PCOS diet

 

Diet  for PCO women -

What to consume ?  Ans: Fresh fruits or canned fruits without sugar.

Non starchy fresh vegetables such as broccoli, spinach or carrots etc.

Whole grains such as whole wheat pasta, brown rice, oats, whole wheat bread, quinoa, milk, oats.

Fruits  high fiber baked goods make from whole wheat flour and oats

Salad chips  , popcorn,  roasted snacks, Unsaturated fats like olive oil, seasame oil, Rice bran oil, Oil seeds like sunflower seeds, pumpkin seeds etc.

Lean chicken  or fish in grilled form

Avid  grilling and microwave as cooking methods.

 

 

Check the Nutrition Label

Read food labels properly so as to look out for hidden sugar and salt in the form of sodium or high fructose corn syrup. One should not    be fooled by fat free treats . Such market products they usually have a lot of added sugar. Also some free foods are made with refined grains such as white flour and can raise your insulin levels the same way as sugar. One should try to stick to the most natural whole form of each food

Increase Fiber Intake

Increase fiber intake including fruits vegetables, oats , barley and beans.

One should aim to eat 25-30 grams of fiber per day. Choose vegetables such as broccoli, lettuce, celery , cabbage, cucumber , parsley , radish, spinach . To choose pulses such as fresh cooked kidney , beans , soy beans, lentils , black eyed peas. Chickpeas, and lima beans. Choose fruits such as strawberries, raspberries, grapefruit, apples, cherries, peaches, pears, and plums.

Essential Fat & Protein Intake

To eat fish two to three times a week. Fish such as tuna, salmon, herring , sardines, and trout can improve  heart health. For eg pomphret , Bombay duck, Mackerel , Rohui , Katla fish etc.

To Include essential  fatty acids in diet like cod liver oil or flaxseeds , walnuts that help to create a healthy environment for conception. To eat protein and and/or  fat with every meal or snack. Protein  has a stabilizing effect on the sugar released from carbohydrates  into the blood. Protein can be found in lean meats, fish , poultry, dairy products , beans, nuts and seeds.

Beware of Sodium

To limit salt intake, Use lemon juice, mustard, vinegar, pepper, herbs and spices instead of table salt to season foods. To limit foods such as marinated and smoked meats, salted nuts, canned and processed vegetables, meats, marinades and sauces.

Supplemets of Vitamins & Minerals

Supplements play a crucial role in managing  PCOS and women with PCOS tend to be deficient in some key vitamin and nutrients like inositol , omega 3 , vitamin D and magnesium. Physician may supplement the diet with chromium, calcium vitamin D and vitamin B.

Alter Dietary and Lifestyle Habits

To limit alcohol and caffeine.

To maintain water intake of 2-3 liters/ day

To Quit smoking

To Lose weight if overweight or obese.

Small frequent meals to help control blood glucose levels. Not to skip meals.

Melatonin Part II

 

Point-counterpoint evaluation of supplementing Melatonin in PCO .

Melatonin is the key mediator molecule for the integration between the cyclic environment and the circadian distribution of physiological and behavioral processes and for the optimization of energy balance and body weight regulation events that are crucial for a healthy metabolism.

There are data confirming that melatonin regulates other aspects of adipocytes biology that influence energy metabolism lipidemia and body weight as lipolysis lipogenesis, adipocyte differentiation and fatty acids uptake among others.

Another major site o melatonin’s action in reference to the regulation of energy metabolism is the pancreatic islets where if influences insulin and glucagon synthesis and release. MTI and/or MT2 mediated action decreases glucose stimulated insulin secretion in isolated rat pancreatic islets and rat insulinoma beta cells.

As a consequence melatonin is fundamental for the maintenance of the internal circadian temporal organization timing many physiological processed including energy metabolism and their synchronization which is crucial for health maintenance.

There are consistent experimental data showing that the absence of melatonin cycle in the blood of pinealectomized animals impairs the temporal organization and circadian distribution of several metabolic functions associated with energy metabolism such as daily insulin secretion, glucose tolerance and insulin sensitivity, metabolic adaptations to activity /feeding and rest /fasting and daily distribution of glycogen synthesis and lipogenesis as opposite to those of glycogenolysis  and lipolysis .

The postulated anti obesogenic effect of melatonin is in part a result of its regulatory role on the balance of energy acting mainly on the regulation of the energy flux to and from the stores and in energy expenditure . Moreover its association with all the physiological processes typical of the daily activity wakefulness/rest sleep rhythm may impact body weight.

In summary it seems that the adequate supplementation of melatonin lowers body weight and body weight gain as well as the intra abdominal visceral fat deposition. This might be the result of the re establishment of the circadian distribution of energy metabolism the recovery of insulin signaling the consequent disappearance of insulin resistance and glucose intolerance and most importantly the accentuation of the energy expenditure over the energy intake resulting in weight loss and stabilization of weight gain.

Concluding Remarks

Melatonin is the key mediator molecule in the integration between the cyclic environment and the circadian distribution of physiological and behavioral processes necessary for a healthy metabolism and for the optimization of energy balance and body weight regulation. Melatonin acts by potentiating central and peripheral insulin action either due to regulation of GLUT4 expression or triggering the insulin signaling pathway. Thus it induces via its G protein coupled membrane receptors the phosphorylation of the insulin receptor and its intracellular substrates. Melatonin is a powerful chronobiotic influencing among others the circadian distribution of metabolic processes synchronizing them to the activity feeding /rest fasting cycle. Melatonin is responsible for the establishment of an adequate energy balance mainly by regulating the energy flow to and from the stores and directly regulating the energy expenditure through the activation of brown adipose tissue. Additionally melatonin causes the browning of the white adipose tissue thereby aiding in regulating body weight. The absence or reduction in melatonin production as during the night induces insulin resistance glucose intolerance sleep disturbance and metabolic circadian disorganization characterizing a state of chronodistruption and metabolic diseases that constitute a vicious cycle aggravating overall health and leading of obesity. The available evidence supports the suggestion that melatonin replacement therapy if adequately carried out might prevent and/or contribute to the elimination of the above pathologies and restore a more healthy state to the organism.

