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GENERAL RESEARCH

GENERAL RESEARCHWOMEN’S HEALTH

COMMON MISCONCEPTIONS ABOUT PCOS

PCOS is quite common nowadays in youngsters as girls of adolescent age already see their periods very early. With this development, it is important have a good knowledge about PCOS than blindly believing in misconceptions.

We carefully picked some common myths to burst about PCOS in this write up. I hope you find them useful:

1. MYTH: diabetes causes PCOS

FACT: PCOS leads to hormonal imbalance and also insulin resistance which could make you vulnerable to diabetes. If you’re obese and have PCOS, you’re prone to having diabetes. So, PCOS could possibly lead to diabetes and not the other way around as the myth suggests.

2. MYTH: Thin women do not get PCOS

FACT: It’s true that majority of women with PCOS are overweight, but thin women could also get PCOS (comparatively rare though). Hormonal assessment and abdominal scan are used to ascertain in such rare cases.

3. MYTH: the symptoms are same with all women

FACT: This is totally not correct as symptoms vary in PCOS. The common symptoms are menstrual problems (irregular periods or delayed periods), and obesity. Other hormonal problems occur in some women with PCOS like abnormal hair growth especially in unusual places. As hormone changes occurs, it causes a dominance of male hormones (androgenic hormones). Some girls start having moustache from young ages.

4. MYTH: NO OVARIAN CYST, NO PCOS

FACT: Most times, cysts fail to show during a scan and this makes most women feel they don’t have PCOS. If you ever notice irregular periods, your best bet is a transvaginal scan which is 100% effective.

5. MYTH: Women with PCOS cannot have babies

FACT: As PCOS affects the ovulation, the process of egg formation, it can lead to infertility. However, some patients have conceived without any treatment or IVF (invitro fertilisation). Infertility is a cause of concern for a woman with a large ovary, no periods, multiple cystic areas and already have hirsutism at the age of 20-23 years. In such a case, you might need diet modification, proper medication and assessment of ovarian function (follicle scan).

6. MYTH: PCOS can be cured.

FACT: PCOS can’t be cured but adequately managed. The treatment options depend on severity and other underlying health problems seen in patient. Diet modification is usually first line in young girls and medication as the case might be.

Treatment options are available in PCOS ranging from dietary modification to oral medications. If you are not trying to get pregnant, taking an oral birth control pill that includes a combination of low-dose estrogen and progestin can help regulate the menstrual cycle and alleviate unwanted hair and acne.

If you’re trying to become pregnant, medication to induce ovulation, such as Clomid, can help you conceive.

References

1. https://www.centrastateobgyn.com/blog/6-common-misconceptions-about-polycystic-ovary-syndrome/#:~:text=Here%20are%20some%20common%20misconceptions,get%20pregnant%20without%20any%20intervention.

2.https://www.google.com/amp/s/www.thehealthsite.com/diseases-conditions/common-myths-about-pcos-polycystic-ovarian-syndrome-busted-b0217-473428/amp/

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GENERAL RESEARCHLIFESTYLE

HOW TO NAVIGATE EFFECTIVELY WITH THE INTERMITTENT FASTING

IF simply involves switching between fasting and eating on your normal schedule.
This method could help you manage your weight and ward off chronic diseases if monitored and done effectively.

BASIC CONCEPTS
Before going into this practice, it is important to know what it entails.
Some basics to know:
– you have to skip one meal
– you can still have your favourite healthy meal while fasting
– you can drink water while fasting
– you can have no-calorie beverages while fasting. Examples include coffee, green or black tea.

So for everyone that has heard about IF or has practised it before, normally, you would skip breakfast while fasting, because it feels easier.
-But, according to a research carried out by USDA economic research service, it was noticed that skipping dinner, reduced more daily calories and lowered diet quality the least when compared to skipping breakfast or lunch.
-Also note that your night fast should be longer than 2 hours and shorter than 24 hours

TYPES OF IF
There are basically 3 popular types of IF:
– 16:8 method
– 5:2 method
– eat-stop eat method.
Others include OMAD, and warrior diet.

16: 8 METHOD

5:2 METHOD

EAT-STOP-EAT METHOD
This method involves fasting for 24 hours twice or thrice a week.
– Fasting for 24 hours would lead to a metabolic shift and ause your body to use up fat
– But staying off food for 24 hours might lead to binging and overconsumption.

IF AND YOUR HORMONES
– IF positively affects the human growth hormone (HGH), especially when done adequately. These hormone levels increase when you do IF, and higher levels of this hormone facilitate fat burning and muscle gain.
– IF also increases the amount of norepinephrine in our bodies which help to breakdown body fat and facilitate it use for energy
– intermittent fasting decreases androgen markers (i.e., testosterone and the free androgen index (FAI)) while increasing sex hormone-binding globulin (SHBG) levels in premenopausal females with obesity.
– fasting may prove to be a valuable tool for treating hyperandrogenism in females with polycystic ovarian syndrome (PCOS) by improving menstruation and fertility.

