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Sunday, 5 July 2015

The Holistic Prevention, Management and Treatment of PCOs analysed through Conventional Medicine Research and Studies(Part III) - The Weight loss approach

"The Holistic Prevention, Management and Treatment of PCOs analysed through Conventional Medicine Research and Studies" provides you the accurate information of the use of natural sources to prevent, management and treatment of Polycystic Ovarian Syndrome, because all presentations are proven through convention research and studies found in PubMed. This is the second time, a research paper has been written this way to general public that you will not find any where in the net. We would like to provide more of this kind the research, but unfortunately, it is time consuming and burdened financially, we have run out of time and the site will be shut down Monday(July 6, 2015). If you like what you read, please donate generously to our site.
at http://kylejnorton.blogspot.ca/
Kyle J. Norton
                 

In Weight Loss Management of PCOs(Unedited)
                                                               


 Weight loss(733)(734) for obese patients is one of most vital factor to reduce PCOs symptoms(735)(737) and risk of PCOs complications(736)(737). Some researchers found that 5-10% of weight low will improve PCOs features(737) by 25%, including pregnancy(738). How can you lose weight and maintain healthy body for a healthy conception?

                           The macro nutrients

1. Carbohydrate
Carbohydrate is simple sugar and complex sugar found abundantly in food, such as fruits, veggies, breads, cereals, and other grains.....with major function in production of energy for nourish cells, tissues and organs, through converting to blood sugar by digestive system(739).
a) Simple sugar
It contains food with no more than 2 simple sugar connected together. It can be release quickly into your bloodstream(740)(741).
b) Complex sugar
It contains food with long chain of simple sugar connected together, because most of them contain high amount of fiber. Foods will be digested slowly and sugars are released slowly into your bloodstream(740)(741).

2. Protein
Protein is important in building our body tissues. Its function is to carry out most of the reactions involved in metabolism and DNA replication, DNA repair, and transcription(742), therefore, it is important element in preparing for the growth of the bady once you are pregnant(743). Dr. Kramer MS1 and Kakuma R. at the McGill University said "Balanced energy/protein supplementation improves fetal growth and may reduce the risk of fetal and neonatal death. High-protein or balanced protein supplementation alone is not beneficial and may be harmful to the infant. Protein/energy restriction of pregnant women who are overweight or exhibit high weight gain is unlikely to be beneficial and may be harmful to the infant"(744).

3. Fat
Fat is essential for digestive system in absorbing several types of vitamins, maintaining healthy skin, hair, body temperature and healthy cells growth(746), stored as energy through its component of glycerol and expression and activity of the lipases of adipose tissue(745). Not all fats are bad(747)(748), by choosing more good fat and limited intake of the bad one, you are ensure yourself for a healthy pregnancy. Fats include saturated fat, transfat, monosaturated fat and polyunsaturated fat(749)


                        The Glycemic index?


Glycemic index is a guide or table which rates all carbohydrates according to how fast they release glucose into the blood stream. The fastest release one has a high GI index. Preferences for only taking  foods with low GI index, if you want to lose weight(751)(750), but following low-GI dietary prescription is difficult(750)
                             
                 The Best PCOs Diet for weight loss

Most women with PCOs are likely overweight or obese according to BMI index. Most diet plans require the endurance and determination of the participants(750).

1. Complex carbohydrate, low protein and only unsaturated fat diet
This is the one which I have made for my diabetic friends, it works well for her. The plan not only helps to stabilize her blood sugar, but also maintain her weight within the normal range of BMI index. If you would like to try, please first consult with your doctor.
a) No Simple sugar
b) Only eat vegetables (prefer rainbow colors), nuts, seeds and limited intake of fruits containing high amount of sugar such as melon. Fruits only should be eaten as soon as after each meal.
b) Limited intake of protein to 1/3 of the daily amount. Meat must be lean (prefer chicken breast) and eat together with vegetables and fruits to further delay the release of sugar.
c) Only use unsaturated fat as toping. Stirring is allowed with occasional fried foods and others.
d) Drink at least 8 cups of pure water and milk ( prefer one cup of green tea and a cup of morning coffee with no sugar and a little bit milk). Since vegetables contain high amount of fiber, drinking more water can prevent constipation.
e) 1/4 table spoon of cinnamon each in the morning and evening. It is said that cinnamon stimulates the production of insulin(752) and regulates the blood sugar in the blood stream(753).
The diet works well for her in maintaining the healthy weight and stabilizing and lowering the blood sugar. Since she does not have PCOs and problem of infertility, it is for your benefit to check with your doctor before applying.

