Health Disease Female Health Food Nutrition

Relationship Between PCOS and Insulin Resistance

Most of the women now-a-days, are facing the issue of PCOS. PCOS known as polycystic ovararian syndrome is a condition in which the ovaries of the female produce abnormal quantity of male sex hormones, androgens. Numerous small cysts filled with fluid are formed in ovaries causing irregularity in menstrual cycle along with other complications. PCOS and insulin resistance is often interlinked with each other but what is the actual relationship between them? How is insulin resistance responsible for causing PCOS and is this thing curable?

It has been researched that 30-40% of the women facing the problem of PCOS are detected with insulin resistance that can lead towards high glucose levels in the body.1 Insulin resistance is considered as the root cause of PCOS that can exacerbate the symptoms of PCOS increasing the risk for type-2 diabetes and obesity. This relationship can be reversed with the management of lifestyle modifications and with the treatment through medications upon requirement. Medications should be recommended after screening so every women facing the issue of PCOS should get themselves screened for.

The condition and bio-chemistry of PCOS

PCOS called as polycystic ovary syndrome is a condition that can cause irregular menstrual cycles, difficulty in conceiving, rise of male hormone levels and development of small follicles on the ovaries of females that hinder the egg production and release in women. PCOS is often linked with insulin sensitivity.

Insulin is produced by the gland pancreas that is located in the abdomen and have number of functions. Insulin is secreted in response of high blood glucose levels in the body. The glucose molecules after breakdown of carbohydrates consumed through diet enters the bloodstream after 15 minutes of intake. Insulin allows the cells to take up glucose for later use of energy.

If a person is resistant to insulin, the body does not responds to insulin in an efficient way. It leads to rise in glucose levels in the body. The consistent high levels of blood glucose can lead to pre-diabetes and then to diabetes in the person.

Link of PCOS and insulin resistance

It has been said that almost 60-70% of women face the issue of PCOS with insulin resistance. It is believed that high levels of hormone insulin cause the male hormone levels to rise in the body. Insulin is responsible for helping the sugar to enter the cells through insulin receptor cells. People facing the issue of insulin resistance needs more insulin than the normal level to proceed and process the sugar in body. If the insulin resistance is left unchecked, it can progress towards the condition of diabetes in women. Diabetes is diagnosed when the blood sugar levels are higher than 200 mg/dl and can also be identified authentically with HbA1c glucose test or with an oral glucose test. When the body produces excess insulin in the body, the insulin receptors function poorly and become incapable of not taking adequate sugars for the cells. Signs of diabetes include:

  • Polydypsia
  • Polyuria
  • Polyphagia
  • Fatigue
  • Numbness in hands and feet
  • Blurred vision

Relationship of diet with PCOS

Diet and nutrition plays a significant role in managing and treating PCOS. The combination of insulin resistance and inflammation in the body is also related with the diet which we consumed on daily basis. The blood sugar levels in the body become high in the state of insulin resistance especially if a person is in the habit of consuming refined carbs and added sugars. There are more chances of becoming insulin resistant with the increase of consumption from such dietary practices of simple carbohydrates and sugars.

People facing the PCOS show different response towards foods. There are different types of foods that can promote inflammation and can even worsen the condition and symptoms. On the other, there are various anti-inflammatory foods that can help to combat inflammation. It is recommended to switch to whole and less processed foods that can naturally provide benefits to the patient of PCOS instead of over-restricting the food items.

Foods to avoid with PCOS

There are various categories of foods that should be avoided if you are facing the condition of PCOS. We categorize them as follows:

  1. Foods and drinks with added sugar in high amounts

Sugary beverages with high amount of simple sugar in them are a lead contributor of high glucose levels in the body worldwide. The drinks like sweetened teas, sugary coffees, soda, and energy drinks are high in added sugars. Consuming such drinks on regular basis can worsen the insulin resistance contributing to inflammation in the body. It is not easy to detect sugar as we cannot easily spot it in foods especially in those which seem healthy. The foods like yogurt, dried fruits and nutrition bars, granola bars have added sugars in them. If you are aiming to lose weight, it is better to cut back on added sugars that can improve the insulin sensitivity in the body and can reduce the symptoms of PCOS in some women.

  1. Foods rich in omega-6 fatty acids

Omega-6 fatty acids and omega-3 fatty acids are often interlinked but the truth is not so. Omega-3 fatty acids have high anti-inflammatory properties while omega-6 fatty acids are pro-inflammatory. The foods which are not allowed on PCOS are from the sources of omega-6 fatty acids including the corn oil, vegetable oil, soybean oil, safflower and sunflower oils. Meat derived from animals that are fed on grain-based diet are also high in omega-6 fatty acids. Instead of these options, try to initiate the healthy fat from foods like fatty fish, nuts, seeds and grass-fed meat.

Foods good for PCOS

There are various anti-inflammatory foods that are considered good for PCOS. Some of them are explained below:

  1. Blueberries

Blueberries belonging to the category of anthocyanins are antioxidants in natures. Antioxidants are crucial for fighting against inflammation, and prevents the cell damage from free radicals. These are considered as the greatest source of fiber are natural sugar. Blueberries can raise the blood sugar levels in moderate amount as compared to the sudden spike caused by the refined sugars. It is due to the high fiber content in them so, blueberries should be included in the PCOS diet.

  1. Magnesium-rich foods

It has been said that women facing the issue of PCOS are likely to be deficient in magnesium. Magnesium is a trace element that promotes relaxation in the body and manages stress level. It also plays a role in controlling insulin resistance. Some of the food sources that are rich in magnesium are:

  • Pumpkin seeds
  • Nuts and butters like peanuts, cashews, nut butter, peanut butter
  • Soymilk
  • Spinach
  • Dark chocolate with 69% of cocoa
  • Black beans
  1. Vegetables without starch

Vegetables are considered as the best foods to eat for PCOS and besides this, they are beneficial for various other health matters too. Non-starchy vegetables are extremely low in carbohydrates and won’t raise your insulin levels in a significant way. Vegetables are extremely helpful for those who are following an insulin-resistant PCOS diet.

Green leafy and orange vegetables are rich in phytochemicals and antioxidants. They help to combat the inflammation in the body and are great choice for a PCOS diet. Starchy vegetables can also be included in a PCOS diet but with a focus on moderate portion size in case of presence of insulin resistance. Starch can be broken down into blood sugar and can raise the sugar levels in the body worsening the insulin resistance. Some of the best dietary sources for non-starchy vegetables that can be included in PCOS diet are:

  • Asparagus
  • Broccoli and Brussels sprouts
  • Cabbage and cauliflower
  • Carrots and cucumber
  • Celery and egg plant
  • Green beans and pea pods
  • Leafy green vegetables like kale, mustard greens
  • Mushrooms
  • Okra
  • Bell peppers
  • Salad greens like lettuce, spinach, endive
  • Squash and tomatoes

Metformin for PCOS and association with food

Metformin is a common ovulation induction agent that is effective for non-obese women facing the issue of PCOS. They are considered advantageous over the other first line treatments for anovulatory fertility conditions like clomiphene. Metformin with combination of clomiphene is an effective step for treatment for clomiphene-resistant women.

