PCOD- Signs & symptoms, causes, diagnosis, dietary treatment

What is PCOD?
PCOD or PolyCystic Ovarian Disease is a hormonal condition which can lead to problems like masculine changes in the body, irregular periods and infertility. Women with PCOD have multiple cysts (polycystic) in their ovary. Cysts are structures filled with a fluid or pus and are hell painful.

What are the signs and symptoms?

Irregular menses (usually delayed)
Weight gain and difficulty in losing weight
Acne, oily skin, dandruff
Excessive hair growth on the face, chest, back
Thinning of hair
Infertility
Miscarriage 
High blood pressure
Diabetes
High cholesterol

What are the causes?
PCOD is due to a combination of genetic and environmental factors. The cause is still unknown. Risk factors include obesity, faulty lifestyle, no physical activity and a family history of someone with the condition.

How to diagnose PCOD?
Women with PCOD usually have an irregular and painful period which can be very heavy. There sometimes might be the need to induce them by taking hormonal medicines. Patients are usually overweight and have facial hair. Although not all patients may have these symptoms.

In order to confirm the presence of this condition, a Pelvic Ultrasound may be done. Enlarged ovaries with cysts on it are the sign of this condition.

Blood tests can be also done.
1. LH and FSH- There are two major hormones present in a woman's body which control the reproductive functions. These are Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). Their levels in our body change as per the stage of the menstrual cycle or pregnancy or lactation. Women with PCOD have more LH than FSH, that is, the ratio of LH to FSH is high (2.1 or 3.1 as tested on the 3rd day of menstrual cycle). However, it is not a sure test to diagnose it.

2. Levels of androgens: 'Andro' for Greek is a male human being, and hence these are a group of hormones which stimulate or control male characteristics. The most common androgen is testosterone which is a male sex hormone. Elevated levels of androgens can point to PCOD. This explains why PCOD patients have excessive facial hair.

3. Oral Glucose tolerance test (OGTT): PCOD leads to insulin resistance, meaning the body cells cannot utilize insulin and hence blood sugar levels go up. Insulin acts as an antagonist to glucose and regulates its amount in the body. 

4. Cholesterol and Lipid profile: Women with PCOD usually have cholesterol and lipid profiles elevated. 


What is the treatment?
Sadly, PCOD has no cure, but it can be managed with diet and regular physical activity.

1. Losing weight: Weight loss for PCOD patients takes time and it is even difficult to maintain the lost weight. I would recommend adding at least 30 minutes of physical activity, like brisk walking, stretching, running\ jogging, yoga etc. Start slow and gradually built it up. No need to do strenuous exercise as it can do more harm than good. Patients need to carefully watch their weight by maintaining a food diary.

2. Dietary treatment: PCOD dietary treatment is similar to Type 2 diabetic diet treatment as the insulin resistance leads to high sugar levels in the blood. You can make the following changes in your diet:

* Carbs- Go for whole grains and cereals like quinoa, whole wheat, buckwheat, ragi, barley, oats. Avoid refined foods like maida (refined flour), sooji (semolina), sago, arrowroot. Whole grains have fiber which is essential to lose weight and keep digestion good.

* Protein- Choose high biological value proteins like chicken, fish, eggs etc. If you are a vegetarian you can go for low-fat milk and milk products, soybean (limited quantities as its high in fat), sprouts, pulses etc.

*Fat- Fat shouldn't be more than 4 teaspoons a day for one person. So suppose you take 3 main meals (Breakfast, Lunch, and Dinner), 3 teaspoons for that and one extra for any snack, for example, using butter in your bread. Avoid high-fat sources. You can choose olive oil, canola oil, refined oil etc. You can also rotate your oils monthly, example, one-month olive oil and the next month refined oil.

*Sugar- Avoid sugar as much as you can. Try increasing it to no more than 2 teaspoons in a day. This includes all types of sugar- jaggery, sweets, chocolates, table sugar, brown sugar etc.

*Water- Drink a good amount of water. Water needs depend on your lifestyle, age, physical activity etc. At least 2.5- 3 liters of water should be taken. Start slow and gradually build it up. If you find it hard to remember to drink water, you can install apps that can reminder you to do it or just set an alarm.

*Salt- Excess salt leads to water retention. Avoid salt and take no more than 5g a day of it.

*Alcohol- If you like to drink, let me remind you one ml of alcohol is about 7 Kcal. So if we assume a Vodka shot is 42 ml total calories coming from it is 294 Kcal. So, I'd say think before you drink. 

