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One of the hardest time I have during consultation's is when a mother brings a child in her teens to me and asks me to 'fix' her periods and 'make her thin'. PCOS is still a tabboo in India, and most parents do not realise that the child is not be be blamed for obesity.

Hormonal fluctuations, for anyone struggling with PCOS, makes it hard for a person to reduce weight or even manage mood swings. Most often, the answer lies by changing the lifestyle habits of the family, not the child alone.

Before we dive in to discuss a meal plan for PCOS management, let's first look at what this condition exactly is and the root cause for PCOS. Without understanding the root cause, we will never be able to get reverse our symptoms completely.

What Is PCOS?

Polycystic Overy Syndrome or PCOS is a condition affecting women, due to hormonal imbalances during their reproductive years.

PCOS can be characterised by multiple features, including excess OR very little sex hormone production, male pattern baldness and excessive facial hair growth, irregular and/ or painful periods etc.

Here is a detailed article I already wrote about PCOS management and reversal:

• Lifestyle Modification Tips for PCOS Management.

PCOS also comes with the risk for, infertility, insulin resistance and a higher chance of developing health conditions like diabetes and blood pressure.

PCOS is one of the major health concerns that persist today and the most common cause of female infertility. Now because PCOS is not really a diseases, but a compilation of a set of symptoms, there is no real 'cure' to PCOS. But the good news is, because PCOS symptoms arise from your lifestyle choices, lifestyle changes can help you reverse the symptoms.

For example, chemical products int he environment like skin lotions and even toothbrushes carry hormone disrupters. These increase your risk of symptoms. Simply making the lifestyle choice to switch these out for cleaner products is enough to see a reversal in your symptoms.

What is the prevalence of PCOS in South India?

PCOS is a leading endocrine disorder among 20% of women in their reproductive age groups.

Reports and data required to define proper evidence and statistics for PCOS patients in the country are very scarce. Most women struggling with the condition are not even aware of the same. Especially women living in rural India, might even be too embarrassed to share their concerns.

We do have some data to show us the prevelance and seriousness of the condition. A cross-sectional study on adolescents, conducted for one month at the Balaji Hospital, Tamil Nadu, found a prevalence of 18% of women affected by the condition in a population size of 126 girls.

What was of more concern was that average age of women diagnosed by the condition was only 18 years of age.

When it comes to region-specific results, likely, the prevalence of PCOS in urban and rural women varies significantly due to different environments, lifestyles, dietary practices etc.

As per of the study mentioned above, PCOS was higher in the urban population in comparison to its rural counterparts. At the same time physical activity and better nutritional practices were prevalent among women who belonged to the rural population.

When we speak in terms of the general population, 30% of women with obesity have been diagnosed with PCOS. This indicates that nutrition and physical activity play a vital role in the mitigation of PCOS.

Another study indicate that PCOS is prevalent in 9.13% to 36% of the population in India. But this figure can be deemed as circumstantial. Due to the lack of awareness and proper assessment facilities in the community, many cases of PCOS remain undiagnosed (50-75%).

What are some significant reasons for PCOS?

We may be aware of a few triggers of PCOS in the body but the disease is still poorly researched. Insulin resistance, the inability of the body to breakdown sugars properly may be the cause of obesity. Obesity in turn can be the cause for estrogen dominance (excess female sex hormones) and PCOS.

Two of the most common contributing factors that triggers PCOS are lifestyle and nutritional habits.

Evidence gathered over the past 200 years indicates the contribution of AGEs- Advanced Glycation End Products, which are also known as Glycotoxins consumption, in increasing the risk of chronic diseases, including PCOS.

AGE levels are very high in protein OR fat rich foods that are fried, broiled, and grilled. Dairy products like ghee, made by exposing milk to heat for long periods of time is one of the most highest in AGE's. Besides this, meat, friend eggs and even deep fried junk food contribute to high AGE levels in the body.

