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Tag: PCOS

  • Can Onions Help with Weight Loss, Cholesterol, and PCOS? | NutritionFacts.org

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    Let’s talk about treating weight loss, cholesterol, and PCOS with diet. What can an eighth of a teaspoon a day of onion powder do for body fat, and what can raw red onion do for cholesterol?

    In one of my previous videos about onions, I talked about the data supporting—or not supporting—the role of onions in boosting testosterone in men, protecting bone health, controlling allergies, and dealing with the side effects of chemotherapy. What about weight loss? Enter the “Effect of Steamed Onion (ONIRO) Consumption on Body Fat and Metabolic Profiles in Overweight Subjects.” Researchers used steamed onions, which aren’t as spicy and have a weaker smell, so they could better disguise them as a placebo. They dried them into onion powder and gave people a minuscule amount—about an eighth of a teaspoon (300 mg) a day. Surely, a little daily dusting of onion powder wouldn’t affect people’s weight. But check out the results reported in the abstract: Measurements using a DEXA scan showed a significant reduction in body fat mass, and a CT scan revealed a significant decrease in whole, visceral, and subcutaneous fat areas.

    Hold on. If a little onion powder is so effective for weight loss, why wasn’t it featured in my book How Not to Diet? Because, as so often happens in studies, the spin in the abstract doesn’t accurately represent the actual data. The DEXA scan results measured no significant change of fat in the group that got the placebo capsules. They only appeared to lose about a spoonful (7 g) of fat, whereas the group unknowingly taking an eighth of a teaspoon of onion powder stuffed into capsules lost nearly one and a half pounds (0.64 kg) of body fat—a significant drop from baseline, but not a statistically significant drop compared to the placebo group, meaning the loss could have just been due to chance. Same thing with the CT scan results: 5 times more loss of overall fat and over 30 times more loss of the dangerous visceral fat, but the results did not reach statistical significance compared to placebo.

    A more recent study tried four teaspoons (9 g) of onion powder a day and similarly failed to accelerate the loss of visceral, total, or subcutaneous fat compared to placebo—but the placebo was also four teaspoons (9 g) of onion powder a day. They used yellow onions versus white onions, and it seems they both may have caused a loss of abdominal body fat, without a significant difference between them. Either way, you might look at these two studies and think, sure, but what are the downsides? It’s only an eighth of a teaspoon of onion powder a day, so why not give it a try? It can’t hurt, but we just don’t have enough evidence to be confident it will actually help.

    Let’s talk about polycystic ovary syndrome, also known as PCOS. It’s one of the most common hormone disorders, affecting 5% to 10% of reproductive-aged women. In addition to causing symptoms like irregular periods, “PCOS is a pre-diabetic state, with decreased insulin sensitivity.” PCOS treatment is challenging due to medication side effects. So, are there dietary options? How about a randomized controlled clinical trial of raw red onion intake?

    Why onions? Well, onion extracts can evidently improve blood sugar and insulin sensitivity in rats with diabetes and, more importantly, were found to reduce blood sugar levels in humans with diabetes, but evidently not in non-diabetic humans. People with PCOS are kind of pre-diabetic, so would it work for them? First, let’s look at those other two studies. To study the “Metabolic Effects of Onion and Green Beans,” people with diabetes spent a week eating either a small onion (60 g) each day or the same diet with about six cups (600 g) of green beans instead—and both approaches worked. The onion lowered people’s blood sugar levels by about 10% compared to a non-onion control diet, while the green beans lowered them by roughly 15% compared to the control.

    Here’s the study that supposedly shows no blood sugar benefits for people without diabetes. It’s true—onions don’t seem to lower normal blood sugar levels, which is a good thing, but check out what happens when you feed people sugar. Have people consume about two and a half tablespoons (50 g) of corn syrup, and their blood sugar levels shoot up over the next two hours before their body can tamp it back down. But give people the exact same amount of sugar along with more and more onion extract, and the blood sugar spike is significantly dampened, almost as much as if you had instead given them an antidiabetic drug, as you can see below and at 4:00 in my video Onions Put to the Test for Weight Loss, Cholesterol, and PCOS Treatment.

    We see the same blunting effect on blood sugar when people get a shot of adrenaline and eat onion extract, compared to receiving adrenaline without the onion extract, as you can see below and at 4:11 in my video.

