OBESITY,NUTRITION, METABOLIC SYNDROME update Dr Rahul Jain & Dr Sharda Jain
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This document discusses obesity, nutrition, and metabolic syndrome. It defines obesity as excess adipose tissue mass, which is commonly measured by body mass index. Obesity can lead to type 2 diabetes, cardiovascular disease, respiratory diseases, cancers, and other health issues. Metabolic syndrome is defined as a cluster of conditions that increase heart disease and diabetes risk, including abdominal obesity, high blood sugar, high triglycerides, low HDL, and high blood pressure. Intermittent fasting is discussed as a treatment approach, including different methods like 16/8 and 5:2 fasting. Nutrition topics covered include macronutrients, energy requirements, protein requirements, and the concept of a colorful plate for a balanced diet.
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Clomifene encourages the monthly release of an egg from the ovaries (ovulation). If clomifene is unsuccessful in encouraging Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Diet and aerobic exercise are two effective ways to lose weight. Medicines are an option if lifestyle changes don't work, another medication called Metformin may be recommended. Metformin is often used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS.
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A varied secretion of high male hormones like Androgen less secretion of female hormones like Estrogen and progesterone are the major cause of polycystic ovarian syndrome. This syndrome usually identified by inflammation in the ovary due to liquid like deposition in it. This imbalanced hormone secretion also affects with sudden weight gain, psychologically stressed condition, Anger, Pimples, growth of hair in jaw line and face, etc. this syndrome sometimes leads to problems in carrying a child.Herbal Health Care uses natural herbs like Neem, Jeera, turmeric, etc., along with Yoga, Varmam, Diet control, etc., to completely cure patients affected with PCOS
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Weight loss through lifestyle changes like diet modification and exercise can help reverse PCOS and improve fertility. Even a 5-10% reduction in initial weight over 6 months improves fertility outcomes. Losing weight decreases insulin resistance, lowers androgen levels, reduces ovarian size and cysts, and restores ovulation. This leads to normalization of hormone levels and menstrual cycles. Weight loss also improves other health markers like cholesterol and blood pressure. Nutrition plays a key role in managing PCOS holistically by controlling inflammation and optimizing gut health in addition to targeting metabolic issues like insulin resistance.
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- Insulin resistance: Insulin resistance and compensatory hyperinsulinemia can stimulate androgen production in the ovaries, contributing to hirsutism and other symptoms. It also increases risk of diabetes and cardiovascular disease.
- Genetic factors: Family history of PCOS increases risk, suggesting a genetic component. Specific genes involved in androgen production and insulin signaling may play a role.
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Weight loss through lifestyle changes like diet modification and exercise can help reverse PCOS and improve fertility. Even a 5-10% reduction in initial weight over 6 months improves fertility outcomes. Losing weight decreases insulin resistance, lowers androgen levels, reduces ovarian size and cysts, and restores ovulation. This leads to normalization of hormone levels and menstrual cycles. Weight loss also improves other health markers like cholesterol and blood pressure. Nutrition plays a key role in managing PCOS holistically by controlling inflammation and optimizing gut health in addition to targeting metabolic issues like insulin resistance.
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Here are a few potential pathways for polycystic ovary syndrome:
- Hypothalamic-pituitary-ovarian axis dysfunction: Dysregulation of the hormones that control the menstrual cycle (luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone) leads to irregular ovulation and menstrual cycles.
- Insulin resistance: Insulin resistance and compensatory hyperinsulinemia can stimulate androgen production in the ovaries, contributing to hirsutism and other symptoms. It also increases risk of diabetes and cardiovascular disease.
- Genetic factors: Family history of PCOS increases risk, suggesting a genetic component. Specific genes involved in androgen production and insulin signaling may play a role.
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DL, a 25-year-old woman, presents with irregular periods, weight gain, acne, and excess hair growth. Her lab tests confirm she has polycystic ovarian syndrome (PCOS) based on irregular periods, signs of excess androgens, and polycystic ovaries. She is started on oral contraceptives to regulate her cycle and reduce symptoms. Now that her symptoms have improved with treatment, she inquires about fertility options as she plans to get pregnant within a year. Treatment options discussed include ovulation induction medications and surgery. Her risks in pregnancy include miscarriage, gestational diabetes, and preterm delivery due to her PCOS diagnosis.
