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Relationship Between PCOS and Insulin Resistance

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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.

Alcohol

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 [email protected]

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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