Polycystic Ovaries Syndrome (PCOS)

Polycystic Ovaries Syndrome (PCOS)

By Arunima Verma  on: 28 August 2017
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Polycystic Ovaries Syndrome (PCOS) is a hormonal condition that occurs in 5-10% of women between late adolescence and menopause. It is one of the most common hormonal related problems in women during their reproductive years. Not only is PCOS a leading cause of infertility it can also be a risk factor for other health problems.

The diagnostic criteria of PCOS has been a topic of debate. Merely the presence of polycystic ovaries ( enlarged ovaries with small cysts on the outer edges) does not qualify for the condition to be called a syndrome. In November 2015, the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE), and Androgen Excess and PCOS Society (AES) released new guidelines in the evaluation and treatment of PCOS and it was mentioned that the diagnostic criteria for PCOS should include two of the following three conditions:

Chronic anovulation ( chronic absence of ovulation), hyperandrogenism (excess of male hormones which can be clinical/biologic), and polycystic ovaries.

Signs and symptoms

The major features of PCOS include menstrual dysfunction, anovulation, and signs of hyperandrogenism. Other signs and symptoms of PCOS may include the following:




Metabolic syndrome ( a cluster of conditions such as high blood sugar, abnormal lipid levels, high blood pressure, obesity)


Obstructive sleep apnea

Most PCOS patients are overweight or obese ( except a small percentage who are not markedly overweight). One of the most common metabolic abnormality associated with PCOS is insulin resistance. In this condition the cells fail to react to insulin which leads to abnormal glucose metabolism and high blood sugar. To compensate this condition, the body produces more insulin, thereby increasing the insulin levels in the blood and causing a condition called hyperinsulinemia. This then further leads to Type 2 diabetes. The mechanisms by which insulin resistance leads to PCOS and Type 2 diabetes are different. The details of which I shall not discuss in this article. PCOS has also been related to Type 1 diabetes. Insulin resistance has also been related to dyslipidemia ( abnormal lipid levels) and risk of cardiovascular disease.

A lot of research still needs to be done on PCOS. Research to gain a clearer understanding of the mechanisms linking each condition is required. Nevertheless, there are enough studies which have shown that even a moderate weight loss of about 5-10% helps in restoring functions of the ovaries which leads to normal hormone production. This then results in improvement in symptoms of PCOS.

Since PCOS is related to so many metabolic abnormalities, many studies have shown that apart from the required drug therapy, diet and lifestyle changes is the first line treatment.

Diet for PCOS

PCOS diet is very individualistic. Since the symptoms will vary from woman to woman. But there are a few basic guidelines

1. Foods with low GI (Glycemic index ): These are foods which release the sugar slowly to the blood stream, therefore there is a steady rise in blood sugar and insulin, as opposed to high GI foods which are broken down and absorbed quickly by the body leading to a rapid rise in blood sugar levels.

Image courtesy of (Grains: rakratchada torsap; fruits and vegetables: Suat Eman; Almonds: phasinphoto) at freedigitalphotos.net

List of low GI foods

Whole wheat ( chapati, bread)

Multigrain bread

Oat bran

Rolled oats

Natural Museli

Whole wheat pasta

Brown rice

Buckwheat ( kuttu )

Kidney beans (Rajmah)

Black eyed kidney beans ( Rongi/ Lobia)



Almost all vegetables except beetroot which is a medium GI, potatoes, pumpkin and parsnips which are high GI.

Cherries, Plums, Grapefruit, Peaches, Apples, Pears, Dried Apricots, Grapes, Coconut, Coconut Milk, Kiwi Fruit, Oranges, Strawberries, Prunes,

Nuts and seeds such as walnuts, peanuts, almonds, chia seeds, ground flaxseeds.  

2. Less than 30 % of the daily calories should be from fat: This should comprise of mostly unsaturated fats and only a very low amount of saturated fat (<10%). So how does one translate this to normal day to day life. The basic idea is to cook the food in very less oil. Stir fry vegetables and let them steam cook. If you are in the habit of adding a bit of ghee ( clarified butter) to your chapatis, it's completely ok since ghee is one of the good fats, but reduce the amount and the number of times you have it in a week. The amount and restrictions will also depend upon the metabolic conditions of the individual.

