Polycystic Ovarian Disease – Nutritional Management

James Meschino DC, MS, ROHP

Polycystic ovarian disease is often aggravated by insulin resistance and thus, the same advice given to non-insulin dependent diabetics and those with metabolic syndrome applies in these cases. High insulin levels promote the proliferation of cysts within the ovaries.

Insulin resistance means that insulin cannot help glucose go from the blood into the cells. As a result, blood sugar remains elevated, even though, insulin is being produced by the pancreas. Research has shown a strong connection between upper body obesity (people with “apple shapes”) and the development of insulin resistance.

Most people with type 2 diabetes or pre-diabetes are overweight. Excess abdominal weight does not stop insulin formation, but it does make the body less sensitive to insulin. Weight loss reverses this problem.

Dietary and Lifestyle Strategies
In most studies, type 2 diabetes and insulin resistance has improved with weight loss. As well, most doctors recommend that people with diabetes reduce intake of sugar from snacks and processed foods, and replace these foods with high-fiber, whole foods

A high-fiber diet has been shown to work very well in controlling diabetes. Studies show that when diabetic subjects ingested a diet containing 50 grams per day of dietary fiber exclusively through the consumption of foods naturally high in fiber—such as leafy green vegetables, granola, and fruit, their blood sugar and blood insulin levels dropped down very significantly and there was a marked decrease in LDL-cholesterol (the bad cholesterol) and triglyceride levels (blood fats).

Fiber is the indigestible part of plant food that acts as roughage for the body. There are two types of fiber. Water-soluble fiber is found in fruits, vegetables, and legumes in the form of guar, pectin, and gums. These products form a gel in the gastrointestinal tract that allows for a food to be held there longer, causing a slow rise in blood sugar. This type of fiber also helps to lower cholesterol. Insoluble fiber is made of cellulose, hemicellulose, and lignins, and can be found in grains and bran. This food also takes longer to be broken down and used for energy, but its main value is in adding bulk and preventing constipation

Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.  Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels. Beans, peas, fruit, and oats have low glycemic index, in that their carbohydrates are absorbed more slowly and tend not to cause a sudden rise in blood sugar.

Almost all legumes (beans and peas) have a moderate glycemic index. They also provide a source of water-soluble fiber that is valuable for lowering cholesterol.

Some vegetables have a high glycemic index and should be used in moderation in cases of diabetes or to improve a pre-diabetic state. These include white potatoes (baked), carrots, beets, and turnips. However, if an individual is eliminating other sources of refined sugar in the diet and is decreasing the amount of starchy carbohydrates (breads and pastas), he/she should be able to eat these vegetables with moderation

Fruits are generally in the middle of the road in terms of glycemic index; but dried fruits, which are concentrated, have a higher index. Drinking fruit juices will increase blood sugar release. Therefore, fruit juices should be limited or diluted with three-fourths water.

Most sweeteners such as honey, molasses, sugar, and white grape juice concentrate tend to have a high glycemic index. Rice syrup and granulated rice sweeteners may be used instead.

Grains such as rice, wheat, and corn tend to have a high glycemic index, but grains such as buckwheat, millet, barley, rye, and bulgur are actually quite low. For successful weight loss and blood sugar control, this group of foods should be used in moderation.

High-fiber supplements, such as psyllium, guar gum (found in beans) pectin (from fruit), and oat bran,  have improved glucose tolerance in some studies.

Vegetarians have been reported to have a low risk of type 2 diabetes. When people with diabetic nerve damage switch to a vegan diet (no meat, dairy, or eggs), improvements have been reported after several days. In one trial, pain completely disappeared in 17 of 21 people.

Exercise helps decrease body fat and improves insulin sensitivity. People who exercise are less likely to develop type 2 diabetes than those who do not.  Exercise can decrease the risk for heart problems in diabetic patients. Regular exercise can improve heart and lung health, make insulin work better, and increase HDL cholesterol while decreasing LDL cholesterol.  Exercise also helps to regulate blood sugar. At a minimum, diabetics should get 30 minutes of some form of endurance exercise at least four days a week.

Alcohol has been reported to worsen glucose tolerance in people with diabetes in some studies. People with diabetes who drink have also been reported to have a high risk for eye and nerve damage

People with diabetes who smoke are at higher risk for kidney damage, heart disease, and other diabetes-linked problems. Smokers are also more likely to develop diabetes.

Supplement Considerations

1. Glucomannan – Glucomannan is a water-soluble dietary fiber that is derived from konjac root. Glucomannan delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. Overall diabetic control has been shown to improve with glucomannan-enriched diets, according to clinical trials. For controlling blood sugar, 500–700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research. (example PGX, which is sold in most health food stores)
2. Bitter Melon – Bitter melon’s most notable benefit is in the area of diabetes treatment. Studies suggest that the fruit may play a role in controlling the production of insulin by the body, thus promoting blood sugar control. Bitter melon was evaluated in one hundred non-insulin dependent diabetics for its impact on serum glucose levels. Eighty-six patients experienced a significant reduction of serum glucose levels following the ingestion of 200 mg of bitter melon, 2 times daily. The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 5.1% triterpenes.
3. Supplements containing Chromium, Hydroxycitric (HCA)Acid and Decaffeinated Green Tea – high in Catechin content) 3 – 6 capsules per day (enough to provide 200 mcg of chromium, 600 mg of green tea extract and at least 1000 mg of HCA) – this product improves insulin sensitivity and helps to reduce body fat, in conjunction with exercise and a low fat, low glycemic diet
4. Prostate Support Supplement with agents that block build-up of dihydrotestosterone (saw palmetto, pygeum africanum, beta-sitosterol, stinging nettle, lycopene, soy isoflavones) – 2 capsules per day. Polycystic ovarian disease is also aggravated by the build up of dihydrotestosterone (DHT). The ingredients in Prostate Support Supplements block the conversion of testosterone into DHT and can be a useful adjunct in the management of PCOD.