+

Differential Effects of Walnuts vs Almonds on Improving Metabolic and Endocrine Parameters in PCOS

European Journal of Clinical Nutrition 2011; 65:386-393.Brooke Beasley and Ruth Sullivan

+Polycystic Ovary Syndrome

Signs and Symptoms Menstrual irregularities Infertility Masculinizing hormones - acne and hirsutism Fluid-filled ovarian cysts

Metabolic Syndrome Insulin resistance Dyslipidemia Increased inflammation

+Study Objective & Methods

Compare the impact of MUFA in almonds to PUFA in Walnuts On metabolic and endocrine components of PCOS

Randomized prospective study 31 women participated Individual packets of nuts containing 31 g of fat

46 grams almonds 36 grams walnuts daily 6 weeks

+Data Collected

Anthropometric Weight Height

Sugar Insulin OGTT HgbA1C

Dyslipedemia Total Cholesterol HDL TG

Leptin

Adiponectin

Inflammatory Markers CRP TNF IL

Masculinizing Hormones Total testosterone Sex hormone binding

globulin (SHBG) Free Androgen Index (FAI)

+Significant Findings

Walnuts reduced HgbA1C levels PUFAs stimulated insulin secretion

Both walnuts and almonds increased adiponectin helps control insulin sensitivity

Both decreased circulating androgen levels Walnuts increased SHBG Almonds decreased FAI

+Strengths and Weaknesses

Strength Well controlled re: compliance of nut intake Collected unused portions

Weakness Small sample size: 31 individuals No control group with PCOS without nuts

+Database Research on PCOS

The Natural Standard database: PCOS Treatment:

Promote normal weight status High intake of fruits, vegetables, whole grains No estrogen-rich food sources (tomatoes, nonorganic

red meat/dairy) Low carb

High carb weight gain estrogen stored in fat cells High estrogen promotes ovarian cysts

*No reference regarding fat quantity/quality

http://www.naturalstandard.com/databases/conditions/condition-pcos.asp

+Database Research on Metabolic

Syndrome

The Natural Standard Database News, December 2008:

“Eating a Mediterranean diet rich in nuts may help reverse Metabolic

Syndrome.”

http://www.naturalstandard.com/news/news200812017.asp

+Our Treatment Strategy for PCOS• Promote optimal body weight

• Low glycemic/anti-inflammatory diet

• Organic animal proteins

• MUFA and n-3 PUFA rich food sources (nuts)

• Liver support (cruciferous vegetables)

• Decrease phytoestrogens (soy) & caffeine

• Spearmint tea for hirsutism

• Reduce stress/toxic environmental exposure

+In Conclusion

A general anti-inflammatory or Mediterranean diet including MUFA and PUFA rich almonds and walnuts appears to be helpful in managing

metabolic and endocrine symptoms in PCOS.