Introduction

Melatonin is an ancient molecule ubiquitously present in nature including both ;plant ad animals . Ii is well known that in mammals melatonin is synthesized in several cells tissues and organs mainly for local utilization and that circulating melatonin is largely provided by the pineal gland where it is produced and directly released to the blood and cerebrospinal fluid. 

While pineal melatonin has all the characteristics of a hormone it also has features which distinguish it from classical hormones. It is centrally produced in an endocrine gland circulates in a free and albumin linked form and can act through specific G protein coupled membrane receptors  as well as on putative nuclear RZR/ROR retinoid receptors. Melatonin’s membrane receptor-mediated mechanisms of action and its physiological effects via those receptors have been defined . Conversely its mechanisms of action at the nuclear level are less well defined . Melatonin’s direct free radical scavenging actions account for its receptor independent effects.

Pineal melatonin production is under control of the par ventricular nucleus of the hypothalamus which project eventually to the intermediolateral column of the upper thoracic segments of the spinal cord where the sympathetic preganglionic neurons are located. The axons of these neurons exit the cord and pass to the rostral third of the superior cervical ganglia which in turn send postganglionic sympathetic projections through the coronary  nerves to the pineal gland. Norepinephrine is released from these nerve endings where it interacts with and postsynaptic adrenoreceptors  to trigger several intracellular transduction mechanisms that activate melatonin synthesis in the pinealocytes.

The activation /deactivation of this complex neural path way controlling pineal  melatonin synthesis is under the precise control of the master circadian clock the suprachiasmatic nucleus of the hypothalamus . Via this pathway melatonin production expresses a circadian rhythm that is tightly synchronized to the light /dark cycle. The circadian control is such that melatonin production is always circumscribed to the night regardless the behavioral distribution  of activity and rest of the considered mammalian species that is it is considered the chemical expression of darkness . Moreover high production is maintained during the dark phase of the light/ dark cycle provided there is no light in the environment as light during the night blocks melatonin production . These functional particularities of the mammalian system that control pineal melatonin production guarantee that the circadian clock triggers melatonin production daily at night and that environmental light and the clock determine the duration of the daily episode of melatonin synthesis . In this way given the adequate ecological and social habitat conditions , the physiological system that controls melatonin synthesis allows the nocturnal profile of circulating melatonin to vary according to the duration of the daily scot period reflecting therefore the season of the year and acting as a neuroendocrine mediator of the photoperiod . Because of this the circadian melatonin rhythm drives annual reproductive and metabolic cycles in photoperiod sensitive mammals. In part due to the above chronobiological characteristics of production melatonin is one of the main mediators used by the central master clock to time central and peripheral tissues acting  as an internal synchronizer or internal zeitgeber. Moreover melatonin is able to act on peripheral oscillators regulating their phase and period mainly by controlling the transcription/translation circadian cycle of the peripheral clock genes . This functional aspect makes melatonin one of the most important chronobiotic that directly participates in the organization of the circadian temporal coordination of physiological and behavioral phenomena.

Melatonin and energy metabolism

All physiological and behavioral processes of the body are organized to balance energy intake storage and expenditure. The energy balance guarantees the individual’s survival growth and reproduction and consequently species perpetuation. Through the adequate circadian distribution and organization of the metabolic processes most animals optimized energy balance by concentrating energy harvesting and intake during the active phase of the day and mobilizing body energy stores during the resting phase in order to produce the energy necessary to sustain the living processes. Melatonin is the key mediator molecule for the integration between the cyclic environment and the circadian distribution of physiological and behavioral processes and for the optimization of energy balance and body weight regulation events that are crucial for a healthy metabolism. In this scenario to fully understand the role played by melatonin in the control of energy metabolism it is necessary to address the subject from following the perspectives 1) from the perspective of the classical endocrinology examining the role played by melatonin in the regulation of metabolic processes 2) from the perspective of the chronobiology considering the role played by melatonin in the regulation of the circadian internal temporal order of the physiological processes involved n energy metabolism 3) and finally understanding the role played by melatonin in the regulation of energy balance and its final outcome that is body weight as a way to sum up its regulatory role on energy metabolism.

Melatonin and the regulation of metabolic processes

The relation between pineal gland melatonin and energy metabolism was initially hinted at in both humans and rodents many years ago. The very first experiments demonstrated that infusion of pineal extracts led to hypoglycemia increased glucose tolerance and hepatic and muscular glycogenesis after glucose loading while pinealectomy induced a diminished glucose tolerance and a reduced hepatic and muscular glycogenesis. More recently the metabolic disruption caused by the absence of melatonin in the pinealectomized animal was characterized as a diabetogenic syndrome the includes glucose intolerance and peripheral insulin resistance. This dramatic pathological picture can be reverted  by melatonin replacement therapy or restricted feeding but not by physical training . Moreover insulin resistance glucose intolerance and several alterations in other metabolic parameters can be seen in some physiological or patho physiological states associated with reductions in blood melatonin levels as aging diabetes shift work and environmental high level of illumination during the night . It is emphasized that adequate melatonin replacement therapy alleviates most of the mentioned metabolic alterations in these situations. Furthermore a similar metabolic syndrome is seen in MTI knockout animals.

The genesis of the pinealectomy induced insulin resistance and glucose intolerance is related to the cellular consequences of the absence of melatonin such as a deficiency in the insulin signaling pathway and reduction in GLUT4 gene expression and protein content. The insulin sensitive tissues of the pinealectomized animal exhibit a greater reduction in GLUT4 mRNA and microsomal and membrane protein contents that reverts to the level of the intact animal following adequate melatonin replacement therapy. Moreover and emphasizing the functional synergism between melatonin and insulin it was shown that melatonin by itself acting through MTI membrane receptors induces rapid tyrosine phosphorylation and activation of the tyrosine kinase B subunit of the insulin receptor and mobilizing several intracellular transduction steps of the insulin signaling pathway .