2. Low carbohydrate and high protein diet (Modified diet with a high-protein, low-glycemic load (30% of daily energy from protein plus low-glycemic-load foods)

This is a type of diet most recommended by dietitian for women with PCOs and wanted to get pregnant.
a) If you have symptoms of PCOs and absence of period, you must see your doctor before attempting any weight loss program.
b) If you have kidney problem, do not attempt this program
c) If you have symptoms of PCOs and irregular menstrual period, this diet plan is helpful
The low carbohydrate diet and high protein diet limits daily intake of amount of carbohydrate and encourages you to take a high amount of protein without restricting yourself to the amount of fat intake. With low levels of carbohydrate in the body, you body needs to burn its fat stores for energy, leading to weight loss(754) and lowering the levels of asting LDL-cholesterol, HDL-cholesterol, glucose, insulin, free fatty acid, and C-reactive protein concentrations(754). In theory, it works well for women with PCOs because by suppressing the levels of insulin(755)(756), The diet improves ovulation(755) and reduce the levels of testosterone(756). It is also recommended that you also engage in moderate exercise to improved the physical fitness level of healthy, pregnant as well(757)(758).


                   The Common Weight Loss  Foods                        
                      
Epidemiological studies, linking certain foods in reduced weight loss for obese individual have produced certain positive results(759)(760)(761), but researchers emphasized that weight loss can not be in the expenses of intake of nutrients(762).

1. Oats
Oat is a species of cereal grain grown for its seed and was first cultivated in Europe but is now grown all over the world, especially in Scotland and England. It is one of good crop to plant in the poor soil after crops are harvested in the Fall(763.
Oat, rich in beta-glucan, may hold a magic power in regulation of  metabolism and liver-protecting effect. According to Chung-Shan Medical University, consumption of oat reduced obesity, abdominal fat, and improved lipid profiles and liver functions with no adverse effects(764). Whole-grain ready-to-eat oat cereal, in a randomized study of 144 Free-living, overweight and obese adults had favorable effects on fasting lipid levels and waist circumference(765). Other study suggested that at-derived beta-glucan, combined with moderate exercise also improved lipid profile and caused a decrease in weight(766).

2. Salmon
Salmon is the common name for Salmonidae. They are anadromous, born in fresh water, migrate to the ocean, then travel thousands of miles in the deep sea cold water throughout their life cycle and within to five years returning to the exacted location where they were born to reproduce and die(767).
Dietary salmon oil, in rat study showed to reduced weight loss in mice model, but induced weight gain in recombinant inbred strains. This findings may suggested that body weight response to salmon oil feeding is controlled by multiple genes(768). A novel oral form of salmon calcitonin (sCT), according to the study at 1Nordic Bioscience, also showed that salmon oil improves fasting and postprandial glycemic control and insulin sensitivity and may be considered as a promising agent for the treatment of obesity-related insulin resistance and type 2 diabetes patients(769)(770).

3. Brown rice
Brown rice or unpolished rice is a kind of whole, natural grain with very brown color of which only the outermost layer of the rice kernel are removed, thus preventing the lost of nutrients(771).
The study of the weigh effect of brown rice on metabolic parameters in type 2 diabetes, showed a positive effect of consumption of the brown rice (LB)  in association with a decreased waist circumference in type 2 diabetic patients(772). Other randomized study of forty women between 20 and 35 years of age in the comparison of white rice and mixed rice of weight control, including brown rice, indicated that meal replacement with mixed rice was superior to replacement with white rice in weight control, improving antioxidant enzyme activity(773).

