Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that results in enlarged ovaries with small cysts on the outer edges. Although the cause behind polycystic ovary syndrome isn't well understood, it may involve a combination of genetic and environmental factors. It is estimated that 1 in 5 Indian women suffer from this syndrome, which may extend for the duration of their lifetime. However, PCOS can be controlled by a combination of good nutrition and healthy lifestyle.

What Causes PCOS?

PCOS can be caused by a combination of multiple factors which include:

• Genetic Predisposition

• Insulin Resistance

• Obesity

Genetic Predisposition

According to a study, PCOS is a hereditary condition and can be passed down from generation to generation. The study identified particular genes that can make a person more susceptible to the condition. However, the condition itself - or the likelihood of developing it - is increased by external factors such as diet and lifestyle.

Insulin Resistance

A study showed that approximately 70% women with PCOS have insulin resistance. Dr Parikhit Bhattacharya, Founder of HealthierX, explains that “Insulin resistance is the inability of the body to utilise insulin properly, leading to increased demand and levels of insulin in the blood.” Increased insulin levels, in turn trigger other hormones in the body which can lead to the development of PCOS.

Obesity

While obesity is not likely to be a direct factor for PCOS, according to a research published in the US National Institutes of Health, it can be a major contributing factor for aggravating the condition. According to Debolina Basu, Clinical Dietician at Calcutta Medical Research Institute, “Obesity can adversely affect PCOS and women with PCOS are likely to develop obesity as well.” The link between PCOS and obesity is complicated, with both being the cause and effect of each other. However, it is universally agreed that obesity and inflammation increase the risk of PCOS.

How Can PCOS Be Managed?

There is no single formula that can treat or reverse PCOS completely. However, a combination of nutritional and lifestyle changes can help women manage PCOS more effectively. Dr Anomitra Das, from the OBG Department at Howrah District Hospital, suggests that a multidimensional treatment comprising of healthy diet, exercise and management of blood sugar levels can help control PCOS.

Nutrition

Since PCOS is exacerbated by dietary factors, proper nutrition can help manage the condition. Dr Debolina Basu suggests that a diet rich in good proteins such as lean meat, fish, eggs and milk along with reduced intake of simple sugars can help manage PCOS. Fertility specialist Dr Michael Fox found that compared to only using medicinal drugs, adding a low-carb diet for PCOS patients increased their chances of pregnancy from 45% to over 90%.

Dr Parikhsit Bhattacharya explains that “weight is just a metric,” a symptom rather than a condition, and that correct nutrition can help manage weight and consequently PCOS. He further adds that a ketogenic diet is extremely beneficial as it helps with insulin sensitivity and inflammation – both conditions that worsen PCOS.

“It is important to focus on the right nutrition which can be sustainable for a period of time,” explains Lakshya Vaibhav Datta, Founder of The Fit Astronaut. According to him, it is important to develop a healthy food habit rather than just focusing on losing weight.

Intermittent Fasting

Intermittent fasting is an eating pattern that oscillates between periods of fasting and eating. Usually, it involves a fasting period of 16 hours, and all calories are consumed in an 8-hour window.

“By alternating the pattern of eating, I was able to help a patient drop about 20 kilos, which improved her PCOS. She was able to get pregnant after years of trying and a history of miscarriages,” says Dr Parikshit Bhattacharya.

According to an article published by Harvard Medical School, intermittent fasting is a solution to hormonal imbalances: “Between meals, as long as we don’t snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down. The entire idea of intermittent fasting is to allow the insulin levels to go down far enough and for long enough that we burn off our fat.” Additionally, a study published by the U.S. National Library of Medicine states, “an intermittent fasting diet may provide a significant metabolic benefit by improving glycemic control (and) insulin resistance…with a reduction of BMI in adults.”

Lifestyle Changes

No amount of nutritional changes can bring about a lasting impact without complimentary lifestyle changes. The modern work life forces us to be sedentary for long periods thereby reducing physical activity. “A brisk walk for 45 minutes is essential” says Dr Debolina Basu. Similarly, Lakshya Datta stresses the importance of a holistic approach to better health which effectively manages diet and exercise.

Exercises to Manage PCOS

• Cardio: Good for reducing insulin resistance, boosting fertility, stabilising mood.

• Strength Training: Good for reducing insulin resistance, increasing metabolic rate, improving body composition (more muscle and less fat tissue).

• High Intensity Interval Training: Good for increasing cardiovascular fitness and decreasing waist circumference.

• Core Strength: Good for general well-being and injury prevention, preparing your body for pregnancy.

While it is difficult to completely reverse PCOS, it can be effectively managed by making nutritional and lifestyle changes. However, it is very important to sustain these habits. While a low-calorie/keto diet or a rigorous exercise routine can help achieve positive results for managing PCOS, it is rendered useless unless these habits are continued over a period of time.

Therefore, it is very important to identify a nutrition and lifestyle regimen that is best suited to your lifestyle in order to manage PCOS. Patience and perseverance are essential in managing PCOS.

(The author is a lawyer turned business intelligence consultant turned chef. He also designs weekly and monthly meal plans for clients and conducts baking and cooking workshops.)