So we can easily deduce that bad nutritional choices - like meat and dairy products - that are high in AGE's, will lead to obesity and then trigger PCOS.

Other factors can be excessive body weight, although we still don’t whether obesity leads to PCOS or vice versa. The prevalence of obesity is very high in women with PCOS, and the chain that leads to obesity usually starts from poor nutritional choices.

But it is not always true that only obese women can get PCOS; indications of high AGE levels and PCOS were also found in some women who are lean and fit.

The ovaries are very sensitive to the [pro] inflammatory and oxidants effects of AGE's, hence cutting down on dietary Glycotoxins like - meat and dairy and changing your cooking methods to more steam, boil, bake rather than grill, fry, broil can help reduce the effects of PCOS.

AGEs are the biggest source of chemically and biologically active toxins. These toxins in the body are produced either internally as metabolism waste or because of poor diet. AGEs have other negative contributions to the body.

AEGs are ageing toxins that can fast-track the ageing process in your body, and reduce the overall integrity and function of your organs. AGEs can cause muscle stiffness, oxidative stress and inflammation in the body.

Further, it can cause macular degeneration and cataract problems in the eye and even dementia. AGE receptors are located primarily in the ovaries, thus, affecting women more than men.

Here is one of my clients talking about her experience with PCOS reversal:

How common is PCOS In India?

Younger women suffer from irregular periods, acne or excessive hair growth in the body as an effect of PCOS. This condition may also deem the body unfit for conceiving children in older women along with the increased chances of miscarriages - as per Dr Duru Shah (founder of PCOS Society).

She adds “ there is nearly a 40% chance that a female child may develop PCOS if the mother has it”.

One in every five women is estimated to have PCOS in India. This 20% of the population is at a large risk of developing high blood pressure, diabetes and further complications in the body. Although there have been several cases in India which also indicated that women usually ignore the direct symptoms of PCOS and only consult a health professional if they have trouble conceiving.

As per Dr Shah, almost 80% of women in India with PCOD also suffer from obesity. And this figure varies significantly when it comes to the urban and rural populations. According to Shah, urban women in India are at an increased risk of PCOS pertaining of their poor diet, lifestyle and evident lack of physical activity.

Also Check: IV Therapy For PCOS

What kinds of foods are to blame for the rise of PCOS in India?

People with PCOS have nearly twice the levels of AGE's circulating in their bodies than people without PCOS. We all know that diet-induced AGE's are responsible for the production of toxins in the bloodstream. Thus,

• elimination of certain foods, and
• inclusion of certain healthier modes of cooking,

can make a large difference in curbing glycotoxin buildup. But first, we must identify which sources of food are high in AEG content.

AEG has been found to be higher in many food groups that have an animal origin - beef, pork, chicken etc, as well as in dairy products which can be responsible for excessive estrogen levels in the body, which in turn can affect reproductive health.

It is best advised to keep your distance from sugary, ultra-processed, junk food that contains trans fat, mainly because they promote oxidative stress and inflammation in the body. They also lack essential nutrients like fibre which is a natural estrogen manager. So avoid white bread, white rice, pastries etc.

It has been observed that within two hours of an AGE-rich meal, artery function reduces.

Apart from knowing what to eat is also important to know how to eat it. Fried and grilled food are not the same as boiled and steamed food. Exposing foods to prolonged heat increases its AGE levels.

It is established that fried chicken will have more amount of AGE levels than boiled chicken, however, fried vegetables will still have less AGE levels than boiled chicken. Animal products are a huge culprit, contributing to PCOS symptoms.

Hence, you may alternate with healthier cooking methods if you want to continue the consumption of certain ingredients, but it is advisable to stick to a low-fat, high-fibre plant-based diet to curb the symptoms of PCOS.

So stick to traditional vegetarian foods like daal rasam, vegetable sambhar, korma, pesarratu, thakkali sadam, Kuzhi Paniyaram etc.