4. Chicken
Chicken are domesticated fowl belonging to the subspecies of Gallus domesticus and is raised all over the world for its delicious meats and eggs. It can be roasted, broiled, grilled or poached into a very delicious, tasteful and nutritious meal(774).
In the comparison of weight loss and total lipid profile changes in overweight women consuming beef or chicken, researchers at 1Rippe Lifestyle Institute, Shrewsbury showed a interest result of weight loss and improved lipid profile can be accomplished through diet and exercise, regardless to dietary protein source including lean beef or chicken(775). But the study at University of Navarra, showed a opposite result in the study of frequent consumption of selenium-enriched chicken meat(776), it may be the result of the presence of antioxidant selenium in the meat.

5. Water
According to Virginia Tech, consuming 500 ml water prior to each main meal may lead to greater weight loss than a hypocaloric diet alone in middle-aged and older adults, because of it acutely reduces meal energy intake(EI)(777) but not in younger subjects(778). The Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial, suggested that replacing caloric beverages with water or diet beverages induced 2% to 2.5% weight loss(779).

6. Nuts
Dietary consumption of nuts with  rich sources of multiple nutrients is associated with health benefits and weight loss, epidemiologically.  but in well-controlled nut-feeding trials, no changes in body weight were observed(780b). Pistachio nuts, a member of the cashew family, can be consumed as a portion-controlled snack for individuals restricting calories to lose weight without concern of weight gain(781b)(782b).

7. Green tea
Green tea contains more amount of antioxidants than any drinks or food with the same volume, and is the leaves of Camellia sinensis, undergone minimal oxidation during processing, originated from China. Green tea has been a precious drink in traditional Chinese culture and used exceptional in socialization for more than 4000 thousand years. Because of their health benefits, they have been cultivated for commercial purposes all over the world.
According to Maastricht University, caffeine intake and green tea supplementation are associated to improved weight maintenance, partly through thermogenesis and fat oxidation, in a randomized placebo-controlled double blind parallel trial in 76 overweight and moderately obese subjects(783b). Catechins the antioxiands found abundantly in green tea, significantly decreased body weight and significantly maintained body weight after a period of weight loss, depending to the moderators of habitual caffeine intake and ethnicity(784b). In a high-protein diet, green tea-caffeine mixture, failed to exert the same effect on body weight maintenance(785b).

8. Coffee
Coffee made from the roasted seeds of the genus Coffee, belonging to the family Rubiaceae native to southern Arabia. Coffee may consist certain substances.
In a randomized, double-blind, placebo-controlled, linear dose, crossover study, green coffee extract, consistent with human and animal studies and a meta-analysis may be an effective nutraceutical in reducing weight in preobese adults(786b). Mannooligosaccharides (MOS), extracted from coffee, exhibited a potential functional use for weight management and improvement in adipose tissue distribution, but varying in gender(787b)
Unfortunately, green coffee extract (GCE), according to University of Exeter, in reviews of the effect  against weight loss of existed data, showed a significant poor methodological quality and suggested that more rigorous trials are needed to assess the usefulness of GCE as a weight loss tool(788b). Other study, reported a case of Brazil Potent Slimming Coffee and possibly also other weight-lossproducts may be contaminated with sibutramine which can cause severe adverse reactions, mentally(789b).



         The Common Weight Loss Herbs



Epidemiological studies, linking herbal medicine, in induction of weight loss have been inconclusive.
Some researchers suggested that intake of certain herbal medicine may enhance appetite suppression. According to the Georgetown University Medical Center, average daily food intake was decreased only with the herbal formulation, not the phenylpropanolamine (PPA) at the low and high doses, in comparison of the effectiveness among herbal formulation and a commonly available(780a). Other researchers insisted that using herbs and supplements to induce weight loss should be taken with care, as a  considerable number of reports have been published on hepatotoxicity associated with herbal products attributed with weight-reducing properties(781a)(108)(1043)(1044). The College of Medicine, The Ohio State University insisted that various dietary, lifestyle, and psychologic factors are involved in the etiology of Prameha, particularly in relation to disturbances in fat and carbohydrate metabolism(1043), without effective management, obtaining a workable weight loss plan may be extremely difficult.