BENEFITS
– WEIGHTLOSS: A 2014 review of scientific literature found that IF can cause 3–8% weight loss over 3–24 weeks, which is a significant amount. Also, participants lost 4-7% of their waist circumference.
– CAN REDUCE INSULIN RESISTANCE: IF can help reduce insulin resistance. According to research, it can help reduce blood sugar by 3–6% and fasting insulin levels by 20–31%.
– HEART-HEALTH: IF may help to reduce bad cholesterol, and blood triglycerides.
– OXIDATIVE STRESS: IF may help reduce inflammation (a key factor in disease processes) and oxidative stress.
– BRAIN HEALTH: may increase the brain hormone brain derived neurotrophic factor (BDNF) and may help in the growth of new nerves. it also may help prevent alzemheirs
– DECREASE IN APPETITE: according to research, time-restricted fasting (16 8), decreased mean ghrelin levels, increased fullness in participants, and decrease the desire to eat.
Also, in the first 12 hours of fasting, there is a slight increase in ketone bodies, this helps in appetite suppression.

POSSIBLE DOWNSIDES
– Malnutrition: if not done properly, intermittent fasting could lead to serious malnutrition. some very vital micronutrients and electrolytes might be lacking in your diet if not monitored.
– Dehydration: during a fast, your body tends to release water and salt via the urine. if this water isn’t replenished, you get dehydrated.
– Bad breath: during fasting, fat is used up majorly as fuel. fat metabolism leads to acetone formation which can affect your breath
-fatigue and low energy: when fasting, especially if you are not adequately monitored, with an inadequate intake of calories, you tend to be fatigued due to a low intake of calories
5. Headaches and lightheadedness: this is most common in intermittent fasting and occurs within the first few days especially if you’re a newbie.
6. Hunger and cravings: normally you’d feel hunger cues during your fasting. they tend to be heavier if you don’t do it well.
Most of these side effects should disappear in 2 weeks,

TIPS TO NAVIGATE EFFECTIVELY
• Know your nutrient needs
• Always incorporate proteins into your eating window
• Know your energy requirements
• Always stay hydrated
• Avoid overeating/undereating
• Maintain a balanced diet
• Try out the different types of IF
• Keep track of your journey
• Adapt a suitable workout routine
• Plan meals
• Speak to a registered dietitian

WHO SHOULD NOT BE ON IF?
• If you are underweight
• If you have a history of an eating disorder
• If you are pregnant
• If you are breastfeeding
• If you are on insulin (type 1)
• Anyone with immunosuppression
• Transplant patients
• Chronic kidney diseases
• Poorly controlled diabetes (unless an endocrinologist is involved).
• Adolescents and kids
• Elderly (muscle mass)

SUMMARY
The intermittent fasting pattern of eating is quite a beneficial one with side effects that can easily be managed. But, it is important that you are monitored by health practitioners before delving into this type of diet.
Also, before starting, be sure of the type of fast that would suit your lifetyle and schedule.

SOURCES:
-https://www.hopkinsmedicine.org/health/wellness-and-prevention/intermittent-fasting-what-is-it-and-how-does-it-work
– https://www.healthline.com/nutrition/6-ways-to-do-intermittent-fasting
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680567/
– https://pubmed.ncbi.nlm.nih.gov/31525701/

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GENERAL RESEARCH

5 FOODS THAT CAN HELP WITH ANXIETY

Anxiety can be normal when you’re worried about the outcome of an event, when you’re scared about the future, or when you are expectant. But, recently,  anxiety can be an indicator of an underlying underlying disease when feelings become excessive, all-consuming and interfere with daily living.

How you deal with anxiety matters a lot, so it doesn’t escalate and become a disorder.

Sometimes, anxiety could be as a result of:

  • Battling with a mental health issue such as depression can raise the chances of having anxiety.
  • Going through negative life events like, emotional and verbal abuse, sexual assault, losing a loved one, and much more.
  • The use of certain medication which has an effect of stimulating the nervous system resulting in symptoms of anxiety.
  • Having certain underlying illnesses such as diabetes, hypertension, obesity, can make you anxious all the time.

In reality, anxiety does more than just getting you scared, worried, or perhaps disconnected from people. It can raise alarm for certain health concerns such as,

  • Having psychological issues which include bipolar disorder, mood swings, psychotic disorder, eating disorder, and much more.
  • You may get tempted to abuse substances like drugs, or alcohol.
  • The digestive tract gets compromised
  • Insomnia may become the new norm
  • Poor quality of life takes the lead

Have you been battling with anxiety for some time now, and have tried quite a lot but still faced with such? Relax, there are dietary means to help curb its effect: 

  • Try bananas- yes! You heard right. Bananas are so helpful when it comes to anxiety management. Findings have shown that consuming bananas can help keep anxiety symptoms far from you. This fruit is a natural beta-blocker that helps block the effect of adrenaline which can trigger anxiety. A research showed that women who ate about 2 fingers of bananas daily were less likely to report symptoms of anxiety. Also, the B vitamin content of banana helps in the production of serotonin (the feel good hormone) which improves mood and anxiety. Findings have also shown that tryptophan (an amino acid) found in banana reduces anxiety and promotes rest and relaxation. 
  • Incoporate fatty fishes- foods such as salmon, mackerel, has been shown to help improve anxiety symptoms effectively. A study reported that individuals who battled anxiety and consumed fatty fishes had their symptoms reduced by 18-34%. Also, another study reported improvements in patients by 20% after consuming fatty fishes for about 3 months. 
  • Incorporate turmeric into your diet- curcumin, an active component found in turmeric has been proven to help perform wonders when it comes to anxiety. It helps to support the gut microbiota, reduces inflammation which alters the feel good hormones (serotonin, dopamine) by increasing the chances of anxiety. A study showed that individuals who consumed turmeric for about 30 days had their anxiety symptoms reduced. 
  • Stock up on yogurt- findings have shown that there is a link between the gut health and the brain. Consuming a food such as the low fat yogurt can help improve the gut health which would positively slow down stress and anxiety. Findings have shown that chronic inflammation may partly influence anxiety and consuming foods such as yogurt would be helpful. 
  • Chamomile : it’s a herb that could be made into tea. It contains some antioxidants that can help lower inflammation associated with anxiety. Also,  it may help regulate the hypothalamic-pituitary-adrenocortical (HPA) axis, a central part of the body’s stress response.