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2. Key features include menstrual irregularities, hirsutism, acne, obesity and infertility.
3. PCOS is associated with insulin resistance which can increase androgen levels and impair follicle development leading to chronic anovulation.
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This document discusses the role of nutrition in managing polycystic ovary syndrome (PCOS). It begins by providing background on PCOS, including its prevalence, pathophysiology, and diagnostic criteria. It then discusses common comorbidities like obesity, insulin resistance, and metabolic syndrome. Lifestyle interventions like modest weight loss through diet and exercise are recommended as first-line treatment. Pharmacological options and herbal supplements that may help with PCOS symptoms by improving insulin sensitivity and reducing androgens are also outlined. The document concludes that combined nutritional supplements and lifestyle changes are effective and safe management strategies for women with PCOS.
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Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.
obesity and fertility implications
The increasing incidence of obesity if affecting fertiliyu . Can we do something as health care personnel ?
Big picture of pcos
This document summarizes the causes and symptoms of polycystic ovarian syndrome (PCOS). It discusses how an unfavorable uterine environment can result in hormonal imbalances like increased luteinizing hormone and hyperinsulinemia in fetuses. These imbalances can lead to insulin resistance and high androgen levels in adolescence, causing physical symptoms of PCOS like hirsutism and metabolic disorders. The body compensates over time through increased abdominal fat and risk of conditions like diabetes and fatty liver disease. Lifestyle changes including exercise and diet are recommended to reduce symptoms.
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The document discusses the metabolic consequences of polycystic ovary syndrome (PCOS), including insulin resistance and risk of diabetes. Women with PCOS have increased insulin resistance compared to controls, which can lead to hyperinsulinemia and compensatory hyperinsulinemia from the beta cells. Insulin resistance and secretion defects are seen in both obese and lean PCOS women. Over time, persistent insulin resistance can cause beta cell dysfunction and increased risk of impaired glucose tolerance or type 2 diabetes. Lifestyle changes like 5-10% weight loss and medication like metformin can help manage insulin resistance and lower diabetes risk in PCOS.
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DL, a 25-year-old woman, presents with irregular periods, weight gain, acne, and excess hair growth. Her lab tests confirm she has polycystic ovarian syndrome (PCOS) based on irregular periods, signs of excess androgens, and polycystic ovaries. She is started on oral contraceptives to regulate her cycle and reduce symptoms. Now that her symptoms have improved with treatment, she inquires about fertility options as she plans to get pregnant within a year. Treatment options discussed include ovulation induction medications and surgery. Her risks in pregnancy include miscarriage, gestational diabetes, and preterm delivery due to her PCOS diagnosis.
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2. Key features include menstrual irregularities, hirsutism, acne, obesity and infertility.
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- 1. Topic :- OBESITY,NUTRITION, METABOLIC SYNDROME Update (2020) Dr Rahul JainDr Sharda Jain for Gynaecologist & Surgery Specialist
- 2. Over 400 ppts are available on slideshare.net ***for use of public/Doctors www.slideshare.net / Lifecarecentre
- 3. B Y - D R R A H U L J A I N G U I D E - D R S H A R D A J A I N OBESITY,NUTRITION, METABOLIC SYNDROME
- 4. OBESITY OBESITY IS A STATE OF EXCESS ADIPOSE TISSUE MASS MOST COMMON WAY TO MEASURE OBESITY IS BODY MASS INDEX(KG/M2)
- 6. PATHOGENESIS- PROGRESSION OF INSULIN RESISTANCE Adipose cell
- 7. PATHOLOGIC CONSEQUENCES OF OBESITY- TYPE 2 DM AND INSULIN RESISTANCE REPRODUCTIVE DISORDERS CVS DISORDERS-CAD,STROKE,CHF PULMONARY DIS.-OSA,OBESITY HYPOVENTILATION SYNDROME LIVER-NAFLD,NASH
- 8. BONE AND JOINT DISEASES-OSTEOARHRITIS SKIN DISEASES-ACANTHOSIS NIGRICANS CANCERS- ESOPHAGUS,COLON,RECTUM,PANCREAS,LIVER ,PROSTATE,GALL BLADDER,CORPUS CANCER SYNDROME,ENDOMETRIUM,BREAST
- 9. METABOLIC SYNDROME- 3/5 SHOULD FULFILL TRIGLYCERIDES>150MG/DL HDL(MALES<50MG/DL) (FEMALES<40MG/DL) FASTING GLUCOSE>=100MG/DL BP>130/85MMHG ABDOMINAL GIRTH(MALE->=102,94CM) (FEMALE->=88,80CM)
- 10. DEFINITION- THE METABOLIC SYNDROME (SYNDROME X, INSULIN RESISTANCE SYNDROME) CONSISTS OF A CONSTELLATION OF METABOLIC ABNORMALITIES THAT CONFER INCREASED RISK OF CARDIOVASCULAR DISEASE (CVD) AND DIABETES MELLITUS .