Metformin is an effective treatment for PCOS that enhances the body’s sensitivity to insulin. This drug decreases the circulating levels of insulin in the body and produces positive effect on the fat tissue. Metformin is recommended to women for PCOS treatment and to those having higher BMI. But the recent advances in nutrition have indicated that metformin is not a first-line therapy for treating PCOS in women. It is a treatment for patients facing the issue of type-2 diabetes. If you are facing the issue of PCOS, you can take metformin but adjust the diet. So, here we recommend the five foods that should be avoided while taking metformin:

Sugary drinks

It is better to avoid the sugary drinks if you are facing insulin-resistance PCOS. Metformin along with restriction of sugary drinks can work in a better way to improve the insulin sensitivity.


Alcoholic consumption along with intake of metformin can lead to development of lower blood sugar levels. Try to limit the alcohol drinks to no or just one drink per day if you are taking metformin for PCOS.

Foods with added simple sugars

Foods with added simple sugars are responsible for triggering the PCOS symptoms are can worsen the insulin resistance in body. It is recommended by AHA to limit the consumption of added sugars to less than 25 grams per day.

Refined grains

Refined grains are likely to raise the blood sugar levels and can worse the insulin resistance in body. Refined grains include all the bakery items like white bread and rice, bagels and tortillas. So, these items should be avoided while taking metformin for PCOS.

Fried food items

Metformin can sometimes cause gastrointestinal side effects in the body which can be due to the consumption of fried foods. You can cut off these fried foods that can help you to lose weight and to improve the PCOS symptoms.

Metformin and allowed food items

Nuts and seeds

Nuts and seeds are composed of unsaturated healthy fatty acids that are good for heart health and promotes healthy blood sugar levels. These are good for PCOS, and does not interfere with absorption of metformin.

Omega-3 fatty acids

Omega-3 fatty acids are anti-inflammatory in nature. So women facing the issue of inflammatory PCOS can consume thedietary sources of omega-3 fatty acids along with metformin.

Protein-rich food items

Protein rich foods like chicken, fish, eggs, lentils and quinoa are helpful for PCOS as they provide feeling of fullness and improve satiety levels in the body. They do not raise the blood sugar levels in the body.

Non-starchy vegetables

Most of the non-starchy vegetables are low in carbohydrates and rich in fiber. These vegetables does not rise the blood sugar levels in the body. All the richly colored fruits and vegetables are good source of anti-oxidants that help in fighting inflammation in the body.

Lifestyle changes for managing PCOS

Along with diet and medications, betterment in lifestyle can also manage the PCOS with insulin sensitivity. These lifestyle changes include:

  • Initiating regular physical activity
  • Managing stress
  • Getting enough sleep
  • Taking PCOS supplements

Stopping the vicious cycle of PCOS and insulin resistance

Unfortunately, there is no cure for PCOS and it can be dealt only with modifications in lifestyle and medications. Symptoms can be managed through these tactics. Lifestyle changes has helped the people with PCOS to manage insulin resistance. You can gradually improve the habits in your lifestyle over the time including some habits below:

1. Exercising regularly

Exercise is one of the best way to manage both insulin resistance and PCOS. It cause the receptors of our muscle cells to take in the sugar without consuming extra insulin production. This process can make the insulin receptors sensitive to lower the insulin levels in body. Body responds to less insulin production for processing sugar. The lower levels of insulin, leads to the reduced androgen production helping in treating PCOS.

2. Healthy eating habits

Healthy eating habits are vital for the women having PCOS and insulin resistance especially in the ones having higher BMI. You goal should be to achieve a sustained weight loss over the time. It is advisable not to follow any fad diets as they are highly disruptive for health. You can lower the cytokine levels through reduction in the abdominal fat as they are harmful for the insulin receptors. Weight loss also helps the insulin receptors to work better and allows the pancreas to lower the production of insulin. It is important to reduce or in cases, cut down the simple sugars and carbohydrates as insulin resistance reduces the body’s ability to break down the carbs.

3. Stress reduction

‍Managing stress levels in PCOS, has shown the reduction in levels of insulin resistance. Stress encourages the stored sugars from the liver to get released that can cause sudden spike in the blood sugar and insulin levels.

Dn.Zainab Naeem is Hosting and Content Writing Head of SDNO. She is a freelance nutritionist and writer, and also a self-taught calligrapher, artist and chef.  She can be reached at @xayni_de_artista.

She can be reached at

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Health Diet Plan Disease Female Health Nutrition

Management of Osteoporosis In Post-Menopausal Women

Menopause, the natural ending of periods that usually occurs between the ages of 45 and 55, can increase the risk of osteoporosis, a condition in which bones become thin, less dense, and fracture easily. Increased bone loss is caused by the reduction in estrogen levels around menopause. In the first five years following menopause, women are thought to lose up to 10%-20% of their bone mass on average. According to research, osteoporosis will cause at least one fracture in one in two women over 60.

Any woman who is in the pre-menopausal stage can manage the risk for osteoporosis. Being a women, you can try some weight-bearing and resistance exercises and can adopt fall prevention strategies that are a part of a bone-healthy lifestyle. It is recommended to limit alcohol and intake of caffeine. Initiating calcium, vitamin D, phosphorus and protein-rich foods are the best dietary management for osteoporosis. 


Around the age of 25 to 30, when the skeleton has stopped growing, and the bones are at their strongest and thickest, women reach their highest bone mass.

Estrogen, a hormone in women, is crucial for maintaining bone density. Estrogen levels fall around the time of menopause, which typically happens around age 50 and causes more bone loss. Any bone loss that occurs around menopause might lead to osteoporosis if your peak bone mass before menopause is less than optimal, which is 1.105 g/cm2 to 1.141 g/cm2, aged 50-54 years.


Osteoporosis, which translates to “porous bones,” is a chronic disorder where bones lose structural support and are more likely to shatter or fracture. Osteoporosis is most frequently brought on by menopause. Estrogen levels begin to fluctuate and then decrease due to hormonal adjustments to accommodate typical menopausal changes. Estrogen’s decline during menopause greatly accelerates bone loss since it slows bone’s normal breakdown, preventing bones from becoming weaker.

One of the three estrogen hormones that the body typically produces is estradiol. Women going through menopause can easily see the effects of estradiol. As the ovaries stop producing estradiol throughout this process, women naturally have decreased amounts of the hormone because the menstrual periods cease.

Other hormones that contribute to the health of bones include vitamin D and calcium. Your body can absorb calcium with the aid of vitamin D. Calcium is required for the development of robust, healthy bones. Without enough calcium and vitamin D, bones may not develop properly in childhood and lose bulk as they age, becoming brittle and susceptible to breaking. If you don’t receive enough vitamin D, your body won’t be able to absorb calcium from your diet, even if you consume adequate calcium.


This alteration frequently brings hot flashes, vaginal dryness, night sweats, and other menopausal-like symptoms. Osteoporosis can develop with time if estrogen levels are too low.


Osteoporosis is frequently referred to as a “silent illness” because the early stages of bone loss are asymptomatic. Before their bones become so fragile that sudden stress, jolt, or tumble results in a fracture or a vertebra collapse, people may not be aware that they have osteoporosis. Initial symptoms of collapsed vertebrae may include excruciating back pain, height loss, or spinal abnormalities like a bent posture.


