You are what you eat, and when you eat it. A recent study at Tel Aviv University has shown that infertility caused by Polycystic Ovarian Syndrome (CPOS) could be prevented by adjusting meal times, with larger meals early in the day and small meals in the evening.
PCOS is a common disorder that impairs fertility by impacting menstruation, ovulation and hormones, and is closely related to insulin levels. Women with the disorder are typically “insulin resistant” – their bodies produce an over abundance of insulin to deliver glucose from the blood into the muscles.
The excess makes its way to the ovaries, where it stimulates the production of testosterone, thereby impairing fertility.
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In search of a possible solution, Professor Daniela Jakubowicz of Tel Aviv University’s Sackler Faculty of Medicine and the Diabetes Unit at Wolfson Medical Center in Israel has found a natural way to help women of healthy weight who suffer from PCOS manage their glucose and insulin levels to improve overall fertility. According to her, it’s all related to timing.
Her study showed that women with PCOS who increased their overall calorie intake at breakfast and reduced their calorie intake through the rest of the day saw a reduction in insulin resistance. “Ultimately, this led to lower levels of testosterone and dramatic increase in the ovulation frequency – both being measures that have a direct impact on fertility,” notes Jakubowicz.
50 percent more fertile
“Many of the treatment options for PCOS are exclusively for obese women,” Jakubowicz explains. “Doctors often suggest weight loss to manage insulin levels, or prescribe medications that are used to improve the insulin levels of overweight patients. But many women suffering from PCOS maintain a normal weight – and they are looking for ways to improve their chances of conceiving and giving birth to a healthy baby.”
A recent study by Jakubowicz and her colleagues showed that a low-calorie weight-loss diet with larger breakfasts and smaller dinners lowers insulin, glucose and triglycerides levels. This finding led them to test whether a similar meal plan could also be an effective treatment for women with PCOS.
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In her study, sixty women suffering from PCOS with a normal body mass index (BMI) were arbitrarily assigned to one of two 1,800 calorie maintenance diets with identical foods. The first group consumed a 983 calorie breakfast, a 645 calorie lunch and a 190 calorie dinner. The second group ate a 190 calorie breakfast, a 645 calorie lunch and a 983 calorie dinner. After 90 days, the researchers tested each group for insulin, glucose, and testosterone levels as well as ovulation and menstruation.
As hypothesized, neither group had a change in BMI, but other measures differed significantly. While participants in the high calorie dinner group maintained consistently high levels of insulin and testosterone throughout the study, those in the high calorie breakfast group experienced a 56 percent decrease in insulin resistance and a 50 percent decrease in testosterone. Reduction in these measures led to a 50 percent increase in ovulation rate by the end of the study.
A king’s breakfast and a peasant’s dinner
“These results suggest that meal timing – specifically a meal plan that calls for the majority of daily calories to be consumed at breakfast and a reduction of calories throughout the day – could help women with PCOS manage their condition naturally, providing new hope for those who have found no solutions to their fertility issues,” says Jakubowicz.
Beyond matters of fertility, this treatment could potentially alleviate other symptoms caused by the disorder, such as unwanted body hair, oily hair, hair loss and acne. It could also protect against developing type-2 diabetes.
The study conducted by Jakubowicz and her fellow researchers has been published in Clinical Science and was recently presented at the Endocrine Society’s annual meeting in June. It was done in collaboration with Doctor Julio Wainstein of Tel Aviv University and Wolfson Medical Center and Doctor Maayan Barnea and Professor Oren Froy of the Hebrew University of Jerusalem.
Photo: Young women sitting at table by Bigstock