- 11. ETIOLOGY- INSULIN RESISTANCE(BEGINS WHEN FREE FATTY ACIDS ARE MORE IN BLOOD) LEPTIN RESISTANCE INCREASED WAIST CIRCUMFERENCE(CENTRAL OBESITY) GLUCOSE TOLERANCE(MARKER OF INSULIN RESISTANCE) PRO INFLAMMATORY CYTOKINES(IL-1,IL-6,IL- 19, TNF- APLHA)-ADIPOSE TISSUE DERIVED MACROPHAGES DYSLIPIDEMIA
- 12. ETIOLOGY- HYPERTENSION- NORMALLY-INSULIN>VASODILATOR WITH SECONDARY EFFECT OF SODIUM REABSORPTION IN KIDNEY. INSULIN RESISTANCE>ONLY SODIUM REABSORPTION INSULIN ALSO INCREASES SYMPATHETIC DISCHARGE HYPERURICEMIA ROLE OF PRO INFLAMMATORY CYTOKINES
- 13. PATHOGENESIS- (ABDOMINAL OBESITY)FFA RELEASE>INSULIN RELEASE>IN LIVER,FFA RELEASE STIMULATES PRODUCTION OF GLUCOSE(HYPERGLYCEMIA) AND VLDL AND ↓HDL AND ↑LDL FFA ALSO DECREASES INSULIN SENSITIVITY IN MUSCLES SINCE INHIBHITS INSULIN MEDIATED GLUCOSE UPTAKE HYPERGLYCEMIA AGAIN STIMULATED INSULIN RELEASE
- 15. TREATMENT- RISK FACTOR CONTROL WEIGHT REDUCTION DIET CONTROL RESTRICTION OF SMOKING AND ALCOHOL LIFE STYLE CHANGES INTERMITTENT FASTING
- 16. FASTING AND INTERMITTENT FASTING
- 17. TYPES OF INTERMITTENT FASTING- 16/8 METHOD 5:2 FASTING 12 HOUR FASTING ALTERNATE DAY FASTING
- 18. ANTI AGING AND FASTING?
- 19. MECHANISM-
- 20. OTHER WAYS TO DELAY AGEING- PHYSICAL ACTIVITY AND EXERCISE METORMIN HORMESIS RED WINE AND GRAPES
- 21. NUTRITION- NUTREINTS ARE ORGANIC AND INORGANIC COMPLEXES CONTAINED IN FOOD.2 TYPES 1.MACRONUTRIENTS-FORMS THE MAIN BULK PROTEINS(10-15%) FATS(15-30%) CARBOHYDRATES(50-70%)
- 22. ENERGY REQUIREMENTS- PROTEIN-4KCAL/GM CARBOHYDRATES-4KCAL/GM FATS-9KCAL/GM HOW TO CALCULATE ENERGY REQUIREMENTS TILL PUBERTY? 100KCAL/KG UPTIL 10KG BODY WT 50KCAL/KG FOR 10-20KGS 20KCAL/KG FOR >20KGS
- 24. ENERGY REQUIREMENTS- MAN- 1. SEDENTARY WORK-2320 KCAL/DAY 2. MODERATE WORK-2730KCL/DAY 3. HEAVY WORK-3490KCAL/DAY WOMAN(PREG+350,LACTATION+600) 1. SEDENTARY WORK-1900 KCAL/DAY 2. MODERATE WORK-2230KCL/DAY 3. HEAVY WORK-2850KCAL/DAY
- 25. PROTEIN REQUIREMENT- FOR CHILDREN- 0.9 GM/KG BODY WT/DAY FOR ADULTS- 0.8 GM/KG BODY WT/DAY
- 26. BALANCED DIET
- 28. THANK YOU? ANY QUESTIONS?