    So, are there blood sugar benefits for both people with and without diabetes? No difference was found in blood sugar levels or other markers of insulin resistance between the high-onion and low-onion groups of PCOS patients, nor were there any differences in a marker of inflammation between the two groups. But women with PCOS aren’t just at higher risk for diabetes and inflammation—they are also at higher risk for high cholesterol.

    Women with PCOS are over seven times more likely to have a heart attack and develop heart disease, the number one killer of women. But consuming raw red onion appears to be effective in lowering cholesterol, though the group that ate more onions only dropped their LDL cholesterol about 5 points (5 mg/dL), which was not significantly different than the group that ate fewer onions.

    I did find this study from 50 years ago where researchers fed people nearly an entire stick (100 g) of butter, and their cholesterol shot up about 30 points within hours of consumption but by only 9 points or 3 points when combined with about a third of a cup (50 g) of raw or boiled onion. The moral of the story: Don’t eat a stick of butter.

    Doctor’s Note

    Check out the previous video I mentioned: Friday Favorites: Are Onions Beneficial for Testosterone, Osteoporosis, Allergies, and Cancer?.

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    Michael Greger M.D. FACLM

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  • Can Vegan Fecal Transplants Lower TMAO Levels? | NutritionFacts.org

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    If the microbiome of those eating plant-based diets protects against the toxic effects of TMAO, what about swapping gut flora?

    “Almost 2,500 years ago, Hippocrates stated that ‘All disease begins in the gut.’” When we feed our gut bacteria right with whole plant foods, they feed us right back with beneficial compounds like butyrate, which our gut bugs make from fiber. On the other hand, if we feed them wrong, they can produce detrimental compounds like TMAO, which they make from cheese, eggs, seafood, and other meat.

    We used to think that TMAO only contributed to cardiovascular diseases, like heart disease and stroke, but, more recently, it has been linked to psoriatic arthritis, associated with polycystic ovary syndrome, and everything in between. I’m most concerned about our leading killers, though. Of the top ten causes of death in the United States, we’ve known about its association with increased risk of heart disease and stroke, killers number one and five, but recently, an association has also been found between blood levels of TMAO and the risks of various cancers, which are our killer number two. The link between TMAO and cancer could be attributed to the inflammation caused by TMAO, but it could also be oxidative stress (free radicals), DNA damage, or a disruption in protein folding.

    What about our fourth leading killer, chronic obstructive pulmonary disease (COPD), like emphysema? TMAO is associated with premature death in patients with exacerbated COPD, though it’s suspected that it’s due to them dying from more cardiovascular disease.

    The link to stroke is a no-brainer—no pun intended. It is due to the higher blood pressure associated with higher TMAO levels, as well as the greater likelihood of clots forming in those with atrial fibrillation. Those with higher TMAO levels also appear to have worse strokes and four times the odds of death.

    Killer number six is Alzheimer’s disease. Can TMAO even get up into our brains? Yes, TMAO is present in human cerebrospinal fluid, which bathes the brain, and TMAO levels are higher in those with mild cognitive dysfunction and those with Alzheimer’s disease dementia. “In the brain, TMAO has been shown to induce neuronal senescence [meaning, deterioration with age], increase oxidative stress, impair mitochondrial function, and inhibit mTOR signaling, all of which contribute to brain aging and cognitive impairment.”

    Killer number seven is diabetes, and people with higher TMAO levels are about 50% more likely to have diabetes. Killer number eight is pneumonia, and TMAO predicts fatal outcomes in pneumonia patients even without evident heart disease. Kidney disease is killer number nine, and TMAO is strongly related to kidney function and predicts fatal outcomes there as well. Over a period of five years, more than half of chronic kidney disease patients who started out with average or higher TMAO levels were dead, whereas among those in the lowest third of levels, nearly 90% remained alive.

    How can we lower the TMAO levels in our blood? Because TMAO originates from dietary sources, we could limit our intake of choline- and carnitine-rich foods. They’re so widespread in foods,” though we’re talking about meat, eggs, and dairy. “Therefore, restriction of foods rich in TMA-containing nutrients may not be practical.” Can we just get a vegan fecal transplant? “Vegan donors provided the investigators with a fresh morning fecal sample…”

    If you remember, if you give a vegan a steak, despite all that carnitine, they make almost no TMAO compared to a meat-eater, presumably because the vegan hasn’t been fostering steak-eating bugs in their gut. See below and at 3:40 in my video Can Vegan Fecal Transplants Lower TMAO Levels?.

