The diets to avoid if you have PCOS, hypertension or thyroid issues

With the plethora of diets trending on social media these days, it’s definitely mind-boggling to zero in on one that may actually work for you the right way. For those with health issues, this goes beyond just confusion that is caused by the conflicting information out there—one wrong diet move and you may find yourself battling further health complications. We spoke to two medical experts to get their views on some popular diets. Needless to say, it's best to consult your own physician before you make changes to your diet if you're also managing pre-existing health conditions. 

If you suffer from hormone imbalances like PCOS or thyroid issues…

“Anyone with hormone issues should follow Intermittent Fasting (IF) only under expert guidance,” stresses Vishakha Shivdasani, the Mumbai-based medical doctor specialising in treating obesity, diabetes, dyslipidemias and other chronic lifestyle ailments. IF, where you cycle between periods of eating and fasting, initially increases one’s cortisol (stress hormones released by the adrenal glands) levels, which can have a negative impact on the above-mentioned health issues, explains Shivdasani. “I often advise my clients with PCOS to restrict IF to just five days a week, and if you’re not trying to lose weight, then three times is good enough to maintain health,” she says.

If you suffer from diabetes or insulin resistance...

Those with Type 2 diabetes (T2DM) that have been prescribed insulin need to be in constant touch with their doctor before and during the adoption of ketogenic diets to adjust their medication, or they risk serious hypoglycaemic (low sugar) attacks, says Juhi Agarwal, physician and nutritionist, SelfCare Health Design. Additionally, as T2DM is in itself a risk factor for heart disease, she says it is not advisable to opt for a diet high in saturated fat content due to its negative impact on cholesterol levels and heart health. “Even though a ketogenic diet can be devised with a higher percentage of its fat from the good variety, unsaturated fat, it is much harder to stick to and will need constant monitoring by a trained nutritionist,” says Agarwal.

The same principles apply for IF as well, she says. This is because large periods of not eating food can cause low sugar levels, further accentuated by prescription medicines, which could lead to severe episodes of low sugars. “Fluctuating sugar levels, which could happen to those on IF and T2DM, is also a risk factor for heart disease,” she adds.

Interestingly, according to Shivdasani those with pre-diabetes do very well on IF. “There is that initial morning surge, known as the dawn effect (described as the abnormal early-morning increase in blood sugar in diabetics), but this is just temporary. Again, cortisol levels are raised but this wears off eventually."

If you have a history of cancer in the family and/or are diagnosed with cancer…

Stay away from high-protein diets, cautions Shivdasani. “Such diets could increase the IGF-1 (insulin-like growth factor) hormone that is known to trigger cancers. Several studies over the recent years have stated the same, putting those in the middle-age category at a higher risk. “Even those lifting heavy weights in the gym should know that while consuming more protein will give your muscle, it will also increase the propensity of cancer,” adds Shivdasani.

If you have a history of heart disease or hypertension...

A ketogenic diet should be avoided by those with a history of pancreatitis, liver diseases or heart disease, warns Agarwal. “This is primarily because of the high-fat recommendations by this diet. Saturated fat has been consistently and significantly linked with increased risk of high cholesterol and heart disease in a multitude of research studies,” she says.

Here’s a slightly different take by Shivdasani—she doesn’t believe cholesterol is bad for you; it’s the ratio of cholesterol that you should be wary of. “Don’t fear or reduce fats, instead stay away from rancid and hydrogenated fats. Choose extra virgin olive oil, avocado oil and ghee instead of seed oils Those will definitely cause heart diseases and blockages increasing Omega 6, and we anyway have an excess of Omega 6 and 9,” she says.

In the case of hypertension, Shivdasani says the focus (laying off the salt) is wrong: “It’s more about the quantity and the quality of the carbs you are eating than your salt intake.” A 2010 study published by Diabetes.co.uk showed that those consuming a diet high in fructose (which has a low glycemic index or GI) led to an increase of blood pressure, suggesting a low carb diet was a better strategy to handle hypertension.

If you are pregnant or below the age of 18...

Avoid keto at all costs, says Agarwal. “Carbohydrates in the preferred source of fuel for the brain, growth and for most other activities. It can be detrimental to the growth and mental well-being of children, while it can cause developmental delays, nutritional deficiencies and behavioural changes in the baby,” she says.

Also read:

Why balancing your cortisol levels could be the key to better health and happier skin

What nobody tells you about the intermittent fasting diet

Why every 20-something should know more about their hormones