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CAN THE KETO DIET IMPROVE PCOS SYMPTOMS?

on January 19, 2022 by ANONYMOUUS add comment

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

LIFESTYLE

WHAT TO DO IF YOU HAVE A FAMILY HISTORY OF HIGH CHOLESTEROL

on December 16, 2021 by ANONYMOUUS add comment

Globally, deaths arising from raised cholesterol levels reads at 2.6 million and this is sad. What’s sadder is the fact that about 10% of these people didn’t realize they have it; even the ones still alive.

Cholesterol might either be termed good or bad and many factors can influence the levels of cholesterol in your blood especially genetics.

Apart from lifestyle, diet and exercise, genetics could be a risk factor for increased cholesterol levels. If a family member has high cholesterol levels, there is every tendency you might have it especially if you don’t pay attention to lifestyle matters.

This phenomenon is termed “familial” since it runs in a family.

SOME FACTS ABOUT FAMILIAL HYPERCHOLESTEROLAEMIA

– 1 person in every 500 persons has it

– Doesn’t have symptoms, but these signs like deposits of cholesterol in skin and tendons could be notice

– Only 10%-20% of people with it know they have it

– Individuals with familial hypercholesterolaemia will pass it on to their children

IS THERE A DIFFERENCE BETWEEN FAMILIAL HYPERCHOLESTEROLAEMIA AND NORMAL HYPERCHOLESTEROLAEMIA?

If high levels of cholesterol occur in any relative of yours, such as a parent, sibling, or grandparent, you’re more likely to have it yourself. This occurrence is totally due to the passing on of genes from parents to children that increase levels of cholesterol in the blood.

Familial hypercholesterolaemia is more like an inherited form of hypercholesterolaemia. People with this type of conditions normally would have high cholesterol levels even with a lifestyle modification. Simply because they don’t have the capacity to regulate their cholesterol levels as other individuals.

There is every tendency that people with familial hypercholesterolaemia might not be able to control their cholesterol levels with just diet and exercise alone, but with medications too.

You should also note that not everyone with a high risk of developing high cholesterol actually has their cholesterol levels sky rocketing.

HOW DO I KNOW IF I HAVE FAMILIAL HYPERCHOLESTEROLAEMIA

One of the major ways to ascertain if you have high cholesterol levels especially if it’s a familial case is through a lipid screening test. This measures the amount of cholesterol in your blood.

Ideally, signs to look out for in adults are cholesterol levels above 190mg/dl and levels above 160mg/dl in children.

In addition, your doctor might help detect physical signs, which might not be common to everyone. These signs includes:

– Bumps or lumps around your knees, knuckles, or elbows

– Swollen or painful Achilles tendon

– Yellowish areas around your eyes

– A whitish grey colour in the shape of a half-moon on the outside of your cornea

WHAT CAUSES FAMILIAL HYPERCHOLESTEROLAEMIA?

This type of cholesterolaemia is a genetic one meaning it is hereditary and is caused by a defect on chromosome 19.

Your body finds it difficult to remove LDL cholesterol from the body making it easy for the narrowing of vessels which might possibly lead to atherosclerosis. You just need to get an abnormal gene from one family member to get this disease.

WHAT ARE THE RISK FACTORS AND HOW DO I MANAGE THEM?

1. OBESITY OR HIGH WAIST CIRCUMFERENCE: Both obesity and a high waist circumference can increase your risk for high cholesterol.

Obesity is defined as a body mass index (BMI) of 30 or higher, while a high waist circumference is 40 or more inches for men and 35 or more inches for women.

If you have a family history of hypercholesterolaemia, then you should be careful so fat wont be unevenly distributed in your body. When fat accumulates in only one part of the body, especially in the abdominal region, it can lead to an increased risk of developing hypercholesterolaemia and other cardiovascular complications.

2. ELEVATED BLOOD SUGAR

As someone with a family history of hypercholesterolaemia, you should also be aware of your glucose levels as high levels of glucose can increase LDL cholesterol and decrease HDL cholesterol, damage the lining of arteries and also increase your risk of fatty deposits building up in your arteries.

Lifestyle choices, like diets high in soda, candy, or other foods containing large amounts of sugar, can also contribute to high blood sugar levels.

Reducing your intake of these things that contribute to an increased glucose level is key to reducing the risks of high cholesterol levels. An increased fibre intake of at least 30-35g of fibre daily would help to keep glucose levels in check.

3. LIFESTYLE FACTORS

If you have a family history of high cholesterol, you should consider some modifications to your lifestyle as it totally affects your chances to also get the disease. Diet, exercise and social vices are risk factors associated with high cholesterol. They can be controlled by modifying your lifestyle.

– Eating a diet high in saturated and trans fats can increase your cholesterol levels. These highlighted foods should be taken away from your diet totally or restricted to the barest minimum if you have a history of high cholesterol in the family.

• red meat

• full-fat milk and yogurt

• fried foods

• highly processed sweets

More so, adding foods that are cholesterol reducing would help reduce the risks of developing high cholesterol. Foods like nuts, beans, whole grains, fruits, vegetables, green vegetables, lentils, oatmeal, whole grain breads, low-fat dairy, low-fat meats, such as poultry are helpful.

