‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Wednesday, May 29, 2013

Don't Wait to Lose Weight and Ovulate

This week's article tackles a topic that is beyond the scope of a dietitian alone. I have enlisted the help of Reproductive Scientist, and great friend, Shannon Everett (Master of Reproductive Science). Polycystic Ovary Syndrome (PCOS): It's bit of a mouthful yes, but believe it or not, fertility is linked to your diet.

PCOS is one of the most common causes of female infertility. This syndrome prevents ovulation due to excessive production of sex hormones, called 'androgens'. Despite the name, not all women with PCOS have ovarian cysts; kind of like how not all vegetarians are healthier than omnivores.

The exact prevalence of PCOS is difficult to ascertain due to differing diagnostic criteria. If we had to put an approximate figure on it, it's somewhere between 6-21%.

'Normal' vs Polycystic Ovaries (Source: MedicineNet)

Presentation of PCOS is generally at least two of:
  • Menstrual dysfunction (infrequent, or lack of periods)
  • Increased acne/facial hair, and other signs of hyperandrogenism (increased production of sex hormones)
  • Polycystic ovaries (cysts identified on the ovaries via ultrasound)
Here's where diet and lifestyle factors come into play: over half of women with PCOS are obese (BMI > 30). Both obesity and PCOS increase the risk of health issues such as infertility, heart disease, insulin resistance and type II diabetes. When a woman falls into both categories, it's like spotting a kid playing with matches in the bush in the middle of summer: sirens are sounding.
The best way to improve PCOS symptoms and regain/improve menstrual function is pretty darn simple and supported by evidence in both dietetics and reproductive science... Weight loss!

A recent meta-analysis (combination and analysis of independent studies) investigated whether diet composition improved outcomes of PCOS. Diet compositions investigated were:
Results did not show one diet composition was superior over another. What is interesting, though, is positive body composition changes (decreased fat mass, waist circumference, waist to hip ratio and increased lean muscle mass) were observed independent of diet type. Menstrual regularity and ovulation improvements were also noted independent of diet composition.

If you were to liken the efficacy of your body to a car:
  • Change the spark plugs for more efficient petrol use (change from fast foods to whole foods and cook at home, you and your wallet will run more efficiently)
  • Use high quality, lower viscosity oil to reduce friction on the engine (whole grains increase the body's ability to efficiently produce energy from other high quality foods)
  • A clogged catalytic converter in the exhaust decreases efficiency (get that body moving to prevent human 'clogging')
  • Properly inflated tyres (tires) increases fuel efficiency, weight of the car has an impact (wear comfortable workout shoes, you're more likely to walk or workout longer if you're comfortable)
Take home messages:
  • PCOS is a serious condition affecting female fertility
  • A safe and sustainable diet, regardless of its specific composition, that results in weight loss has clinical benefits with regards to PCOS
  • The safest and most sustainable way to lose weight is through lifestyle modification:
  • Moderating portion sizes of meals destined for your pie hole
  • Physical activity
  • Eating plenty of unprocessed foods like fruits, vegetables and whole grains, with moderate amounts of lean meat and dairy

Big thank you to my wonderful friend and co-author, Shannon Everett (Master of Reproductive Science).
Also, thanks to the good folks at Come Racing for helping me liken a well oiled car to a well oiled body: http://www.comeracing.com/

For further reading, check out "Baby Making Nutrition" at http://pureformenyc.com/blog/baby-making-nutrition


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