Remember, you can keep anxiety at bay by just consuming the right quantity of these foods in your diet. Thinking of how to start? Your dietitian is here for you. We are just a click away!

SOURCES:

1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3600408/

2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728608/

3.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839572/

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GENERAL RESEARCHLIFESTYLE

ALCOHOL AND THE RISK FOR HYPERTENSION

Do you know what is funny? How people think alcoholic beverages can be taken without caution because most of them seem to be bitter.

So, you see people taking bottles/cans of beer, and shots of spirits at a sitting, feeling it won’t be detrimental to their health.

Our work-hard-party hard kind of lifestyle has made it possible for the risk of hypertension to be increased especially among youths. Hypertension is a lifestyle disease, so we must all be able to look at our lifestyle and make a change to it.

Also, the idea that alcohol is a stress reliever, makes it possible for people to consume without caution which in turn hurts the liver and brain, possibly leading to hypertension

WHAT IS THE LINK BETWEEN ALCOHOL INTAKE AND HYPERTENSION?

Alcohol is one of the modifiable ways to reduce hypertension. The link between alcohol and hypertension is clear as alcohol is a major contributory factor in hypertension

Studies have shown that taking more than three alcoholic drinks a day can increase the chance of developing hypertension in later life by up to 75%.

Alcohol has both direct and indirect links to hypertension: It can cause you to gain weight which is linked to hypertension, and it can also directly affect your blood pressure readings.

Furthermore, alcohol may stimulate adrenals which release adrenaline. When adrenaline is released, it leads to increased cardiac output, increased heart rate, and increased systolic blood pressure.

BUT RED WINE IS GOOD FOR MY HEART?

Well, several past studies have made this popular. The idea behind this is that grapes used in making red wine contain reservatol and can help keep the heart and provide other benefits. But truly, the amount of reservatol in red wine is affected by the processing, fermentation, and even aging of wine and cannot be sufficient to provide any heart health benefits as purported.

It is important to pay attention to your lifestyle: quit binge drinking, reduce or stop consumption of alcohol if you’re on blood pressure medications or have a family history, try abstinence!

SOURCES:

– https://www.medanta.org/patient-education-blog/the-truth-about-alcohol-and-hypertension/#:~:text=Drinking%20too%20much%20alcohol%20can,doubles%20the%20risk%20of%20hypertension.

– https://pubmed.ncbi.nlm.nih.gov/18259032/

– https://www.drugsandalcohol.ie/24301/1/Alcohol-and-Hypertension_Factsheet.pdf

– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038773/#:~:text=It%20is%20possible%20that%20alcohol,oxidative%20injury%20to%20the%20endothelium.

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GENERAL RESEARCH

3 REASONS YOUR BLOOD SUGAR FLUCTUATES

Blood sugar readings can be fickle; and this is regardless of whether you were just diagnosed recently, or you’ve been diagnosed over a long period of time.

Apart from the fact of its fickleness, it is also very important that it is always in check and managed well

Proper blood glucose management can help to prevent you from potential diabetes complications like nerve damage, kidney disease, vision problems, heart diseases and stroke

Learning how different habits and factors can cause blood sugar to fluctuate can help you prepare for, and predict fluctuations

It is important to note that some of these factors are out of control; even though you stick to your medications and diet, your blood sugar will still tend to fluctuate.

But that doesn’t mean it cant be prepared to defend against those fluctuations. Keep reading to see factors that could affect blood sugar and what to do about them.

1. DEHYDRATION: sounds awkward right? Well, being dehydrated and having diabetes are co-related. When your body is short of enough fluid supply, the sugar in the cells tends to be high concentrated and this leads to hyperglycaemia.

To make things worse, high blood glucose leads to excessive urination, which can in turn increase dehydration.

So, if you have been diagnosed with diabetes, it is in your interest to stay hydrated always, especially with water.

  • 2. SOME MEDICATIONS AFFECTS BLOOD SUGAR: apart from your oral drugs to help manage diabetes, some other over-the-counter drugs you’re on can alter glucose readings.

Drugs used to treat inflammatory conditions, autoimmune disorders, and asthma can cause a spike in blood glucose.

3. DAWN PHENOMENON: you might have experienced this one time or the other when your blood sugar levels spike at early mornings even if you did so well with your drugs and diet the previous night.

It might just be dawns phenomenon: your body releases cortisol during 2am-8am, and this hormone has a way of making your body less sensitive to insulin.

You should check with your doctor if this continues regularly.

Apart to inadequate management and abuse of oral glycaemic drugs, some other factors might be influencing your blood sugar readings

You have noticed that your crossed all your T’s and dotted all your I’s and still? Just maybe, these factors are involved.

