Low Carb High Fat - Ketogenic

Notes:

most common endocrine disorder in women in the reproductive age, with an estimated prevalence ranging from 6 to 15%

Common signs of PCOS not included in diagnostic cri-teria are represented by insulin resistance, reversal of the FSH/LH ratio and obesity, which is an important clinical feature of PCOS.

it is important to remark that these metabolic abnormalities may also be present in non-obese patients

96% of westerners have impaired metabolic health, its not just the visibly obese!

The ovaries of PCOS patients usually maintain a normal response to insulin.

It's tragic, people with impaired metabolism have elevated insulin levels, but their ovaries are still very insulin sensitive - so the signal is just too strong!

PCOS women present a peculiar dietary pattern, characterised by reduced use of extra-virgin olive oil, legumes, seafood and nuts, a lower amount of complex carbohydrate, fiber, monounsaturated fatty acids, and higher simple carbo- hydrates, total fat and saturated fatty acid, compared to normal women.

it is controversial whether diet composition per se has an effect on reproductive and metabolic outcomes. Blood glucose levels are affected by carbohydrate intake and regulate insulin secretion from the pancreas, so very-low carbohydrates diets may be superior to standard hypocaloric diets in terms of improving fertility, endocrine/metabolic parameters, weight loss and satiety in women with PCOS

That is a UNDERSTATEMENT!

This was a 12 weeks, single-arm study. The outcome measures were body weight, BMI, FBM, LBM, FBM percentage, LBM percentage, glucose, insulin, HOMA-IR, total cholesterol, HDL, LDL, triglycerides, total testosterone, free testosterone, progesterone, estradiol, LH, FSH, DHEAS, LH/FSH ratio, SHBG and Ferriman Gallwey Score.

Anthropometric and body composition measurements revealed an

• average weight loss of 9.43 kg (pre 81.19 ± 8.44 kg vs post 71.76± 6.66 kg; p < 0.0001)
• significant reductions (− 3.35) of BMI (pre 28.84 ± 2.10 vspost 25.49 ± 1.69; p < 0.0001)
• FBM (− 8.29 kg) (pre 27.96 ± 5.11 kg vs post 19.67 ± 3.72 kg; p < 0.0001).
• LBM absolute value showed a slightly significant decrease (pre53.23 ± 5.02 kg vs post 52.09± 4.60 kg), but its percent- age value was slightly increased (pre 65.74 ± 3.75% vspost 72.71 ± 3.55%; p < 0.0001)
• VAT showed a very signifi-cant (pre 1750 ± 181.58 grams vs. post 1110,36 ± 189.23;p < 0.0001) decrease
• waist circumference decreased in a significant manner (pre 100.7 ± 4.81 vs post 96.69 ± 3.82; p = 0.0015)

Not bad for a 3 month study!

Not bad at all!

KDs could be considered, as a nutraceutical therapy aimed to increase insulin sensitivity. The data available in the literature [26, 30–32], although few, confirm the assumption that a KD, correcting hyperinsulinemia and improving body composition, can contribute to the normalization of the clinical picture in PCOS. During fasting or a carbohydrate restriction such as a KD, blood insulin concentration decreases, while glucagon increases to maintain the normal blood glucose level, first through glycogen stores, then through the β-oxidation of fatty acids stored in fat depots. Approximately 3–5 days after a very low carbohydrate diet, when the concentration of KBs begins to grow, hunger considerably decreases, but maintaining a state of well-being [51]

we can be assumed that 12 weeks were not sufficient to observe a decrease in hirsutism scores: the hair cycle, in fact, depending on the body area can last for some months and it is known that pharmacological therapy based on antiandrogens takes from 6 to 12 months to obtain a good reduction of the score.

This is a very important point, hormonal interventions (which a KD is), will take months if not years to fully correct. If it took 30 years to get into a biological state, it might take longer then a 12 week study to correct it.