Normally, during each menstrual cycle, many small follicles grow in your ovaries and form eggs. At mid-cycle, or ovulation, one egg is released from one of the ovaries and all the other follicles over-ripen and break down. However, in PCOS, ovulation does not occur and an egg is not released. The follicles don’t break down, but fill with fluid and turn into cysts. The ovaries can then swell in size, sometimes becoming two to five times larger than normal.

As to the exact cause of this condition doctors are still uncertain, but research suggests that the ovaries of women with PCOS produce more male hormones known as androgens (such as testosterone) than normal because the women can’t process insulin properly. This insulin resistance is caused in part by lifestyle factors including being overweight due to poor diet or physical inactivity.¹

Signs and Symptoms

Symptoms can begin at any age, they may develop during puberty and the start of menstrual periods may be delayed or not happen at all. Each woman’s symptoms may be different, but usually they will include some or all of the following:

• Excessive hair growth on the face, chest or abdomen
• Irregular or absent periods
• Abnormal bleeding from the uterus
• High blood pressure
• Acne
• Obesity, particularly centred around the middle
• Thinning hair or hair loss in a classic male baldness pattern
• Difficulties getting pregnant or infertility
• Symptoms of diabetes, such as thirst or excessive urination, vaginal thrush (candidiasis) or chronic skin infections
• Polycystic ovaries shown on ultrasound, although this sign may not always be present. Conversely, about 20% of women who have not gone through menopause are shown to have polycystic ovaries on an ultrasound yet they may have no symptoms of PCOS itself.

Preferred Dietary Approaches

It is thought that the combination of an unlimited food supply and a modern sedentary lifestyle can trigger full-blown PCOS with insulin resistance and infertility.² The most beneficial way to deal with the symptoms and cause of PCOS is through dietary modifications.

Dietary changes can include:

• Avoiding sugary foods. The worst offenders are soft drinks, cookies, cakes, chocolate, sweets, and processed breakfast cereals.
• Avoiding foods containing unhealthy sugar compounds such as high-fructose corn syrup, sorbitol, mannitol, maltitol, isomalt, and glycerol.
• Consider swapping out your sweets for fruits. You should be getting two servings of fruit daily and it’s a much healthier “sweet” option.
• Increase the consumption of vegetables. Ideally you should consume five servings of vegetables daily.
• Obtain organic fruit and vegetables if possible. Organic produce is a better option as your hormone imbalance may make you overly sensitive to the hidden chemicals commonly found in conventional fruit and vegetables.
• Limit processed grain-based foods such as boxed breakfast cereals, white bread, and pasta. Choose small amounts of whole grain alternatives.
• Fiber contributes to improved blood sugar control and healthy bowel function. Aim to eat 25-30 grams of fiber per day.
• Protein helps balance your blood sugar and can help tame a sweet tooth. Fresh fish, lean red meat, organic chicken, organic eggs, whole grains, and legumes are all good sources of protein.
• The type of fat in your diet plays an important role in assisting with insulin reception at the cell level. Cold-water fish, organic eggs, avocadoes, extra virgin olive oil, and raw nuts and seeds are rich in essential fatty acids.
• Ensure you eat regularly and choose healthy snacks mid-morning and mid-afternoon to balance your blood sugar levels between meals. Fruit, nuts, seeds and natural yogurt all make healthy snacks.

Nutritional Supplements That Are Considered Helpful

Co-Enzyme Q10 – Important for energy production and normal carbohydrate metabolism

Chromium – Helps to control sugar cravings and encourages the formation of glucose tolerance factor (GTF), which is a substance released by the liver and required to make insulin more efficient at transporting glucose into the cells.

B Vitamins – Important in helping to correct the symptoms of PCOS. Vitamin B2 helps to turn fat, sugar, and protein into energy. B3 is a component of GTF, which is released every time blood sugar rises and also helps to keep the levels in balance. Vitamin B6 is important for maintaining hormone balance and together with B2 and B3 is necessary for normal thyroid hormone production. B vitamins are also essential for the liver to convert your old hormones into harmless substances, which can then be excreted from the body.

Zinc – Important for appetite control and also necessary for the correct action of many hormones, including insulin.