SOURCES:
– https://www.everydayhealth.com/type-2-diabetes/symptoms/surprising-causes-of-blood-sugar-swings/
– https://www.cdc.gov/diabetes/library/spotlights/blood-sugar.html
– https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/dawn-effect/faq-20057937#:~:text=The%20dawn%20phenomenon%2C%20also%20called,a.m.%20%E2%80%94%20in%20people%20with%20diabetes.
– https://www.ncbi.nlm.nih.gov/books/NBK430893/

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GENERAL RESEARCH

High fiber linked to immunotherapy response among patients with melanoma

Cancer has been a threat globally and every professional has been on their toes to proffer a solution.
Immunotherapy, therefore, is one of the ways to help manage cancer patients
Immunotherapy involves stimulation of the immune system to help fight cancer. This method has shown tremendous improvements in the treatment of many tumors.

Even with this development, there are individual responses to the treatment. For some people, the tumors might shrink or disappear totally, and for some, no effects at all.

Further research has gone into this case, and it has been noticed that the gut microbiome might have a role to play in the efficacy of immunotherapy. So, therefore, modifying the gut bacterium may help improve tumor response to immunotherapy.

FIBER INTAKE AND MELANOMA RISK

According to a study, a higher intake of dietary fiber (responsible for the promotion of healthy gut) was associated with improved response to immunotherapy, and in preclinical models, dietary fiber manipulation impacted antitumor immunity. According to Jennifer McQuade, MD, assistant professor of melanoma medical oncology at The University of Texas MD Anderson Cancer Center, “The dietary pattern associated with response to immunotherapy is the same diet recommended by American Cancer Society and American Institute for Cancer Research, which includes a diet rich in fruits and vegetables, whole grains and legumes. This diet is also recommended for secondary cancer prevention and prevention of cardiovascular disease and health in general.”
Furthermore, research has it that every 5% increase in fiber intake resulted in a 30% reduced risk of cancer progression or death.

RATIONALE
Previous research has shown gut microbes may regulate response to drugs that block protein (T-cells) checkpoints. Extensive studies on the effect of diet and probiotic supplements on patients with melanoma using drugs that inhibit these proteins are needed.

METHODOLOGY
McQuade and colleagues conducted a randomized prospective clinical trial to assess how varying fiber intake affects the gut microbiome and immune response among 128 patients with advanced melanoma receiving treatment with immune checkpoint inhibitors.

Researchers examined fecal microbiota profiles, dietary habits, and commercially available probiotic supplement use, and performed parallel preclinical studies.

KEY FINDINGS
According to a randomized prospective clinical trial to assess how varying fiber intake affects the gut microbiome and immune response among 123 patients with advanced melanoma, Patients who reported higher consumption of dietary fiber intake from fruits, vegetables, legumes, and whole grains experienced significantly longer PFS. Median PFS was not reached among the 37 patients with sufficient fiber intake, compared with median PFS of 13 months among the 91 patients with insufficient fiber intake.
After this, it was noticed that 82% of patients with both sufficient fiber intake and no probiotic use responded well to immunotherapy, compared with only 59% of patients who reported either insufficient fiber intake or probiotic use.
Probiotic supplement use alone did not appear associated with a significant difference, in short, data suggests it reduces chances of survival.

IMPLICATIONS
Based on these findings, oncologists, dietitians, and all others managing cancer patients, it is important to focus on how much fiber is consumed in their diet.
The aim is to test the hypothesis that dietary fiber will help modulate the gut environment and enhance immunity.
Further research is still going on to ascertain variations in fiber and their roles in helping patients with cancer (melanoma especially).

SOURCES:
1. https://www.nih.gov/news-events/nih-research-matters/fiber-diet-linked-cancer-immunotherapy-response
2. https://medicaldialogues.in/diet-nutrition/news/association-between-vitamin-d-and-type-2-diabetes-is-affected-by-magnesium-intake-study-finds-86270?infinitescroll=1
3. : Dietary fiber and probiotics influence the gut microbiome and melanoma immunotherapy response. Spencer CN, McQuade JL, Gopalakrishnan V, McCulloch JA, Vetizou M, Cogdill AP, Khan MAW, Zhang X, White MG, Peterson CB, Wong MC, Morad G, Rodgers T, Badger JH, Helmink BA, Andrews MC, Rodrigues RR, Morgun A, Kim YS, Roszik J, Hoffman KL, Zheng J, Zhou Y, Medik YB, Kahn LM, Johnson S, Hudgens CW, Wani K, Gaudreau PO, Harris AL, Jamal MA, Baruch EN, Perez-Guijarro E, Day CP, Merlino G, Pazdrak B, Lochmann BS, Szczepaniak-Sloane RA, Arora R, Anderson J, Zobniw CM, Posada E, Sirmans E, Simon J, Haydu LE, Burton EM, Wang L, Dang M, Clise-Dwyer K, Schneider S, Chapman T, Anang NAS, Duncan S, Toker J, Malke JC, Glitza IC, Amaria RN, Tawbi HA, Diab A, Wong MK, Patel SP, Woodman SE, Davies MA, Ross MI, Gershenwald JE, Lee JE, Hwu P, Jensen V, Samuels Y, Straussman R, Ajami NJ, Nelson KC, Nezi L, Petrosino JF, Futreal PA, Lazar AJ, Hu J, Jenq RR, Tetzlaff MT, Yan Y, Garrett WS, Huttenhower C, Sharma P, Watowich SS, Allison JP, Cohen L, Trinchieri G, Daniel CR, Wargo JA. Science. 2021 Dec 24;374(6575):1632-1640. doi: 10.1126/science.aaz7015. Epub 2021 Dec 23. PMID: 34941392.