1. Ephera (Ma Huang)
Ma Huang is also known as ephedra. The acrid, slightly bitter and warm herb has been used in TCM to promote urination and sweating, and rid of cold,  sooth wheezing asthma, etc. as it calms dyspnea,   asthma, cough, etc., by enhancing the functions of lung and bladder channels(888)
Ephedra sinica, the Chinese herb may be effective in induced weigh loss. According to the Dongguk University, certain chemicals found in Ephera showed an association with changes of BW and BMI through alteration of gut microbiota varied by indigenous microbiota of each subject(1007). The combined study of a low-calorie diet and Ephera, In 125 otherwise healthy obese women, showed  effectively in reducing BMI. RMR change not compensated for by the herbal medicines tried. Resting metabolic rate (RMR) change seemed to be affected by constitution and body composition rather than by medicine(1008). The Dongeui University study of composition GGEx18( Laminaria japonica, Rheum palmatum, and Ephedra sinica) in high fat diet-induced obese mice suggested that GGEx18 improves obesity through skeletal muscle AMPK and AMPK-stimulated expression of PPARα and its target enzymes for fatty acid oxidation, through inhibited lipid accumulation, and similar activation of genes(1042).
Please note that  due to its  adverse reactions of palpitations, stress, headache and insomnia and stroke, heart attacks, cardiac arrhythmias, seizures and psychotic,  the Dutch Inspectorate for Health Care and the Ministry of Health in Canada have recently requested a market recall of some ephedrine-containing herbal products in response to above adverse reactions. In the Netherlands, the status of Ephedra-containing products is currently reconsidered(790).

2. Ginseng
Ginseng is a slow-growing perennial plants with fleshy roots, the genus Panax, belonging to the family Araliaceae. Depending to the climate where it grows, ginseng can be classified mainly into Panax ginseng Asian ginseng (root), Red ginseng, wild ginseng, American ginseng (root)(791).
In 10 obese middle-aged Korean women who took Panax ginseng extracts for 8 wk, showed  effectively in influence on gut microbiota in promoting weigh loss but depending to the composition of gut microbiota prior to ginseng intake(792). In mice fed on a high-fat diet, ginseng saponin and ginsenosides not only exerted anti-obesity effects via the modulation of physiological lipid metabolism in vivo or intracellular signalling in cell culture systems, but also promoted anti-obesity effects, through abnormal physiology via HFD. Leptin, insulin, and adiponectin, which carry out critical functions in energy and lipid metabolism(793).

3. Zingiber Officinale(Ginger
Ginger (Zingiber officinale) or ginger root is the genus Zingiber, belonging to the family Zingiberaceae, native to Tamil. It has been used in traditional and Chinese medicine to treat dyspepsia, gastroparesis, constipation, edema, difficult urination, colic, etc.(794).
According to the Tehran University of Medical Sciences, Slimax (extract of several plants including Zingiber officinale and Bofutsushosan) showed a significant decrease in body weight or inhibition of weight gain(795). The composition of multi-ingredient supplement containing primarily raspberry ketone, caffeine, capsaicin, garlic, ginger and Citrus aurantium, also found the improvements in body composition, waist and hip girth, in an eight-week diet and exercise weight loss program(796). In a comparison of the weight loss effect of Orlistat, a pharmacological agent promoting weight loss and ginger (Zingiber officinale Roscoe, Zingiberacae) in male albino rats, researchers at the Ain Shams University Cairo, found that ginger has a great ability to reduce body weight without inhibiting pancreatic lipase level, or affecting bilirubin concentration, with positive effect on increasing peroxisomal catalase level and HDL-cholesterol(797).

4. Cissus quadrangularis (CQ)
Cissus quadrangularis is an ancient herb used to treat a variety of indications, belonging to the grape family, probably native to India or Sri Lanka. A randomized, double-blind, placebo-controlled design  involving 123 overweight and obese persons (47.2% male; 52.8% female; ages 19-50). conducted by University of Yaoundé I, Cissus quadrangularis showed a statistically significant net reductions in weight and central obesity, as well as causes of metabolic syndrome(798). In comparison of the effectiveness of Cissus quadrangularis-only and a Cissus quadrangularis/Irvingia gabonensis combination, on weight loss in overweight and obese human subjects, Cissus quadrangularis-only group showed significant reductions on all variables compared to the placebo group, the Cissus quadrangularis/Irvingia gabonensis combination resulted in even larger reductions(799). CQR-300, a proprietary extract of Cissus quadrangularis, also showed a significant reductions in weight and blood glucose levels, while decreasing serum lipids thus improving cardiovascular risk factors, according to the University of Yaoundé I,(800).