Magnesium – Levels have been found to be low in people with type 2 diabetes, and there is a strong link between magnesium deficiency and insulin resistance. It is, therefore, an important mineral to include if you are suffering from PCOS

Lifestyle Changes

Weight loss and exercise are known to improve insulin sensitivity and reduce the risk of progression from impaired glucose tolerance to diabetes. Weight loss is also encouraged as it may help induce ovulation and make menstrual cycles more regular.³ Although weight loss can help, altering the diet can have a profound influence on insulin sensitivity.

The recognition of the link between PCOS and insulin resistance offers an excellent opportunity for early intervention to prevent or delay the onset of type 2 diabetes. On the balance of evidence, a diet low in saturated fat and high in fiber with predominantly low glycemic index carbohydrate foods would appear to be the most logical choice for women with PCOS. Such a diet may help short term in improving the symptoms of this condition, as well as long term in reducing the risk of diseases linked with insulin resistance. In the long term, according to current evidence, these lifestyle changes can help with abdominal obesity, hyperandrogenism, and markers for insulin resistance.⁴

Long-term Risks Associated with PCOS

Long-term complications can appear in women of all ages and women with PCOS have an increased risk of:

• Insulin resistance
• High blood fats/cholesterol
• Heart disease (cardiovascular disease and stroke)
• Pre-diabetes/type 2 diabetes
• Endometrial cancer
• Reduced fertility

Fortunately, with early diagnosis and effective management, the symptoms of PCOS can be treated and the long-term health risks can be prevented, delayed, or minimized.

References:

1.”What causes PCOS.” Managing PCOS. August 2011

2. Holte J. “Polycystic ovary syndrome and insulin resistance: thrifty genes struggling with over-feeding and sedentary life style?” Journal of Endocrinol Invest 1998, 21 (9):589-601

3. “Polycystic Ovary Syndrome (PCOS).” Merck Manuals. November 2012

4. Moran, L., et al., “Lifestyle changes in women with polycystic ovary syndrome.” Cochrane Database of Systematic Reviews, 2011(2).

Photos courtesy of Shutterstock.

The post Polycystic Ovary Syndrome: What Is PCOS and How to Treat It With Diet appeared first on Breaking Muscle.

It’s important to give your body the ability to react favorably to the things you eat, but the presence of insulin resistance may be the most substantial way to curtail your results in the gym and to negatively impact your health. It’s common sense and common knowledge these days to have good dietary habits and to avoid excessive sugar intake to prevent metabolic diseases like diabetes. Most people are already aware that reducing body fat can help the symptoms of diabetes as well. Yet despite this, diseases like diabetes are on the rise. Metabolic diseases can make your life and maintaining good health a challenge. But how does exercise influence your insulin resistance?

A recent study in the International Journal of Behavioral Nutrition and Physical Activity looked at how insulin sensitivity is mediated by exercise. To do this, they had an uphill climb to eliminate the confounding variables – those other aspects of health and behavior that might cloud the results. They considered, but factored out cardio fitness, body fat, sex, age, and smoking status from the results to obtain the real answers.

They found that moderate to vigorous daily activity was more important than actual cardiorespiratory fitness level for impacting insulin resistance. Just getting out there and exercising on a regular basis will lower insulin resistance, and thus improve your health by reducing metabolic disease. The results also suggest the amount of time spent exercising may be an important part of improving the body’s response to glucose. Insulin resistance was improved by 25% going from no exercise to 60 minutes of exercise per day. It improved 50% from no exercise to 120 minutes of exercise. In addition to the more vigorous types of exercise, there was a trend for higher insulin sensitivity even doing light exercise such as walking, but not a significant one. It could be that the stimulus for improved glucose metabolism requires glucose utilization.

It’s probably no surprise to the readers of Breaking Muscle that exercising daily is important for health, but it can help motivate when you know some of the reasons why. If you’ve been trying to improve your health or get someone else motivated to exercise on a regular basis, solid research like this is a good resource. Also, good insulin sensitivity will help you achieve greater results in the gym, so it’s important even for people already fit and looking to get even more fit. Get out there, exercise often and, if you are at risk for or suffering from metabolic diseases, long distance work may be of great benefit to you.

References:

1. Rachael Nelson, et. al., “Daily physical activity predicts degree of insulin resistance: a cross-sectional observational study using the 2003-2004 National Health and Nutrition Examination Survey,” International Journal of Behavioral Nutrition and Physical Activity 2013, 10:10

Photo courtesy of Shutterstock.

The post 60 Minutes of Exercise Can Improve Insulin Resistance 25% appeared first on Breaking Muscle.