All of these can be made healthy, without the use of meat or dairy products and are yet, oh so tasty!

What kind of Indian foods should you consume for PCOS reversal?

A plant-based diet naturally allows you to keep the trans fat at bay and consume food in the most natural way possible. You also consume more fiber, which helps with symptom management. Watch this to understand more:

Consumption of soy products like tofu, soy milk, tempeh and soy beans has also proven to be quite helpful.

Dr Neal Barnard, a pioneer is lifestyle medicine, reveals that Canadian researchers who tested Soy products on women with PCOS discovered that with only two cups of soy milk consumption per day, helped with hormonal balance.

Soy products are naturally high in phytoestrogens, a natural antioxidant, that literally fights excess estrogen in the body.

Let's look as other important food groups to consume for PCOS management:

• Include 50- 100 grams of leafy green vegetables per day. These are fiber rich and natural appetite suppressors. Besides this, leafy greens are high in folic acid, helping when you plan for fertility.
  
  
• Whole grains like brown rice, millets, oats, quinoa & wheat, are rich in B vitamins, naturally boosting hair and skin health. Grains are also anti- inflammatory and loaded with essential minerals.
  
  
• Start each meal with something raw first. For example, a salad before lunch or fruit before breakfast. It is observed that raw fruits, vegetables, and nut butter have upto 30 times less AEG levels as compared to cooked food.
  
  
• Many essential herbs like marjoram help with PCOS management. Read this article for a detailed list.
  
  
• Include pulses/ lentils with every meal. These help boost insulin sensitivity and aid in fat loss. Most of us omit daal's and other pulses thinking it is all 'carbs', but unprocessed carbs are what heals the body.
  
  
• Whole, un- roasted nuts and seed must be a part of every meal. You will not need anything more than 1-2 tbsp, but this plays an important role in helping absorb fat soluble vitamins.

Lifestyle changes for PCOS in India.

Eat Right

Prioritize the type of nutrition your body needs. Choose fibre over fat because fibre effectively absorbs toxins in the body along with plenty of other health benefits. Make sure that your food is well portioned and well balanced - like consuming two portions of soy, 5-10 proportions of fruits and vegetables, 100 gm of antioxidants etc to keep out AEG in the system.

Choose drinking water over sugary beverages and alternate your cooking methods to more steaming and boiling rather than searing or frying to control the AEG level intake in your body.

Quit the bad habit

Say a complete no to smoking even if its passively. Smoking can increase the AEG in the body and increase inflammation and deteriorate your condition. Apart from this, drinking alcohol and consumption of drugs are strongly not advised.

Add some movement

Regular exercise paired with a proper nutrition can help you tackle a lot of other lifestyle-related issues besides just PCOS.

It is a debatable fact that cardio is the only form of exercise to lose weight. In reality adding any form of strength and resistance training to your workout routine is suggested. The same helps builds muscles, prevents gaining fat and changes the way food is absorbed in your body.

Sample South Indian Diet Chart For PCOS/PCOD.

Traditional South Indian cuisine is naturally balanced and low in AGE's. Granted, that our mordanization of food lately, including excessive amounts of oil's and butter, deep frying techniques and use of processed grains is a problem.

But if you looked at how our ancestors ate, you notice that they used a lot of fresh vegetables, whole grains and spices that heal the body.

Here is a sample one week meal plan to help you gain a better understanding. You can find a lot of recipes mentioned below here.

• Recipes by Roshni Sanghvi.

Conclusion

Lifestyle management and nutritional choices should be the main stay focus in lowering insulin resistance in the body which is one of the major drivers of PCOS.

Sometimes, the medical route might become the only option. But most of the time, lifestyle changes must be the first choice for treatment.

Encourage yourself to eat more fibre-rich food, turn down the meat and increase the vegetables, regularly exercise and undergo small but significant lifestyle changes like proper sleep, stress management and nutritional intake.

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