You can lower your risk of acquiring osteoporosis around the time of menopause by adhering to a few lifestyle suggestions, such as:

  • Aim for a daily Calcium intake of 1,300 mg.
  • Three to four portions of dairy stuff are included in this.
  • Numerous non-dairy foods also contain calcium, including fish with edible bones, such as sardines or tinned salmon, firm tofu, almonds, brazil nuts, unhulled tahini, and calcium-fortified soy or almond beverages.
  • Engage in regular, suitable weight-bearing exercise, such as resistance training with weights.
  • Avoid high extensive exercises or other activities that call for quick, powerful movements.
  • Exercise involving weight, such as weight training, tai chi, dancing, and brisk walking.
  • Do aerobic activity for your body two to three times weekly.
  • Perform strength exercise (resistance) once or twice each week.
  • Include stretching or flexibility exercises in your routine.
  • Maintain healthy amounts of vitamin D. Calcium absorption by the body is aided by vitamin D.
  • Following sun exposure, it is produced in the skin, and some foods contain a level of vitamin D.
  • Limit your alcohol consumption: current guidelines recommend a maximum of two standard drinks per day with two alcohol-free days per week for women.
  • Don’t smoke: smoking cigarettes is associated with a higher risk of osteoporosis.
  • Limit your caffeine intake.

Nutrients Helpful in  Management of Osteoporosis


sources of


·         Green leafy vegetables including spinach, methi, mustard leaves, turnip greens

·         Fish with bones

·         Nuts and seeds like almonds, sesame seeds, flax-seeds  (High in calcium and omega-3 fats)

·         Quinoa (A light and healthy whole grain offering 60-100 mg of calcium in one cup)


sources of

Vitamin D

·         Egg yolks

·         Liver

·         Saltwater fish

·         Salmon

·         Mackerel and tuna


sources of


·         Meat

·         Seafood

·         Poultry

·         Eggs and dairy

·         Cheese and beans


sources of



·         Milk

·         Cheese

·         Yogurt

Agents with


Agents with vengeance means that there are some things in diet that can interfere with how much calcium our body can absorb. These includes:

·         Phytic acid (found in: Unleavened bread, raw beans, seeds and grains)

·         Oxalic acid (found in spinach)

·         Sodium (Keep the sodium intake down as high levels of sodium interferes with calcium retention)


Depending on your age, the results of a bone density test, and your history of fractures, some therapies & medical treatments are recommended by a doctor.

The medical treatments for osteoporosis:

  • Selective estrogen receptor modulators (SERMS)
  • Bisphosphonates
  • Menopausal hormones therapy (MHT) or hormone replacement therapy (HRT)
  • Denosumab
  • Parathyroid hormone
  • Supplementation of calcium and vitamin D.

Supplement use in relation to bone health


of focus



Protein supplementation has a small but positive effect on lumbar spine bone mineral density.

Vitamin D

Supplements of vitamin D prevent fractures in older people as formulated and tested. Calcium and vitamin D supplements collectively are required in preventing hip and any other type of fracture.

Vitamin D

Supplementations of vitamin D has further shown small benefits at the femoral neck but no effects were seen at the other sites.

Vitamin D

Oral vitamin D supplementation (700-800 IU/day) can reduce the risks of hip and non-verbal fractures in institutionalized elderly persons.


Supplementation of calcium and dietary intake has shown small non-progressive increases in bone mineral density.

Vitamin K

Supplementation of vitamin K has shown positive results to increase bone mineral density at lumbar spine but not at the femoral neck.



There is no evidence found that the supplementation of phosphorus intake is related to the demineralization of bone or to excretion of calcium in the urine.

Recommended Questions

How can you treat pre-menopause and osteoporosis? Pre-menopause and osteoporosis can be treated by:

  • Combination oral contraceptives
  • Selective estrogen receptor modulators
  • Bisphosphonates
  • Teriparatide or PTH (1-34)

Which treatment is given to early osteoporosis in pre-menopausal women? Early treatment includes the initiation of bisphosphonates. It is the first choice treatment for osteoporosis. Bisphosphonates include alendronate (Fosamax) once in a week. Actonel can also be taken as a monthly pill.

How can women prevent the risk of osteoporosis in early menopause? The risk of osteoporosis during menopause can be reduced:

  • Initiating 1300 mg of dietary calcium intake, every day in diet.
  • Doing regular and appropriate weight-bearing physical activity, including the resistance training exercise with weights.

What do you mean by pre-menopausal osteoporosis? The chance of bone-thinning disease called as osteoporosis increase with the age in women especially after menopause. It is not an uncommon thing for women to get this condition before menopause and is called as pre-menopausal osteoporosis or bone loss.

Can a 40 years old women have osteoporosis? 40 Years old women can also get osteoporosis. It is more common in young people including the premenopausal women in their 20s, 30s and 40s.

Which is the best natural treatment for osteoporosis? The best natural treatment for osteoporosis includes:

  • Trying a vitamin-D supplement
  • Increasing the magnesium intake in diet
  • Tackling the stress
  • Making dietary changes
  • Avoiding sparkling juice and caffeine
  • Practicing some moderate exercise
Alnoor Naseem is a Nutritionist and Dietitian by profession and a writer by passion. Being a nutritionist, she loves to explore the science behind food and spread authentic knowledge so that people can clear their misconceptions regarding holistic nutrition and lifestyle.

She can be reached at

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Health Disease Food Habits Nutrition

Eating Disorders Types and Treatment

(EDs) means “persistent eating disturbance.” In other words, unhealthy eating habits to develop is known as eating disorders. Eating disorders are serious mental disorders. The patient may eat very less or the patient may eat a very large amount of food. Many people disengage from treatment. All the conditions including eating disorders are medical conditions. Heart and kidney issues arise and the patients may also suffer death. The causes of these disorders are vague. Some causes may include:

  • Genetic causes
  • Biological causes
  • Causes related to behavior
  • Psychological causes
  • Social factors

Symptoms may vary depending on the severity of the condition. In binge eating, the patient may eat a very large amount of meals. During binge periods, the patient may eat very fast. The patients may eat alone due to fear of embarrassment. Frequent dieting may be a characteristic of these patients. Throwing food or use of laxatives comes under symptoms of bulimia nervosa. Fasting is also a symptom of bulimia. In bulimia nervosa, sore throat is also present. Teeth become scary (decay). Gastro problems arise. Imbalance in electrolytes is also present. In anorexia nervosa, excessive exercise is a common symptom. There is a fear of gaining weight. Chronic health problems may also arise. Anemia is also present. Nails become brittle. The patients may present with fine hair over the body. Hypotension persists. Internal body temperature falls. Fatigue persists. The function of the heart becomes poor with organs malfunctioning. Some patients may also die of suicide. In severe circumstances, it can cause serious health problems and result in death if it is left untreated. We all should know the term that is diabulimia. It’s when people reduce taking insulin to lose weight.

Anorexia Nervosa (AN)

(two subtypes are: restrictive eating only and restrictive eating with purging)

Severity based on current body mass index in adults and body mass index percentiles in children. This condition is more common in industrialized countries. Genetic, physiologic, environmental, and temperamental factors are the major risk factors. Inefficiency in executive functioning is common in these people. Many changes occur during anorexia nervosa. Organs become damaged especially the heart, nervous system, and kidneys.