5. Sambucus nigra
Elder also known as Common Elder, is a shrub or small tree of the genus Sambucus of 30 specie, belonging to the family Adoxaceae, native to the temperate-to-subtropical regions of both the Northern Hemisphere and the Southern Hemisphere. The herb has been used in traditional and herbal medicine to treat constipation, colic, diarrhea, colds, flu, bronchial and upper-respiratory, irritation of the skin, rheumatism, etc.
The composition of supplement with Sambucus nigra and Asparagus officinalis study, showed an effectiveness in reduced weight, blood pressure, enhanced physical and emotional well-being and the quality of life had significantly improved (ITT analysis)(801). The Tehran University of Medical Sciences, Sambucus nigra study, showed a significant decrease in body weight in numbers of animal studies(802).

6. Asparagus officinalis
Asparagus is a flowering plant belong to species the genus Asparagus, native to the western coasts of northern Spain, north to Ireland, Great Britain, and northwest Germany, northern Africa and western Asia. Asparagus has been used from early times as a vegetable and medicine, because of its delicate flavour and diuretic properties(803). Asparagus officinalis L. powder tablets provided 19 mg saponins per day study showed an effectiveness of the tablets in reduced mean weight, blood pressure, and enhanced physical and emotional well-being and the quality of life with the rate of very good or good by most of the completers(804). In 12 weeks supplementation of a botanical extract-based weight loss formula, including Asparagus, researchers at the Poznan University of Medical Science, indicated a significantly change of the Body Composition Improvement Index (BCI), induce greater weight loss than placebo, probably through a concurrently performed exercise program recommended strategy for life style modification(805).

7. Slimax
Slimax (extract of several plants including Zingiber officinale and Bofutsushosan), in the reviews of the data base of studies published, showed a significant decrease in body weight. In 41 animal studies, the formula was found to be effective in significant induced weight loss or inhibited of weight gain(806).

                   The Weight Loss Vitamins C

Vitamin C, also known as L-ascorbic acid, is a water-soluble vitamin, found in fresh fruits, berries and green vegetables. It is best known for its free radical scavengers activity and regenerating oxidized vitamin E for immune support.

Vitamin C deficiency and incidence of obesity
Vitamin C  and other nutrients deficiency not only are associated to the risk of Obesity(807) but also enhances the risk of lipids, inflammation and insulin resistance(808). According to the research team at Universidad Autónoma de Querétaro, there is an associated link between Obesity and  Zinc and vitamins A and C concentration in women from rural Mexico, in a fasting blood sample analysis (809).
Although genetic susceptibility to obesity is associated with gene polymorphisms affecting biochemical pathways which also impacted by specific foods and nutrients. According to Dr. Johnston CS., vitamin C depletion is associated to positively related to body mass, individuals with adequate vitamin C status oxidize 30% more fat during a moderate exercise bout than individuals with low vitamin C status(810)

Vitamin C, the protective effect against obesity
Endothelial dysfunction has found to be associated to the incidence of obesity(811). The study of 76 healthy subjects (50 men and 26 women aged 21-45 years) obese subject, showed a positive effect of vitamin C and indomethacin in reduced oxidative stress contributed to endothelial dysfunction in human obesity(812).
In the evaluation of the potential inhibitory activity on α-glucosidase and pancreatic lipase of Citrus spp. fruits of Spanish origin, grapefruit, containing higher contents of phytochemicals, vitamin C, is found to have a great value for nutrition and treatment of diet-related diseases(813).
L-Ascorbic acid, in the study of whether the vitamin would facilitate the anti-obesity effects of chitosan and psyllium husk in vivo, indicated that addition of vitamin C in diet  influences the reduction in body weight gain and food efficiency ratio, and increases in total fecal weight and fecal fat excretion in guinea pigs fed a high-fat diet(814).