– Exercise has the tendency to help increase your HDL cholesterol and decrease your LDL cholesterol. If you can aim at 150 minutes of moderate to intense aerobic exercise weekly, then you’re on journey to increasing you HDL levels which helps to reduce risk for developing high cholesterol and other coronary diseases.

If you just want to start, you can try out walking a distance first before doing other types of exercise so as not to get fagged out easily.

– Tobacco Smoking damages the wall of your blood vessels and is detrimental to your heart health. This makes it more likely for fat deposits to build up, thereby increasing your risk of high cholesterol levels.

CONCLUSION

Apart from other risk factors, genetics is a major risk factor related to high cholesterol levels. It is very important to be aware of this condition especially if it runs in your family and also aware of measures to curb its progression.

SOURCES

1. https://www.healthline.com/health/high-cholesterol/is-high-cholesterol-hereditary#outlook

2. https://www.health.harvard.edu/heart-health/when-very-high-cholesterol-runs-in-the-family-

3. https://medlineplus.gov/ency/article/000392.htm#:~:text=Familial%20hypercholesterolemia%20is%20a%20genetic,of%20LDL%20in%20the%20blood.

4. https://www.cdc.gov/cholesterol/facts.htm

DIET THERAPY OF DISEASES

Cholelithiasis: treatment options

on June 25, 2021 by ANONYMOUUS add comment

Stones form in different organs in the body due the retention of excess types of minerals in the body that can easily crystallise if there is insufficient fluid around to dissolve them.
Cholelithiasis is one condition that affects the bile duct and gall bladder. In cholelithiasis, hard stones composed of cholesterol or bile pigments form in the gall bladder (choleccystolithiasis) or in the bile duct (choledocholithiasis). In the US alone, about 9% of women and 6% of men have gallstones, and most are asymptomatic. While in the south western region of Nigeria, Ibadan, the prevalence of cholelithiasis is 2.1%.
When the concentration of cholesterol rises to the point of supersaturation, crystallization occurs. In other parts where stones form, stones could be composed of calcium, oxalate, uric acid, struvite. But in this case, stones are composed of cholesterol. A sludge containing cholesterol, mucin, calcium salts, and bilirubin forms, and, ultimately, stones develop. This occur when the concentration of cholesterol rises so high to the point of supersaturation. Normally, in bile, cholesterol leves are at equilibrium with bile salts and phosphatidylcholine.
Although gallstones are typically asymptomatic (they show no symptoms), some cause biliary colic, in which stones intermittently obstruct the neck of the gallbladder and cause episodes of abdominal pain. Chronic obstruction may result in cholecystitis (infection and inflammation of the gallbladder) or cholangitis (infection and inflammation of the common bile duct). Both of which are very serious and, if untreated, may result in sepsis, shock, and death.

Presenting symptoms include episodic right-upper-quadrant or epigastric pain, which often occurs in the middle of the night after eating a large meal and may radiate to the back, right scapula, or right shoulder. Diaphoresis, nausea, vomiting, dyspepsia, burping, and food intolerance (especially to fatty, greasy, or fried foods; meats; and cheeses) are common. More severe symptoms, including fever and jaundice, may signify cholecystitis or cholangitis.

What Are the Possible Risk Factors?
1. Family history: there is every tendency to develop gallstones if there is a family history. In short, it is twice as more in rates.

2. Increasing age: Gallstones are mostly very common in individuals above the age of 40.

3. Female sex: with the presence of the hormone estrogens in female, they are more likely to develop gall stones at all age groups. This increased risk is most notable in young women, who are affected 3-4 times more often than men of the same age.

4. Elevated estrogen and progesterone: During pregnancy, oral contraceptive use, or hormone replacement therapy, estrogen and progesterone induce changes in the bile duct that predispose one to gallstones.

5. Obesity: Due to the elevated secretion and production of cholesterol in obese individual, they are at high risk of developing gall stones.

6. Rapid weight loss: Bariatric surgery and very-low-calorie diets adopted for weight loss regimes can increase risk of gallstone formation, possibly due to increased concentrations of bile constituents.

7. Diabetes mellitus: Hepatic insulin resistance and high triglycerides may increase risk of gallstones.

8. Gallbladder stasis: When bile remains in the gallbladder for an extended period, supersaturation can occur. Gallbladder stasis is associated with diabetes mellitus, total parenteral nutrition (probably due to lack of enteral stimulation), vagotomy, rapid weight loss, celiac sprue, and spinal cord injury.

9. Cirrhosis: Cirrhosis i.e scarring of the liver tissues, increases the risk of developing gall stones 10 times more.

10. Medications: Drugs implicated in the development of cholelithiasis include clofibrate, octreotide, and ceftriaxone.

11. Physical inactivity: Exercise may reduce gallstone risk. Findings from the Health Professionals Follow-Up Study suggested that the risk of symptomatic cholelithiasis could be reduced by 30 minutes of daily aerobic exercise. Young or middle-aged men (65 years or younger) who were the most physically active had half the risk for developing gallstones, compared with those who were least active. In older men, physical activity cut risk by 25%. Physical activity is also associated with reduced gallstone risk in women.