Other treatment options are surgery and medications. But no treatment can cure it. I'd advise maintaining a good diet with proper physical exercise. Take medicines after consulting with your doctors.

PCOD is a serious condition and its management requires a lifetime commitment. Feel free to leave any questions as comments and I'll be happy to help. Till then, take care guys.

Is green tea really healthy? The truth!

I was sipping on some green tea and then I thought why not make a post about it here.

What is it?

Green tea is a tea made from the leaves of Camellia sinensis. This is a evergreen shrub which is used to produce tea. It requires less processing to get green tea than to get black tea. Green teas are anti oxidants and reduce the effect of free radicals in our bodies.

What are free radicals?

Our body produces some amount of free radicals during chemical reactions for various life processes. Free radicals are highly reactive oxygen molecules which have lost an electron while travelling through the blood stream. Since they are at a loss of an electron they are ready to accept electron from other chemical processes going in our bodies. 

What these bad guys do is they take up electrons from other molecules and stop that reaction from happening altogether. This disrupts various important functions in our body. This makes them stable but in turn does a lot of damage, which in the long run can lead to cancer and heart disease.

The production of free radicals can increase due to factors like faulty eating habits, exposure to cancer causing substances like tobacco etc, toxic drugs, over exercising etc. In simple words, more the free radicals, more the damage to our bodies.

What are anti oxidants?

This is where anti- oxidants step in. As the name suggest, 'Anti' meaning to stop, 'oxidant' meaning oxidation. They stop the oxidation process.

Green tea is an anti-oxidant and what is does is to provide the electron which the free radical is looking for and neutralise it. They donate their electrons so that free radicals get stable and dont cause a havoc in our bodies. 

Green tea thus help to reduce the risk of:

Cancer

Heart diseases

Sugar control

Lipid control

Weight gain

Toxicity

What are the other various anti oxidants and their food sources?

The following are the other antioxidants with their food sources. The names are hard to remember, I know but we all can just remember the foods they are rich in.

Phytochemicals: Fruits, brocolli etc

Lycopene: Tomatoes, fruits and vegetables

Glutathione: Avocado and asparagus

Vitamin C: Citrus fruits, brocolli, brussels sprouts, amla etc

Vitamin A: Butter, dairy, fish products, carrots, egg yolk

Vitamin E: Almonds, spinach, walnuts, wheat germ etc

Selenium: Seafoods

Healthy Indian snacking | What to eat in between meals?

We, dietitians and nutritionists would recommend you to eat 5-7 meals in a day. That means, 3 main meals- Breakfast, Lunch and Dinner in a day and the rest as small snacks. These snacks should be filling and low calorie (if you are watching your weight). Snacking in between helps to keep your metabolism good and prevents over-eating in the next meal.

Today we'll learn about some low calorie snacking options:

1. Murmura chat- Murmura or puffed rice can be slightly roasted in a kadhai. You can add a little oil, add turmeric for taste. Murmura chat can be eaten as it is, or you can add your favorite vegetables like chopped onions, capsicum, tomatoes etc to make it more nutritious and fibrous. You can also add dry, boiled dal (like kala channa, rajma etc) or steamed sprouts to make it protein rich. A lot of recipes are available or you can make your own. If you are watching your weight, then avoid putting too much potatoes or peanuts in it.

2. Fruits- Fruits are the best food items you can have as snacks. They are delicious, control your sugar cravings and they are filled with vitamins and minerals. You can make your own bowl of fruit salad by choosing bunch of your favorite fruits. Avoid eating too much mangoes, grapes, bananas, muskmelon, chiku etc if you're trying to lose weight. Go for fruits like apple, strawberries, papaya, oranges, keenu, guava etc.

3. Nuts- Nuts are excellent source of fiber and essential fatty acids. Popular misconception is that they are fatty and can lead to weight gain. Studies show the the type of nut and their quantity can provide many health benefits. Best nuts are almonds ( 4-5 in a day, roasted\ soaked), walnuts (2-3, whole), peanuts\ groundnuts ( a handful per day). If you like cashews you can have 1-2 in a day, raisins 2-3 and pistachios 1-2 per day for optimum health.

4. Salads- Salad is that term which can disappoint many foodie people, including me. I never thought salads can be tasty too, until I tried those in Subway. You can make salads at home or choose your salads when you are eating out. If you eat meat, you can go for a chicken salad. Paneer lovers can choose paneer salads. Just remember to avoid adding too many dressings as they make your salad heavy.