One of the first direct pieces of evidence of the functional synergism between melatonin and insulin was published by Lima and coworkers two decades ago . This group showed that in vitro incubation of isolated visceral white adipocytes with melatonin shifted the dose x response curve for c-2 deoxy D glucose uptake stimulated by insulin to the left. This was the first demonstration that the peripheral function of insulin was potentiated by the action of melatonin and in addition it was the first evidence of a direct action of melatonin on adipocytes. This indicated that the adipose tissue is a peripheral target of melatonin for the regulation of the overall metabolism . Similarly Brydon et al demonstrated that melatonin activation of MT2 receptors in human adipocytes modulates glucose uptake by these cells.

In reference to adipose tissue physiology it was possible to document the synergistic effect of melatonin on several other insulin actions in addition to glucose uptake. In a series of reports. Alonso vale et al demonstrated that insulin induced leptin synthesis and release in isolated adipocytes is potentiated by the MTI mediated melatonin action . The potentiating effect is enhanced by 100% if the in vitro incubation with melatonin mimics its usual 24 hr cycle this was achieved by alternating melatonin added medium for 12 hr with melatonin free medium for the following 12 hr for 3-5 cycles. There are data confirming that melatonin regulates other aspects of adipocyte biology that influence energy metabolism lipidemia and body weight as lipolysis lipogenesis adipocyte differentiation and fatty acids uptake among others .

Another major site of melatonin’s action in reference to the regulation of energy metabolism is the pancreatic islets where it influence insulin and glucagon synthesis and release. MTI and / or MT2 mediated melatonin action decreases glucose stimulated insulin secretion in isolated rat pancreatic islets and rat insulinoma beta cells . The activation of these receptors inhibits glucose and forskolin induced insulin secretion showing that melatonin acts by inhibiting the adenylate cyclase /cAMP system and reducing the content of PKA with no alteration in the content of PKC subunit in parallel to a reduction in cGMP . In addition through MTI activation melatonin induces insulin receptor IRS-1,AKT ,ERK1/2 and STAT3 phosphorylation controlling insulin synthesis and release by islets B cells.

Additionally this indolamine induces IGF-1f receptor phosphorylation which participates in the integrity and trophism of islet cells . Moreover it has been demonstrated as well that melatonin stimulated glucagon synthesis and secretion either in vivo or in a particular glucagon producing alpha cell line . Most importantly however is that these actions of melatonin are required to build the circadian profile of insulin secretion keeping the daily peak allocated to the first half of the active phase of the day and contributing to the synchronization of the pancreas metabolic rhythms with the circadian rhythm of activity feeding /rest fasting.

Finally considering the physiological and patho physiological importance of the regulatory action of melatonin on the pancreatic islet function it has been suggested using genome wide association studies that common non coding variants in MTNR 1B increase type 2 diabetes risk . This is a result of a putative inadequate pancreatic beta cell response to the action of melatonin on insulin secretion resulting in morning hyperglycemia . It should be noted that insulin is able to regulate pineal melatonin synthesis by potentiating norepinephrine stimulated melatonin production at two sensitive time points during the night , one immediately after lights off and another just before lights on.

As an addition to the importance of melatonin on the regulatory processes in energy metabolism it was recently demonstrated that the intrauterine metabolic programming is modified if there is deficiency of melatonin in the pregnant mother. The adult offspring of melatonin deficient dams show glucose intolerance insulin resistance and a serious impairment in the glucose induced insulin secretion by isolated pancreatic islets. These programming effects disappear with the appropriate schedule of melatonin replacement therapy to the mothers during gestation.

Melatonin and the regulation of daily rhythms in energy metabolism

The mammalian circadian master clock times all peripheral clocks and consequently all the physiological and behavioral processes. This regulatory effect is accomplished using direct or indirect neural connections and /or humoral/hormonal mediators. As mentioned above melatonin is one of these mediators being one of the most important internal synchronizing agents. As a consequence melatonin is fundamental for the maintenance of the internal circadian temporal organization timing many physiological processes including energy metabolism and their synchronization which is crucial for health maintenance.

The energy balance and energy metabolism are under control of the circadian system and exhibits a clear differential 24 hr distribution. The active/ wakefulness phase of the day is typically associated with energy harvesting and eating that results in energy intake utilization and storage. It is a period associated with high central and peripheral sensitivity to insulin and high glucose tolerance  elevated insulin secretion high glucose uptake by the insulin sensitive tissues glycogen synthesis and glycolysis blockade of hepatic gluconeogenesis and increased adipose tissue lipogenesis and Adiponectin production. By comparison the rest/ sleep phase of the day is characterized by the usual fasting period that requires the use of stored energy for the maintenance of cellular processes. This phase of the daily cycle exhibits insulin resistance accentuated hepatic gluconeogenesis and glycogenolysis adipose tissue lipolysis and leptin secretion.

 

Several metabolic parameters exhibit a pronounced diurnal rhythm including bold glucose and insulin levels. Although blood insulin and glucose levels being correlated to the feeding schedule their diurnal variation in fasted animals was clearly demonstrated. These data and free running experiments point to the possible role of endogenous factors, in addition to environmental ones such as food availability on the regulation of the 24 hr rhythmic fluctuations of energy metabolism . There is experimental evidence that melatonin and the autonomic nervous system output are among the mediators of the circadian master clock in the regulation of circadian glucose and insulin blood levels.

It is well known that both humans and rats exhibit a diurnal fluctuation in response to an oral and intravenous glucose tolerance test as well as in the insulin tolerance test. In humans during the first hours after awaking the glucose tolerance and insulin sensitivity were reported as the highest of the day and both diminished as the day progresses reaching their nadir at the time of sleep onset. In rodents a similar phenomenon is observed but as these animals have nocturnal habits the pattern of variation in glucose tolerance and insulin sensitivity is in phase opposition in comparison with humans.

There are consistent experimental data showing that the absence of melatonin cycle in the blood of pinealectomized animals impairs the temporal organization and circadian distribution of several metabolic functions associated with energy metabolism such as daily insulin secretion, glucose tolerance and insulin sensitivity metabolic adaptations to activity /feeding and rest/fasting and daily distribution of glycogen synthesis and lipogenesis as opposite to those of glycogenolysis and lipolysis . The picture of circadian metabolic chronodistruption in pinealectomized animals is reversed by the appropriate melatonin replacement therapy.