    Remarkably, even if you give plant-based eaters the equivalent of a 20-ounce steak every day for two months, only about half start ramping up production of TMAO, showing just how far their gut flora has to change. The capacity of veggie feces to churn out TMAO is almost nonexistent. Instead of eating healthier, what about getting some vegan poop?

    In a double-blind, randomized, controlled trial, research subjects either got vegan poop or their own poop back through a hose snaked down their nose, and it didn’t work.

    First of all, the vegans recruited for the study started out making TMAO themselves, in contrast to the other study, where they didn’t make any at all. This may be because the earlier study required the vegans to have been vegan for at least a year, and this study didn’t. So, there wasn’t much of a change in TMAO running through their bodies two weeks after getting the vegan poop, but the vegan poop they got seemed to start out with some capacity to produce TMAO in the first place.

    So, the failure to improve after the vegan fecal transplant “could be related to limited baseline microbiome differences and continuation of an omnivorous diet” after the vegan-donor transplant. What’s the point of trying to reset your microbiome if you’re just going to eat meat? Well, the researchers didn’t want to switch people to a plant-based diet since they knew that alone can change our microbiome, and they didn’t want to introduce any extra factors. The bottom line is that it seems there may not be any shortcuts. We may just have to eat a healthier diet.

    Doctor’s Note

    Want to become a donor? Find out How to Become a Fecal Transplant Super Donor.

    For more on TMAO, check out related posts below. 

    See the microbiome topic page for even more.

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    Michael Greger M.D. FACLM

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  • PCOS, a painful condition for millions of women, linked to memory loss, study finds

    PCOS, a painful condition for millions of women, linked to memory loss, study finds

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    Study finds link between PCOS and cognitive decline in mid-life.

    Study finds link between PCOS and cognitive decline in mid-life.

    Photo by kevin turcios on Unsplash

    Statistically, you know someone — or several someones — who have it. It affects an estimated 8–13% of reproductive-aged women, according to the World Health Organization, and continues to be one of the most ubiquitous yet mysterious conditions in modern medicine.

    Polycystic ovary syndrome, or PCOS, is a female hormonal disorder defined by irregular menstruation and high levels of the hormone androgen. It comes with a slew of undesirable, uncomfortable, and even dangerous symptoms, from irregular periods and ovarian cysts to type 2 diabetes and endometrial cancer. There are so many symptoms associated with the condition that it is often difficult to diagnose, as many of these symptoms could have a variety of causes, according to Women’s Healthcare of Princeton

    Now, a new study has found yet another hardship associated with PCOS: cognitive decline in mid-life.

    Researchers followed 907 women for 30 years, according to the study published Jan. 31 in the journal Neurology. At the beginning of the study, all participants were 18-30 years old, and 66 of them had PCOS. 30 years later, at the end of the study, the researchers gave the women tests to measure memory, verbal abilities, processing speed and attention.

    The researchers found that the people with PCOS scored lower (about 11% lower) on tests in memory, attention and verbal abilities, compared to those without PCOS.

    The study also included brain scans of a subset of the participants. Analyzing the scans, researchers noticed that the participants with PCOS had significantly reduced integrity of the white matter in their brains.

    White matter “connects regions that send and receive signals, affecting the ability to focus and learn, solve problems, and stay balanced when walking,” according to the Gillings School of Public Health. “It’s a significant area of interest for public health experts since conditions that impact white matter can lead to significant cognitive impairment and increase the risk of long-term neurological problems.”

    According to the study, this could be further evidence of early brain aging among participants with PCOS.

    In a news release, study author Heather G. Huddleston spoke about the impact this kind of decline could have on people’s lives, aside from just forgetting where they put their keys.

    “This could impact a person on many levels, including quality of life, career success and financial security,” she said.

    But all is not lost. Next, Huddleston said future studies should examine how to possibly mediate the adverse cognitive effects of PCOS for those who live with it.

    “Making changes like incorporating more cardiovascular exercise and improving mental health may serve to also improve brain aging for this population.”

