (77%), often in combination. Of the women with PCOS who were following a diet specifically for their PCOS (57%), regimes included low glycaemic index (34%), weight loss diets (16%) or a combination (26%). Of interest, 73% of overweight women were not following a diet to promote weight loss. Nutritional information predominately came from books, with only 15% of women having seen a dietitian. Eighty four percent of women with PCOS who had increased physical activity (48%) self reported an improvement in their symptoms. Conclusions Women with PCOS recognise the importance of diet, but few received dietary advice from a registered dietitian. The dietary information women with PCOS received was often from an unregulated source. A consensus statement of evidence based dietary advice for women with PCOS is needed and would be a useful resource for dietitians. Introduction:Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, affecting up to 10% of women (Franks, 1995, Lindholm et al., 2008. The clinical and biochemical features of the syndrome are heterogeneous, including menstrual irregularity and fertility problems, excess hair and acne (Diamanti-Kandarakis, 2008). Women with PCOS are also more likely to be overweight and have an increased risk of metabolic syndrome, type 2 diabetes and cardiovascular disease (Dokras, 2008, Ehrmann et al., 1999. Approximately 33% of UK women with PCOS are obese (Barr et al., 2007) compared with 20% of women in the general population (Ruston et al., 2004).

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“…Effective approaches to nutrition and diet improve endocrine features, reproductive function and cardiometabolic risk profile -even without marked weight loss. 10 Reduced-energy diets (500-1000 kcal/day reduction) are effective options for weight loss and can reduce body weight by 7% to 10% over a period of 6 to 12 months. This study was of limited duration (90 days) and thus, overall reduction in weight was not one of the outcome measures.…”

Section: Discussionmentioning

confidence: 99%

“…9 A realistic approach to exercise depends on the assessment of the patient's current exercise habits, preferences regarding type of exercise, and inclination to undertake exercise. 10 Keeping this in mind, the exercise program was based on the AVIVA method and included Bollywood dance numbers to make it interesting for the participants. The types of exercises were frequently changed to avoid boredom.…”

Section: Discussionmentioning

confidence: 99%

Holistic approach in the management of PCOS: a pilot study of an online PCOS-reversal program

Mehta

Jayaraman²,

Agarwal³

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Polycystic ovary syndrome (PCOS) is a complex disorder that can be managed but not permanently cured. Each woman has her own PCOS symptoms and its own root causes. A number of medications are prescribed to women with PCOS. However, a holistic approach could be the best way forward in managing a disease as complex as PCOS. Authors conducted this pilot study called the Sepalika 5-petal PCOS reversal program which consisted of individualized diet plans, magnet acutherapy, fitness regimens, dietary supplements and herbal products to evaluate whether these interventions improve PCOS symptoms, insulin resistance and hyperandrogenism.Methods: A total of 30 patients were recruited online from all parts of India using the PCOS symptom quiz. Various baseline investigations were performed at recruitment. They were suggested personalized diet plans, followed by exercise videos, magnetic acutherapy and herbal and micronutrient supplements. The program spanned over a period of 90 days and patients outlook and quality of life were also assessed at the end of the program.Results: The main goal of most participants was improvement in weight and energy issues, and regularization of periods. Each of these goals were achieved in all participants of the program. Patient-reported outcomes showed a definite improvement in the quality of life of the participants at the end of 90 days.Conclusions: PCOS is a physical - sexual, psychological and social syndrome; therefore, it is necessary to taking a more holistic approach to patient care beyond treating physical symptoms. Larger studies with more objective and subjective endpoints is the way forward.

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Diet and nutrition in polycystic ovary syndrome (PCOS): Pointers for nutritional management

Cited by 72 publications

References 114 publications

In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake

In polycystic ovary syndrome, adrenal steroids are regulated differently in the morning versus in response to nutrient intake

Dietary management of women with polycystic ovary syndrome in the United Kingdom: the role of dietitians

Holistic approach in the management of PCOS: a pilot study of an online PCOS-reversal program

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