To emphasize this critical role of melatonin it is documented that the adult offspring of pinealectomized dams experience a misalignment of their circadian rhythms of energy metabolism by misplacing gluconeogenesis predominance to the active /feeding daily phase. Rhythmic melatonin replacement therapy to the pregnant mothers completely eliminates this dysynchromy.

Other hormones that exert powerful influences on cellular metabolism for example glucocorticoids growth hormone and catecholamines also show circadian rhythmic fluctuations in their secretion and action. One of the putative roles of melatonin in the circadian organization of the metabolic processes is to prepare and modify the central and peripheral metabolic tissues to respond to several of those hormones.

The importance of melatonin in the timing of circadian metabolic processes was confirmed in an in vitro adipocyte preparation subjected to 24 hr rhythmic melatonin exposure. In this experimental setup melatonin was added to the preparation media in a rhythmic fashion so that the cells were exposed to alternating periods of 12 hr with melatonin followed by 1 hr of an absence of melanin this was repeated for four cycles. Under these conditions melatonin synchronized the expression of clock genes particularly . More interesting however was that important metabolic functions of the adipocytes were synchronized by rhythmic addition of melatonin so that during the in vitro induced night high lipogenesis incorporation of glucose into lipids high fatty acid incorporation and low lipolysis were observed . During the in vitro induced subjective day the opposite was observed.  

Melatonin and the regulation of energy balance and obesity

The classical energy balance cycle and the putative points of action of melatonin. A precondition of life is being able to balance energy intake storage and expenditure and it is the net result of this balance that determines the final body weight. When energy intake exceeds energy expenditure overweight and obesity are the consequence . The postulated anti obesogenic effect of melatonin is in part a result of its regulatory role on the balance of energy acting mainly on the regulation of the energy flux to and from the stores and in energy expenditure . Moreover its association with all the physiological processes typical of the daily activity wakefulness/rest sleep rhythm may impact body weight.

In spite of the well defined regulatory action of melatonin on the seasonal variation in food intake and body weight  herein we concentrate the discussion on the role of melatonin on the day by day control of body weight.

Unpublished observations from our group show that in rats long term pinealectomy leads to overweight and that daily  rhythmic melatonin replacement therapy completely reverses this effect .

Additionally however it was demonstrated that even with an intact pineal production of melatonin supplementation therapy in young animals reduces long term body weight gain, and the size of the visceral fat deposits . These effects were not dependent on a reduction in food intake . The same anti obesity protective effect of melatonin was seen I experiments of diet induced obesity.

 

The anti obesogenic and the weight reducing effects of melatonin supplementation therapy are clearly seen in another experimental model as well that is the aging animal. When middle age already fat animal monitored to old age were supplemented with  melatonin in the drinking water they showed a significant reduction in body mass and intra abdominal visceral fat. The reduced body weight already apparent within persisted throughout the study period and disappeared with the interruption of melatonin administration. It is important to stress that the body weight and abdominal visceral fat reductions were not dependent on either the decreased food intake or on alteration of any other hormones that could influence energy metabolism for example testosterone total thyroxine total triiodothyronine or insulin like growth factor 1 . The exceptions were nonghosted plasma insulin and plasma leptin levels which dropped in melatonin treated animals.

This study also demonstrated that in addition to an increase in the nocturnal locomotors activity by  19% the treated rats showed an increases in the core body temperature indicating a putative rise in energy expenditure rather than a reduction in the energy intake. This elevation in core body temperature is consistent with a rise in the energy expenditure dependent on the trophic and metabolism activating effect of melatonin in the brown adipose tissue and in the browning of the white adipose tissue . Recently Tan et al suggested the potential involvement of brown adipose tissue as a factor whereby animals  loss weight in response to melatonin administration . BAT has high metabolic activity and is responsible for non shivering thermo genesis as a result BAT burns large numbers of calories for the purpose of heat production thereby consuming glucose nd fatty acids and limiting fat deposition. Moreover BAT seems to be of crucial importance in the regulation of glycemia lipidemia and insulin sensitivity . As BAT is present in adult humans the observed effect of melatonin as a weight reducing agent in rodents may be applicable to humans as recently suggested.

It should be noted that during the aging process the insulin signaling pathway is impaired which accounts for the appearance of insulin resistance and glucose intolerance that might be partially responsible for the observed age associated weight gain. Related to this we recently demonstrated that the rhythmic melatonin supplementation treatment of aged rats provoked a full recovery of central and peripheral insulin signaling well before any detectable concurrent weight loss. In addition melatonin supplementation of aging rats improves considerably the metabolic and body weight reduction beneficial effects of physical training.

In summary it seems that the adequate supplementation of melatonin lowers body weight and body weight gain as well as the intra abdominal visceral fat deposition. This might be the result of the re- establishment of the circadian distribution of energy metabolism the recovery of insulin signaling the consequent disappearance of insulin resistance and glucoses intolerance and most importantly the accentuation of the energy expenditure over the energy intake resulting in weight loss and stabilization of weight gain.

Concluding Remarks

Melatonin is the key mediator molecule in the integration between the cycle environment and the circadian distribution of physiological and behavioral processed necessary for a healthy metabolism and for the optimization of energy balance and body weight regulation . Melatonin acts by potentiating central and peripheral insulin action either due to regulation of GLUT4 expression or triggering the insulin signaling pathway . Thus it induces via its G- protein coupled membrane receptors the phosphorylation of the insulin receptor and its intracellular substrates. Melatonin is a powerful chronobiotic influencing among other the circadian distribution of metabolic processes synchronizing them to the activity feeding /rest fasting cycle. Melatonin is responsible for the establishment of an adequate energy balance mainly by regulating energy flow to and from to and from the stores and directly regulating the energy expenditure through the activation of brown adipose tissue. Additionally melatonin causes the browning of the white adipose tissue thereby aiding in regulating body weight. The absence or reducing in melatonin production as during aging shift work or illuminated environments during the night induces insulin resistance glucoses intolerance sleep disturbance and metabolic circadian disorganization characterizing a state of chronodistruption and metabolic diseased that constitute a vicious cycle aggravating overall health and leading to obesity. The available evidence supports the suggestion that melatonin replacement therapy if adequately carried out might prevent and/or contribute to the elimination of the above pathologies and restore a more healthy state to the organism.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Melatonin in PCO

