‘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, October 30, 2013

Breakfast: Kick Start Your Ovaries

Pie hole devotees will recall a few months ago we discussed the most common cause of female infertility: Polycystic Ovary Syndrome (PCOS). The abridged digest of "Don't Wait to Lose Weight and Ovulate" is that weight loss, irrespective of diet composition (eg: high protein, low fat, low carb, etc) improved menstrual regularity and ovulation in women with PCOS. Oh, I almost forgot, the usual disclaimer for potentially blush-worthy words applies to this article: Words including ovulation, menstruation, sex hormones and ovaries will appear frequently. But stick around, today we're talking about improving fertility without weight loss.

A quick recap of PCOS: It prevents ovulation due to excessive production of sex hormones, called 'androgens'. Two major factors cause this overproduction of hormones: Insulin resistance and hyperinsulinaemia. Don't freak out! I'll explain: 
  • Insulin is the hormone that moves glucose (sugar) from your blood into your cells. Think of it as the ball boys at a tennis tournament who clear excess tennis balls from the court, allowing the game to continue
  • Insulin resistance means you require more ball boys to remove the same number of tennis balls as someone who is not insulin resistant
  • Hyperinsulinaemia is tied to insulin resistance as it refers to higher than expected levels of insulin (or ball boys) for a given amount of glucose (or balls... tennis balls that it)
PCOS affects 6-10% of reproductive aged women. Over half of women with PCOS are obese (BMI >30). Overweight and obese women can improve the above factors through diet and weight loss. But what about lean women with PCOS? Weight loss is not a viable option for them.

Previous research shows that timing of meals, hormones and nutrients can effect metabolism, fat metabolism and fat storage. A recent study looked at overweight and obese women with insulin resistance, and found that caloric distribution of meals impacted insulin levels. The group eating a high calorie breakfast and low calorie dinner had both improved weight loss and insulin sensitivity (fewer ball boys needed), compared to the low calorie breakfast and high calorie dinner group (lunch calories were identical).

Where it gets really interesting is with a new study that investigated lean women with PCOS (where weight loss is not an appropriate treatment option). One group had a high calorie breakfast and low calorie dinner (BF group), the other had a low calorie breakfast and high calorie dinner (D group). Both groups had the same number of calories for lunch. After 90 days the results showed:
  • Women in the BF group were significantly less insulin resistant (they needed fewer ball boys)
  • Women in the BF group had significantly lower levels of the sex hormones associated with irregular menstruation and ovulation
  • Almost 50% of women in the BF group had ovulated at least once during the study, compared to only 20% in the D group (these results were significant)
  • The D group did not show adverse insulin effects, their insulin resistance and other factors (like sex hormones) remained constant
This is exciting because it is a simple, safe way for lean women with PCOS to improve factors like sex hormone levels and insulin resistance without medication. These factors, in turn improve menstrual cyclicity and ovulation. 

So go on ladies, make breakfast really pack a nutritional and caloric punch to get those ovaries off to a great start!

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