Bulimia Nervosa (BN)

(uncontrollable eating of food)

Self-induced vomiting, laxatives overuse, diuretics, the use of thyroid hormones, fasting, and overburdened exercise are the compensatory methods. There are the following levels of the condition: mild, moderate, severe, and extreme. It is found in women (2%) and men (0.5%). The diagnosis rate is 10-15% of cases. It is also prevalent in industrialized states. Genetic, physiologic, environmental, and temperamental factors are the major risk factors.

Binge Eating Disorder

(a clinical disorder; characterized by recurrent episodes of binge eating)

Mild, moderate, severe, and extreme are the severity levels of the condition. It is more in women (3.5%) and men (2%). The rates are found in Caucasians, Asians, and Americans. There is no crossover between BED to other eating disorders. It has an official diagnosis.

Other Specified Feeding and Eating Disorders (subclinical AN, BN, and BED)

This category is used in situations in which doctors select to communicate a particular reason.

Unspecified Feeding or Eating Disorder

This category is used in situations in which doctors select not to communicate the particular reason.

Avoidant or Restrictive Food Intake Disorder

(lack of interest in eating apparently)

There is weight loss. There is a need for oral nutrition supplements. The disease is not explained by a lack of available foods. This is not associated with any other adjacent medical condition.


(eating of nonfood substances)

Additional clinical attention is a need in the condition.

Rumination Disorder

(repeated regurgitation of food)

It is not associated with other complex medical conditions. Additional clinical attention is needed.










Anorexia nervosa


Disorders of anxiety

A range of brain abnormalities





Bulimia nervosa

Increased concerns regarding weight. Childhood physical abuse.

Reduction in self-esteem. Social anxiety problems/disorder.

Early pubertal maturation. Genetic vulnerability. 

(Diagnostic and Statistical Manual of Mental Disorders)

(American Psychiatric Association 2013)


Treatment for eating disorders is done by doctors, nutritionists, therapists, and nurses. Individual or family psychotherapy is a treatment to change behavioral patterns. Nutritional counseling is also very potent. Anti-depressants are prescribed forms of medications. Some patients may need hospital treatment.


Dietitian Zoya Faisal is a Gold medalist in Doctor of Nutrition and Sciences (UMT), and did her M.Phil in food and nutrition (UVAS), Pakistan. She can be reached at

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Disease Female Health Health Nutrition

An Unconventional Guide to PCOS

PCOS stands for Polycystic Ovary Syndrome. PCOS is a hormonal disorder that affects women during their reproductive years (ages 15 to 44). PCOS is a condition that affects a woman’s ovaries, which are reproductive organs that generate estrogen and progesterone, which regulate the menstrual cycle. Normally, the male hormones termed androgens are also produced in modest amounts by the ovaries. The ovaries produce eggs that are fertilized by sperm from a man. In short, the polycystic ovarian syndrome is characterized by:

  • cysts in the ovaries
  • high levels of male hormones
  • irregular or skipped periods

Many tiny, fluid-filled sacs form inside the ovaries as a result of PCOS. The term “polycystic” refers to a person who has a lot of cysts. Each of these sacs is a follicle, which contains an immature egg. Ovulation is never triggered because the eggs are never developed enough. Ovulation deficiency affects estrogen, progesterone, FSH, and LH level. The levels of progesterone are lower than typical, while the levels of androgen are higher than usual. Extra male hormones cause the menstrual cycle to be disrupted, resulting in fewer cycles for women with PCOS.

Causes of PCOS

  • Excess insulin is a problem. Insulin is a hormone generated by the pancreas that helps cells to consume sugar, which is your body’s main source of energy. Your blood sugar levels may rise and your body may create more insulin if your cells grow resistant to the effects of insulin. Excess insulin may boost testosterone production, making ovulation problematic.
  • Low-grade inflammation. Inflammation at a low level. The synthesis of chemicals by white blood cells to fight infection is referred to as this phrase. Women with PCOS have a form of low-grade inflammation that causes their polycystic ovaries to create androgens, which can cause heart and blood vessel problems, according to research.
  • Excess androgen. Hirsutism and acne are caused by unusually high quantities of androgen produced by the ovaries.

Common symptoms of PCOS

  • Irregular periods. The uterine lining is not shed every month due to a lack of ovulation. PCOS causes some women to have fewer than eight periods per year, or none at all.
  • Heavy bleeding. Because the uterine lining develops over a longer length of time, your periods may be heavier than usual.
  • Hair growth. Hair grows on the face and body of more than 70% of women with this disorder, including the back, belly, and chest. Hirsutism is the term for excessive hair growth.
  • Acne. Male hormones can induce breakouts on the face, chest, and upper back by making the skin oilier than usual.
  • Weight gain. Up to 80 percent of women with PCOS are overweight or have obesity.
  • Male pattern baldness. Hair on the scalp gets thinner and may fall out.
  • Darkening of the skin. In bodily creases such as the neck, groin, and under the breasts, dark patches of skin can appear.
  • Hormone changes can trigger headaches in some women

Complications of PCOS

  • Infertility
  • Gestational diabetes or pregnancy-induced high blood pressure
  • Miscarriage or premature birth
  • Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
  • Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Depression, anxiety and eating disorders
  • Abnormal uterine bleeding
  • Cancer of the uterine lining (endometrial cancer)

Dietary and lifestyle tips to treat PCOS

  • Infertility
  • Gestational diabetes or pregnancy-induced high blood pressure
  • Miscarriage or premature birth
  • Nonalcoholic steatohepatitis — a severe liver inflammation caused by fat accumulation in the liver
  • Metabolic syndrome — a cluster of conditions including high blood pressure, high blood sugar, and abnormal cholesterol or triglyceride levels that significantly increase your risk of cardiovascular disease
  • Type 2 diabetes or prediabetes
  • Sleep apnea
  • Depression, anxiety and eating disorders
  • Abnormal uterine bleeding
  • Cancer of the uterine lining (endometrial cancer)

Dietary and lifestyle tips to treat PCOS

PCOS treatment usually begins with a change in lifestyle, such as weight loss, nutrition, and exercise.

Losing just 5 to 10% of your body weight can help regulate your menstrual cycle and alleviate the symptoms of PCOS. Weight loss can also:

  • improve cholesterol levels
  • lower insulin
  • reduce heart disease and diabetes risks

Any diet that aids in weight loss can aid in the treatment of your disease. Some diets, on the other hand, may have advantages over others.

  • Low carbohydrate diets are helpful for both weight loss and reducing insulin levels, according to studies comparing PCOS diets.
  • A low glycemic index (low GI) diet rich in fruits, vegetables, and whole grains regulates the menstrual cycle better than a traditional weight-loss diet.
  • Women with PCOS can reduce weight by doing 30 minutes of moderate-intensity exercise at least three times a week, according to a few studies. Exercise-induced weight loss enhances ovulation and insulin levels.
  • When exercise is combined with a balanced diet, it is even more helpful. Diet with exercise aids weight loss more effectively than either intervention alone.

Process of Seed Cycling:

Seed cycling, often known as a seed rotation diet, is a natural remedy for balancing women’s hormones. It is thought to be particularly useful in the treatment of Polycystic Ovarian Syndrome(PCOS) and irregular menstruation cycles.

