Polycystic ovarian syndrome (PCOS) is the most common endocrine abnormality, affecting 6-8% of the female population. There can be a cascade of hormonal imbalances causing irregular menstruation, insulin resistance and weight gain, excess androgens (male hormones) resulting in hair growth and other symptoms, and also systemic inflammation. There are a variety of supplements and strategies that health practitioners recommend to implement in an attempt regulate ovulation and support weight loss and hormonal health, and there is now information that coaches us towards a new, free and relatively simple way to support these efforts.
Reactive molecules called “advanced glycation endproducts” or AGEs, are formed when carbohydrates are broken down to simple sugars and bind with proteins, nucleic acids or lipids. These are not good products and they are known to induce cellular damage and are elevated in PCOS patients, as well as being with associated with diabetes, obesity, atherosclerosis, chronic renal failure, and Alzheimer’s disease. Through several studies it is clear that elevated AGE serum levels (in blood) are a contributing factor to PCOS endocrine disruption. One study concluded this “There is an intricate relationship between the AGE-RAGE (receptor for AGEs) system and some aspects of PCOS, such as granulosa cell dysfunction, adipocyte pathophysiology, obesity and insulin resistance. Additionally, irregular ovarian AGE signaling might in part explain the abnormal ovarian histology observed in women with PCOS. The ovarian dysfunction due to AGEs in women without PCOS suggests a role for the AGE-RAGE system in the ovarian follicular environment, and might relate to assisted reproduction technology outcome and measures of ovarian reserve.” In other words, these AGEs are bad and should be avoided, especially for women with PCOS who already have issues with insulin resistance. They can have an effect on the ovarian environment and are probably negatively affecting IVF/ICSI/IUI outcomes.
Another study recommends “In women with PCOS, dietary modification…may reduce serum AGEs and oxidative stress markers as well as serum testosterone levels.”
Other researchers conclude that “overexposure to exogenous AGEs, which are considered potent endocrine disruptors and are common in westernised diets, may exacerbate the metabolic and hormonal profile as well as oxidative stress in PCOS. Conversely, lowering the concentration of AGEs in food may improve these variables. The role of dietary AGEs in the clinical course of PCOS should be further explored. The forms of dietary AGEs, which can be absorbed, their mode of absorption and their pathway of cellular action upon target organs, including the ovary, have not been elucidated yet. Until then, it is advisable that assessment of dietary AGEs consumption be part of the evaluation of women with PCOS, and diets with low AGEs content along with other lifestyle modifications should be encouraged.”
Sources of AGEs in our environment include tobacco, uncooked animal derived food (cheese) high protein/fat, dry heat processed foods (chips, crackers, etc.), red meat, and poultry. They are also found in the environment (smoke, air pollution, toxins, etc.) and so are difficult to avoid completely.
However there is one key source of AGEs that is within our control, and that is in our food and how it is affected by the cooking temperature we choose. Browning our food for flavour and aroma can increase dietary AGEs, specifically cooking at temperatures in excess of 180℃.
Steamed or low heat cooking are best to minimize the intake of AGEs but you will notice that with these cooking methods the colour is different, lighter and possibly with more moisture. With aroma and flavour for food the AGEs are increased, which is why they are so prevalent in the North American diet. To avoid AGEs in our diet can take some time and effort, but with effort comes change and implementing some of these simple changes into your daily habits can produce significant results in terms of hormonal balance.
Use more fruits, vegetables, low fat milk, grains, and legumes. Yoghurt, puddings and ice cream are low in AGEs due to the moisture removal to concentrate the fat. Avoid animal fats and spreads, and breaded or fried foods. Never reheat fish, meats or chicken. Limit pasta cooking times to 10 minutes. Avoid processed foods. Never toast breads, bagels or rolls. Get to know your slow cooker, and change cooking techniques to include boiling, poaching, steaming, and low temperature stewing. Don’t fry your eggs.
PCOS: The Role of Insulin Resistance and Inflammation. By: Debra Minjarez, MD