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GENERAL RESEARCH

CAN THE KETO DIET IMPROVE PCOS SYMPTOMS?

In all indications, diet changes and physical activity are lifestyle changes that are recommended for women with polycystic ovary syndrome, but some investigators have evaluated the effects of a ketogenic diet on some selected population of patients.
With this write up, we will see the outcome of the intervention.

According to a new study findings in the International 

Journal of Environmental Research and Public Health, the ketogenic diet showed great promise as adjuvant treatment alongside pharmacological therapy in the treatment for women with polycystic ovary syndrome (PCOS), especially for women classified as obese.

Some common comorbidities that comes with of PCOS includes insulin resistance, dyslipidemia, and obesity. When these conditions are not managed effectively, they could increase the risk of diabetes and metabolic syndrome among women with the endocrine disorder.

In this study, seventeen women whose mean (SD) age was 28.5 (5.38) years (fertile age, according to the investigators) with PCOS and who were classified as obese (body mass index [BMI] > 25) were used; all were enrolled at the University Medical Service of Dietetic and Metabolic Diseases of the Faculty of Medicine and Surgery of the University of Foggia, in Italy.
The most therapeutic and suitable prescription with evidence for women who were obese and had PCOS was lifestyle correction according to this study. “This is the first study on the effects of the ketogenic diet on PCOS.” This type of diet adopted included one with increased fat intake, reduced carbohydrate intake, and adequate protein. For this study, daily intakes were set at 600 kcal for calories, 1.1 to 1.2 g of protein per kilogram body weight, 30 g for carbohydrates, and 30 g for fats.

“Following a 45-day dietary protocol, baseline/first visit findings were compared with 45-day/final visit results for gynecological evaluation of oligo/amenorrhea status, nutritional status, body composition, biochemical measurements, and diet administration.

The baseline overall average total body weight was 81.5 (13.56) kg and the baseline BMI, 31.84 (5.85) kg/m2”.

There were decreases in the following measures:
• Average weight: 9.4 kg (P < .0001)
• Average BMI: 3.6 kg/m2 (P < .001)
• Waist circumference: 9.4 cm (P < .001)
• Hip circumference: 8.1 cm (P < .001)
• Fat mass: 7.90 kg (P < .001)
• Free fat mass: 1.41 kg (P < .05)
• Muscle mass: 1.32 kg (P < .05)
• Total body water: 1.32 kg (P < .01)
• Basal metabolic rate: 67 kcal (P < .001)

There was improvements in several of the metabolic parameters (all P < .001) as shown below:
• Mean blood and urinary concentrations of ketones rose to 1.7 (0.58) mmol/L and 83 (54.34) mg/dL, respectively, from zero at baseline for both
• Mean blood glucose decreased 10.07 mg/dL
• Blood insulin dropped 12.90 mcU/mL
• C-peptide blood concentration decreased 0.87 ng/mL
• Triglycerides fell to 70 mg/dL
• Total cholesterol dropped to 40 mg/dL
• LDL cholesterol dropped to 35 mg/dL
• HDL cholesterol rose to 15 md/dL

Changes in endocrine parameters, were recorded as:
• Luteinizing hormone (LH) decreased to 4.6 mIU/mL (P < .001)
• Free and total testosterone decreased to 0.17 and 7.34 ng/dL, respectively (P < .001)
• LH/follicle stimulating hormone (FSH) ratio decreased to 1.32, from 2.72 at baseline (P < .01)
• FSH value increased to 1.46 mIU/mL (P < .05)
• Sex hormone binding globulins 12.43 nmol/L (P < .001)
• Positive correlations were seen between LH/FSH and weight, BMI, and fat mass
• Negative correlations were seen between LH/FSH and weight, BMI, and fat mass
• Positive correlations were seen between glycemia and LH and FSH
• Negative correlations were seen between LH/FSH and glycemia

For some patients, say about 5 of them, regular menstrual cycles reappeared “after years of amenorrhea,” while for the other 12 patients, there was restoration of regular menstruation—5 of whom when on to become pregnant naturally.

According to recorded results, using the ketogenic diet alongside medical intervention was effective in managing PCOS. So, by reducing the amount of carbohydrates and inducing therapeutic ketosis, PCOS patients can have a better life as the diseases is also influenced by lifestyle.

Even though this study came out positive, it is important to note that it is the first ever of its kind and further studies are needed to elucidate the effects of the ketogenic diet and its mechanism.

Reference
Cincione RI, Losavio F, Ciolli, et al. Effects of mixed of a ketogenic diet in overweight and obese women with polycystic ovary syndrome. Int J Environ Res Public Health. Published online November 27, 2021. doi:10.3390/ijerph182312490

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GENERAL RESEARCH

AM I ADDICTED TO SUGAR?

When you hear the word “addiction”, I’m sure your mind goes straight to drugs, alcohol or some practices. But sugar addiction is real and some people might not just be aware of what it is and the fact that they’re victims.

In this write up, we would help explain what sugar addiction is, why you always crave sugar and some tips to help overcome the feeling.

Quitting sounds logical as that is the remedy for other types of addictions, but for sugar, it’s not as simple as that.

Firstly, what is addiction?

There are two categories of addiction, which are:

1. A substance addiction such as drugs, alcohol or tobacco

2. A non-substance behavioural addiction such as gambling.

So, the definition could be controversial if you view it with just one lens.