It is actually used to remedy infertility and symptoms like hot flashes, fatigue, etc. However, there is no scientific proof or approval to back this up.

Women must consume 2 tablespoons of seeds such as pumpkin, flax, chia, sunflower, and sesame seeds when using the seeds cycling method. These seeds have hormone-regulatory qualities and can aid in the body’s maintenance of oestrogen and progesterone levels.

Raw and freshly ground seeds are ideal. You may also include them into other foods, such as oatmeal, milkshakes or cornflakes.

Foods to Eat and Avoid:

Food to Eat:Food to avoid:

High-fiber fruits and vegetables (apples, plums, broccoli, cauliflower)

Leafy greens

Root veggies

Red berries and grapes

Beans, legumes, lentils

Whole-grain or multigrain bread, crackers, pasta, tortillas

Brown rice, quinoa

Oats, rye, barley

Flax, chia, and sunflower seeds

Cottage cheese

Lean chicken or turkey (without the skin)

Fatty fish (salmon, tuna)

Veggie burgers

Eggs, egg whites, egg substitutes

Low-fat and Greek yogurt

Non-dairy milk alternatives (almond, rice)



Coconut and coconut oil

Nuts and nut butters

Olive oil, flax seed oil

Fresh herbs and spices (turmeric, cinnamon, ginger)

Dark chocolate (in moderation)

Green tea

Bread, baked goods, crackers, pasta, and cereals made from refined white flour

Starchy vegetables (white potatoes, corn, peas)

White rice

Red meat

Full-fat dairy

Processed meat (lunch meat, hot dogs, sausage, bacon)

Fried food, fast food

Potato chips, microwave popcorn, salted pretzels

Dried fruit

Packaged snack foods

Frozen meals and snacks

Artificial sweeteners

Granola, cereal bars

Margarine, shortening, lard

Instant noodles, packaged pasta/soup mix

Bouillon cubes, broth, stock

Commercial salad dressing, marinades, seasonings

Milk/chocolate, candy

Ice cream, pudding, custard

Pastries, cake, cookies, pies


Sugary fruit juice

Energy drinks

Gluten and wheat

Soy products (tofu, soy milk)

Medical treatment

Birth control pills and other drugs can help treat PCOS symptoms like hair growth and acne by regulating the menstrual period and regulating the menstrual cycle.

Birth control

Taking progestin daily can:

  • restore a normal hormone balance
  • regulate ovulation
  • relieve symptoms like excess hair growth
  • protect against endometrial cancer. These hormones come in a pill, patch, or vaginal ring.


Metformin (Glucophage, Fortamet) is a type 2 diabetes medication. It also aids in the treatment of PCOS by lowering insulin levels. Metformin, when combined with dietary and activity adjustments, promotes weight reduction, reduces blood sugar, and restores a normal menstrual cycle better than diet and exercise alone, according to one study.


Clomiphene (Clomid) is a fertility drug that can help women with PCOS get pregnant. It’s important to note that, as you’re discussing family planning, to keep in mind that clomiphene increases the chances for twins and other multiple births.


If alternative therapies fail to increase fertility, surgery may be a possibility. Ovarian drilling is a technique that uses a laser or a thin heated needle to create microscopic holes in the ovary to restore regular ovulation.

Dn.Sadia Fatima is Director and Co-Founder of SDNO. She is a great nutrition entrepreneur and leader. Her actions inspire others to dream more, learn more, do more and become more. She can be reached at @nutracare21_.

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Disease Food Knowledge Nutrition

Foodborne Illnesses and their Types

Do you know about food-borne illnesses?

About six Americans get sick from these types of illnesses according to the (CDC). Illness leads to complications if not managed properly. “Health promotion” consists of safe food and water supply. Investigation of outbreaks caused by foods is very important. The groups of foods have ingredients associated with concerns about the safety of food.  When new methods of producing foods are introduced then many outbreaks take place.

What are different types of common foodborne illnesses?

Let us talk about the illnesses, onsets, and durations.


Symptoms along with signs

Duration and onset

B. cereus

Watery (diarrhea) with vomiting

6-15 hrs. (after taking contaminants) and duration is 24 hours


C. jejuni

Bloody diarrhea and abdominal cramping

(2-5 days) after eating contaminants and duration is 2-10 (days)


Clostridium botulinum

Muscle paralysis, eyelids drop, dryness of mouth, infants are lethargic and constipated, and muscle tone is poor

In foodborne illness, symptoms generally begin 18-36 hours after eating contaminated food and the duration is days/months


Clostridium perferengens

Nausea/vomiting, acute gastroenteritis, and diarrhea

Within 6-24 hrs. after eating the food contaminated with contaminants


Cryptosporidium parvum

Stools (watery), nausea, fever, and cramping

2-10 days (after eating food)


Enterotoxigenic Escherichia coli (ETEC)

Diarrhea, fever (low-grade), and malaise

With high dose (infective) diarrhea can be induced within 24 hours


Enterohemorrhagic E.coli (EHEC)

Painful (diarrhea)

Slow onset and duration is 5-10 (days)


Listeria monocytogenes (LM)

Fever (mild), vomiting, sepsis, febrile gastroenteritis, and headache

Onset 2-30 (days)



Gastroenteritis, abdominal cramping, chills, and aches in muscles

After eating contaminated food (24-48 hours), and can be 12 hours in some cases



Diarrhea, and cramping

After eating food (12-72 hours)



Diarrhea, and stomach cramping

After eating contaminated food (12-48 hours)


Staphylococcus aureus

Nausea, retching, and prostration

Hours (1-6), and duration is (1-2) days


Streptococcus pyogenes

Red throat, tonsillitis, headache, vomiting, rhinorrhea, and rash

Days (1-3)


Vibrio vulnificus

Vomit, diarrhea, and mild illness

Gastroenteritis after 16 hours of eating food


Yersinia enterocolitica

Fever, diarrhea, right-sided abdominal pain, and appendicitis

After exposure (1-2) days

What are critical control points?

A strategy that is used to control foodborne illness. “Risk management” consists of evaluation, options assessment and implementation, monitoring, and then the review of the whole process. (HACCP) involves monitoring biological, chemical, and physical agents. It also monitors those critical points where control can be applied. So, it ensures proper food safety education which is necessary for all people involved in serving food to the population.  Adoption of Hazard Analysis Critical Control point (HACCP) regulation, food quality assurance programs, handling of freshly produce guidelines, technologic advances designed to reduce contamination, enhanced food supply regulations, and a greater emphasis on food safety education have contributed to a potential decline in illnesses caused by food.


What is the term “contamination” and is food and water safety important?

Precautions in the region of contaminants are very important. Many public water supplies, built using 20th-century technology, will need to invest more than one hundred and thirty-eight million dollars during the next 20 years for safe drinking water. Seafood is in contact with methyl-mercury. So, pregnant women need precautions in eating these kinds of plates of seafood. The dietetics professionals play an important role in spreading this kind of education. The (CFSAN) provides guidance and monitoring as well. On the other hand, we need to know the importance of food and water safety. We have to reduce pesticides, ensure safe food handling practices, reduce incidents and spreads of diseases with the administration of water, and reduce many environmental pollutants. The following are food and water safety resources:

  1. Agricultural Marketing Services, (USDA)
  2. The Academy of Nutrition and Dietetics Duplicate
  3. The (CFSCAN)
  4. The (CDC)
  5. The (FEMA)
  6. Food Marketing Institute
  7. FoodNet
  8. Foundation for Food Irradiation Education
  9. International Food Information Council
  10. National Broiler Counsel
  11. National Institutes of Health (NIH)
  12. National Restaurant Association Educational Foundation
  13. Produce Marketing Association
  14. S. Department of Agriculture
  15. S. Department of Education
  16. S. EPA _ Office of Ground and Drinking Water
  17. S. Food and Drug Administration (FDA)


What is bioterrorism?