 

The bottom line is we still do not have sufficient research works or  lab evidence to deficiency of Melatonin in PCO women

 

Melatonin is an old and ubiquitous molecule in nature showing multiple mechanisms of action and functions in practically every living organism. In mammals, pineal melatonin functions as a hormone and a chronobiotic, playing a major role in the regulation of the circadian temporal internal order. The anti-oestrogen and the weight-reducing effects of melatonin depend on several mechanisms and actions. Experimental evidence demonstrates that melatonin is necessary for the proper synthesis, secretion, and action of insulin. Melatonin acts by regulating GLUT4 expression and/or triggering, via its G-protein-coupled membrane receptors, the phosphorylation of the insulin receptor and its intracellular substrates mobilizing the insulin-signaling pathway. Melatonin is powerful chronobiotic being responsible, in part, by the daily distribution of metabolic processes so that the activity/feeding phase of the day is associated with high insulin sensitivity, and the rest/fasting is synchronized to the insulin-resistant metabolic phase of the day. Furthermore, melatonin is responsible for the establishment of an adequate energy balance mainly by regulating energy balance mainly by regulating energy  flow to and from the stores and directly regulating the energy expenditure through the activation of brown adipose tissue and participating in the browning process of white adipose tissue. The reduction in melatonin production, as during aging, shift-work or illuminated environments during the night, induces insulin resistance, glucose intolerance, sleep disturbance, and metabolic circadian disorganization characterizing a stats of chronodistruption leading to obesity. The available evidence supports the suggestion that melatonin replacement therapy might contribute to restore a more healthy state of the organism.

Point-counterpoint evaluation of supplementing Melatonin in PCO .

Melatonin is the key mediator molecule for the integration between the cyclic environment and the circadian distribution of physiological and behavioral processes and for the optimization of energy balance and body weight regulation events that are crucial for a healthy metabolism.

There are data confirming that melatonin regulates other aspects of adipocytes biology that influence energy metabolism lipidemia and body weight as lipolysis lipogenesis, adipocyte differentiation and fatty acids uptake among others.

Another major site o melatonin’s action in reference to the regulation of energy metabolism is the pancreatic islets where if influences insulin and glucagon synthesis and release. MTI and/or MT2 mediated action decreases glucose stimulated insulin secretion in isolated rat pancreatic islets and rat insulinoma beta cells.

As a consequence melatonin is fundamental for the maintenance of the internal circadian temporal organization timing many physiological processed including energy metabolism and their synchronization which is crucial for health maintenance.

There are consistent experimental data showing that the absence of melatonin cycle in the blood of pinealectomized animals impairs the temporal organization and circadian distribution of several metabolic functions associated with energy metabolism such as daily insulin secretion, glucose tolerance and insulin sensitivity, metabolic adaptations to activity /feeding and rest /fasting and daily distribution of glycogen synthesis and lipogenesis as opposite to those of glycogenolysis  and lipolysis .

The postulated anti obesogenic effect of melatonin is in part a result of its regulatory role on the balance of energy acting mainly on the regulation of the energy flux to and from the stores and in energy expenditure . Moreover its association with all the physiological processes typical of the daily activity wakefulness/rest sleep rhythm may impact body weight.

In summary it seems that the adequate supplementation of melatonin lowers body weight and body weight gain as well as the intra abdominal visceral fat deposition. This might be the result of the re establishment of the circadian distribution of energy metabolism the recovery of insulin signaling the consequent disappearance of insulin resistance and glucose intolerance and most importantly the accentuation of the energy expenditure over the energy intake resulting in weight loss and stabilization of weight gain.

Concluding Remarks

Melatonin is the key mediator molecule in the integration between the cyclic environment and the circadian distribution of physiological and behavioral processes necessary for a healthy metabolism and for the optimization of energy balance and body weight regulation. Melatonin acts by potentiating central and peripheral insulin action either due to regulation of GLUT4 expression or triggering the insulin signaling pathway. Thus it induces via its G protein coupled membrane receptors the phosphorylation of the insulin receptor and its intracellular substrates. Melatonin is a powerful chronobiotic influencing among others the circadian distribution of metabolic processes synchronizing them to the activity feeding /rest fasting cycle. Melatonin is responsible for the establishment of an adequate energy balance mainly by regulating the energy flow to and from the stores and directly regulating the energy expenditure through the activation of brown adipose tissue. Additionally melatonin causes the browning of the white adipose tissue thereby aiding in regulating body weight. The absence or reduction in melatonin production as during the night induces insulin resistance glucose intolerance sleep disturbance and metabolic circadian disorganization characterizing a state of chronodistruption and metabolic diseases that constitute a vicious cycle aggravating overall health and leading of obesity. The available evidence supports the suggestion that melatonin replacement therapy if adequately carried out might prevent and/or contribute to the elimination of the above pathologies and restore a more healthy state to the organism.

Introduction

Melatonin is an ancient molecule ubiquitously present in nature including both ;plant ad animals . Ii is well known that in mammals melatonin is synthesized in several cells tissues and organs mainly for local utilization and that circulating melatonin is largely provided by the pineal gland where it is produced and directly released to the blood and cerebrospinal fluid. 

While pineal melatonin has all the characteristics of a hormone it also has features which distinguish it from classical hormones. It is centrally produced in an endocrine gland circulates in a free and albumin linked form and can act through specific G protein coupled membrane receptors  as well as on putative nuclear RZR/ROR retinoid receptors. Melatonin’s membrane receptor-mediated mechanisms of action and its physiological effects via those receptors have been defined . Conversely its mechanisms of action at the nuclear level are less well defined . Melatonin’s direct free radical scavenging actions account for its receptor independent effects.