How can it be Diagnosed?
Laboratory tests include complete blood count (CBC), liver function tests, amylase, and lipase.

– Right-upper-quadrant (trans-abdominal) ultrasound will reveal the presence of gallstones and show evidence of cholecystitis, if present.

– Hydroxy iminodiacetic acid (HIDA) scan is sometimes indicated to rule out cystic duct obstruction and acute cholecystitis.

– Endoscopic retrograde cholangiopancreatography (ERCP) or magnetic resonance cholangiopancreatography (MRCP) assesses the presence of gallstones within the bile ducts. ERCP can also be used to extract stones when they are found, preventing the need for surgery.

Are there Treatment options?
Asymptomatic gallstones are generally not treated. Cholecystectomy (surgical removal of the gall bladder) is the treatment of choice for symptomatic disease.

Oral bile acids (e.g., ursodeoxycholic acid) can be used to dissolve small stones and stone fragments. However, they are not really efficient as the stones typically reoccur.

It is helpful to avoid large, fatty meals, as a large caloric load is the most likely trigger for biliary colic symptoms.

Long-term statin use has been associated with a reduced risk of gallstone development.

Nutritional Considerations
Gallstones are strongly related to high-fat, low-fibre diets. In areas like Asia and Africa populations which have plant-based diets as traditional diets. An abundance of high protein and high saturated fatty diets are risk factors to developing gallstones. Diets low in dietary fibre, especially the westernized diets play a major role in the development of gall stones. The following factors are associated with reduced risk of gallstones:

– Plant-based diets: Both animal fat and animal protein may contribute to the formation of gallstones. According to research, up to 90% of gallstones are cholesterol. This totally suggests that a change diet (e.g., reducing dietary saturated fat and cholesterol and increasing soluble fibre) may reduce the risk of gallstones.
“Vitamin C, which is found in plants and is absent from meat, affects the rate-limiting step in the catabolism of cholesterol to bile acids and is inversely related to the risk of gallstones in women”
In a 12-year prospective cohort study among US men, individuals consuming the most refined carbohydrates have a 60% greater risk for developing gallstones, compared with those who consumed the least. Conversely, in a 1998 cross-sectional study of men and women in Italy, individuals eating the most fiber (particularly insoluble fiber) have a 15% lower risk for gallstones compared with those eating the least.

– Avoidance of excess weight: staying within a healthy BMI results in reduced risks of developing gall stones as obesity is a huge factor to increased risk. Those with BMI above 30 kg/m2 should endeavour to shed some few extra pounds to reduce their risk.

– Weight cycling: simply meaning repeatedly intentionally losing and unintentionally regaining weight. This cycle increases the likelihood of cholelithiasis.

– Moderate alcohol intake: alcohol consumption, especially when it is too much, has always been linked to different types of ailments; gallstone formation isn’t left out.

SUMMARY
Adopting western diets totally puts you at risk of developing gall stones. A diet rich in antioxidants, fibre, anti-inflammatory substances keeps you at reduced risk rate.
Stones make life very unbearable, you should be very conscious about your diet and lifestyle.

SOURCES
Biddinger SB, Haas JT, Yu BB, et al. Hepatic insulin resistance directly promotes formation of cholesterol gallstones. Nat Med. 2008;14(7):778-82. [PMID:18587407]
Leitzmann MF, Giovannucci EL, Rimm EB, et al. The relation of physical activity to risk for symptomatic gallstone disease in men. Ann Intern Med. 1998;128(6):417-25. [PMID:9499324]
Leitzmann MF, Rimm EB, Willett WC, et al. Recreational physical activity and the risk of cholecystectomy in women. N Engl J Med. 1999;341(11):777-84. [PMID:10477775]
Erichsen R, Frøslev T, Lash TL, et al. Long-term statin use and the risk of gallstone disease: A population-based case-control study. Am J Epidemiol. 2011;173(2):162-70. [PMID:21084557]
Bodmer M, Brauchli YB, Krähenbühl S, et al. Statin use and risk of gallstone disease followed by cholecystectomy. JAMA. 2009;302(18):2001-7. [PMID:19903921]
Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-87. [PMID:22570746]
Ahmed A, Cheung RC, Keeffe EB. Management of gallstones and their complications. Am Fam Physician. 2000;61(6):1673-80, 1687-8. [PMID:10750875]
Pixley F, Wilson D, McPherson K, Mann J. Effect of vegetarianism on development of gall stones in women. Br Med J (Clin Res Ed) . 1985;291:11-12.
Tsai CJ, Leitzmann MF, Willett WC, et al. Fruit and vegetable consumption and risk of cholecystectomy in women. Am J Med. 2006;119(9):760-7. [PMID:16945611]
Simon JA, Hudes ES. Serum ascorbic acid and gallbladder disease prevalence among US adults: the Third National Health and Nutrition Examination Survey (NHANES III). Arch Intern Med. 2000;160(7):931-6. [PMID:10761957]

DIET THERAPY OF DISEASES

Cholelithiasis: Treatment Options