A matter of balance – Health – Lifestyle.
By Colette Harris.
1 September 2002
The Sunday Times
(c) 2002 Times Newspapers Ltd Not Available for Re-dissemination.
The right diet could help to protect women with PCOS from further illnesses, says COLETTE HARRIS
What’s that, then?” is a common response when I tell people I have polycystic ovary syndrome (PCOS). Unfortunately, it is not just the name that’s complicated. The symptoms of the syndrome – the result of cysts growing on female ovaries – are wide-ranging, from excess hair, weight gain and acne to irregular periods. And, despite the fact that almost one in ten British women suffer from it, until now there has been one principal way to treat it: the Pill.
I have been a sufferer for several years, however, and have discovered that eating a healthy diet can be still more effective. Obviously, good nutrition is important for anyone with an illness. However, in the case of PCOS sufferers, eating properly can help to regulate the bodily imbalances that come with the condition.
Despite a growing body of research showing that PCOS could make sufferers up to seven times more likely to develop Type 2 diabetes and up to four times more likely to develop heart disease and to have high blood pressure, treatment still focuses on getting rid of symptoms with the Pill. But the underlying metabolic problems are not dealt with.
“The metabolic problems in PCOS cause the increase in body fat and raised insulin, which affects ovarian function, raising levels of male hormones in the blood and triggering symptoms such as hirsutism, irregular cycles and acne,” says Adam Balen, a consultant obstetrician and gynaecologist at Leeds General Infirmary.
Many PCOS sufferers have insulin resistance, a prediabetic state in which the body’s tissues do not respond well to the hormone insulin, which is responsible for blood-sugar balance. Insulin resistance causes swings in blood-sugar levels, which sets up cravings for sugary foods and encourages the body to store energy as fat.
The other problem is that women with PCOS are programmed not to use up energy during digestion, a process known as postprandial thermogenesis, which usually accounts for up to 80% of daily energy use. “On eating seven days’ worth of food, a woman with PCOS stores energy equivalent to eight days’ worth,” says Dr Helen Mason, a senior lecturer in reproductive endocrinology at St George’s Hospital Medical School, London. This adds to the ease with which a woman with PCOS can put on weight, which in itself increases the risk of heart disease, diabetes and high blood pressure.
Why, then, does treatment of PCOS focus on clearing the short-term symptoms with the contraceptive pill? Although it’s a controversial view, many forms of the Pill contain synthetic oestrogens, which can trigger the onset of diabetes mellitus, according to the British Medical Association’s Concise Guide to Medicines and Drugs.
Diet and exercise that help to control insulin and heart disease are an obvious solution. Choosing complex, high-fibre carbohydrates, such as vegetables, whole-grain bread, brown rice and pulses, gives a steady release of blood sugar. Essential fats called omega-3s, found in oily fish, nuts and seeds, regulate hormone function. Cutting down on animal fat and salt, eating five portions of fruit and vegetables a day and protein with every meal, and eating little and often, all combined with exercise, help to reduce insulin resistance and the amount of testosterone in the bloodstream.
Sally Wharmby and Claire Mellors, dieticians at the Queen’s Medical Centre Nottingham, have started a successful PCOS clinic, where they have found diet and exercise can work on its own or in partnership with medical treatment. And Dr Adam Carey of the Centre for Nutritional Medicine in London (www. nutritionalmedicine.co.uk) believes an integrated approach is crucial: “In the future, I am sure doctors will use individual profiles to make drug recommendations, and combine them with dietary advice.”
Gerard Conway, a consultant gynaecologist at Middlesex Hospital, London, agrees. He is investigating the use of the diabetes drug Metformin, which is not yet licensed for use with PCOS, but may be a possible treatment due to its ability to reduce insulin resistance. “Better, long-term results can only be sustained if diet and exercise plans are in place,” he says.
So, at last, PCOS sufferers may not only be able to alleviate their symptoms, but increase their general wellbeing. All they have to do is ask about healthy living – with their prescription for the Pill. n The PCOS Diet Book by Colette Harris and Theresa Cheung .
(c) Times Newspapers Ltd, 2002.