3. Dairy: The effect of dairy on PCOS has some conflicting views. Studies have shown that regular consumption of dairy increases insulin production. It is also believed to increase androgen production (except cheese). At the same time whole milk and whole milk products have been related to increased fertility. There are very few studies relating dairy to PCOS. So the effect of dairy will probably vary from person to person. Therefore an individual with PCOS can avoid dairy for a certain period of time and observe if there are any changes in the way they feel. As for the calcium, there are other sources such as broccoli, okra ( bhindi), kidney beans, chickpeas, sweet potato, to name a few which are easily available in our country . Also since cheese is said to have a lesser effect on insulin production, one can try having cheese in moderation. Apart from this, one should take a good calcium supplement and a multivitamin, which is recommended by their physician.

4. For non vegetarians, organic good quality chicken and fish are the best options.

Foods to avoid: White rice, White bread, Maida, White pasta, Bagel, Potatoes, Refined sugar, Processed packaged foods, Red meat. A person with PCOS has a very fragile system. Therefore as much as possible have organic products. Keep yourself as much chemical free as possible.

In smaller cities the availability of organic products might be a bit difficult. But all is not lost. There are a lot of products that you can find online.

Living with PCOS is not easy but a few changes in your diet and some form of regular exercise of about 30 mins will help you deal with it.


