Exploring The Connection Between Pcos And Weight Loss – Post-overfeeding in children induces neurodevelopmental delays and anxiety-like behavior with sex- and brain region-specific synaptic and metabolic changes
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Exploring The Connection Between Pcos And Weight Loss
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Exploring What Causes Pcos Weight Gain In Women And How To Control It
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Exploring Pcos Belly: A Guide For Beginners
Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
Submitted: 22 July 2023 / Revised: 5 August 2023 / Accepted: 14 August 2023 / Published: 15 August 2023
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Hyperandrogenism, hyperinsulinism and insulin resistance (IR) are the main drivers of the clinical, metabolic and reproductive phenotypes of PCOS. In adolescence, the mainstays of PCOS treatment are lifestyle and nutritional interventions. In particular, the quality and quantity of carbohydrates introduced into the diet play an important role in the benefits of the diet on PCOS. Recently, the ketogenic diet (KD) has attracted particular interest for the treatment of IR and for the control of carbohydrate metabolism, which has been shown to be beneficial for many dysmetabolic conditions, including PCOS. The goal of the KD is to stimulate a fasting-like metabolism with the production of ketone bodies. Ketosis is a good regulator of calorie intake and mimics the effect of hunger in the body, controlling body weight and consequently metabolism. Additionally, during ketogenesis, insulin receptor sensitivity is also developed. We performed an extensive review of the existing literature regarding KD indications and its metabolic benefits useful for improving PCOS management. Available data support that the low-calorie ketogenic diet (LCKD) plays a positive role as a regulator of weight control, IR, glucose and lipid homeostasis and hormonal profile. Unfortunately, the evidence regarding the benefits of LCKD in adolescents with PCOS and excess body weight is still numerically low. Further studies are necessary to understand whether these effects are due to weight loss or the nutritional properties of this diet. Considering the long-term consequences of PCOS, it is important to explore the possibilities of nutritional intervention to protect fertility, starting in adolescence.
Polycystic ovary syndrome (PCOS) is the most common reproductive disorder in women of reproductive age [1, 2]. The epidemiology of PCOS is still unclear; Diagnosed cases involve up to 13% of women of reproductive age, but changes in clinical presentation and diagnostic criteria lead to a large underestimation, which is believed to involve 70% of affected women [2]. The disorder is associated with significant reproductive, metabolic and psychological consequences.
Achieving Weight Loss With A Pcos Diet
The pathogenesis of PCOS is not fully defined, and it is thought that both extrinsic and intrinsic factors lead to hyperandrogenism, hyperinsulinism and insulin resistance (IR) being the main drivers of the clinical, metabolic and reproductive phenotypes. [3]. IR and hyperandrogenemia can establish a vicious cycle with each stimulating the other, providing the basis for metabolic treatment of these patients [ref].
There are limited data regarding the diagnosis, prognosis, treatment and prognosis of PCOS in the adolescent population, although early recognition of signs of the disease can significantly benefit cardiovascular prognosis and fertility [4].
Treatment options for PCOS vary depending on the targeted manifestation, patient phenotype and preferences (ie, fertility, hyperandrogenism, obesity). In adolescence, the mainstays of treatment for PCOS are weight loss through lifestyle and nutritional interventions, followed by pharmacological or surgical treatment [4].
Regarding dietary intervention, the main point of interest is the effect of diet composition on insulin sensitivity. Dietary carbohydrate intake subsequently affects glucose levels and, in turn, insulin [ 5 ]; Additionally, the anti-inflammatory properties of the diet are associated with endocrine and metabolic profiles [6]. It is important to highlight that any diet that guarantees weight loss can improve IR, hyperandrogenism and fertility in PCOS women. The obesity-induced metabolic effects of the PCOS phenotype seem to reverse after weight loss [7].
Pcos: Exploring The Complexities, Risks And Solutions
The quality and quantity of carbohydrates introduced into the diet play an important role in the benefits of the diet on PCOS. The Mediterranean diet (MD) is a dietary pattern rich in complex carbohydrates and fiber, and high in monounsaturated fat, which is closely associated with lower levels of chronic inflammation, IR, and improvement in hormonal abnormalities in PCOS [ 4].
Recently, the ketogenic diet (KD) has attracted significant interest in the treatment of IR and in the control of carbohydrate metabolism. The KD is an isocaloric, high fat and hypoglycemic diet that has been increasingly used in recent years for specific pathological conditions, such as refractory epilepsy. The KD aims to induce a fasting-like metabolism with the production of ketone bodies which has been shown to be beneficial for many dysmetabolic conditions, including type 2 diabetes mellitus, cardiovascular disease, and ultimately PCOS [7]. Ketosis is a good regulator of caloric intake and mimics the effect of hunger in the body, leading to body weight control and additional benefits that affect obesity-related insulin resistance [8]. During ketogenesis, insulin receptor sensitivity is also enhanced; Therefore, KD can alter the insulin flux and secretion that are also caused by carbohydrate depletion, ultimately leading to improved insulin sensitivity [ 8 , 9 , 10 ]. In addition to the positive regulation of glucose metabolism, KD can also result in improved lipolysis and fatty acid oxidation, a better lipidic profile [8].
We present a comprehensive review of the available literature regarding low-calorie KD indicators and their metabolic benefits on PCOS management, focusing on the adolescent population. Since PCOS is one of the main causes of anovulatory infertility in women, it is important to pay attention to the childbearing age. A review of data on the possibilities of nutritional intervention in the care of PCOS is important for fertility preservation, starting in adolescence.
We present a meta-review, a non-systematic collection and analysis of the available literature on the topic of the application of low-calorie KDs in women with PCOS, focusing on adolescents [11]. The most relevant original scientific articles, clinical trials, meta-analyses and reviews published in the last 15 years were considered. We also put restrictions on the English language and the human race. Exclusion criteria used were as follows: in vitro studies, animal studies, elderly population, epilepsy, and nutrition respectively. For this purpose, we searched for relevant papers in three databases (MEDLINE/PubMed, Scopus and Web of Science) using a combination of text and MeSH (medical subject headings) using specific keywords to enhance the search strategy. , such as polycystic ovary. syndrome, youth, diet, dietary intervention, ketogenic diet, low-calorie ketogenic diet, and very low-calorie ketogenic diet.
Managing Weight Gain And Pcos
Starting from a total of 201 articles, three authors reviewed the titles and abstracts (n = 69) and reviewed the full text of the resulting relevant studies (n = 41). We resolved any disagreements in consultation with the fourth author. Reference lists of all manuscripts were also considered to identify relevant manuscripts.
Despite the high incidence of infertility in the affected population, PCOS presents a high prevalence in adult women. Reports on the epidemiology of PCOS in adolescents are rare, and estimating its prevalence in adolescents may be difficult because of the high prevalence of paraphysiologic ovulatory dysfunction and the common echographic finding of micropolycystic ovaries in this population; Statistics depend on which diagnostic criteria are used and on the population observed [12]. A recent systematic review and meta-analysis that included approximately 150,000 adolescent girls worldwide suggested that PCOS may be prevalent.
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