An aggravated Polycystic Ovary Syndrome (PCOS) coupled with gestational diabetes, excessive weight gain and back issues troubled Delhi-based nutritionist Simrun Chopra nearly eight years ago when her son was born. Such complications can lower a person's self-esteem, and Simrun’s case was no different. But she wasn’t one to let these health hurdles bring her down. Within months of her delivery, she took charge of her health and shed 25 kilos with a healthy diet and dedicated fitness regime in five months. This journey of going from flab to fit wasn’t easy and her first few attempts proved to be fruitless. But it helped change her outlook towards life and taught her that PCOS is after all, manageable. Today, she’s helping others transform their lives by customising lifestyle programs through her fitness and nutrition start-up Nourish with Sim.
PCOS is a condition that affects women of reproductive age (15-44 years). According to a 2018 study published by Metropolis Healthcare, a multinational chain of pathology laboratories, approximately 1 in 5 women in India is affected by this condition. It is caused due to an imbalance of reproductive hormones – androgens (male) and estrogen (female) - and weight gain, hair thinning, and mood swings are a few of the most common signs and symptoms of PCOS. In the past couple of years, several Bollywood celebrities have opened about their battle with PCOS, including Sonam Kapoor, Sara Ali Khan and Shruti Haasan. Each actor mentioned how, if not properly managed, this hormonal imbalance can wreak havoc in your body. So, how do you manage PCOS? We picked Simrun’s brains on the topic in an interview. Edited excerpts are below.
1. Can you please explain the difference between PCOS, PCOD (Poly Cystic Ovarian Syndrome) and endometriosis?
Since both PCOS and PCOD are associated with the ovaries, people often used them interchangeably. But that’s wrong, both conditions are different. PCOD is a condition developed via an imbalance of hormones and is considered less severe than PCOS, which is a disorder of the endocrine system.
Meanwhile, endometriosis is an issue where pieces of endometrium (a tissue that lines the uterus) grow into other areas of the body such as pelvic organs, ovaries or the fallopian tubes. Once out of the uterus, the endometrium lining thickens and bleeds along with the normal endometrium during a menstrual cycle. This is accompanied by intense pain or menstrual cramps.
2. How important a part, would you say, diet plays in the process?
Diet is one of the critical components; but as I always say: it is a confluence of various factors. You need to pair a proper diet with at least 30 minutes of exercise a day. Women with PCOS also face insulin resistance, which means they are pre-diabetic, and research shows that unchecked PCOS can cause diabetes by the time you are 40. I had severe gestational diabetes during my pregnancy, and my sugar levels fluctuated a lot post-delivery because of my lifestyle. Controlled blood sugar levels help in managing PCOS, weight management and overall health.
I follow the 80|10|10 rule – where 80 per cent of my meal includes vegetables, fruits, whole grains, lentils/legumes, and proteins. I aim for two bowls of veggies a day, at least two fruits a day, in addition to other foods mentioned earlier. Coming to foods to avoid, I would suggest sugar (including substitutes such as honey and jaggery), refined foods like bakery items made using maida, oily dishes and processed foods that contain loads of sugar, sodium and fats. Lastly, eat till you are 80 per cent full and avoid overeating.
3. What role does exercise play in managing PCOS?
Staying fit and active through exercise not only helps in the PCOS battle but also overall health. Exercising has shown multiple benefits in women with PCOS, including regular periods, ovulation cycles, improved body composition, reduction in androgen production and, most importantly, its impact on insulin resistance. Multiple research papers have investigated the efficacy of training in dealing with metabolic syndromes on PCOS patients.
4. While we know that women cannot sweat their PCOS away, misinformation has led many to believe that they need to focus on fat-burning exercises. What are your thoughts on this?
Misinformation is rampant. There is no such thing as a fat-burning exercise. To fuel exercise in a calorie-deficit situation, our body needs to dig into its reserves – stored fat. Just losing weight doesn't show the same effects on PCOS symptoms compared to overall lifestyle modification. Weight loss or fat loss via a combination of exercise and healthy eating habits helps regulate symptoms. It brings me back to my point: it is not just exercising or being on a crash or fad diet that helps. One needs long-term lifestyle modifications that are sustainable to control symptoms. I specifically use the word control because, without sustainable changes, the symptoms may resurface.
5. You often speak about an element of sustainability in one's physical activity and nutrition. Could you elaborate?
Everything must be sustainable, or it may die a quick death. You must eat what is affordable, easily available and what your family likes. The moment you cross this threshold, problems arise.
In my case, I figured out a diet that works for my husband, son and me. I stuck to cooking what we regularly ate, at the same time, ensuring that it was a healthier version. I still eat the things I love but in moderation.
6. Is there a way to prevent this hormonal imbalance?
You can reduce the severity of PCOS but not prevent it. It is crucial here to increase awareness among parents of teenagers so that they can notice and address symptoms at the right time.
Building blocks for PCOS management
1. Adding at least 30 minutes of exercise, five to six times a week,
2. Reduce the consumption of refined and packaged foods,
3. Reduce the consumption of alcohol and smoking,
4. Include a variety of whole grains, fruits and vegetables daily.
5. Include a natural source of protein in each meal.
6. Ensure your diet is rich in B6, B12 and folic acid.
7. Ensure your dietary needs meet the Omega 3 fatty acid requirements.
Note: These are the basics for managing PCOS and remember that none of these work in isolation. Also note, that you need to consult a medical professional to address further complications and solutions.