Kimchi is a traditional Korean dish that consists of fermented, salted vegetables. It can contain a variety of ingredients but most often includes cabbage and seasonings such as sugar, salt, onions, garlic, ginger, and chili peppers. Kimchi can provide some potential health benefits, but the fermentation process it undergoes also means that it may come with some risks.
Before advances in agriculture and technology, it was difficult to store food for long periods of time without spoilage. Therefore, people developed food preservation methods to keep food for longer.
Fermentation is a process that utilizes microorganisms and enzymes to create chemical changes in food that can improve the shelf life of some foods and beverages.
Traditionally, during the fermentation process of kimchi — which can take up to 1 month — people place kimchi in special jars that they partially or totally store underground.
This article discusses the possible benefits and risks of kimchi and provides tips on how people can prepare it.
The nutritional content of kimchi can vary due to it having more than 200 different variations. However, it is generally low in calories and rich in nutrients.
Kimchi is also a good source of vitamin A, B vitamins, vitamin C, minerals, fiber, and amino acids.
A 1-cup serving, which amounts to approximately 150 grams (g), contains around:
23 calories
1 g of protein
under 1 g of fat
4 g of carbohydrates
2 g of fiber
2 g of sugar
The abundance of minerals, vitamins, and antioxidants present in kimchi can provide important health benefits. For example, some evidence suggests that kimchi may help promote good health and may help prevent or control certain conditions.
Some health benefits of kimchi may include the following.
Improved digestion
The method of producing fermented foods such as kimchi involves a lacto-fermentation process that uses the Lactobacilli bacteria to break down sugar and starches into lactic acid.
These “good bacteria” are also present in yogurt, and people often refer to them as probiotics. Eating fermented foods containing probiotics can help maintain healthy gut flora and reduce the negative symptoms of digestion-related conditions.
Heart health
According to some research, kimchi consumption may reduce the risk of heart disease by lowering cholesterol and inflammation.
Inflammation is one contributing factor to metabolic syndrome, which refers to a cluster of conditions that occur together to increase the risk of heart disease, stroke, and type 2 diabetes. People with risk factors such as high cholesterol and chronic inflammation are much more likely to develop heart disease.
Kimchi may also help lower cholesterol. In one 2018 study, researchers fed mice a high cholesterol diet, with some mice receiving kimchi extract. The mice consuming the kimchi had lower fat levels in the liver and circulating blood than those only consuming the high cholesterol diet.
Immune support
In addition to reducing inflammation, some research suggests that eating fermented foods such as kimchi can also help remodel the gut microbiome and alter and strengthen the immune system.
This is consistent with a 2014 mouse study that indicates that consuming kimchi can lower levels of the inflammatory marker tumor necrosis factor-alpha, which is typically present in higher levels in the body during infections.
A 2019 test-tube study investigating bacteria in kimchi also notes that it possesses immune-enhancing effects.
Weight loss
Kimchi is not only low in calories but may also help with weight loss.
A 12-week randomized clinical trial in 114 adults with obesity suggests that Lactobacillus sakei derived from kimchi might help reduce body fat mass and waist circumference.
Similarly, an 8-week mouse study indicates that kimchi may exhibit anti-obesity activity.
Although kimchi may exhibit many potential health benefits, it still contains live bacteria. The bacteria that people use to ferment kimchi are safe to consume. However, people must prepare and store kimchi correctly, or there may be a risk of pathogenic bacteria growth during fermentation and storage.
Foodborne pathogens are not typically present in fermented foods. This is because lactic acid typically forms during fermentation, which can help control any harmful pathogens that may be present. However, like most foods, kimchi is still vulnerable to these harmful microorganisms.
In the past 10 years, researchers have linked kimchi to outbreaks of both Escherichia coli and norovirus. People can minimize the risk of food poisoning by buying kimchi from a reliable retailer and ensuring that they store it correctly.
Another consideration is the high sodium content in kimchi. People at risk of high blood pressure might have concerns about the high salt content of this food. However, one 2014 study suggests that eating kimchi does not increase blood pressure.
Although people can purchase kimchi at many grocery stores and Korean markets, they may also consider preparing it at home.
It can be safe to make kimchi at home, but people must follow proper sanitation practices to prevent contamination by spoilage or harmful bacteria. This will involve proper hand-washing, using clean equipment, and cleaning surfaces throughout all preparation steps.
