PCOS- nutritonal therapy, supplements, diet, recipies, causes, symptoms,etc

Hi all spent ages researching PCOS for college and have since graduated! Thought u might want some of this info (although there is a lot!)

Polycystic Ovarian Syndrome

Risk Factors:

Diet Related: Non-Diet Related:

* Excess consumption of animal * Being overweight or obese
foods and therefore high levels * Familial history or genetic
of arachidonic acid predisposition
* High sugar diet * Ethnicity (Native American,
* Diet high in complex Latino and Greek women
carbohydrates have higher incidence.
* Diet high in saturated fats * Family history of diabetes,
Hyperinsulinemia or insulin
resistance.
* Family history of irregular
menses or anovulation
* Family history of
cardiovascular disease.
* Abnormal blood lipid profile
with a low level of HDL and
and high level of LDL
cholesterol.

Factors that reduce Risk:

Unfortunately PCOS and its causes are poorly understood. Most sufferers are found to have a hereditary tendency towards Polycystic ovarian syndrome (Girens, JR, 1988) Although there are no guaranteed steps to undertake that will reduce the likelihood of the condition occurring, the complex disorder seems to be effected by a woman’s emotions, diet and personal history (Northcup, C, 1995). Therefore it seems appropriate to support all components of wellbeing. Individuals predisposed to the syndrome should also be aware of associated diseases such as hyperinsulinemia, cardio vascular disorders and infertility.

Diet Related: Non-Diet Related

* eat as many wholefoods * exercise to maintain a healthy
as possible and include a weight
variety of food packed with * support endocrine function
nutrients. * reduce stress and use
techniques to improve emotional
* aim for a healthy weight wellbeing (eg: meditation,
and do not over consume hobbies, counselling, plenty
calories of sleep, joining support
systems, spirituality)
* get regular health checks

Foods to include/increase:

* soy foods
* phytoestrogens
* legumes (beans, lentils)
* fibre rich foods (oat bran)
* fruit and vegetables
* omega 3 (fish and flax)
* antioxidant rich foods (blueberries)
* low GI foods
* olive oil and nuts (walnuts)

Foods high in phytoestrogens such as soybeans are rich in antioxidants and mimic or modulate the effects of the steroid hormone oestrogen in the body and suppressing the development of disease (Rolfes, 2006, pg 465-466). They also contain Isoflavones, which bind to oestrogen and androgen receptors and minimise their effect (Christian J, 2002). Including low GI foods and fibre into the diet will also keep a person feeling full and prevent snacking, which can push calorie intake over the recommended daily limit. Low GI foods not only provide satisfaction and slow release energy, they also stop high insulin levels from being released in the blood stream, helping combat problems such as hyperinsulinemia and insulin resistance, which is a risk for PCOS suffers due to the increased production of androgens (Duniaf A, 1987).

Foods to avoid/reduce:

* red meat
* saturated fats
* fried foods
* meat grown using hormones (chicken)
* tea
* coffee
* alcohol
*cigarettes
* refined carbohydrates (white bread)
* sugar
* high GI foods
* calorie rich foods

Unfortunately obesity is highly associated with PCOS, it is listed as both a symptom and an associated risk factor for obtaining the disease. None-the-less, even moderate or mild obesity certainly contributes to rates of associated infertility for women with PCOS as well as higher levels of poor pregnancy outcomes, including failure to carry a pregnancy to full term (Hamilton-Fairly, 1992). This would suggest reducing calorie rich foods in the diet such as saturated fats in red meat and fried foods as well as simple carbohydrates and sugars. A diet high in red meat and animal products can also cause an overabundance of arachidonic acid in the body leading to inflammation (Rolfes, 2006, pg 156). This has adverse effects on the body and causes inflammation and disease. Of course high saturated fats can further increase risks such as heart disease and associated problems, which are common is PCOS (Dahlgren E, 1992).

Dietary guidelines and recommendations:

monday tuesday wednesday thursday friday saturday sunday
breakfast Low fat Jalna yoghurt with blueberries and walnuts Avocado,
tomato and poached on sourdough Home-made peanut butter with olive oil on two slices of grainy bread Soy milk smoothie with banana and oat bran Quinoa porridge with mixed berries Smoked salmon , onion and asparagus omlete. Museli with LSA and soy milk
snack Small cup of Miso soup orange Beetroot, ginger, carrot and spinach juice kiwifruit Hommus and carrot sticks banana apple
lunch Stir fried tempeh with carrot, peas, capsicum and onion in a little olive oil Tofu with black bean and Asian greens Tahini on rye crackers with salad Seaweed salad and sashimi Sweet potato and fish curry Mixed leaf salad with fresh mushrooms and capsicum and a little olive oil and vinegar Sardines on a slice of wholemeal toast
snack kiwifruit Licorice tea apple Mixed walnuts, pecans and almonds with seeds Dry roasted soy nuts Dry roasted soy nuts Fresh mixed vegetable juice
dinner Kidney beans in a tomato sauce on quinoa Mixed bean salad Poached salmon with vegetables Mixed leaf salad with fresh mushrooms and a little olive oil and vinegar Tacos with kidney beans tomato and lettuce Mixed vegetables on brown and wild rice Hommus with celery and cucumber stick
desert Chamomile tea Low fat yoghurt with fresh peach cherries Soy chai mandarin Licorice tea Baked apples
Recipes:

Breakfast:

Bircher Muesli:

Ingredients:

* 1 gala apple, unpeeled, quartered, core removed
* 1 cup rolled oats
* 1/2 cup (125ml) apple juice
• 1/2 cup (130g) fat-free natural yoghurt, plus extra to serve
• Large pinch ground cinnamon
• 1/4 cup (25g) flaked almonds
• 1/4 cup (30g) walnuts
• 2 tbs pepitas
• Blueberries, to serve

Method:

1. Coarsely grate the apple. Mix the grated apple, rolled oats, apple juice, yoghurt and cinnamon in a bowl until well combined. Cover and place in the fridge for 1 hour or overnight.
2. Combine the flaked almonds, walnuts and pepitas in a small bowl.
3. Stir half the nut mixture through the muesli with 1/2 cup of yoghurt if the muesli has been soaking overnight. (If the muesli has been soaking for 1 hour, add a little extra yoghurt only as desired.) Top with the remaining nut mixture and blueberries to serve.

Lunch:

Hommus:

Ingredients:

* 2 1/4 cups whole chickpeas
* 1 tsp bicarbonate of soda
* 1-2 cloves garlic, crushed
* Salt to taste
* 1/4 cups, plus 2 tbsp. tahini
* 1-2 lemons

* 4 tbsp olive oil
* A pinch of paprika
* Finely chopped parsley

Method:

1. Soak the chickpeas covered in cold water over night. Drain, cover with water and bicarbonate soda and steam in a pressure cooker for 20 minutes or simmer for 1 ½ hours in a saucepan. Drain the chickpeas and set aside the liquid.
2. Using a little of the cooking liquid blend the chickpeas to a puree in the blender, add the garlic salt and tahini. Lastly add the lemon juice too a thick creamy consistency.
3. Put in a dish and pour olive oil on top. Garnish with parsley and paprika.
4. Serve as a dip with vegetable sticks or use as a sandwich spread.

Dinner:

Tray-baked salmon steaks:

Ingredients:

• 500g sweet potato, peeled and sliced
• 1 eggplant, thickly sliced
• 4 large ripe tomatoes sliced
• 4 anchovy fillets, drained, rinsed and finely copped
• 2 tablespoons of olive oil
• 1 tablespoon of bottled capers, rinsed and chopped
• 4 salmon steaks (about 150g each)
• 1 lemon

Method:

1. Preheat the oven to 200°C. Cook the potatoes in a saucepan of boiling water for about 8 minutes until they are just tender, then drain.
2. Arrange the sweet potato, eggplant and tomato slices in overlapping rings in a large, lightly oiled roasting tin.
3. In a small bowl, combine the anchovies with the oil and capers, then season well with pepper (no salt is needed). Pour the mixture over the vegetables. Cover the dish with foil and bake in the oven for 20 minutes.
4. Arrange the salmon steaks on top of the vegetables, re-cover with the foil and cook for 10 minutes. Remove the foil and cook for a further 10 minutes until the salmon and vegetables are cooked through.
Serve with lemon.

Dessert:

Baked tofu cheesecake:

Ingredients:

• 700g firm tofu, drained
• 150ml soy milk
• 2 tsp lemon juice
• finely grated lemon rind
• 1 tsp vanilla essence
• 2 tbsp argave nectar

Pastry:
• 90g of wholemeal or rye flour
• 40g rolled oats
• ½ tsp salt
• 125 ml oil

Method:

1. to make the pastry combine all ingredients in a bowl with two tablespoons of water and mix until mixture holds together.
2. Press over the base of a 20cm loose bottomed tin and prick several times with a fork and back 10 minutes
3. Meanwhile preheat oven to 150 degrees Celsius. Stir together tofu soy milk, argave, lemon juice, rind and vanilla.
4. Pour mixture into pastry case and return to over for 35-40 minutes.

Supplements:

Magnesium: HPO/HPA (hypothalamus pituitary ovarian/ hypothalamus pituitary adrenal) axis regulation- the binding of oestrogen to its receptor requires magnesium and can prevent elevated non-cyclic oestrogen. Magnesium will also help relax the smooth muscle on the artery walls and lower blood pressure, which can be high in people suffering from PCOS (Hendler, 1991,pg159). This is turn will decrease chances off associated cardiac problems and cardiac disease. 200-400mg/daily

Chromium and Alpha-lipoic-acid: Both are important for Glycemic control and fat loss. Chromium activates the GLUT 4 transporter, therefore increasing insulin receptors and lowering blood glucose levels. Alpha-lipoic-acid has a similar action to Chromium however it has the extra benefits of being a powerful antioxidant. Chromium: 200 mcg TDS, Alpha-lipoic-acid: 400 mg daily.