Some reports have suggested that sugar addiction is a thing and some people can be addicted to it as heroin and cocaine. Some people who might be addictive to other foods with “addictive agents” like fat and salt could also show same result as someone with drug addiction. Even with all these speculations, no actual study has been carried out on human subjects concerning drug addiction.

Sugar addiction – is it the same as being addicted to drugs?

Since we somewhat have agreed that sugar addiction is a thing, we need to check if it’s the same thing with substance addiction and probably has the same symptoms.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it diagnoses a Substance Use Disorder (substances such as tobacco, alcohol, drugs) based on 11 symptoms. These can be grouped into four categories:

• Impaired control: symptoms relating to failed attempt to stop drug use after noticing a strong desire and craving to use such drug.

• Social issues: symptoms relating to a disruption of person’s work, home and social life.

• Risky use: symptoms relating to continuous use of drug/substance even after being aware of the consequences.

• Drug physiological effects: symptoms of tolerance (when the body requires more of the substance to have same effect) and withdrawal ( the body shows withdrawal symptoms when the drug is no longer in the body).

So, Are These Symptoms the same in Sugar Addiction? 

You might need to ask yourself if you’ve notice same symptoms as mentioned above before.

For example:

• Do I have cravings and a strong desire to eat sugary foods? Yes!

• Have I repeatedly attempted to cut back or “quit” sugar? Yes!

• Do I feel so “out of control” with food that I’m not in the mood to attend social events? Yes!

How is this Diagnosed? 

– For a substance use disorder diagnosis, the symptoms need to cause “significant impairment or distress” meaning that the distress should impair daily functioning of the individual.

This significant distress might most likely be linked to eating patterns and might even be more of an overall eating disorder.

– Secondly, a key part of diagnosis shows that the symptoms produce physiological effects. Drug taking can cause people to develop withdrawal and tolerance symptoms. No studies shows that sugar taking can lead to tolerance and withdrawal.

So am I addicted to sugar if I crave it all the time?

Reasons why you might be craving sugar every time might include:

1) Restriction

Recent articles supports that the root cause of overeating a particular food or feeling out of control around food is restriction and not addiction. This knowledge comes with evidence thaty if you restrict yourself from a particular food, you even want it more and would tend to consume more of it if given the chance. Restrictive food rules which recommends elimination of foods leads to the exacerbation of disordered eating.

For the animal studies that claims that sugar is addictive, these studies failed to emphasise that these animals were actually deprived of sugar for a long time, so they’ll obviously binge on it when re-introduced.

2) Food is pleasurable (which is not a bad thing!) and needed for survival

Food is for survival and the major basic fuel we need to stay alive. Sugar is needed for the functioning of our body, so how would one suggest that you can be addicted to it?

Now, when we mean sugar, I hope you’re aware that we are not talking about refined or processed sugar from pastries or soda drinks but from foods (carbs).

What’s the conclusion? 

Sugar can be found in starchy foods such as potatoes, breads, yam, rice, beans and pastas as well as in fruit, vegetables and dairy products. Things we usually eat in conjunction with many other things!

Now this doesn’t in any sort downplay the fact that some people might feel helpless or out of control when around some foods, but this cant be termed as addiction.

If you feel this is you, you can seek help from a registered dietitian or try intuitive eating. There are online articles on intuitive eating and so many dietitians around who could help you build a healthy relationship with food

That’s the actual thing that’s needed! A healthy relationship with food will go a long way in helping you appreciate food and its functions in the body, and also help you not to be “out-of-control’ around any particular food .

SOURCES:

– https://nudenutritionrd.com/am-i-addicted-to-sugar/

– https://jandonline.org/article/S0002-8223(96)00161-7/pdf

– https://www.mentalhelp.net/addiction/vs-behavioral-addictions/

-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174153/pdf/394_2016_Article_1229.pdf

– https://www.psychiatry.org/psychiatrists/practice/dsm

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DIET THERAPY OF DISEASESGENERAL RESEARCH

NUTRITION INTERVENTIONS IN SICKLE CELL ANAEMIA

Sickle cell disease is an inherited blood disorder where red blood cells that carry oxygen assume a totally different shape from the normal. Normally, red blood cells assume a disc shape while flowing through blood vessels, but in sickle cell anemia, red blood cells assume a crescent like shape.

Devastating as the disease might be, no cure has been found yet.

Interestingly, through research and a bid to increase knowledge, it has been found out that nutritional problems are fundamental to the severity of the disease, thereby increasing interests to promote dietary supplementation for decreasing morbidity and to help improve the quality of patient’s life.
Several methods of treatment and management have been in use for quite a while now and they include:

MANAGEMENT OPTIONS
-Hydroxycarbamide (or hydroxyurea) This substance helps to reduce the number of painful episodes in Hbss patients.
-Blood transfusion: A number of observational and randomised controlled trials have established the pivotal role of transfusion therapy in the management of SCD, most notably in primary stroke prevention.
-Allogeneic HSCT and gene therapy: Allogeneic haemopoietic stem cell transplant (HSCT) is the only curative treatment for SCD and is successful in 85%–90% of patients. Transplantation offers disease-free survival and stabilisation of neurological lesions.
Features as growth retardation, impaired immune function, and delayed menarche do suggest a relationship between sickle cell disease and undernutrition. Also, a variety of micronutrient deficiency has been suggested in sickle cell disease.
– Several reports indicate that vitamin E levels are low in sickle erythrocytes. Since these abnormal red cells both generate excessive oxidation products and are more sensitive to oxidant stress, supplementation with vitamin E is advised in people with sickle cell anaemia.
– Complications of sickle cell disease as poor ulcer healing, growth retardation, delays in sexual development, immune deficiencies have been linked to zinc deficiency. It is also pertinent that zinc be supplemented in people with sickle cell.
– Deficiency of Vitamin D is common in sickle cell disease due to dark skin pigmentation, limited sun exposure, increased catabolism and decreased nutrient and energy intake. Vitamin D in it’s entirety is crucial for calcium homeostasis and essential for bone mineralization.