5. Roasted channa-  Roasted channa is easily available in markets. They are protein packed and fibrous. You can add vegetables into it to make it roasted channa chat.

6. Makkhana chat- Makkhanas are the seeds of lotus flower. They are edible and provide an excellent source of protein, has zero cholesterol and negligible fat content. They are very tasty, just roast them slightly in a kadhai!

7. Smoothies\ shakes- You can make shakes\ smoothies by choosing a variety of fruits. I prefer to use apples, bananas (less quantity), strawberries, papaya, grapes etc in milk. You can also use yoghurt or curd. What I like to do is add roasted flax seeds for taste. Dont add sugar into it, as those added fruits will provide you with the sweetness.

8. Health drinks- You can make your own drink at home. Nothing fancy. You can make nimbu pani (lemonade\ lemon water), shikanji, detox water ( using cucumber, ginger, mint and lemon) etc. They not only are tasty, but they help you fight dehydration too.

9. Vegetable juices- As a nutritionist myself, I hate recommending anyone fruit juice, as it is only fructose (at least majorly). Instead I ask them to go for vegetable juice. They are especially good for people who do not like eating vegetables (like me). You can make it at home. Take your favorite veggies and toss it in a juicer and you are ready to go. I mean ready to drink it, lol. I like to put carrots, amla (indian gooseberry), lemon, tomatoes ( not very much, I hate tomatoes), beetroot (again not too much) and oranges or keenu. It tastes amazing and you can add chat masala too as per your taste!

10. Green tea- Not exactly a snack but it can curb your cravings. Just boil or warm about a cup\ glass of water in a pan and add your green tea sachet into it. Dip your sachet multiple times, just dont go overboard as it will make the green tea bitter. You have to dip for not more than a minute. Green tea contains anti oxidants (which I'll cover in a post soon) which helps you to fight off free radicals in body and keep you free from diseases. Free radicals are villains, which are produced naturally due to chemical reactions taking place inside us. Have green tea with other snacks mentioned above like murmura or makhana chat.

SO guys this is all for today. I will bring out more articles like these for you soon. I hope you try these and comment down below your experience. Thank you so much, take care. Bye.

10 things you’re doing to spoil your weight loss regimen!

Are you trying to lose weight but cant? Are you finding it hard to maintain your weight? Do you want to make healthier food choices? 

Trying to lose weight can be really frustrating especially if your weight is bouncing back over and over again or it’s just stuck. What people don’t understand is that some foods might be working totally against their weight loss goal. If you think you are doing everything correctly, see my list of top 10 food myths and comment down below if you're guilty of any of these!  

Myth number 1: You can only lose weight on a low carb diet!

It is true that low carb diets lead to weight loss in a short amount of time. But during this time the weight loss is due to fewer intakes of food, water loss and loss of muscle tissue. When the amount of carbs gets decreased, body burns protein and fat sources to provide energy.  If this is continued for a long time it can lead to ketosis and can be really fatal. When you go back to your normal eating patterns, BOOM the weight is gained back again! And it also becomes harder to lose weight the next time as your metabolism slows down due to improper eating practices.

What I suggest:  A diet should consist of complex carbs- like whole grains, pulses, fibrous vegetables and fruits. Use of simple carbs like maida, sooji, etc is to be kept at limited as they have reduced fibre content and get digested real quickly in body.

Myth number 2: Fruit juices are healthy!

A lot of people think that fruit juices are healthy (I used to think the same before I studied nutrition). WHHHHAT!? Most juice companies use artificial flavoring agents. Even if they use real fruits, the goodness of the fruit is removed by processing and preserving it. Fruit juices contain a lot of sugar in them. This sugar is enough to make you gain extra kilos!

                                                       Label of a fruit juice packaging

his is probably because they know that fruits are healthy! If you see any label of a fruit juice package you'll notice that it doesn’t even have any fruit in it!

What I suggest: If you can have fruits directly do have them. They are a good source of fibre and other vitamin and minerals. If you're not able to have fruits, you can make juice in your home without adding sugar. Diabetics should avoid fruits like mango, grapes, chiku and include more of apples, pear, and pomegranate in their diets.

Myth number 3: I'm on a diet but I can have a diet carbonated drink!

