August 2023

Polycystic ovary syndrome is a common diagnosis for women of childbearing age. As many as six million women in the United States (nearly 10% of the US population) have symptoms of PCOS.¹ 

PCOS is a hormonal disorder classified by three main features: the lack of ovulation, overproduction of androgen hormones, and the presence of multiple cysts on the ovaries.² A diagnosis can be made when the patient has two or more of the features with no other notable cause.² PCOS can cause symptoms like infertility, thinning hair, changes in the menstrual cycle, and multiple ovarian cysts. Many people with PCOS also have an increased risk of endometrial cancer because of anovulation; decreased insulin sensitivity, which can lead to diabetes; and increased fatty deposits in the liver, leading to liver damage.¹ The exact cause of PCOS is still unknown, but there have been some advances in the treatment of the condition. 

Typical treatment for PCOS can consist of medications, diet changes, and surgery, in some instances. We now know that phytochemicals can be an important part of treatment for PCOS. There are thousands of phytochemicals, each with unique characteristics and potential health benefits. Recent studies have started to unveil the intriguing connection between phytochemicals and gynecological health.^2,3,4 

Some phytochemicals, like flavonoids, can temper PCOS symptoms by inhibiting enzymatic activity.³ The ring structure of these phytochemicals mimics the site of interaction of some key enzymes in the formation of androgen hormones that exacerbate symptoms of PCOS.³ When the enzymes connect with phytochemicals instead, there is a decrease in the amount of androgens made in the body and a subsequent decrease in symptomatology. As our understanding of these potent compounds deepens, we gain valuable insights into how they may positively impact gynecological health. 

Quercetin is a flavonoid found in red peppers, broccoli, apples, and blueberries. It has been shown to lower the amount of circulating androgens in the blood as well as having anti-inflammatory and antioxidant effects.⁴ Quercetin is not absorbed well into the body on its own. To assist quercetin uptake, foods with quercetin should be eaten alongside good sources of vitamin C or bromelain (an enzyme found in pineapples). 

While research into the role of phytochemicals in gynecological diagnoses is promising, it is crucial to approach these findings with caution. Further rigorous studies, including clinical trials, are necessary to establish the safety and efficacy of phytochemical-based treatments. Additionally, it is essential to remember that phytochemicals should not replace conventional medical treatments. Instead, they should be viewed as complementary approaches to support gynecological health when incorporated into a healthy diet and lifestyle.

Recipes are everywhere, but Google and Pinterest can be overwhelming, and relocating that dish that you saw on social media a few weeks ago can be impossible. When we run across a curated recipe resource that can be reliably relocated and fills the healthy niche, we’ll share it. This month, check out the “Eat Healthy Monthly Recipes” shared by our friend Andrea Sherrill, RD and FCS Extension Agent in Iredell County.

I attended the American Society of Nutrition Conference in Boston in late July. Scientists and healthcare professionals from all over the world came together to exchange information about the future of food and nutrition science in healthcare.

The session Food as Medicine particularly resonated with me and reaffirmed the work we are doing to incorporate dietary guidance as a complement to traditional treatment plans. Several speakers gave their views and visions for the future of food in the medical and healthcare domain. 

Representative Jim McGovern from Massachusetts and co-chair of the Hunger Caucus, spoke about his hunger policy for the United States. He is passionate about decreasing hunger for American families. He says that hunger is a political issue and that it is hidden in plain sight. Poor diets cost the country in medical costs, decreased productivity, and death. He suggested that we need to rethink the education of medical students to provide better nutrition training, and we need to teach people about their food and the best ways to cook it to sustain a healthy life. His goal is to use his position in the government to strengthen nutrition policies that will help Americans maximize their health.

Dr. Dariush Mozaffarian, a cardiologist from Tufts University, described how 20th century nutrition policies focused on getting calories and vitamins to people through fortification and industrial technology. For the most part, the policy was successful.⁵ For example, cereal fortification and consumption was prioritized. Because this was the focus, we now have lots of fortified processed foods that provide high calorie meals with added vitamins and minerals. Moving forward, he says that we need to get back to whole foods that provide nutrient dense meals without the calorie density and the processing.

Healthcare systems can take the lead in changing the focus with medically tailored meals, medically tailored groceries, produce prescriptions, and medical nutrition education. Dr. Mozaffarian suggests that we need to build layers of programs that help address patients and their needs, from prevention to treatment, in a spectrum of health as illustrated in the Food is Medicine pyramid.

Citations

1. Endocrine Society. (2022) Polycystic ovary syndrome. Endocrine Society. 

2. Rudnicka, E., et al. (2022) Oxidative Stress And Reproductive Function: Oxidative stress in polycystic ovary syndrome. Reproduction (Cambridge, England), 164(6), F145–F154. 

3. Luo ED, et al. (2023) Advancements in lead therapeutic phytochemicals polycystic ovary syndrome: A review. Frontiers in Pharmacology. 

4. Tabrizi F.P., et al. (2020) Quercetin and polycystic ovary syndrome, current evidence and future directions: A systematic review. Journal of Ovarian Research. 

5. CDC, M. (1999). Achievements in public health, 1900-1999: safer and healthier foods. October, 15, 48.

6. Mozaffarian, D., et al. (2022). A Food is Medicine approach to achieve nutrition security and improve health. Nature medicine, 28(11), 2238–2240.