To safely prepare kimchi at home:
Prepare the cabbage:
Rinse the cabbage and discard any spoiled or damaged spots.
Cut the cabbage into quarters and remove the core from each.
Then, chop these quarters into 2-inch (in) pieces.
Salt the cabbage:
Prepare a saltwater solution, comprising half a cup of salt and 1 gallon of cold water, in a large mixing bowl.
Briefly dip the cabbage in the saltwater solution, then discard the salt water.
Place the cabbage in a bowl. Sprinkle over some salt, then massage it into the cabbage.
Allow the cabbage to sit at room temperature for 3–6 hours.
Rinse the cabbage three to four times with cold water, then place it in a colander for 30 minutes.
Prepare the seasonings:
Add sweet rice flour to half a cup water in a saucepan. Bring to a boil and set aside to cool.
Clean, peel, and finely mince the garlic and ginger. Mix with the cooled sweet rice flour paste and add Korean red pepper powder.
Clean and peel the radish, green onions, and Asian pear. Slice into matchsticks about 1 in in length.
Using clean hands, mix the seasoning paste and vegetables together in a large mixing bowl.
Then, mix in fish sauce to create a veggie paste.
Combine the cabbage with the spicy veggie paste, rub together, and mix thoroughly.
Pack the container:
Pack the kimchi tightly into the container, minimizing air exposure and encouraging brine formation.
Fill the container about two-thirds full with kimchi and cover tightly.
If using jars, seal them fingertip tight. If using bags, squeeze out any excess air.
Fermentation:
Place the kimchi in the refrigerator so that it ferments slowly over 3–4 days. This may be preferable, especially during hot weather.
Alternatively, place the sealed container in a well-ventilated location with a relatively constant room temperature.
Ferment for only 1–2 days at room temperature, tasting it daily until it reaches one’s preferred taste and desired texture.
Storage:
People can now store the kimchi in the refrigerator. It is important to cover it tightly to minimize air exposure. Kimchi may become more sour and spoil over time.
Discard the kimchi if there are any signs of mold or if it develops a strong, foul odor.
Kimchi is a versatile dish that people can add to many meals. People can eat it as a side dish, use it as an ingredient in other meals, or eat it on its own.
Although individuals can cook kimchi, keep in mind that heating any fermented foods can start to kill off the healthy probiotics. So, to retain the health benefits, it is best to add kimchi in at the end of the cooking process.
Some ways that people can enjoy kimchi include:
served on top of potato pancakes
used as a filling in an omelet
stirred into homemade fried rice
used inside burritos and Korean-style tacos
added to noodle dishes such as ramen, udon, and soba
used to flavor soup broth
Kimchi is a Korean food that typically consists of fermented cabbage and various seasonings. It is an easy addition to most meals. Due to the probiotics, vitamins, and minerals it contains, it may provide some health benefits.
However, if a person incorrectly prepares or stores kimchi, it may contain harmful bacteria that can make people ill. Although people can make kimchi at home, it is often readily available in many grocery stores.
Share on PinterestAccording to a small study, even people of moderate weight can reverse diabetes by losing visceral fat. EMS-FORSTER-PRODUCTIONS/Getty Images
Researchers have shown that for people with overweight or obesity, losing weight can reverse type 2 diabetes.
In a small study, the team found that weight loss reversed type 2 diabetes in participants, even though their body mass index (BMI) was in a moderate range.
The study authors believe that lowering levels of fat around the organs may be more important than lowering BMI.
In a small, preliminary study, researchers have found that people with type 2 diabetes who also have a BMI that falls within a moderate range can reverse their diabetes by losing weight.
The condition occurs when a person’s body does not produce enough insulin or if the insulin no longer works effectively. Insulin normally helps glucose enter the cells of the body. In the absence of insulin, glucose stays in the blood, where it can damage organs and tissues.
This means that a person with type 2 diabetes has an increased risk of several health issues, including stroke, heart disease, issues with their feet, kidney disease, dental issues, and bladder problems.
According to researchers writing in the journal Nutrients, scientists for a long time believed that type 2 diabetes was incurable, so they primarily focused on how people should manage symptoms of the condition.
However, evidence now suggests that if individuals who are overweight or have obesity achieve and maintain weight loss, they can reverse type 2 diabetes.
In the present small, preliminary study, researchers have gone one step further and examined whether weight loss might reverse type 2 diabetes even in those whose weight falls within the moderate BMI range.
