Polycystic Ovary Syndrome (PCOS) is an endocrine disorder that affects 1 in 10 women. It is a leading cause of infertility, and in fact, many women discover that they have PCOS when trying to conceive. Besides infertility, it’s important to understand the lifelong health implications of PCOS. In this article, we discuss one of the most common side effects of PCOS: heart disease.
Regardless of whether they are overweight or not, women with PCOS are at higher risk at an earlier age for atherosclerosis (plaque buildup inside the arteries), high blood pressure (hypertension), and heart attack.
Fortunately, managing PCOS and heart disease with diet and lifestyle changes can be the first line of defense. If you have PCOS and/or heart disease, work with your healthcare provider to develop a well-rounded health maintenance plan.
Connecting Insulin Resistance and Heart Disease
Insulin is a hormone that controls blood sugar levels. Up to 70% of women with PCOS have insulin resistance, meaning that their cells are resistant to insulin and do not efficiently absorb glucose (sugar) from the bloodstream. Therefore, an insulin resistant person produces more insulin to help process glucose. This high level of insulin in the blood is called hyperinsulinemia. Hyperinsulinemia is associated with type 2 diabetes and can lead to other serious health concerns such as heart disease.
Managing PCOS and Heart Disease with Exercise
The buildup of fatty deposits in the arteries, known as atherosclerosis, leads to clogged arteries. Regular exercise can help fend off atherosclerosis. Studies show that exercise helps endothelial function, and poor endothelial functioning is what can is what can lead to the buildup of plaque in the arteries.
Exercise also encourages your cells to use insulin more efficiently, decreasing the excess insulin that may be circulating in your system. PCOS fitness expert, Erika Volk, recommends strength training as the best type of exercise for those with PCOS.
Start slowly. Ask a friend to go on walks with you. Also, scour the internet to check out exercise programs that interest you, and then try a class for the activities you find exciting. Experts recommend making a plan for putting exercise in your schedule, that way you’ll follow through. It may sound obvious, but choose exercises that you like, you’ll be more likely to keep doing them!
Eat a Heart-Healthy Diet
Eating a heart-healthy diet can play an important part in reducing your risk for heart disease. A heart-healthy diet is rich in vegetables, fruits, lean meats, healthy fats and whole grains. It is low in saturated fats, cholesterol, sodium and trans fats.
Sticking to a heart-healthy diet may also help you manage your weight. Losing weight can be a struggle though, especially for women with PCOS. A registered dietitian or nutritionist who is trained in PCOS management can personalize a weight loss plan for you, your food preferences and your lifestyle. Search here to find a nutrition professional.
Add Nutritional Supplements for PCOS
Eating a heart-healthy diet and moving is the best way to start managing PCOS and heart disease. There is also research to suggest that certain nutritional supplements for managing PCOS may be helpful.
Supplements are one component of an ongoing program of care to help reduce your risk for heart disease. Discuss what supplements you take with your healthcare provider.
Inositol is a nutrient found naturally in fruits, beans, grains, and nuts and it is also produced by the body. There are different forms of inositols, but the two types that have shown benefit for women with PCOS are myo-inositol and D-chiro-inositol.
INOSITOLS AND PCOS
Studies have shown that inositols can reduce insulin resistance, decrease testosterone levels, and improve triglycerides levels and blood pressure in women with PCOS. Inositols have also been shown to reduce cardiovascular risk.
Research has shown that when women with PCOS take a combination of these two forms of inositols, in the body’s naturally occurring ratio of 40 to 1, they experience more benefits than taking either form alone. In this study, participants received a recommended dose of inositol powder that provided a combination of both inositols (2,000 mg of myo-inositol plus 50 mg of D-chiro-inositol, taken twice a day).
Speak to your healthcare practitioner and ask if inositols would be right for you.
Omega-3 Fatty Acids
Omega-3 fatty acids are essential polyunsaturated fats. A nutrient is “essential” when your body does not make it on its own. You must consume it through food or supplements. Three types of omega-3s include ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). The benefits of EPA and DHA are in the news often, and these omega-3 fatty acids are linked to a reduction in risk of heart disease.
OMEGA-3 FISH OILS AND PCOS
Research shows that omega-3 fish oils offer many benefits to women with PCOS, including reducing depression, reducing testosterone levels, improving heart health, reducing inflammation, and helping to regulate menstrual cycles.
A 2017 study found that women with PCOS taking a supplement of 2,000 mg of omega-3 fatty acids for 6 months had higher levels of HDLs (high-density lipoproteins), and lower levels of total cholesterol and LDLs (low-density lipoproteins). They also had lower triglycerides and a lower waist circumference.
HDLs are the “good” cholesterol and LDLs are the “bad” cholesterol which contributes to plaque buildup in the arteries. Experts believe that HDLs act as scavengers bringing dangerous LDLs away from the arteries and back to the liver. The liver can break down HDLs remove them from the body.
Get the omega-3 fatty acids you need by eating fatty fish more than twice a week. Some good fatty fish choices are salmon, herring, sardines, tuna, trout, and mackerel. If you’re concerned about mercury level or sustainability, the Monterey Bay Aquarium Seafood Watch site is a great place to do some research on the type of fish you plan to eat.
If you do not eat fish that often, you may benefit from taking a fish oil supplement. Research suggests that supplementing 1,200 mg of omega-3 fatty acids daily may be beneficial. The Food and Drug Administration (FDA) recommends not exceeding 2,000 mg per day of omega-3 fatty acid supplements since a larger amount may extend bleeding time for some people.
This important vitamin plays a significant role in the normal functioning of your brain and nervous system and the formation of your blood cells.
VITAMIN B12 AND PCOS
Women with PCOS may be prescribed the medication metformin. Research has shown that long-term use of metformin can decrease levels of vitamin B12 in the body. A deficiency of vitamin B12 can cause anemia, affect energy levels and mood, and cause neurological and nerve damage.
In addition to the side effects listed above, deficiency of vitamin B12 may also increase homocysteine levels. Women with PCOS may already have high levels of homocysteine, which is a risk factor for heart disease. Couple that with long-term metformin use, and women with PCOS are at an even higher risk for vitamin B12 deficiency. Vitamin B12 is involved in homocysteine metabolism and may help lower these levels.
If you are taking metformin, it’s a good idea check your vitamin B12 level every year. After looking at your B12 level, discuss the amount of vitamin B12 you should take.
If you have PCOS there are plenty of things you can do to decrease your risk for heart disease. Eating a heart-healthy diet and exercising are the best ways to protect your heart. If you’re overweight, consider working with a nutrition professional to help you manage your weight.
Regardless of weight, ask your healthcare practitioner about possibly taking supplements such as inositol, vitamin B12 and omega-3 fatty acids. Studies show that these supplements may help with managing PCOS and its symptoms. Moreover, these dietary supplements may also be beneficial for heart health.
For more tips on how you can help your heart health see this blog by PCOS Nutrition expert, Angela Grassi, MS, RDN, LDN.
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