The last thing you want to do to destroy your weight loss routine is by drinking a carbonated drink. Cokes alone contain artificial flavoring agents and heaps of sugar. Diet carbonated drinks have artificial sweetening agents in them usually ASPARTAME that is known to cause many health ailments in the long term if consumed in large amounts!

What I suggest: Stay away from diet cokes\ sodas. Instead have homemade beverages like, green tea, buttermilk, fruit smoothies and shakes etc.

Myth number 4: I cannot go wrong with packaged and ready to eat soups!

Packaged, canned and ready to eat items contain preservatives. And for preservation to be possible a good amount of sodium\ sugar is required. You wouldn’t want these to be in your diet. Excess salt consumption can lead to retention of fluid in body leading to weight gain. You would’ve noticed that after eating salty food items like chips, pickles the next day you feel a bit bloated, puffy under the eyes. 

What I suggest: It would be better to make homemade versions of soups as they have less sodium content and are not packed with preservatives.

Myth number 5: I want to build muscles; I need a lot of protein.

People who want to gain muscles need to remember that excess of protein in the body gets utilized as a fuel for the body. Adults only need about 1g protein per kg body weight per day. That means if you weigh 70 kgs you would need 70g of protein in a day. So a proper exercise routine, apt calories and good sources of protein is necessary.

What I suggest:  People who are non vegetarian have no dearth of good quality protein. Include eggs, chicken, fish, dairy and dairy products in your diet. People who are vegetarian or vegan can go for sprouts, pulses, soya milk, nuts and oilseeds to cover up the protein requirement.

Myth number 6: Skipping a meal would make me lose weight!

Skipping a meal makes you not only crave for more food until the meal but also slows down the metabolism. People usually skip their breakfast, which makes them hungry until the next meal. This lead to loss in concentration and consuming excess of food eventually leading to more weight gain.

What I suggest: Never skip a meal instead have 3 main meals – breakfast, lunch and dinner along with 2 small meals for the snack. Have snacks\ fluids after every 2-3 hour interval. This makes you feel full and keeps your metabolism proper. Some in between snacks are roasted channa, roasted murmura, almonds, walnuts, buttermilk, green tea or herbal tea, fruits etc. These are not only low calorie but also will make you feel full till the next meal.

Myth number 7: Chocolates are bad for your health.

Dark chocolates are really good for your health. Studies have proven that they improve the health and lower the risk of heart diseases. It has fibre, iron, magnesium and other trace elements.

                             

                                          Label of a dark chocolate packaging

What I suggest: If you’re a chocolate lover you can eat a small box of chocolate per day to control your sweet cravings. That definitely doesn't mean eating a big chocolate bar, of course.

Myth number 8: Olive oil provides lesser calories than any other oil

If you add olive oil to your salad every day thinking that it has no calories, you’re wrong. Oil is oil no matter what you do. A teaspoon of any oil (roughly 5 g) provides 45 kcals, be it olive oil or refined oil, canola oil. Although olive oil has many other benefits like reduction in risk of heart diseases and type 2 diabetes etc but it would be wrong to say that it has lesser calories.

What I suggest: Limit the intake of oil to about 4 teaspoons daily. You can use different oils and rotate them monthly. Like olive oil for one month, mustard oil for the next and so on.

Myth number 9: Full cream milk is nutritious than toned and double toned milk

The major part of full cream milk consists of fat. As it gets processed, into toned and double toned milk the quantity of fat also decreases. Excess fat in the long run is known to cause obesity and heart problems.

What I suggest: If you’re trying to lose weight or don’t want to gain extra kilos, stay away from excess fat. Go for toned\ double toned or skimmed milk.

Myth number 10: Sooji is better than maida.

Sooji and maida both are refined sugars, which mean that they are a result of processing. Wheat flour is processed and due to that a major amount of fibre and other nutrients are removed from it.

A whole grain consists: the outer portion husk which is inedible, bran which consists of fibre, endosperm which provides energy and carbs and finally the germ which consist of vitamins and minerals. After processing the wheat (which is bran+ endosperm+ germ) only endosperm is left to get sooji and maida. Hence both fall in the same category.

                                         Composition of a wheat kernel

                              (Image courtesy- https://daddystractor.com)

What I suggest: Fibre is a must for you if you’re trying to lose weight or not. About 40 g of fibre everyday should be provided through diet to prevent constipation, cleansing of toxins and for promoting good gut.

I hope this helped you. I'll bring out more articles like these. Comment down below if you have any questions. Like my Facebook page for more such tips: Your Nutritionist's Plate. 

Till then take care guys!