Zinc: Zinc is essential for follicle development. It works by increasing activity and levels of FSH (follicle stimulating hormone (Hendler, 1991, pg 201) and fertility. Zinc will also highly involved in controlling blood sugar levels. Insulin is stored in beta cells in the pancreas as zinc crystals. The zinc enhances the binding of insulin to liver cells and is involved in promoting lipid synthesis in fat cells (Hendler 1991, 203). 30-50mg daily (not for long periods of time as this may cause toxicity)

B complex vitamins (with additional panthothenic acid and especially B6/pyridoxine especially): B5 an B6 work closely together in the utilisation of one another as do all the B vitamins. Therefore a lack in one may cause deficiencies in another. Pantothenic acid is important for adrenal function and Pyridoxine is particularly indicated for individuals with PCOS, it is involved in enzyme and hormone activity, including metabolism of oestrogens and macronutrients, including carbohydrates (Davies 1987, pg 20). B5: 100-10000 mg daily. B6: 50-200 mg daily.

Omega 3: These essential fatty acids carry oxygen across the mitochondrial membrane, therefore improving energy uttilisation of lipids and glucose, metabolism and ultimately promotes weight loss and glycemic control. Omega 3 is also used for ovulation stimulation. 3 gms daily or 1gm TDS

Vitamin E: vitamin E is often used for ovarian health as it regulates oestrogen activity (Osiecki, 1998, pg 69). It has been concluded therefore, that vitamin E may reduce cyst development in ovaries. Vitamin E will help lower cholesterol levels, particularly in young people (Davis and Stewart, 1987, pg 40). Therefore vitamin E stands out as an appropriate supplement for PCOS sufferers who additionally have raised LDL cholesterol levels. 600 ius daily

Tyrosine: When used with a B complex, tyrosine supports adrenal function and normal blood glucose levels as tyrosine phosphorylation causes the insulin signaling on a cell (Schmelzle, 2006). Tyrosine is a precursor to adrenal hormones and supports the thyroid gland.

Peony and Licorice: These herbs are often used for reproductive function. Licorice can help lower increased androgens and testosterone levels, whereas peony increases progesterone and normalises ovarian function.

Medical treatment:

Oral Contraceptive Pill: The pill contains a combination of oestrogen and progesterone, which aids in a women’s hormone regulation. The oral contraceptive pill can affect metabolism of B vitamins and is associated with B6 deficiency, therefore car must be taken in addressing deficiencies.

Provera: This will bring on menstruation if you haven’t had a period for a while.
Chlomid: This increases fertility or chances of conceiving by helping start ovulation
Metformin: this is used to increase insulin sensitivity and better insulin binding to cells.

References:

* Christian, J, Gruber, M, D, et.al, 2002, ‘Production and action of oestrogens’, New England Journal of Medicine, vol 346, 340-52.
* Dahlgren, E, Janson, P, et.al, 1992, ‘Polycystic ovary syndrome and risk for myocardial infarction elevated from a risk model based on a prospective study of women’, Obstet Gyneocol Seand, 71: 599-604
* Davis, S, Stewart, A, 1987, ‘Nutritional Medicine- The drug free guide to family health, Pan Books, London.
* Franks, S, 1995, ‘Polycystic ovarian syndrome’, The New England Journal of Medicine, vol 333, 13: 853.
* Girens, JR, 1988, ‘Familial PCOD endocrinal metabolism’, Clinic North America, 17: 771-83.
* Hamilton-Fairley, D, Kiddy, D, Watson, H, et.al, 1992, ‘Association of moderate obesity with a poor pregnancy outcome in women with Polycystic ovarian syndrome, treated with low dose gonadotrophin, British Journal of Obstet Gynaecol, 99: 128-31.
* Hendler, S, 1991, ‘The doctors vitamin and mineral encyclopedia’, Simon and Schuster Publishing’s, New York.
* Norden, R, 2004 ‘The Journal of complementary medicine’, vol 3, 4: 1446.
* Northcup, C, 1995, ‘Women’s bodies, women’s wisdom’, Judy Piakus Publishers, Great Britain.
* Osiecki, H, 1998, ‘The Physicians and book of clinical nutrition- 5th edition, Bioconcepts Publishing’s, Kelvin Grove, QLD.
* Rolfs S, et al, 2006, ‘Understanding Normal and Clinical Nutrition’, Thompson Higher Education, USA, pg 197 and pg 754.
* Schmelzle, K, Kane, S, Gridley, S, 2006, ‘Temporal dynamics of tyrosine phosphorylation in insulin signaling’, The American Diabetes Association, vol 55, 8: 2171-79.