Dietary managements for pcos. .pptx

Pcos diet

1. POLYCYSTIC OVARY SYNDROME By R. L akshmi Mahendran JSSINYS

2. BASICS Hypothalamus –GnRh –pituitary gland –FSH FSH-formation of the follicular growth-estrogen Estrogen acts on uterus –proliferate the endometrium Estrogen – negative feedback to hypothalamus –stop FSH Endometrium – positive feedback -LH

3. CONT….. LH –increases –rupture the follicle –forms corpus lutem It forms – progesterone –forms secretion in the endometrium .

4. PCOS PCOS is a highly inherited complex polygenic ,multifactorial disorder. Endocrine –metabolic disorder in reproductive age of female characterized by amennorrhea,obesity,hirsuitism and is associated with enlarged polycystic ovaries. Known as Stein levanthal syndrome & HAIRAN syndrome.

5. ETIOLOGY GENETIC FACTORS (cytochrome P450-CYP-17,11 alpha) INSULIN RESISTANCE LIFEESTYLE & DIETARY MODIFICATION ENVIRONMENT FACTORS

6. SIGNS & SYMPTOMS Menstrual irregularities Weight gain Hirsuitism Acanthosis nigricans Acne Depression & anxiety

7. pathophysiology Defective aromatisation in the ovary Theca cell hypertrophy Normal peripheral aromatisation

8. Health risk Heart disease Pregnancy complication Psychological disorder Obesity Endometrium cancer Diabetes mellitus

9. D iagnose Rotterdam criteria Hyperandrogenism (acne, hirsutism , hair loss,free testosterone) Ovulatory dysfunction US

10. GOALS Regulation in cycle Promote weight loss Correct of metabolic abnormalities (cholesterol, insulin resistance ,blood sugar, HTN) Balance hormones Improve fertility Prevent complication

11. Guidelines Obtain medical history( lab,med,family, DM ,HTN Symptoms( MC ,skin ,hair, craves) Weight gain & diet Mood swings ,sleep & energy level Physical activity & work Educate on PCOS,IR ,complication Set small goals

12. objectives Increased regularity of menstrual cycle Decreased levels of androgens Improvement in lipid levels Decreased risk of diabetes Improves insulin sensitivity Weight loss.

13. Diet plan CARBOHYDRATES – low – only for weight loss –improves ovulation , testosterone levels & insulin resistance.( rev-15 article) PMID-24914605.

14. PROTEIN Boost metabolism –thermic effect -15 -30 % Satiety –stimulates production of cholecystokinin ,glucagon –like peptide 1,peptide yy –reduce craving & appetite. Hormones – glucagon increase. 40 g /day Weight loss & improvement in glucose metabolism (PMID-22158730)

15. FAT GOOD FAT –GHEE ,COCONUT OIL ,OLIVE OIL PMID -34371961 Nutrition strategy & life style in pcos -narrative review.

16. ADD OMEGA 3 FATTY ACID –EPA ,DHA & ALA Acts on the inflammation & oxidative stress Reduces the endoplasmic reticulum stress causes by metabolic abnormalities. Reduces lipid deposition in the cells Improves insulin sensitivity Improves the insulin action on the ovary

17. Cont.….. Inflammatory –it blocks the NF –KB signaling pathway –protect against abnormal expression of inflammation factor. Hormonal levels –inhibits the arachidonic acid induced activation of acute regulatory protein factor & regulates the expression of LH ,reduces testosterone .( PMID-29580250)

18. ADD VITAMIN D – 3 of 5 with pcos will have vit D def. Increase insulin sensitivity by stimulating expression of insulin receptor Vit D & OMEGA 3 FATTY ACIDS.

19. ADD FENUGREEK – Saponins ,trigonelline & flavonoids Contains vitamin ,minerals ,antioxidants Regulates on ovarian androgen biosynthesis ,theca cell proliferation & endometrium growth. Maintains the LH /FSH ratio MC regulation Improves pregnant rate.

20. ADD FLAX SEEDS – lignan which increases SHBG reduces androgen levels PINEAPPLE – bromelain -regulate the cycle,Mn –prevents PMS. BERRIES –contain high antioxidants which increases insulin sensitivity

21. ADD CINNAMON –flavonoids & polyphenols Free radical scavenging activity & antioxidants Reduce fasting blood glucose ,insulin ,IR , total cholesterol, LDL. Reduces serum triglycerides & BMI 1.5 g /12 weeks –MC regular & lipid profile

22. ADD POMEGRANATE – Phytochemical & antioxidant & enriched probiotic. Reduced androgen levels - reduces hirsuitism Acts on IR ( PMID -30538082)

23. ADD PAPAYA – contains carotene regulates menstruation ZINC –acne & hair growth MAGNESIUM –improves in IR CHROMIUM – reduces the blood glucose & controls craving ,reduces hunger( onion ,tomatoes , wholegrain,potatoes )

24. MANAGEMENT LOW CARBS HIGH PROTEIN DIET LOW GLYCEMIC INDEX FOOD LIFE STYLE CHANGES PHYSICAL ACTIVITY SLEEP