“A deliberate use of microorganisms to induce disease”. The seven foodborne pathogens are introduced by (CDC):

  • Tularemia
  • Brucellosis
  • Clostridium botulinum toxin
  • Clostridium perferengens toxin
  • Salmonella
  • coli
  • Shigella

Current surveillance networks are designed to detect foodborne illnesses. Food serves as a vector (a primary agent). So, rapid communication and analysis of disease are important.


What is meant by a healthy food system?

To serve the population is the main aim of community nutrition as a field. (ADA) in 2014, issued some standards of professional importance. This ensures to sustain this type of application of standards for a prolonged time. The system is built and nourished properly which ensures sustainability. The safety, as well as the quality of the food and water supply, are components that built sustainability.

Dietitian Zoya Faisal is a Gold medalist in Doctor of Nutrition and Sciences (UMT), and did her M.Phil in food and nutrition (UVAS), Pakistan. She can be reached at

Doctor Awais Ibrahim Bajwa (MBBS), Mohiuddin Islamic Medical College, Pakistan, and clinical instructor in University of management and technology, Lahore campus. He can be reached at

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Health Disease Female Health Knowledge Nutrition

The complete beginner’s guide to Pre-Menstrual Syndrome

Menstrual cycle is a normal phase which every female has to face during her days of puberty. This cycle holds great significance as it is associated with the release of various hormones in female body and for well-being. There is a term called as Pre-menstrual cycle or syndrome which we often hear but only a few of us are aware with the actual meaning of this word.

PMS stands for Pre-menstrual syndrome and includes a series of physical and emotional symptoms which women feel before the start of their menstrual period and after ovulation. Such symptoms are usually seen after the days of ovulation due to the drastic fall in estrogen and progesterone levels and go away within a few days when women’s menstruates. The signs are mild in some women while in some cases, the symptoms are so severe that the daily activities are disrupted.


Pre-menstrual syndrome holding a series of various symptoms are often seen in women who:

  • Have high level of stress due to various factors
  • Have a family history of depression and other non-communicable diseases
  • Have a history of postpartum depression

Symptoms of Pre-Menstrual syndrome

Women often ask that when do PMS symptoms start. Sometimes there are PMS symptoms but no period. There are potential signs and symptoms that indicates the presence of pre-menstrual syndrome faced by women of various age groups who menstruate each month.

Behavioral signs and symptoms

Physical signs and symptoms


Muscle or joint pain

Depressed mood


Mood swings



Weight gain or fluid retention

Sudden episodes of anger


Sudden food cravings

Bloating in abdominal region


Breast tenderness

Social withdrawal

Acne or break outs on face

Poor concentration

Constipation or Diarrhea

Change in libido

Alcoholic Intolerance


Causes of Pre-menstrual syndrome

Scientific researches have concluded that there are no specific causes of PMS or severe PMS disorder. People experience the symptoms in a more severe way and here are a few theories suggested for you which are considered as causes of pre-menstrual symptoms.

  1. Hormonal changes

Experts suggests that PMS is a response to changing levels of hormones in body. The major hormones involved are estrogen and progesterone that naturally fluctuate throughout the menses cycle. Hormones reach a specific peak and then rapidly decline during the luteal phase followed by ovulation. It leads to anxiety, irritability and changes in mood.

  1. Chemical changes in the brain

Chemical messengers are also a factor of symptoms of PMS. The neurotransmitters called as serotonin and norepinephrine are important for bodily functions. They help to regulate mood, emotions and behavior. A sudden drop in estrogen leads to release of norepinephrine. It leads to decline in production of dopamine, acetylcholine and serotonin. Such changes eventually triggers sleep problems leading to low or depressed mood changes.

  1. Lifestyle factors

Our lifestyle plays a significant role in maintaining our overall health. Potential lifestyle factors can worsen the PMS symptoms leading to irregular menses. The factors worsening the condition are:

  • Smoking
  • Eating lots of high fat food
  • Consuming excessive sugar and salt
  • Lack of quality sleep

PMS affecting other health problems

Due to lack of awareness, majority of the women are not able to detect the pre-menstrual symptoms. There is a need to normalize the concept of premenstrual syndrome meaning in Urdu. There are many other health problems which gets worse before the menstrual period starts. These health problems has association with PMS including:

Depression and anxiety disorders

These are the common conditions that overlap with PMS. Depression and anxiety symptoms get worse before the menstrual period starts.

Myalgic encephalomyelitis or chronic fatigue syndrome

Women suffering from ME/CFS are more likely to have heavy menstrual bleeding, premature menopause or no menses at all.

Irritable bowel syndrome

IBS can lead to cramping, bloating and abdominal gas. These symptoms get worse before the period starts.

Bladder pain syndrome

Women who suffer from bladder pain syndrome have painful cramps during PMS.

Methods to ease the symptoms of PMS

There is a cure to every problem and so is the case with Pre-menstrual syndrome. The symptoms of PMS can be slowed down by adopting the following methods:

  • It is recommended to drink plenty of fluids for easing the abdominal bloating. You can consume herbal teas including chamomile or red raspberry leaf that may ease cramping.
  • Try to consume an overall balanced diet including all five servings of food groups. Focus on the intake of whole grains, fruits and vegetables.
  • Cut back on the items like sugar, salt, excessive caffeine and alcohol which can trigger the symptoms.
  • You can seek help from healthcare professional in case of excessive cramps and mood symptoms. You can try supplements like folic acid, vitamin B-6, calcium and magnesium.
  • It is recommended to get more vitamin D in the form of natural light, food or through supplements.
  • Try to get maximum sleep of 7 to 9 hours each night to help relieve fatigue and overall health.
  • Try at least half an hour of physical activity on daily basis. It is necessary to help relieve bloating and cramping and also lessens the anxiety and depression symptoms.

Diet related suggestions

A healthy diet plays a major role in overall well-being of a person. A balanced diet can cure all sort of symptoms associated with PMS too. Good food leads to good mood so here are few suggestions which can be adopted to lessen the PMS symptoms.

  1. Intake of high-quality calcium foods

According to studies, it has been seen that women who consume the highest intakes of calcium and vitamin D are less likely to develop PMS. It is recommended to consume calcium at about 1200 milligrams per day. RDA for women of age group 19-50 years should consume 1000 mg. RDA for women below 70 years regarding vitamin D consumption is 700 IU and above 70 years is 600 IU.