Therefore, a high dose of 100,000 International units (IU) (equivalent to 3,333 IU/day) versus the standard treatment 12,000 IU (equivalent to 400 IU/day) of oral vitamin D3 supplements might just help in reducing risk of respiratory infections.
– Amino acids like arginine and glutamine also play important roles in the synthesis of nitric oxide. Nitric oxide makes it possible for easy blood flow by dilating the blood vessels properly. Increased deficiency of the duo might lead to metabolic stress, increased resting energy expenditure (REE), muscle wasting and decreased immune function. Supplementing with 600mg/kg/day of glutamine showed improved nutritional status of glutamine.

EMERGING INTERVENTIONS
Recently, derivatives from plants has been studied to show their effects in treating people with SCD. Some plants which contain peculiar antioxidants are being studied and there might just be hope to managing SCD.
Exploration of extracts from Moringa oleifera (Moringa), Cajanus cajan (pigeon pea) , Zanthoxylum zanthoxyloides (artar root), and Carica papaya (paw paw) are all being studied to see their possible effects in treating oxidative stress in SCD patients.
With these ongoing experiments, it has been noticed that extracts from these plants could aid in the resistance of hemolysis and reduce the number of sickled red blood cells.

Also, it has been noticed that exercise might play an important role in SCD patients. Exercise helps in reducing oxidative stress and also in the release of nitric oxide which helps in the proper flow of blood through vessels.

CONCLUSION
The nutritional risks faced by SCD patients are usually high and mostly unnoticed. Its imperative to include nutrition as an adjuvant therapy for addressing chronic diseases related with SCD in order to aid effective management.

SOURCES: https://pubmed.ncbi.nlm.nih.gov/3551592/
https://www.dovepress.com/nutrition-in-sickle-cell-disease-recent-insights-peer-reviewed-fulltext-article-NDS
https://www.health.harvard.edu/a_to_z/sickle-cell-anemia-a-to-z
https://adc.bmj.com/content/100/1/48
https://www.todaysdietitian.com/news/042412_news.shtml

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GENERAL RESEARCHMEN’S HEALTH

NITRIC OXIDE AND PERFORMANCE

You may have heard of nitric oxide supplements, which claim to increase workout performance and boost your productivity in general and even enhance endurance in za oza room. You might even find some inside your pre-workout formulas too.

SO WHAT IS, OR WHAT DOES NITRIC OXIDE DO?

“Nitric oxide (NO) is a gas that the body produces, and it helps with blood flow (vasodilator) and could also act as a neurotransmitter. Nitric oxide supplements are formulated in order to try to increase the amount of nitric oxide in your blood, which might in turn help increase blood flow to working muscles and help reduce time to fatigue during a workout..

(To be clear, nitric oxide is very different from nitrous oxide, a.k.a. the stuff that gets you high.)

Theoretically, NO supplements could do wonders for your fitness routine. But in terms of scientific evidence, well, let’s just keep our fingers crossed…

So many questions might be running through your mind now like: Are nitrous oxide supplements safe? Do they work? First off, some of those supplements might not actually be nitric oxide—so be careful with which ones you’re buying. “While companies may label them as ‘nitric oxide’ supplements and boosters, they really don’t contain any nitric oxide. For example, Some ‘boosters’ could  contain compounds such as L-arginine

While the L-arginine in your body is involved in nitric oxide production, research is mixed as to whether taking it in supplement form will increase nitric oxide production, and if it could, whether that would actually enhance exercise performance and improve health.

“It’s also important to note that many booster supplements may contain additional ingredients that are not well researched or well regulated, so it’s wise to read labels carefully and seek professional advice before popping them pills.

If you’re looking to still give nitric oxide a try, here’s what you should know.

FUNCTIONALITY.

In the body, nitric oxide is secreted by the endothelial cells, which line the inner walls of the blood vessels, and it communicates with the smooth muscle cells, triggering them to relax. This blood flow regulation plays a role in multiple body functions, including maintaining erections and controlling blood pressure.

NO supplements, however, don’t actually contain nitric oxide. Instead, they contain ingredients (or substrates) that are thought to give your body a nudge to produce more nitric oxide, such as L-arginine and L-citrulline.

“If you’re ingesting nitrate or L-arginine, the idea is that it’s supposed to stimulate the synthesis of nitric oxide in the endothelial cell. So the more substrates there are, the more NO can be produced,”

Because blood is responsible for the transportation of oxygen to working muscles, the reasoning is that the increased blood flow caused by taking NO supplements might help you work out for a longer period of time and speed up recovery time. Proponents also claim that increased blood flow might make your muscles bigger and more pronounced.

EFFICACY OF NO SUPPLEMENTS

Honestly, me self nor know. There’s simply not enough evidence to suggest that they do.

