HEALTHWATCH
PCOS: Manage your lifestyle
DR. SHEELA NAMBIAR
|
Keeping obesity under check helps you deal with Polycystic Ovaries.
|
Improvement in body composition is possible only with weight training.
PHOTO: S.S. KUMAR
Best option: Keep fit.
Anxious mothers with their young daughters and young women wanting to conceive often approach the Gynaecologist with an ultrasound report that says she has something that sounds quite ominous – Polycystic Ovaries.
“Polycystic Ovarian Syndrome” (PCOS) is really a constellation of various disorders that have been liked together. Symptoms like- Anovulation (or the inability of the ovaries to produce eggs), irregular menstruation, Hirsuitism (or excess body and facial hair), weight gain, hyper pigmentation of certain areas of the body especially the neck exist together and constitute the term Polycystic Ovarian Syndrome.
Weight Loss
The treatment for the disorder is multifaceted. Besides inducing ovulation (if the woman wants to conceive), treatment for PCOS has to focus on weight loss as one of the primary objectives. More than half the women who have PCOS are over weight or obese. In these women, the excess fat in the body adversely affects their current medical condition and also sets the stage for the appearance of full blown Diabetes Mellitus, Heart disease and even some forms of cancer in the future. Loss of weight therefore is a crucial treatment modality for PCOS and cannot be over emphasized. This may seem rather simplistic, but has been found repeatedly through several studies to be very effective. An average weight loss of 5-10 kgs not only helps regularize menstruation and aid conception, but more importantly helps prevent diabetes, hypertension, heart disease etc in the future.
Trying to achieve weight loss makes the woman feel she has an active role to play in her disease management. This gives them the ability to have some semblance of control over their own treatment. It is beneficial to her self esteem and morale which is often painfully low in an obese young girl.
Does weight gain lead to PCOS or PCOS lead to weight gain? It is not unlike the question of does “the chicken come before the egg”? It has been found that “Insulin Resistance” is the primary cause of weight gain in such women. What is Insulin resistance? Insulin is the hormone produced by the pancreas that helps keep our blood sugars on an even keel by helping the cells absorb and utilise it. Excess blood sugar gets sent to the liver where it is converted to fat and stored. When we are insulin resistant, although the amount of insulin released into the blood stream after a high carbohydrate meal is sufficient (and may even be in excess, called ‘Hyperinsulinemia’), the body is resistance to the insulin and is unable to utilise the glucose. The excess blood sugar gets converted to fat and obesity results. Obesity in turn leads to further Insulin resistance and worsens the condition of PCOS.
Regular Exercise
Start with regular cardiovascular activity like walking, cycling, cross training etc. A longer duration, low intensity workout – about an hour of moderate paced walking for instance, can be beneficial in initiating the weight loss. A higher intensity workout may cause discomfort for an overweight girl initially causing her to get discouraged and give up too easily. It is imperative; however, that one increases the intensity of the workout, as one’s fitness levels improve. A common mistake is to persist with a slow amble on the treadmill. This may be due to fear of pushing one’s body to higher levels of fitness or just plain laziness!
Adding weight training gradually will augment weight loss by increasing one’s muscle mass and basal metabolic rate. Weight training (when done right) will also make the muscles stronger, preventing injury and rectifying muscle imbalances. According to one study, it is not only the numbers on the weighing scale that matter in the outcome of PCOS, but the body composition of the woman (her lean body mass versus her fat percentage). Improvement in body composition is possible only with weight training.
Needless to say one’s diet plays a crucial role in aiding or deterring weight loss and managing PCOS. Weight is lost by ensuring that intake of calories is less than the expenditure. Simple mathematics. When one is insulin resistant, it is also crucial to remember that your food combinations determine your insulin levels (and therefore your blood sugar). Avoid eating purely carbohydrate meals. A whole bowl of plain pasta or rice with no added protein will send our blood sugar skyrocketing followed by a spike in the insulin levels. Adding protein modulates the sugar spike. Eat smaller meals more frequently. Half an apple with a small piece of cheese for instance can constitute a “meal”. This also prevents drastic food cravings when one gets ravenously hungry at mealtimes causing you to eat everything placed in front of you !
No to sugar
Avoid sugar. Sugar is a recipe for disaster for someone with an already compromised insulin status. Does this mean no desserts? A fruity dessert with nuts would be an option—there you have your carbohydrate (the fruit) and your protein and fats (the nuts). Because insulin resistance is one of the hallmarks of PCOS, many experts recommend following a diet similar to one recommended for people with Type 2 Diabetes. High fibre, low glycemic index foods (like whole grains), instead of high sugar more refined carbs (like white bread and potatoes). Artificial sweeteners have also been found to increase insulin levels and are avoidable.
Fat loss therefore is a fundamental prerequisite for better management of PCOS if the woman is overweight. There are women who are of normal or even underweight who suffer from PCOS. Interestingly, these women also benefit from exercise. In their case the exercise appears to control the insulin resistance.
A woman with PCOS requires not only medical management but more importantly “lifestyle management”. A change in attitude towards exercise and food will help her achieve physiological normality and also improve her emotional status.
Dr. Sheela Nambiar is a Obgyn, Fitness & Lifestyle Consultant. Email: drsheela@tfl-inc.com
Printer friendly
page
Send this article to Friends by
E-Mail
Magazine