Calcium works in the brain to relieve some depression symptoms while vitamin D influences emotional changes. Calcium and vitamin D can be consumed through diet from various dietary sources such as:

  • Low-fat milk
  • Cheese
  • Yogurt
  • Fortified orange juice
  • Soy milk
  • Salmon
  • Fortified milk


  1. Don’t skip breakfast

It is recommended to never skip breakfast in any means. Try to consume regular meals and snacks throughout the day. It is beneficial to start the day with breakfast as it has various benefits. PMS includes a hormone storm and can affect the appetite of person. The mood becomes more irritable when a person skips meals and leads to rise in blood sugar levels.

  1. Consume whole grains, lean protein, fruits, and vegetables

Eating a nutrient rich and balanced diet can prevent the person from various health problems. It is a better approach to eat well to tweak the symptoms of PMS. Try to include plenty colorful and fiber-packed vegetables and fruits in your diet which are rich in antioxidants. Consume the maximum servings of whole grain foods like brown rice, oatmeal and rye bread to cure bloating.

It is also a good approach to consume Vitamin B-fortified breads and cereals. Researches have proven that higher intakes of thiamine and riboflavin can lower the risk of PMS. But the source should be through diet, not from the supplements. Initiate complex carbohydrates in diet which can help to stabilize your mood and keeps the cravings under control. Complex carbohydrates include lentils, potatoes and unprocessed oats providing the feeling of fullness and moderately rises insulin levels.

Focus on consuming iron-rich foods from lean meat sources to avoid anemia. Iron-rich foods are necessary to avoid any sort of anemic problem as heavy menstrual bleeding can lead to loss of blood in female body. Don’t forget to remove the excess fat from the meat sources. If you are a vegan, then you can ask your doctor for an iron supplement too in order to avoid iron deficiency.

  1. Don’t overload on sugar items

Cravings for sugar is a common issue faced by females showing symptoms of PMS and is difficult to resist it. It is due to the shifting levels of estrogen and progesterone hormones and can also decrease the serotonin levels in brain. All these changes trigger the PMS symptoms and affect’s the mood in a woman. Studies have shown that a women with PMS should consume extra 200-500 calories per day. But, in our daily life those extra calories come from sweet foods and fats. It is advisable to consume whole grains instead of sugars to boost the serotonin levels.

To avoid sugar cravings, you can snack on nuts which are rich in omega-3 fatty acids and provide the feeling of fullness in body. There are variety of nuts like pecans, walnuts, almonds and hazelnuts. A person should munch on healthier sources of snacks instead of sugary items to avoid inconvenience in health.


There are some prescription medicines and over-the counter pain relievers that can help to treat some PMS symptoms.

  • Over-the-counter pain relievers

These are available on almost all sort of medical stores which help to lessen physical symptoms like cramps, headaches, backaches and breast tenderness. These pain relievers include:

  • Naproxen
  • Aspirin
  • Ibuprofen


  • Prescription medicines

You can also seek help from prescription medicines, if in case over-the-counter medicines are not working. These includes:

Antidepressants: These can help to relive emotional symptoms of PMS in some women where other medicines are not working. SSRIs (selective serotonin reuptake inhibitors) are the common type of antidepressants used to treat the symptoms of PMS.

Diuretics: They are also called as water pills and helps to reduce the symptoms of bloating and breast tenderness.

Anti-anxiety medicines: These may help to reduce the feelings of anxiousness.

It is recommended to consult your doctor before taking any sort of medicine as they can have side effects too. Avoid taking any sort of medication without prescription.

Supplements and vitamins

Vitamins and minerals also help to relieve the symptoms of PMS. FDA does not regulates vitamin and minerals or any sort of herbal supplements like they regulate medicines. It is recommended to talk to your doctor before taking any sort of supplement.

Here we will discuss some benefits of vitamins and minerals which help to ease the symptoms of PMS.

  1. Calcium:Calcium is a mineral found in foods such as milk, cheese, yogurt and other dairy products. It helps to reduce some PMS symptoms including fatigue, cravings and depression. There are also some fortified cereals, breads and orange juices available in market which have calcium added in them. These items can also be implemented in diet instead of a calcium supplement.
  2. Vitamin B6:This vitamin may also help to treat the PMS symptoms including moodiness, irritability, forgetfulness, bloating and anxiety. Vitamin B6 is found in various food items like fish, poultry, potatoes and fruits excluding citrus fruits and fortified cereals.
  3. Magnesium:It helps to relieve some symptoms of PMS including migraines. Magnesium is rich in green leafy vegetables such as spinach, nuts, whole grains and fortified cereals. It can also be taken as a supplement.
  4. Omega-3 and omega-6 fatty acids:Polyunsaturated fatty acids help to reduce cramps and other PMS symptoms. Flaxseeds, nuts, fish and green leafy vegetables are some good sources of polyunsaturated fatty acids.

Related questions

What syndrome is common before the period starts? PMS known as pre-menstrual syndrome is a combination of syndrome seen before the start of menstrual cycle in women. The symptoms include bloating, headaches, and moodiness.

How long does the PMS lasts in a women? PMS called as pre-menstrual syndrome lasts for about 2-3 days after the period begins. The symptoms are worse during the starting days of period. Certain body changes and mood changes are seen during this phase.

Why does a female feel crazy before her period? Low levels of serotonin causes the feelings of sadness and irritability. This neurotransmitter helps to regulate the mood, sleep cycle and appetite in a person.

What are signs which indicate that date of menstrual cycle is near? There are some signs which indicate that period is coming which includes:

  • Soreness or heaviness in breasts
  • Break outs on face
  • Tiredness and cramps
  • Constipation or diarrhea
  • Bloating
  • Headache and mood swings

Why does females get anxiety before a week of their period? The rollercoaster of hormones affects the neurotransmitters in brain such as serotonin and dopamine. These are associated with mood regulation and leads to increase in symptoms such as anxiety, depression and mood swings.

How can a female balance her hormones before the period starts? Hormones can be balanced during and before the start of periods through the following means:

  • Get enough sleep
  • Exercise regularly
  • Eat complex carbohydrates, proteins and healthy fats
  • Drink a lot of water

Dn.Zainab Naeem is Hosting and Content Writing Head of SDNO. She is a freelance nutritionist and writer, and also a self-taught calligrapher, artist and chef.  She can be reached at @xayni_de_artista.

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Disease Food Health Nutrition


Obesity is an excess of adipose tissue or body fat. It can be defined as a proportion of body weight composed of adipose tissue (percent body fat) that exceeds a range that is considered healthy. Adult males are generally considered obese when their percent body fat is 25% and adult females are considered obese when their percent body fat is 33%.

Methods to detect obesity

1- Body Mass Index:

Because it is often impractical to determine body composition in the clinical setting, and because accurate measurements of height and weight can be easily obtained, obesity in adults is often defined as a BMI of more than 30.0 kg/m2. Though not a direct measure of body fatness, BMI (also known as Quetelet’s index) can be considered a proxy for measures of body fatness and is regarded as a convenient and reliable indicator of obesity. Overweight is a body weight in excess of some standard  weight, usually in relation to height. In adults, overweight is generally defined as a BMI of 25.0-29.9 kg/m2, “healthy weight” is defined as a BMI of 18.5-24.9 kg/m2, and underweight is defined as a BMI below 18.5 kg/m2.