Pineal melatonin production is under control of the par ventricular nucleus of the hypothalamus which project eventually to the intermediolateral column of the upper thoracic segments of the spinal cord where the sympathetic preganglionic neurons are located. The axons of these neurons exit the cord and pass to the rostral third of the superior cervical ganglia which in turn send postganglionic sympathetic projections through the coronary  nerves to the pineal gland. Norepinephrine is released from these nerve endings where it interacts with and postsynaptic adrenoreceptors  to trigger several intracellular transduction mechanisms that activate melatonin synthesis in the pinealocytes.

The activation /deactivation of this complex neural path way controlling pineal  melatonin synthesis is under the precise control of the master circadian clock the suprachiasmatic nucleus of the hypothalamus . Via this pathway melatonin production expresses a circadian rhythm that is tightly synchronized to the light /dark cycle. The circadian control is such that melatonin production is always circumscribed to the night regardless the behavioral distribution  of activity and rest of the considered mammalian species that is it is considered the chemical expression of darkness . Moreover high production is maintained during the dark phase of the light/ dark cycle provided there is no light in the environment as light during the night blocks melatonin production . These functional particularities of the mammalian system that control pineal melatonin production guarantee that the circadian clock triggers melatonin production daily at night and that environmental light and the clock determine the duration of the daily episode of melatonin synthesis . In this way given the adequate ecological and social habitat conditions , the physiological system that controls melatonin synthesis allows the nocturnal profile of circulating melatonin to vary according to the duration of the daily scot period reflecting therefore the season of the year and acting as a neuroendocrine mediator of the photoperiod . Because of this the circadian melatonin rhythm drives annual reproductive and metabolic cycles in photoperiod sensitive mammals. In part due to the above chronobiological characteristics of production melatonin is one of the main mediators used by the central master clock to time central and peripheral tissues acting  as an internal synchronizer or internal zeitgeber. Moreover melatonin is able to act on peripheral oscillators regulating their phase and period mainly by controlling the transcription/translation circadian cycle of the peripheral clock genes . This functional aspect makes melatonin one of the most important chronobiotic that directly participates in the organization of the circadian temporal coordination of physiological and behavioral phenomena.

Diet in PCO

 

An ideal diet plan for the PCOS  not only comprises food; the timing of meals, frequency and duration of the meals and  the cooking methods are also equally important.

Ideally, within thirty minutes of waking  up, we  need to take some form of food to kick start our metabolism. A good balanced breakfast is a must, skipping that would be a big NO NO.

 

 It is better to eat every 3 to 4 hours, rather than taking infrequent big meals. Sounds good doesn’t it, one need to eat more often if she wants to lose weight and control her PCOS.

 

Eating should not be a hasty affair, take plenty of time, enjoying every bite to savor the goodness and flavor of the delicious food that nature has kindly provided us (we do not know how long we are going to get this!). To a great extent, digestion should happen in the mouth itself, so make it a point to chew the food properly. Brain takes about twenty minutes to register that stomach is full, hence if one  eat quickly one is  at the risk of consuming more food than  is needed. Even though her stomach is full she will go on eating, so one has to go slow.

 

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Glycemic index (GI)  indicates the  level of sugar in blood after food intake. The rate at which blood sugar level shoot up is different, depending on the type of carbohydrates that one eats. PCOS women need low glycemic index foods, as the sugar will spurt up only little and that too slowly.

This will help to keep the insulin level low. The insulin levels are way too high in PCOS, which is the main reason for insulin resistance and  high androgens .

Reduce calorie intake if your weight is on higher side, around 60 % of women with PCOS are overweight and it has been proven that a significant number of women benefitted from losing weight.

 

Tips

 

1.     Food should be fresh – “eat like Chinese, they always take it boiling”.

 

2.     To take varieties of food, so that you get all the nutrients that the body needs. Increase the fiber intake, which means lots of roughage in diet. Eat whole fruits  and not in the form of  juice, take whole wheat and avoid refined flour. Whole wheat, Barley,Pasta,

Brown rice ,Rolled Oats (oatmeal), Sweet Corn, Whole wheat kernals, Bulgar, Linseed

Rye

 

 

3.   To take natural foods, avoid processed food, limit sugar and sweet intake. WE know   that sugar undergoes lots of chemical treatment before it looks bright white? Choose whole grains  like boiled rice, whole wheat flour, millets (Ragi), oats etc. To reduce salt intake, this will help reduce the risk of hypertension and other cardiovascular diseases.

 

4.    To choose unsaturated fats. Boil, grill, steam, bake and avoid microwaving and frying. Make sure that one is consuming  enough protein with every meal  for controlling PCOS.

 

Varieties of food

 

1.     Green leafy vegetables are good, so when one  go shopping put a green only glasses 

2.     Pulses are very good sources of protein, hence a good low calorie alternative to the non vegetarian food.

3.     Whole grains must occupy a smaller portion of ones  meal plate, rather than bulk.

4.     Fish, chicken, lean meat and lean cuts of red meat can be taken in moderation, but they should not be fried in oil.

5.     Being a vegan  will  not only make her  kind towards animals, but also kinder to your own self, as ones body is struggling hard to tackle  all the fat that is being loaded into it.

6.     Oils can be olive oil or other plant source oil, essential fatty acids are as important to health as vitamins.

7.     Fruits are again good when taken in raw and whole form, eat plenty of berries, cherries,  grapefruit, pears, plums and other seasonally available fruits.

8.     Nuts are good for PCOS, take just 4 to 5 numbers of either almonds or Walnuts,  Flax seeds, sunflower and pumpkin seeds are also beneficial.

 

 

For reducing insulin resistance, there are natural remedies  advised in ayurveda, like neem, tulsi, fenugreek, basil etc.

 

Foods to avoid

 

Sweets and candies are neither good for her  nor for the kids. (people act as if candies and chocolates are ok to be given as gift to others kids, as if they are resistant to the bad effects. Please understand that they are bad for everyone, so

please stop buying them for  kids.  