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    Julia Daye

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  • I Struggled With PCOS-Induced Hirsutism. Here’s How I Found My Confidence

    I Struggled With PCOS-Induced Hirsutism. Here’s How I Found My Confidence

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    The teenage experience is fraught with angsty firsts—navigating puberty and the bodily changes that come with it, finding a place among the high school social hierarchy, the pangs of a classroom crush. Dealing with it all is a lot. Then imagine if you threw a condition with debilitating physical and mental symptoms into the mix.

    This was the case for Megan Stewart, who was diagnosed with polycystic ovary syndrome (PCOS) at 16, years after first experiencing a litany of symptoms. PCOS is an endocrine disorder caused by an imbalance of reproductive hormones. It can produce cysts in the ovaries, which impede the natural ovulation process, leading to irregular periods. It also has symptoms like weight gain, chronic stomach pain, mood swings, and excessive body hair growth (hirsutism). Ultimately, PCOS is the most common cause of infertility among women of childbearing age, according to the Endocrine Society.

    Thanks to higher levels of androgens (male hormones), as many as 70 percent of women with PCOS can experience excessive hair growth in areas typically seen in men—the upper lip, chin, breasts, lower abdomen, inner thighs, and lower back. On an emotional level, this can be one of the most frustrating symptoms to deal with for those affected.

    For Stewart, the hair growth also led to hyperpigmentation. “I kept my hair long my whole life to try to hide [the facial growth and marks] and I didn’t put myself out there much because I was so embarrassed,” she says.

    Even so, Stewart, now in her 30s, was determined not to be defined by the disease—or suffer in silence. Ten years ago, she co-founded the PCOS Awareness Association to help support others with the condition, spread awareness, and provide resources. Today, it ranks as the world’s largest nonprofit organization dedicated to polycystic ovarian syndrome.

    Trial and Error

    An estimated five million women in the U.S. suffer from PCOS, a lifelong condition. Management ranges from changes in diet and exercise to hormone therapies. On the cosmetic front, getting rid of unwanted hair is possible.

    For Stewart, finding a method that worked was a long but ultimately successful road.

    Waxing, tweezing, electrolysis—I’ve tried them all over the years,” Stewart says. “Tweezing caused inflammation and hyperpigmentation. Waxing left thick patches of dark skin. And electrolysis never got rid of the hair—it just kept growing back.”

    About a year ago, she tried Milan Laser Hair Removal for laser hair removal treatments on her face and neck, abdomen, and underarms—but not without some trepidation. “As a Black woman, I was a little worried about side effects,” she says. “I tried laser hair removal 15 years ago and it burned my skin. But my provider at Milan explained that laser technology has advanced and is now more effective and safe for people of color.”

    milan laser center

    Before laser hair removal.

    milan laser center

    After laser hair removal.

    PCOS and Laser Hair Removal

    “Our laser has the ability to treat all skin tones,” says Shikhar Saxena, M.D., CEO of Milan Laser, which has over 260 locations across the U.S. explains. “There are a few hair colors and types you can’t treat—peach fuzz, grays, or white hair—but as long as there’s some degree of pigment to your hair, the laser can pick up on that. And it’s safe for all areas of the body.”

    A major difference with laser hair removal compared to other methods like shaving, waxing, or depilatories is that it’s a permanent solution. Laser hair removal is successful in getting rid of hair in sensitive areas like the face, neck, and chest because it’s precise enough to target the hair follicle and eliminate it at the root without damaging your skin, Dr. Saxena explains. This precision also helps reduce the chance of inflammation and hyperpigmentation.

    While each person is unique, people with PCOS tend to require more sessions than the average patient, Dr. Saxena says. “Laser hair removal treats hairs that are actively growing, but PCOS can cause dormant hairs to become active at various times, causing new growth,” he says. Because treatment needs vary, Milan Laser offers an Unlimited Package, which starts as low as $29 per month and covers as many sessions as needed for smooth results.

    The Physical and Mental Results

    Stewart calls her experience with laser hair removal a “blessing.” A year in, she hasn’t had to shave or pluck any excessive hair growth. “The last time I saw my mother, she looked at my skin—without any hair growth on my face and neck—and started crying,” she recalls. “She says I’ve come out of my shadow.”

    And several months ago, Stewart had the confidence to do something she never would have imagined: She got seven inches cut from her hair.

    “The fact that I can literally just throw on moisturizer and sunscreen in the morning and go, and not have to worry about being self-conscious about the dark marks or visible hair, has been amazing,” she says.

    For more information about laser hair removal visit Milanlaser.com or @milanlaser on social media.

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