Kolasa, Kathy

Kathy Kolasa

Q: My daughter has been diagnosed with polycystic ovarian syndrome. What lifestyle measures can help her? JF, Winterville

A: Yes, lifestyle changes can help your daughter and other women who are diagnosed with PCOS and can reduce some of the undesirable side effects. Chloe Opper, a Brody medical student will explain.

PCOS is a hormone imbalance affecting about 1 in 10 young girls and women of childbearing age that can cause unwanted symptoms such as excessive hair growth, irregular periods, weight gain and/or trouble losing weight and acne. Some but not all women have small cysts on their ovaries. Through a series of biochemical pathways, PCOS can cause an increase luteinizing hormone (a chemical in the pituitary gland) or insulin levels (released from the pancreas), causing the ovaries to make extra amounts of testosterone. Testosterone is one of the hormones in the body that causes hair growth and acne in puberty.

One of the most important treatments is working toward a healthy lifestyle which include a health-promoting diet and physical activity. Why? Since girls like your daughter are in a state of insulin resistance, similar to Type 2 diabetes, reducing this resistance can lessen signs and symptoms of the disease. One of the ways to do this is through weight loss. If her Body Mass Index (BMI) is higher than 25, she may benefit from some weight loss. If her BMI is in the normal weight or underweight category, you would want to talk with her doctor as losing weight may not be the best strategy for her.

Physical activity of at least 150 minutes weekly, or around 20 minutes daily, is recommended to raise the heart rate to decrease insulin resistance. Easy ways to achieve this goal are walking, running or riding a bicycle. Encourage her to do this earlier in the morning or after dinner before it gets dark to stay cool, and remember to always stay hydrated!

Want to avoid the hot summer heat entirely on those days that are just unbearable? Tell her to download a workout app on her phone or put on a YouTube/Pandora playlist of her favorite songs and dance indoors. She does not have to do these activities all at once, but she can spread them throughout the day to avoid fatigue. For example, your daughter could go for a 15-minute walk around your neighborhood when she wakes up in the morning and then again after dinner before bed. Most people find it helpful to have a partner to walk with, so you could ask her if she wants you or a friend to walk with her.

There are also several dietary strategies she can use to help her work toward or maintain a healthy weight. One of the most important changes to make is to only occasionally have sugar-sweetened beverages — including but not limited to, sodas, fruit drinks (Capri Sun, SunnyD), sweet tea and sports drinks (Gatorade, Powerade). The American Academy of Pediatrics also recommends limiting 100 percent fruit juices (orange juice, apple juice) to under 8 ounces/day and to eat whole fruits instead since they contain fiber that juices lack.

You may hear people refer to these drinks as “empty calories,” or calories with no added nutritional benefit. If it is difficult to switch entirely to water, substitute these drinks out for sugar-free versions or start by eliminating one serving or drink for a week at a time to slowly wean yourself off. Removing just one soda per day can help you lose one-half pound per week without any other dietary changes.

Another key element of nutritional change is eating a balanced diet with appropriate portion sizes. Although the international guidelines don’t specify any specific diet, a great resource for balancing carbohydrates with protein and healthy fats is MyPlate (www.choosemyplate.gov), which has a normal plate divided into the five food groups for a healthy meal. For example, you should make sure that half of your plate is filled with fruits and vegetables. The website also has examples of each different type of food group as well as the recommended portions of each. It even has weekly menus, recipe ideas, and tips for different calorie goals, budgets, and cuisines!

Remember, when making lifestyle modifications, whether it be nutritional or dietary, it can be helpful to make small changes to start. For example, adding an extra portion of vegetables daily can be an easier goal to achieve than completely changing and then maintaining a new diet long-term.

The side effects of PCOS can be discouraging for young women like your daughter, but nutritional and activity changes are in her control and have been proven to help. Although lifestyle modifications are the best and safest place to start for everyone, she still may experience undesirable symptoms of PCOS. Speak with her doctor about medications or other strategies to help.

Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an affiliate professor in the Brody School of Medicine at ECU. Con- tact her at kolasaka@ecu.edu.