 

Instead of ice creams, choose fruit platter at theaters. Skip the bakery section in super markets, so that you are not tempted to  buy  cakes, pastries, biscuits or other sweets. Everyone knows that soft drinks and energy drinks are bad for health, but still we cannot stop. Sweet yogurt drinks  or milk shakes at home to reduce the brisk rise of blood glucose

·        To conclude : natural, unprocessed foods.

·        high-fiber foods.

·        fatty fish, including salmon, tuna, sardines, and mackerel.

·        kale, spinach, and other dark, leafy greens.

·        dark red fruits, such as red grapes, blueberries, blackberries, and cherries.

·        broccoli and cauliflower.

Ack:DRAnita Mani , ART specialists  

-------------------------------------------------------------------------------------------------------- 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Diet in PCO women

 

Ack:   Dr Anita Mani of Cochin , Sr ART specialist

Low Glycemic Food Chart for PCOS (Poly Cystic Ovarian Syndrome)

 

 

 

What are low glycemic foods chart to control pcos and such duet for Diabetes

 

 Consumption a low- glycemic diet   is beneficial in controlling PCOS and it will also help to maintain optimum glucose  level in diabetes patients too . Glycemic index measures the rise in the level of blood glucose after the intake of a particular food from the range of 0 to 100. However, intake of some types of  food causes sudden increase in glucose level in blood, while the glucose is released only gradually in some types of food.

 

The former category of food has high glycemic index and the later has low glycemic index. So if one is suffering from PCOS or diabetes, she must consume and select  food items  in consulation with dietician  which contain low glycemic index in her diet. Body takes more time to digest the low glycemic foods, hence her frequent hunger pangs are kept at bay, which in turn help in weight will lose. Bakery products, colas and other fizzy beverages, refined flour (maida), rice, potato are some of the food items which have high- glycemic index and should be strictly avoided.  
The common low glycemic index foods are Whole wheat Barley,.sta.Brown rice , Rolled Oats (oatmeal), Sweet Corn,Whole wheat kernals. ,Bulgar,Linseed,Rye

 

 

The Glycemic index ranks carbohydrate foods based on the rate at which they are broken down into glucose. Food with high GI will release too much glucose in the blood stream at a fast rate, which triggers the pancreas to release the hormone, insulin .  Insulin removes the surplus glucose from the blood and lowers the speed at which the body burns fat. A large surge in insulin, caused by eating high-GI foods will start reactions in the body that leave you feeling lethargic, hungry and craving for more sugar.

Eating low-GI carbohydrate foods will only cause a steady rise in the level of glucose in the blood, which in turn leads to a small and gentle rise in insulin. Small increases in insulin keeps you feeling full, satiated and energised for hours after eating and also encourage the body to burn fat. Foods which do not contain much carbohydrate  are naturally non glycemic and most of the green vegetables fall in this group. 

 

 

 

Below is a list of Low glycemic  food items foods  which should be taken in limited quantity.

 

 

 

Whole wheat 

Barley

Pasta

Brown rice 

Rolled Oats (oatmeal)

Sweet Corn

 

Whole wheat kernals

Bulgar

Linseed

Rye

 

 

 

Nuts and seeds

vegetables

Legumes

Lentils

Chickpeas

Kidney beans

Beans







                 

                                                                     

 

 

 Soyabeans
 Soyamilk
 Dairy Foods

 Almond Milk

 Yogurt

 Meats, poultry, fish

 Eggs, tofu

 Cheese

 

 

 

 

 

 

 

FRESH FRUITS

Most common berries

Plums 

Peaches 

Nectarines

Apricots 

Oranges 

Grapefruit 

Pears 

Papaya 

Apples 

Watermelon 

Blueberries 

Pineapple 

 

DRY FRUITS 

Apples 

Plums (Prunes) 

Apricots 

Peaches 

Pears 

Figs

Dates

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

 

 

 

Posted by Unknown on September 07, 2014 

Labels: cause of PCOS, Exercise and PCOS, food for PCOS, infertility and PCOS, PCOS, treatment for PCOS

1 comment:

1.         

kate27 August 2017 at 06:19

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Gift IVF Hospital, Cochin

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Welcome to my blog! Many parents are told that they can never fulfill their dream of bringing a new life into this world. This blog aims to a bring a ray of hope to struggling couples.

Popular Posts

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Psychological Impacts Of Infertility

Conceiving a child and becoming a parent is a beautiful feeling. However, not all couples are blessed with this gift. The problem of infer...

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§ Fresh gooseberry ( nellikai / amla ) tea

§ Stages of Sexual Response Cycle and role of female...

§ NACE test helped in avoiding amniocentesis

§ Aerocide air purifier with NASA technology for IVF...

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Infertility

Sunday, 7 September 2014

Low Glycemic Food Chart for PCOS (Poly Cystic Ovarian Syndrome)

 

 

 

LOW GLYCEMIC FOODS CHART TO CONTROL PCOS

 

Following a low- glycemic diet is beneficial in controlling PCOS and it will also help to maintain optimum sugar level in diabetes patients. Glycemic index measures the rise in the level of blood sugar after the intake of a particular food from the range of 0 to 100.  Intake of some types of  food causes sudden increase in glucose level in blood, while the glucose is released only gradually in some types of food. The former category of food has high glycemic index and the later has low glycemic index. So if you are suffering from PCOS or diabetes,  include food items which contain low glycemic index in your diet. Body takes more time to digest the low glycemic foods, hence  your frequent hunger pangs are kept at bay, which in turn will help in weight lose. Bakery products, colas and other fizzy beverages, refined flour (maida), rice, potato are some of the food items which have high- glycemic index and should be strictly avoided.  
http://bangaloreivf.blogspot.ae/2017/08/article-on-pcos-causes-symptoms-and.html

 

 

The Glycemic index ranks carbohydrate foods based on the rate at which they are broken down into glucose. Food with high GI will release too much glucose in the blood stream at a fast rate, which triggers the pancreas to release the hormone, insulin .  Insulin removes the surplus glucose from the blood and lowers the speed at which the body burns fat. A large surge in insulin, caused by eating high-GI foods will start reactions in the body that leave you feeling lethargic, hungry and craving for more sugar.
http://bangaloreivf.blogspot.ae/2015/08/pcos-diet.html

 

Eating low-GI carbohydrate foods will only cause a steady rise in the level of glucose in the blood, which in turn leads to a small and gentle rise in insulin. Small increases in insulin keeps you feeling full, satiated and energised for hours after eating and also encourage the body to burn fat. Foods which do not contain much carbohydrate  are naturally non glycemic and most of the green vegetables fall in this group. 

