Can you fight polycystic ovarian syndrome (PCOS) over breakfast?
A new study conducted at the Universities of Jerusalem and Tel Aviv has found that a hearty breakfast could help improve fertility in women suffering from polycystic ovaries .
Polycystic ovary syndrome is one of the most common causes of infertility in women (10% of women of reproductive age suffer from this pathology), and is associated with hormonal imbalances that lead to very irregular or absent menstruation, which makes it very difficult in conception.
Many women with PCOS also have impaired blood insulin levels or become insulin resistant. This means that their body does not respond correctly to changes in blood insulin levels, which results in an increase in testosterone levels (male hormone) which in turn alters the menstrual cycle.
As you can well understand, our reproductive system is based on an intricate hormonal balance which, if altered, leads to the inability to conceive.
Reducing blood insulin through weight loss or with the help of medications can improve fertility, but these are not the best ways if a woman is already thin on her own. For this reason, the researchers sought to understand whether dividing meals in a particular way could improve the control of blood insulin levels in women with PCOS.
A research team from these two universities studied 60 thin women with PCOS and aged between 25 and 39 over a 12-week observation period.
Each of these women was asked to eat approximately 1800 calories per day, slightly below the recommended daily total for women (2000 calories). Half of them were asked to eat the largest meal at breakfast, while the other half were asked to eat the largest meal in the evening.
The results were published in the journal Clinical Science:
First group (large breakfast):
- a large meal at breakfast of 980kcal
- a medium-sized lunch meal of 640kcal
- a small meal at dinner or 190kcal
Second group (large dinner)
- a small breakfast meal of 190kcal
- a medium-sized lunch meal of 640kcal
- a large meal at dinner of 980kcal
At the beginning of the study, the researchers measured:
progesterone levels during the follicular phase of the menstrual cycle, insulin, glucose, steroid hormones, SHBG.
The researchers then measured the women’s progesterone levels each week to figure out if ovulation had occurred. The researchers also measured body mass, blood pressure and waist circumference every two weeks.
25 women from the first group and 26 from the second completed the study.
Results :
After 90 days of this diet the blood glucose concentrations in the women of the first group had significantly decreased by 8% (from 89.1 to 81.8 mg/dl) and so had the insulin levels, which had decreased by 53% (14.3 to 6.7 microIU/mL).
In the second group, however, there was no significant change in fasting blood sugar or insulin.
Blood testosterone values were also found to be halved in the group with the big breakfast.
Regarding ovulation, 50% of the women who followed the high-calorie breakfast diet had ovulated at least once, compared with 20% of the high-calorie dinner group.
The research was done on a small number of women and therefore larger-scale studies are needed to get more confirmation. A control group that should have followed a normal diet is also missing. The study should also be continued from a temporal point of view to understand if the differentiated diet leads to pregnancies but also to understand how many ovulations occur per year and if the situation improves over time. The study also did not consider the effects on general health of continuing to follow this particular high-calorie breakfast diet.
Although these results are encouraging, it is important to remember that one of the main ways to improve fertility in PCOS is to maintain a healthy weight with a body mass index between 19 and 25 kg/m2. If you are overweight, losing as little as 5% of your body weight can lead to a significant improvement in your PCOS symptoms.
Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.
Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.