Polycystic ovary, insulin resistance and nutrition

Edited by Doctor Roberto Uliano

"Polycystic ovary

Polycystic ovary (PCO) is a very heterogeneous condition characterized by ovarian dysfunction and menstrual disorders often associated with clinical and biochemical signs of hyperandrogenism, hirsutism and ultrasound presence of ovarian cysts. Often the clinical picture of this syndrome is very blurred and confused. The most frequent endocrinological disorders include:

1) menstrual irregularities (80%) (oligomenorrhea, amenorrhea, metrorrhagia, infertility);

2) hyperandrogenism (60%) (hirsutism, acne, alopecia);

3) obesity (50%).

The presence of polycystic ovary is one of the most common causes of infertility among women and of spontaneous abortions in the first trimester of pregnancy.

Among the metabolic causes, insulin resistance plays a key role. Insulin is a protein hormone secreted by the pancreas with mainly anabolic functions, that is, it allows the nutrients taken in through diet to be assimilated. Thanks to insulin, the body allows you to regulate blood sugar within acceptable limits to help both brain, muscles and liver work well and consistently. When we produce a lot of it, as a result of hyperalimentation and lack of physical activity, the body implements defense strategies in which the tissues take only the amount of hormone that interests them, while the rest release it freely in the body with a consequent compensatory hyperinsulinemia . This defense situation is called insulin resistance. The organs most affected by this syndrome are skeletal muscle, liver, adipose tissue, ovary and uterus. In the genesis of PCO, insulin resistance leads to the production of a greater quantity of androgens by the theca of the ovary, which lead to a dysregulation of the pulsatility of LH (the key hormone of ovulation), while in parallel the endometrium undergoes an abnormal growth (with consequent problems in embryonic implantation). The treatment of insulin resistance leads in a high percentage of cases to the resolution of PCO and consequent increase in fertility, decrease in menstrual disorders and early abortions.

NUTRITION AND POLYCISTIC OVAR SYNDROME

One of the strategies for resolving insulin resistance is to follow a diet with a low glycemic index. The glycemic index of a food represents the rate at which the blood sugar (ie the concentration of glucose in the blood) increases following the intake of that food. "food. The index is expressed in percentage terms with respect to the speed with which blood sugar increases when consuming a reference food (which has a glycemic index of 100): a glycemic index of 50 means that the food raises blood sugar with a speed that it is equal to half that of the reference food. After the intake of carbohydrates with a high glycemic index, the blood sugar undergoes a sudden rise, a great deal of insulin is secreted with consequent hyperstimulation of the tissues.

Foods with a low glycemic index are fruit and vegetables, dairy products (yogurt, whole milk, etc.), whole grains (especially oats and barley), pasta cooked al dente, while those with a high glycemic index (above 60-70) are all those easily assimilated: sugar, refined grains (rice, chips, wafers, biscuits), sweets and cakes, sugary, carbonated drinks, foods that contain sugar, dextrose, glucose syrup in ingredients. Other foods to watch out for for their medium to high glycemic index are: white bread, biscuits, potatoes, croissants, raisins, some types of fruit and vegetables (carrots, melon, pumpkin).
The useful considerations that can be made on the glycemic index are the following:

the glycemic index decreases if the food or meal is rich in fiber, so a whole grain cereal or pasta with vegetables has a lower index than a refined cereal or pasta with sauce.
The glycemic index decreases if fat is added to a food. This phenomenon is due to the fact that the digestion of the food to which the fat has been added is slower, and therefore the carbohydrates it contains go into circulation more slowly. In fact, whole milk has a much lower glycemic index than skim milk. This is also true for all light foods such as yogurt; the whole one has a lower glycemic index than the light one.
The total release of insulin also depends on the amount of carbohydrates ingested and not only on the glycemic index. Therefore a meal must not exceed a quantity of carbohydrates greater than 55% of the daily calories and must also contain fat and protein (complete meal).
Along with an adequate diet, it is also necessary to carry out moderate daily physical activity which helps the tissues and in particular the muscle to make better use of sugars and to have an efficient response to insulin.