 

 

To know more about how PCOS affect fertility visit the link http://bangaloreivf.blogspot.ae/2014/08/dr.html

 

 

Below is a list of Low glycemic  food items foods  which should be taken in limited quantity.

 

 

 

 

 

Whole wheat 

Barley

Pasta

Brown rice 

Rolled Oats (oatmeal)

Sweet Corn

 

Whole wheat kernals

Bulgar

Linseed

Rye

 

 

 

Nuts and seeds

vegetables

Legumes

Lentils

Chickpeas

Kidney beans

Beans







                 

                                                                     

 

 

 Soyabeans
 Soyamilk
 Dairy Foods

 Almond Milk

 Yogurt

 Meats, poultry, fish

 Eggs, tofu

 Cheese

 

http://bangaloreivf.blogspot.ae/2014/12/soya-too-much-of-good-is-bad.html

 

 

 

 

 

 

FRESH FRUITS

Most common berries

Plums 

Peaches 

Nectarines

Apricots 

Oranges 

Grapefruit 

Pears 

Papaya 

Apples 

Watermelon 

Blueberries 

Pineapple 

 

DRY FRUITS 

Apples 

Plums (Prunes) 

Apricots 

Peaches 

Pears 

Figs

Dates

Dr. Anita Mani
Infertility Specialist at Gift IVF Centre

anitadane@gmail.com

www.giftivf.com

 

 

 

Posted by Unknown on September 07, 2014 

Labels: cause of PCOS, Exercise and PCOS, food for PCOS, infertility and PCOS, PCOS, treatment for PCOS

1 comment:

1.         

kate27 August 2017 at 06:19

This comment has been removed by a blog administrator.

Reply

Note: only a member of this blog may post a comment.

Newer PostOlder PostHome

Subscribe to: Post Comments (Atom)

Dr. Anitha Mani

Gift IVF Hospital, Cochin

Follow me on

·         SATYA- Svasthya Ayurveda Treatment, Yoga & Agriculture

·         GIFT IVF Hospital

Search This Blog

Top of Form

Bottom of Form

Welcome to my blog! Many parents are told that they can never fulfill their dream of bringing a new life into this world. This blog aims to a bring a ray of hope to struggling couples.

Popular Posts

·        

Fertility food series - Passion fruit is great for infertility & other medical conditions !!!

Cancer:  Passion fruit contains  rich amounts of antioxidant Vitamin C  and 50% of daily   RDA value .   These antioxidants h...

·        

Green gram (hara moong) for fertility and weight reduction

Green gram, known as hara moong in Hindi and cherupayar in Malayalam is traditionally used to treat infertility, enhance breast milk ...

·        

YOGA - remedy for male infertility

Yoga has many ways of improving fertility. There are Physiological, Psychological and Neurological Changes happening in the body,...

·        

Lemongrass is an antidote for infertility and a plethora of medical ailments

Lemongrass is a  herb used in Asian cuisines to add flavor to the food, it is also used in the treatment of a wide spectrum ...

·        

Sesame seeds for Infertility, PCOS, Diabetes, BP, Heart Disease, Osteoporosis

Sesame seed known as “Til” in Hindi and “Ellu” in Malayalam is an ancient condiment and is used widely around the world in different cu...

·        

PCOS (Polycystic ovarian syndrome) is the common reason for Sub Fertility in women

   Polycystic ovarian syndrome (PCOS) is extremely prevalent among women now and is one of the common reason for  sub fertility i...

·        

Don’t let azoospermia (absence of sperm) turn your life upside down

Azoospermia is a medical condition in men, where there is a a complete absence of sperms in the semen. After the first test, It is...

·        

Lose weight, cool your body and keep your reproductive organs healthy with ash gourd

Ash gourd, (white gourd) known as petha in Hindi and kumbalanga in Malayalam has been traditionally used in Ayurveda for treating inferti...

·        

The benefits and medical properties of Basella Alba ( Malabar Spinach, Bengali Cheera)

Basella Alba, commonly known as Vine Spinach, Malabar Spinach, Bengali Cheera  or Ceylon spinach is a tropical creeper plant with da...

·        

Psychological Impacts Of Infertility

Conceiving a child and becoming a parent is a beautiful feeling. However, not all couples are blessed with this gift. The problem of infer...

Blog Archive

·  ►  2020 (1)

·  ►  2019 (1)

·  ►  2017 (4)

·  ►  2016 (7)

·  ►  2015 (23)

·  ▼  2014 (68)

o ►  December (5)

o ►  November (9)

o ►  October (9)

o ▼  September (12)

§ Fertility food series - Nuts & Dry Fruits - Mothe...

§ Fertility food series - Carrots, melon, tomatoes f...

§ Gooseberry/ Amla - A treasure chest of Vitamins a...

§ Reduce stress to improve fertility

§ Fertility food series - Orange tea refreshes you...

§ Fresh gooseberry ( nellikai / amla ) tea

§ Stages of Sexual Response Cycle and role of female...

§ NACE test helped in avoiding amniocentesis

§ Aerocide air purifier with NASA technology for IVF...

§ Frequently asked questions in IVF/ ICSI

§ Low Glycemic Food Chart for PCOS (Poly Cystic Ovar...

§ Fertility food series - Passion fruit is great fo...

o ►  August (21)

o ►  July (9)

o ►  June (3)

·  ►  2013 (12)

Labels

·         cause of PCOS

·         Dr.Anita Mani MRCOG

·         Exercise and PCOS

·         food for PCOS

·         food for sperm count

·         icsi

·         infertility

·         infertility and PCOS

·         infertility treatment

·         ivf

·         PCOS

·         pregnancy

·         sperm count improve

·         treatment for PCOS

Report Abuse

·         Home

Psychological Impacts Of Infertility

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