Taking altogether, deficiency of vitamin C and other nutrients are associated to increase risk of obese incidence. Vitamin C may be effective in induced weight loss for obese subjects due to its positive interaction in inhibiting oxidative stress causes of endothelial dysfunction. Daily ingestion of high-dose vitamin C may be considered safe, but in rare incidence, overdoses in a prolonged period of time, may cause intra-renal oxalate crystal deposition, a fatal nephrotoxicity(815)(816).


                 The Weight Loss Vitamin D


Vitamin D is a fat-soluble secosteroids found in small amount in few foods, including salmon, mackerel, sardines and tuna. The vitamin plays an important role in modulation of cellular proliferation, apoptosis induction, tumor growth suppression and promotion in absorption of minerals, including calcium, iron, magnesium, phosphate and zinc.
The serum level of vitamin D
Low levels of micronutrients, including vitamin D are most common among overweight and obese children. According to the study, low serum 25-hydroxyvitamin D3 (25(OH)D) levels not only is associated to insulin resistance and cardiovascular diseases risks(817) but also  incidence of obesity(818).
The study of Suspected Nonalcoholic Fatty Liver Disease in Chinese American Children also supported the link of obesity and metabolic syndrome among Chinese American  childrenand suggested that testing for metabolic disorders and low vitamin D levels would be necessary to identify the early indication of NAFLD in childhood will allow for intervention with lifestyle modification, providing a means to reduce the prevalence of NAFLD in children and adults(819).
DR, Peterson CA,  and Dr. Belenchia AM. told PubMed "There is a well-established inverse relationship between vitamin D status and obesity; however, it is unknown as to whether vitamin D deficiency contributes to, or is a consequence of obesity"(820). Some researchers suggested that correction of poor vitamin D status through dietary supplementation may be an effective addition to the standard treatment of obesity and its associated insulin resistance(821) as vitamin D deficiency is accounted for the secular trends in the prevalence of obesity and for individual differences in its onset and severity(822).

Vitamin D and adiponectin
A suggestion of association of low levels of Vitamin D and adiponectin is associated to obesity instead of vitamin D itself(823).
Adiponectin is a  protein involved in regulating glucose levels as well as fatty acid breakdown.
According to the study by the Università del Piemonte Orientale, in the confirmation Adiponectin tight association with obesity and diabetes mellitus, suggested that multimeric adiponectin may be a key plasma protein that links vitamin D deficiency to pediatric obesity(824).

In support the link between Vitamin D and adiponectin and obesity, the Ramathibodi Hospital, Mahidol University study showed that circulating adiponectin appears to be inversely related to beta cell dysfunction in addition to insulin resistance only in obese women(825). Other in the study insisted that since low serum levels of 1α,25-dihydroxycholecalciferol (DHCC) attenuates (monocyte chemotactic protein-1)MCP-1 and adiponectin production in human adipocytes, thereby reducing the expression of both pro- and anti-inflammatory factors may explain the difficulties so far in determining the role of DHCC in insulin sensitivity and obesity in human(826). Taking altogether, low serum levels of vitamin D and vitamin D deficiency are associated to increase risk of obesity and obese complications through involvement of vary mechanisms. Over doses of vitamin D supplement may cause excessive calcium absorption, calcification, Urinary stones etc. please make sure to follow the guideline of  the Institute of Medicine of the National Academies.
(See the references page for citations)

1. The Holistic Prevention, Management of PCOs analysed through Conventional Medicine Research and Studies(Part I) - The Prevention
2. The Holistic Prevention, Management of PCOs analysed through Conventional Medicine Research and Studies (Part II)- The Conventional Supplement page
3. The Holistic Prevention, Management of PCOs analysed through Conventional Medicine Research and Studies(Part III) - The Weight loss approach
5. The Holistic Prevention, Management of PCOs analysed through Conventional Medicine Research and Studies(Part V) - The TCM approach
7. The Holistic Prevention, Management of PCOs analysed through Conventional Medicine Research and Studies(References page of 700 -1499)