Seemingly, the idea is that these supplements will increase NO, and then because of that, it’ll support the process of vasodilation, and obviously, the downstream  effect of vasodilation would be this massive increase in blood flow, which leads to increased exercise performance and enhanced recovery. “But most, if not all, of [these purported benefits] have not been supported by available evidence.”

In studies that have shown a link between improvements in performance and nitrate levels in the blood, such positive results could simply be a result of extensive training, as exercise itself enhances NO activity. Plus, dietary nitrate comes from other sources, like vegetables, and most studies don’t control for this.

Even if there are benefits to NO supplementation, it’s unclear whether they would apply to everyone. A review of 42 studies related to the effects of dietary ingredients linked with NO and exercise performance found mixed results: the review concluded that while NO supplements may “improve tolerance” to aerobic and anaerobic exercise in people who either aren’t in shape or are moderately trained, there seems to be no benefit in highly trained people.

BEETS AND IMPROVED WORKOUT?

 A few studies have shown that nitrate supplementation through beetroot juice can be effective at increasing endurance and overall power. One study found a link between 15 days of beetroot juice supplementation and an increase in power max during moderate–intensity cycling tests. While more research is required, it might interest you to note that of the ingredients that may have an impact on NO levels and exercise performance, beetroot juice is the most promising.

“Beets are the highest dietary source of nitrates, which are converted into nitric oxide in the body. Because of their natural nitrate content and it’s ability to convert to nitric oxide so well, beets have been shown through many studies to support the heart, especially by improving blood pressure,”.

Beets are also linked to other nitric oxide benefits, including improvements in both increasing strength and endurance performance as well as improvements in cognition during exercise, lower inflammation levels, greater antioxidant function, improved cognition.

Plus, beets are also good for your heart and muscle recovery, and are a good source of fiber. 

It’s important to note that blood nitrate levels peak within 2–3 hours. Therefore, to maximize their potential, it’s best to consume beets 2–3 hours before training or competing

SIDE EFFECTS OF NITRIC OXIDE SUPPLEMENTS

Even though the jury’s out on whether NO supplements really do improve performance, Bloomer says if you want to try them at a low dosage, go ahead. That said, if you’re prone to hypotension (or low blood pressure), you might want to skip them, as they could leave you feeling lightheaded or dizzy.

You should note that high dosages of NO supplements could put your kidney function at risk, particularly if you already have a nitrate-heavy diet. In such cases, “it might actually cause a reduction in performance, because your kidneys are too stressed out trying to process all this extra nitrate. To be on the safe side, just stick to the dosage stated on the package.

DOES NITRIC OXIDE HELP SEXUALLY OR BOOST LIBIDO

Since Nitric oxide itself plays a  substantial role in initiating and sustaining erections in males, and since it also increases blood flow to the penis, which can help a man maintain his erection, it could increase performance in bed and help you go longer. But there are other intrinsic factors to this.

A recent study did show that L-arginine supplements might enhance the effects of a common erectile dysfunction drug, but studies on people without dysfunction is limited, so general benefits aren’t totally known.

IS NITRIC OXIDE DANGEROUS FOR YOUR LIVER?

“While research isn’t conclusive, the answer to this may depend on whether you’re ingesting high amounts of synthetic nitrates and nitrites from processed meats or eating nitrates naturally from vegetables,”.

The World Health Organization and American institute for cancer research advise against any intake of processed and cured meats, and most contain sodium nitrates and nitrites. “Some research has linked sodium nitrates to free radical damage to cells including those in the liver, however much of this research has been conducted on animals with human studies being based on correlation rather than causation,” she says.

FOODS THAT ARE HIGH IN NITRIC OXIDE

Beetroot juice contains a notable amount of nitric oxide, and there is research to show that drinking it before competition can help with performance. One study found cyclists who drank beetroot juice two to three hours before exercise increased peak power and pedaling velocity. Another review also shows that beetroot juice can increase overall endurance and power for athletes.

It could also be found in leafy greens and other vegetables, but in smaller amounts. Vegetables are rich in nitrates, and high nitrate intake is associated with higher nitric oxide levels in the body, reason why incorporating veggies to your diet is important; so long as you have a healthy oral microbiome. Regular use of antibacterial mouthwash actually kills the bacteria that aid in production of nitric oxide from nitrates (and may impact the bacterial balance in your lower digestive tract),”.

There are a few vegetables with nitric oxide, but the ones with the highest nitrite content are beets which tops the list, as well as celery, chard, watercress, lettuce, spinach, and arugula. The next group with the greatest amount includes cucumber, celeriac, Chinese cabbage, endive, fennel, kohlrabi, leeks, and parsley.

IS DAILY INTAKE OF NITRIC OXIDE ADVISED?

Consuming nitrates through food is totally encouraged. The research on beet juice and beet powder shows the best success in improving exercise performance and heart health with daily consumption of at least 2 weeks. “Nitrate content may be an additional reason high vegetable intake is associated with better heart health, too,”

When it comes to supplements containing ingredients other than pure beet or vegetable powder, you want to be careful. Supplements are not well regulated for safety, purity, potency or effectiveness of claims, so if you do choose another “nitric oxide booster” pick one that is third party tested, preferably by NSF for Sport or Informed Choice for Sport.

To be candid, from a professional view, I don’t think you should supplement daily. No dietitian would recommend it. There isn’t much research on these supplements, so it’s difficult to assess what the long term side effects might be. Instead, just eat your darn veggies  or beets to get your nitric oxides you must. 

SOURCES: https://www.healthline.com/nutrition/benefits-of-beets#section3

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