One of the major ways the body achieves this flexibility is through insulin. Insulin has powerful effects on the use of fuels. Namely, high insulin means carbs will be the preferred source of fuel, and low insulin means fat will be preferred. However, it is known that chronic consumption of sugary foods and high body fat is associated with something called “insulin resistance.”

In a nutshell, insulin resistance is when your cells don’t respond as strongly, or in a normal way, to circulating insulin. Insulin resistance is a facet of metabolic diseases like diabetes. Chronic insulin resistance isn’t a good thing, but it may play a role in how the body alters its utilization of fuels.

In a recent study in Nutrition and Metabolism, researchers compared the use of carbs and fats as fuels in regards to insulin resistance in a group of 180 women. They wanted to find out if insulin resistance led to metabolic inflexibility creating a situation in which the body could not react appropriately to changes in diet. They discovered that both insulin resistance and a family history of diabetes led to metabolic inflexibility even when they factored out both body fat levels and age.

Because of this, when the participants would consume higher levels of fats their fat oxidation (utilization of fat as a source of fuel) rates were lower than normal. They also indicated that the levels of mitochondria, the parts of your cells that create energy, were reduced, and total metabolic activity consequently went down. This means reduced energy levels, even while you’re at rest. Metabolic inflexibility reduces your overall ability to make energy at all. Big problem.

So what can be done to prevent this downward spiral into eventual metabolic disease? The answer is simple and makes a lot of sense, but it’s worth putting in print. First of all, exercise not only helps reduce your body fat, it also increases insulin sensitivity, and not just in the short term. Exercise also increases your mitochondrial levels, which means a greater capacity overall for the use of fat as a fuel and greater metabolic flexibility. A higher fat diet also favors the use of fat as fuels and ultimately will help improve insulin sensitivity in metabolically inflexible people. In particular, omega 3 fatty acids cause a strong preference for the use of fat as a fuel.

If you have a consistent high carbohydrate diet, especially a sugary one that yields a big insulin response, or a family history of diabetes it’s time to start being mindful of metabolic disease. Exercise frequently, especially with a focus on aerobic exercise, and eat healthy fats while reducing sugar intake. I personally believe that regularly fasting may help as well.

References:

1. Madelaine Carstens, et. al., “Fasting substrate oxidation in relation to habitual dietary fat intake and insulin resistance in nondiabetic women: a case for metabolic flexibility?,” Nutrition & Metabolism 2013, 10:8

Photo courtesy of Shutterstock.

The post Understanding Metabolic Flexibilty and the Role of Insulin appeared first on Breaking Muscle.

Researchers for this study analyzed data from the 1999-2004 National Health and Nutrition Examination Survey, which is a study of health risk factors. The responses to the survey were analyzed to see if there was a correlation between lifting weights and metabolic syndrome. There were 5,618 American adults who provided blood samples for analysis. Of those only 8.8% indicated that they lifted weights. Weight training was approximately twice as common in men as women (11.2% versus 6.3%). It was also more common for the younger generation (under 50 years old) to answer that they lifted weights.¹

There are five risk factors that determine metabolic syndrome. People with at least three of these indicators are considered to have the syndrome:

1. Waist circumference greater than 40 inches for men and 35 inches for women
2. High triglyceride levels
3. Reduced levels of “good” cholesterol or high-density lipoprotein (HDL) cholesterol
4. Elevated blood pressure
5. High glucose levels

The results of the study found there was a lower occurrence of metabolic syndrome amongst the people who reported lifting weights – 24.6% compared to 37.3% in those who did not lift weights. The study also adjusted for demographic factors and determined that lifting weight was associated with a 37% reduction in the odds of having metabolic syndrome.²

Key researchers in the study concluded that lifting weights should be strongly encouraged to people of all ages by exercise professionals. Other recent studies have also linked greater muscle strength and muscle mass to lower rates of metabolic syndrome, which is consistent with the findings in this study, since lifting weights ultimately increases muscle strength and mass.

This study goes to show that although lifting weights may be more popular amongst the younger generation, lifting weights can provide health benefits to people at any age. In combination with other new research that indicates cardio can reduce your risk for both cardiovascular disease and metabolic syndrome, perhaps a sensible approach for all ages includes both strength training and aerobic training.

Photos courtesy of Shutterstock.

The post Lifting Weights Reduces Risk of Metabolic Syndrome appeared first on Breaking Muscle.