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I have been hearing for a while that many people are going gluten- free and that it is healthy. Many believe that it would definitely lead to weight loss. But before we generalize anything let us understand a little more about gluten. Gluten is the general name which is used to describe a mixture of proteins found in grains such as wheat, barley and rye. The protein groups are divided into two groups Prolamines and Glutelins. Different grains have different amounts of these proteins. So... is gluten bad? No gluten is not bad for everyone but only for certain people. Image courtesy of (rolling dough: lemonade; wheat: KEKO64; bread basket: amenic 181) at freedigitalphotos.net Gluten related disorders 1. Autoimmune reactions: i. Celiac Disease: This is probably the most widely studied gluten related disorder wherein gluten triggers an autoimmune response and causes inflammation of the intestines. The Western countries have given it a lot of importance and rightly so, because if it goes undetected then it leads to a lot of other complications. But it is a myth if one thinks that it occurs only in the west because studies conducted in India shows the existence of this disease here too. But the only problem is lack of awareness. It was observed that it occurred mostly in northern India than the southern part of the country obviously because wheat is the staple grain in the north. ii. Dermatitis herpetiformis or Duhring Brocq disease. This is a chronic autoimmune skin blistering condition. iii. Gluten Ataxia which is a neurological condition consisting of lack of voluntary condition of muscle movements and includes gait abnormality. 2. The other form of gluten sensitivity is Non celiac gluten sensitivity (NCGS): There is no specific test for this condition. This is understood after celiac disease and the other known conditions are ruled out. NCGS is under much debate. There are many studies which support the existence and many which don't. Therefore, one needs to rule out other conditions such as the ones mentioned above and others such as irritable bowel syndrome, wheat allergy, to finally come to the conclusion the it is gluten sensitivity just by itself. Many studies on gluten sensitivity have been not very conclusive because some of the test subjects reacted even to other food components such as milk proteins, eggs, tomatoes. 3. Sometimes the individual might be allergic to just wheat but can tolerate other grains: This is simply called wheat allergy. The symptoms of wheat allergy are similar to Celiac disease and NCGS but the difference is in the onset. Wheat allergy has a fast onset. Some patients with wheat allergy can tolerate other grains such barley, oats. While others maybe advised to completely give up gluten. So if one feels discomfort after consuming gluten containing products, should get themselves tested. The symptoms of Celiac disease are different for infants and young children, for teenagers and adults. Infant and young children: Diarrhea, constipation, growth problems, difficulty in gaining weight, irritability, fatigue, vomiting, abdominal bloating and pain. Teenagers: For teenagers with Celiac disease symptoms may not occur unless triggered by some stressful situation. Symptoms are; diarrhea, vomiting, weight loss, delayed puberty, irritability, depression, abdominal pain and bloating, mouth sores, skin rashes Adults: Iron deficiency, joint pains, arthritis, osteoporosis, depression or anxiety, seizures, irregular menstruation, mouth sores, skin rashes, tingling numbness in hands and feet. Even if someone has just a few of these symptoms should consult a physician. It has been observed that the number of people being affected by gluten is rising. So the question which arises is why? Is it a real situation or is there too much awareness? I think it is a bit of both. Of course there is awareness. Just as there is awareness about a whole lot of other things but it is also real. The food that we have now is far more different than what our ancestors would have. The kind of wheat that is available is said to be different than what it used to be. Excessive use of antibiotics might have destroyed a lot of the gut flora leading to inability to digest a lot of things including gluten. Even environmental factors may be responsible. Pesticides, hybrid variety of food products. The exact reason behind why it is increasing could be anything. But what we need is awareness and with awareness the understanding that not everyone needs to go gluten-free. There are some who believe that it is better to give up grains completely. But in a country like India where our diet primarily consists of grains, it is not practical. If you have been experiencing digestive problems or other symptoms mentioned above, it could be gluten, just wheat, milk, eggs, fish (few of the common allergens) or many other factors. So please consult a health professional to understand the exact cause. But if the tests turn out to be inconclusive and you feel better with a gluten-free diet, then by all means go ahead. At the end of the day we just want to feel good and healthy.
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Dietitian Arunima Verma is a nutritionist based in Ansal Sushant City, Panipat, India (presently consulting online). Online Nutritionist Arunima Verma is a weight loss diets expert . She is helping people to reach to their health related goals with her healthy diets & lifestyle. Online Dietitian Arunima Verma provides weight loss diet consultations online. Online diet consultation, customised online diet plans, personalised Diet chart are provided for services like fast and Healthy Weight Loss, Healthy Weight Gain, control and manage diabetes , Healthy Online Diabetic Diet, Weight Loss for kids, Healthy Heart Diet, Online diet, Child nutrition, diet for toddlers, Post natal diet, Therapeutic diet and other disease management.In this fast-paced, high-stress society, where everything is going online, why not diet? My e clinic;  " Dietitian Arunima's Diet Clinic " helps you attain optimal health by online diet plans and motivating diet counselling sessions. Looking after your health today gives you a better health for tommorow!  She is one of the best Dietitians in Panipat.Looking for top online weight loss diet in Ansal Sushant City, Panipat, or a Dietitian in Ansal Sushant City, Panipat? Interested in excellent weight loss service online or in Ansal Sushant City, Panipat?( Presently consulting online) Then contact famous weight loss diet consultant Diet Specialist Arunima Verma.You can view our testimonial, weight loss success stories and experience of our clients who have successfully reduced weight through healthy weight loss diet charts. One of the leading weight loss consultant in Panipat. (Presently consulting online)Nutritionist Arunima's Verma major area for diet counseling is therapeutic diets, weight gain, weight loss, diabetes, diet for toddlers, pre and post natal program, Kids diet, therapeutic diet, heart related problems specially pertaining to cholesterol. With a right diet a 100 % reversal can be brought down for pre diabetics and type 2 diabetics where the blood sugar level can be completely controlled for a better and disease free life.Online Diet Consultant Arunima's Verma diets aims at overall nutritional correction with comprehensive individual assessment, with long term results and benefits. Lets make life better by bringing in a total lifestyle change!!Online dietitian Arunima Verma is a qualified nutritonist/dietitian providing Diet programs such as Weight loss diet, Pregnancy and Lactation diet, Diet for toddlers and Diet for other disorders.Email & phone consultation is also provided. If you're looking to consult best dietitian in Ansal Sushant City, Panipat, then do register on this eClinic. PRESENTLY CONSULTING ONLINE.
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