I have POLYCYS OVOSIS, how to eat it? How to move?

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Too long to look at

Obesity is a consequence of PCOS, not the cause.

Obesity in turn can exacerbate the condition.

Fat people lose fat and thin people gain muscle, both help to improve the condition.

In the last few live broadcasts, basically every time someone asked the question of polycystic ovary syndrome, how to eat polycystic patients, what to pay attention to in life with polycystics, and heard that polycystics are too fat, that is not as long as you lose weight...

These problems are difficult to explain in a few words in the live broadcast, so today I will carefully talk to you about the topic of polycystic ovary syndrome in the WeChat article.

1

POLYCYS OVIAL SYNDROME: Not fat out

Obesity is more a consequence of PCOS than a cause, but obesity can in turn exacerbate the condition.

A common metabolic disease in a sick and obese woman

Polycystic ovary syndrome (PCOS) is a common group of clinical syndromes characterized by reproductive disorders, endocrine abnormalities, metabolic disorders, etc. in women of childbearing age, and the incidence in the appropriate age population is about 5%-10%, and Jay Chou's wife Kunling has polycystic ovary syndrome.

The more common clinical manifestations of polycystics include irregular menstruation, hyperandrogen-related manifestations (hirsutism, acne, androgenic alopecia, etc.), ovulation disorder infertility, etc., which can be accompanied by metabolic abnormalities such as obesity, insulin resistance, hyperinsulinemia, and glucose and lipid metabolism disorders. [1,2]

In addition to causing more familiar symptoms such as hirsutism and acne, high androgens are also associated with insulin resistance and glucose and lipid metabolism disorders

Leads to obesity, especially abdominal obesity. [2]

Moreover, this fat is the real "drink cold water and grow meat" type of fat. Many women, especially adolescent girls, initially go to an obesity clinic because of uncontrolled weight gain, only to find out to have POLYOS.

A syndrome that goes through a vicious circle

Obesity is present in 30% to 70% of polycystic patients, and 70% have a vicious cycle in which dyslipidemia, obesity, and dyslipidemia promote each other. [2]

The incidence of obesity in polycystic patients in different countries and regions is 30% to 70%. In 2006, Peking Union Medical College Hospital surveyed 196 polycystic patients who visited the obesity clinic, with a higher incidence of obesity in polycystic patients of childbearing age than 50%, while the incidence of obesity in adolescent PCOS was higher. [3]

Abdominal obesity (centripetal obesity) is another important feature of some patients with polycystics, with abdominal obesity occurring in up to 80% of patients with polycystics, and 50% of polycystic patients with normal BMI may still develop abdominal obesity.

Obesity and abdominal obesity, in turn, increase the risk of hyperandrogenemia, glycolipid metabolism, cardiovascular disease and reproductive dysfunction. [3,4]

In addition, about 50% to 70% of polycystic patients have insulin resistance, which is also associated with hyperandrogenemia and ovulation disorders. [2]

2

Fat loss really helps

Polycystic ovary syndrome, a disease that seriously affects women's fertility, quality of life and long-term health, is still unknown to this day, and there is no effective cure. It can only be treated symptomatically and requires long-term health management.

Compared with other treatments, lifestyle interventions can effectively improve the health and related quality of life of overweight or obese patients with polycystics, while the side effects are small and safe, so domestic and foreign guidelines regard it as the preferred basic treatment. Simply put, it is diet, exercise, and behavioral intervention. [1]

Fat fat loss, lean muscle gain

For overweight and obese polycystic patients, fat loss is a first-line treatment option. Studies have shown that after 5% to 10% of the initial weight loss at 6 months, 50% of polycystic patients can resume menstruation and ovulation. [5] Reduced body fat also increases insulin sensitivity, and after improvement in insulin resistance, 40% to 50% of patients with polycystics can return to regular menstruation without drug intervention. [4]

For patients with no overweight or obese polycystics, a healthy lifestyle can also help prevent long-term complications and improve quality of life.

Dietary control

Controlling total calories and choosing healthy foods are the two main measures.

It should be noted that 85% of polycystic patients in China have hyperandrogenemia, and controlling obesity can significantly improve hyperandrogenemia and related symptoms. [4]

Long-term low-calorie diets require vigilance that may lead to excessive ketone and avoid very low-calorie diets, which may worsen the condition.

In addition, it is to quit smoking, drink less, drink less coffee, and reduce mental stress.