2- Waist Circumference

A practical approach for estimating the amount of adipose tissue in the hips and thighs is to measure the circumference of the hips or buttocks. This measurement is taken at the point yielding the maximum circumference around the hips or buttocks. Waist circumference is particularly useful in assessing the disease risk of patients who are categorized as having a healthy body weight (BMI of 18.5224.9 kg/m2), who are considered overweight (BMI of 25.0229.9 kg/m2), or who are mildly obese with a BMI of 30.0234.9 kg/m2.



40 inches (102 centimeter)


35 inches (88 centimeter)

3- Waist to Hip Ratio

The WHR(Waist to Hip Ratio) is calculated by dividing the WC measurement by the hip circumference measurement. A WHR 1.0 results when WC is greater than hip circumference. The WHtR(Waist to Height Ratio) is calculated by dividing a person’s WC by his or her height. Both have been shown to better identify health risks than BMI alone.

Shapes of obesity

1- Pear Shape

It combines a slimmer “ectomorph” upper body with an “endomorph” lower body. People with this shape have extra fat in the hip and thigh area. It is more common among women, and it may be part of the reason they often live longer than men.

2- Apple Shape

It is also called a “beer belly,” which means you have more fat stored around your stomach, while your lower body stays thin. It is more common in men, and it’s worse for your health than the pear shape. That is because belly fat is often a sign that you have more fat deeper inside, around your internal organs, as opposed to just beneath the skin. This kind is more closely linked to heart disease, cancer, type 2 diabetes, and high cholesterol.

Etiology of obesity

Obesity develops when the body’s chronic energy intake exceeds its energy expenditure. At first glance this may seem simple and straightforward. However, because of the multiple and complex neuroendocrine and metabolic systems influencing energy intake and energy expenditure, obesity is actually a heterogeneous group of disorders. Its etiology remains elusive, and its successful, long-term treatment is difficult.Among the key factors contributing to obesity are specific medical and psychiatric disorders or their treatment, genetics, and an obesogenic environment that promotes a high energy intake and discourages physical activity.

Medical Nutrition Therapy

1- High protein energy-restricted diets:

They result in larger reduction of body weight, reduction of body fat mass and long-term weight loss maintenance. They promote a sustained level of satiety, sustained energy expenditure and increased fat oxidation and sparing of fat-free mass.

High Protein foods include:

  • Meat
  • Poultry
  • Fish
  • Eggs
  • Lentils
2- Low-Carbohydrates diet:

The low-carb diet is that decreasing carbs lower insulin levels and causes the body to burn stored fat for energy, which ultimately leads to weight loss.

A low-carb diet restricts foods high in carbs including

  • Sugar
  • Gluten Grains
  • Trans Fats
  • Artificial Sweeteners
  • Highly Processed Foods

Allowed foods in low-carbs diet

  • Fruits
  • Vegetables
  • Whole grains

Physical Activity

Physical Activity is bodily movement produced by skeletal muscles that requires energy expenditure(can be measured in kilocalories). When combined with dietary changes, physical exercise can result in additional weight loss, and when not combined with dietary changes, it can result in modest weight loss. Furthermore, physical activity is linked to enhanced long-term weight loss and weight loss maintenance after initial weight loss.

Dn.Khadija Naseer is Consultant dietitian at Din Medical Complex Burewala, Lecturer at Masterjii Network. She can be reached at @dn.khadijanaseer.

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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Disease Food Health Nutrition



by Dietitian Zoya Faisal on January 27th,2022

Our digestive system is one of the most important part of our body and involves various organs and associated structures which helps in maintaining the metabolism of body and helps the digestive system to work properly. Without a healthy digestive system, it is not possible for us to survive in a healthy way. Sometimes our behavioral and dietary habits upset the mechanism of digestive system which provokes various health related issues such as GERD and esophagitis. So let’s discuss the causes and dietary management of GERD.

Gastroesophageal reflux disease (GERD) is a condition in which the lower esophageal sphincter relax transiently and permits the contents to enter the esophagus. Regurgitation and spitting up of components are the main symptoms of GERD. GERD is totally treatable disease and can be treated through adopting various behavioral and dietary modifications.

Photo Credits: Cleveland Clinic

Etiology of GERD

It is a normal physiologic process that occurs several times a day in infants (healthy), children, and adults. We can associate this condition with transient relaxing of the (LES) lower esophageal sphincter (permit contents to enter the esophagus). In about 50% of infants, regurgitation and spitting up are the main symptoms. In simple words, we can say that this condition arises when the reflux of gastric contents in the esophagus occurs (it can also reflux back and go to the oral cavity/lungs). HEART BURNING is more prevalent in developed countries than in ASIA. Esophagogastroduodenoscopy (EGD) helps in identifying different types of GERD. GERD can be classified as the presence of symptoms without abnormalities or erosions on endoscopic examination (non-erosive disease or NERD) or GERD with symptoms and declines present (ERD). 

(ERD) has more severe symptoms than (NERD). There is a condition called nocturnal GERD in which patients experience symptoms more at night time than in day time. Nocturnal GERD leads to esophagitis (inflammation) of the esophagus and the patient has difficulty sleeping. (ERD) is more common in men, and (NERD) is more common in women. GERD is also linked with obesity. Different studies show that GERD is more common in those with high BMI. GERD is also common in pregnancy and can occur in any trimester. 

Coming towards its pathophysiology

GERD has a complex pathophysiology. Read the table below to know the possible causes.

       Let’s try to find out the mechanisms involved in the cause of GERD.

  • You can get this condition when your saliva is decreased
  • Transient lower esophageal sphincter relaxation is a cause of GERD
  • When (LES) pressure is down, you can get GERD
  • Impaired esophageal acid clearance
  • An increase in the sensitivity of one’s esophagus leads to GERD
  • Acid pocket (during the postprandial period)
  • Growth in the intraabdominal pressure leads to this condition
  • Delayed gastric emptying

The esophagogastric junction has three components: (LES) a 3-4 cm segment made by smooth muscles, the crural diaphragm, and the anatomic flap valve. (Anti-reflux barrier)

The tone of (LES) varies. 

The gastric distension enhances the relaxation of (LES). On average, transient (LES) relaxations persist for about 20 seconds, significantly longer than the typical swallow-induced relaxation. The reflux occurs when the pressure in the proximal stomach increases. Patients with (COPD) are at more risk as their intraabdominal pressure is high. It is the same case with the pregnant population and obese persons. The erosive esophagitis leads to hypersensitivity. It is also caused by impaired mucosal barrier function. The studies show us that delayed gastric emptying ultimately leads to GERD. Some studies support that this relationship has nothing to do with developing this condition (GERD). We have to overcome the complications. 

Behavioral modifications (Esophagitis) 

We should avoid

  • Eating within three to four hours of retiring
  • Lying down after meals
  • Tight-fitting garments
  • Cigarette smoking  

Nutrition management of GERD

Firstly we have to set our small and short-term goals. We have to decrease the exposure of the esophagus to gastric contents. We have to reduce the acidity of gastric secretions. We have to prevent pain and irritation. There are certain things which we have to avoid. 

  1. Large meals
  2. Fat (dietary)
  3. Alcohol 
  4. Coffee more than one cup in a day
  5. Fermented alcoholic beverages
  6. Any food that the patient feels exacerbate their symptoms

Dietitian Zoya Faisal is a freshly graduate nutrition student and is clinical internee at Farooq hospital, Lahore. She can be reached at @doctors_and_dietitians

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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