Heart Health and PCOS

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Regardless if you are thin or not, women with PCOS have a higher rate of
cardiovascular risk factors. These risks include elevated triglyceride (TG)
levels (the blood storage form of fat), blood pressure, C-reactive protein
(marker of inflammation and oxidative stress), total cholesterol and LDL
cholesterol (the so-called "bad" type of cholesterol), and low levels of HDL
(the "good" type of cholesterol that we should have high levels of). Studies
show that as many as 70% of all women with PCOS have elevated levels of
LDL cholesterol and low levels of HDL (1,2) both of which are strong
predictors of cardiovascular disease. Whether you have abnormal cholesterol
levels or not, now is the time to take measures to improve your heart and your
health. The following are some of the best ways to help your heart.

Eat more of a plant-based diet.

A plant-based diet is one that is rich in fruits, vegetables, whole grains, legumes, and nuts but is limited in animal products, many of which contain saturated fats and cholesterol that are
known to clog arteries (butter, margarine, cream, red meat, mayonnaise). In
addition, plant-based foods contain important vitamins, minerals, and fiber
needed to reduce blood lipid levels, blood pressure, and insulin. They are low
in calories and take longer to chew thus adding to fullness with meals. To
bring more of a plant-based diet into your life start slow. For example, make 2
meals a week without using meat or other animal products. Remember, you
don't have to eliminate meat altogether, just make it so it is less of an
important staple in your everyday way of eating.

Consume omega-3 fatty acids on a regular basis.

Omega-3 fatty acids have long been known to bring down cholesterol and triglyceride levels.
Foods that include omega-3 fatty acids include walnuts, egg yolk,
flaxseed, canola oil, fish (especially salmon and tuna). While some of these
foods do contain relatively more calories and fat per serving than some other
foods, omega-3's are a crucical part of the diet for PCOS and heart health.
Eat these foods more throughout the week and you can expect to see your
blood lipid levels fall toward lower and healthier levels within a few short
months.

Use phytosterols in place of foods containing saturated fats.

Phytosterols (also called sterols and stanols) are cholesterol-lowering plant
chemicals that can help women with PCOS. They are so structurally similar to
cholesterol that they compete for absorption in the intestine. The cholesterol
that does not get absorbed is eliminated from the body. A 2006 study in the
Journal of the American College of Nutrition found that 1.8-2.8 grams of
phytosterols a day for one to three months lowered cholesterol by 11%.
Phytosterols have no taste or odor and many food manufactures are fortifying
foods with them for their cholesterol-lowering effects. Some foods that are
currently available that contain phytosterols include granola bars, bread, lowfat
milk (available at Kroger stores nationwide), yogurts, soft margarine or
butters, and multi-vitamins. If you do have high cholesterol (or a strong family
history of it), consider substituting your current food selection with foods
fortified with phyotsterols. Approximately two to four servings will meet the
recommended amount of 2 grams of phytosterols per day.

Choose whole grain and other lower-glycemic index carbohydrates.

Replacing refined carbohydrates with whole grain ones not only benefits
women with PCOS by aiding in lowering insulin levels but helps to improve
cholesterol levels as well. This is because lower-glycemic index foods like
whole grains are rich in fiber which grabs cholesterol in the body and carries it
out so it's less likely to be absorbed. Fiber-rich foods are also more filling.
Government guidelines recommend women consume 25-35 grams of fiber
each day. This can easily be met by a diet that includes a variety of fruits,
vegetables, legumes, and whole grains.

Engage in some form of physical activity daily.

Being physically inactive is a risk factor for cardiovascular disease. It also contributes to insulin
resistance seen with PCOS. Try to make an effort to be more physically
active. This does not mean having to join a gym or other structured activity.
Simply adding more activity into your daily life is a great way to start. For
example, parking your car further away at stores, getting off the bus or
subway a few stops earlier, dancing more at home or out, walking down the
hallway to talk to a co-worker instead of emailing them are all forms of
physical activity. Try using a pedometer during the day with a goal of getting
10,000 steps in daily. If you currently engage in an exercise regiment,
consider making it more challenging by adding more resistance, time, heavier
weights, or trying new activities. Not only will you see improvements to your
cholesterol levels, but blood pressure, insulin, and perhaps even mood and
body image!

For more information on ways women with PCOS can improve their heart
including recipes and tips for eating out visit the American Heart Association's
website at www.americanheart.org.

1. Legro RS et al. Prevalence and predictors of dyslipidemia in women with polycystic ovary
syndrome. American Journal of Medicine. 2001;111:607-613.
2. Apridonidze T et al. Prevalence and characteristics of the metabolic syndrome in women with
polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism. 2005;90:1929-
1935.

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