Strengthen the movement

Exercise is effective in weight loss and prevents weight gain. Moderate regular fat loss exercise, 30 minutes a day, at least 5 times a week, and reducing sedentary behavior are the most effective ways to lose weight.

For those who are not obese or abdominally obese, overweight, the goal of your exercise may be to focus on muscle gain. Because muscle deficiencies also exacerbate insulin resistance.

It is recommended that regardless of fat loss or muscle gain, according to the patient's physical condition, do not less than 3 times a week, each time not less than 15 minutes of resistance exercise. Appropriate resistance exercise, combined with reasonable nutrition, plays an important role in improving bone mass and maintaining lean body mass (which can be simply understood as weight other than fat). [4]

Consider supplements appropriately

Vitamin D supplementation, as well as inositol and D-chiral inositol, may be considered for supplements, which have also shown good results in some clinical trials.

3

What should I do if the effect of diet and exercise is not good?

The general dietary intervention and exercise intensification method, the cycle is long, will also occupy more daily time, for most patients, it is more difficult to adhere to, it is difficult to achieve the desired weight loss effect.

At this time, the short-term use of the ketogenic diet under the guidance of a doctor can achieve the goal of weight control.

Using a ketogenic diet on your own is not recommended, nor is it recommended for healthy people to use a ketogenic diet to lose weight.

Why the ketogenic diet?

The ketogenic diet, the concept of which is no stranger to everyone, is a special diet structure that is high in fat, low in carbohydrates and in the right amount of protein. In the ketogenic state, our human body switches to an energy supply mode based on lipolysis.

Ketogenic diet studies in polycystic patients have found that ketogenic and low-carbohydrate diets can not only significantly improve the weight and insulin resistance of polycystic patients, but also have a significant improvement effect on polycystic patients with complicated hyperandrogenic hormonemia.

Moreover, the ketogenic diet combined with resistance exercise can achieve the effect of reducing body fat without reducing muscle, or even increasing muscle. [4]

Reminder: Not all patients with polycystics are suitable

The use of a ketogenic diet to intervene in patients with polycystic ovary syndrome has strict indications and contraindications, and there may be many adverse reactions during use... Therefore, whether you can use it or not, how to use it, must be evaluated by the doctor, and used under the guidance and monitoring of the doctor.

4

Seek medical attention as soon as possible and standardize treatment

You may find that the lifestyle intervention mentioned above, I only gave some principled advice, that is because the specific physical condition and physiological stage of different patients are different, and it is recommended that you seek medical treatment if you want to get personalized lifestyle advice.

More critically, the treatment of POLYOS is not only a lifestyle intervention, but also a standardized clinical treatment. Because of the complexity of the condition, multidisciplinary combination therapy may be required.

According to the patient's different physiological stages and treatment requirements, gynecologists may give different treatment plans in different directions such as adjusting the menstrual cycle and promoting fertility.

For those patients who do not have the effect of lifestyle interventions, it may be necessary to work with an endocrinologist to correct insulin hypo-resistance, hypoglycemic, and lipid regulation.

For patients with acne due to hyperandrogenemia, it is best to seek the specifications of a dermatologist.

You also need your gynecologist and dietitian to monitor your indicators in stages during the entire process of treatment, find problems in time, and adjust the treatment plan in a targeted manner.

I hope that everyone can have a high quality of life

Resources

Endocrinology Group and Guideline Expert Group of Obstetrics and Gynecology Branch of Chinese Medical Association. Chinese Guidelines for the Diagnosis and Treatment of Polycystic Ovary Syndrome[J].Chinese Journal of Obstetrics and Gynecology,2018,53(1):2-6.

[2] Song Ying,Li Rong. Interpretation of Chinese Diagnosis and Treatment Guidelines for Polycystic Ovary Syndrome[J].Journal of Practical Obstetrics and Gynecology,2018,34(10):737-741.

Yuan Yingying,Zhao Junli. Epidemiological characteristics of polycystic ovary syndrome[J].Chinese Journal of Practical Gynecology and Obstetrics,2019,35(03):261-264.DOI:10.19538/j.fk2019030102.

Jiang Bo, Bai Wenpei, et al.Chinese expert consensus on ketogenic dietary interventions for polycystic ovary syndrome (2018 edition)[J].Journal of Practical Clinical Medicine,2019,23(01):1-4.