Medical News Today spoke with the study’s first author, Dr. Ahmad Al-Mrabeh, a Transitional Research Fellow at the Centre for Cardiovascular Science at Queen’s Medical Research Institute at the University of Edinburgh in the United Kingdom.
He explained that they decided to explore whether weight loss could be effective at reversing type 2 diabetes for people with moderate BMI after looking at the results of their previous research.
“We observed that the metabolic profile changed markedly after following a low calorie diet even when the change in body weight was […] minor. We, therefore, wanted to test whether inducing modest weight loss could achieve remission in those who are non-obese,” said Dr. Al-Mrabeh.
According to the principal investigator of the study, Prof. Roy Taylor, Director of the Newcastle Magnetic Resonance Centre at Newcastle University, U.K., “[o]ur previous research has shown that weight loss of 10–15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} can achieve remission in people with type 2 diabetes who are overweight or obese.”
“Doctors tend to assume, however, that type 2 diabetes has a different cause in those who aren’t overweight. This means that, unlike those who are overweight, those who are of [moderate] weight aren’t usually advised to lose weight before being given diabetes drugs and insulin.”
“Instead, there’s a tendency to start them on insulin and other medication at a much earlier stage.”
“What we’ve shown is that if those of [moderate] weight lose 10-15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of their weight, they have a very good chance of getting rid of their diabetes.”
“This should be a wake-up call to doctors, and, with 1 in 10 of the 4.5 million people with type 2 diabetes in the U.K. of [moderate] weight at diagnosis, there is no time to be lost in getting the message across.”
– Prof. Taylor
The study involved just 23 people. Of these, 12 individuals had a type 2 diabetes diagnosis with an average age of 58.3 years and an average BMI of 24.5. The remaining 11 did not have diabetes and were of similar age and BMI. This group acted as the control.
The Centers for Disease Control and Prevention (CDC) classify BMI scores of 18.5–24.9 as “healthy.”
All participants followed a low calorie diet for 2 weeks, consuming no more than 800 calories each day. The researchers then supported them to maintain their new weight for 4–6 weeks.
They completed this cycle two or three times until all participants had reduced their body weight by 10–15{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.
The researchers measured each participants’ visceral fat and insulin sensitivity before, during, and after the study.
At the end of the study, the researchers matched the people with diabetes with control participants of the same age, sex, and BMI. The scientists found that the individuals with diabetes lost more than twice as much fat in their liver compared with the controls.
In the diabetes group, fat in the pancreas reduced from 5.1{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} to 4.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}. Also, their average triglyceride levels fell from 1.6 millimoles per liter to 1.0 millimoles per liter — a significant reduction similar to the control group.
Most significantly, two-thirds of the participants found that their type 2 diabetes went into remission and could stop taking their medication.
Prof. Taylor says that “[t]hese results, while preliminary, demonstrate very clearly that diabetes is not caused by obesity but by [carrying too much weight] for your own body. It’s due to having too much fat in your liver and pancreas, whatever your BMI.”
“In the liver, this excess fat prevents insulin from working normally. In the pancreas, it causes the beta cells to stop producing insulin.”
Dr. Al-Mrabeh said to MNT that the results may be reproducible in larger studies, “however, it is important to understand the mechanisms of excess fat buildup within these vital metabolic organs (liver and pancreas) in non-obese people.”
Speaking with MNT, Prof. Pål R. Njølstad, Leader of the Center for Diabetes Research at the University of Bergen, Norway, said that “[t]he findings are interesting and indicate that weight loss is also important in non-obese individuals with type 2 diabetes.”
Prof. Njølstad added that “[m]ore studies are needed with an increased number of study participants and increased time of follow up, in addition to investigating the effect of other factors, such as age, sex, and ethnicity.”
Dr. Al-Mrabeh said to MNT that he will continue developing the initial findings.
“I have recently moved to the University of Edinburgh to establish an independent research program looking into the mechanisms of how excess fat causes damage to the pancreas in type 2 diabetes. My aim is to dissect these mechanisms using both human and animal studies.”
Share on PinterestA recent review appeared for backlinks concerning diet and psychological nicely-getting in small children. xavierarnau/Getty Illustrations or photos
Several things impact psychological effectively-becoming, together with nutrition.
A modern examine uncovered that feeding on extra fruits and veggies was connected to much better mental effectively-becoming amongst little ones.
On the other hand, young children who skipped foods were being additional likely to have lower perfectly-remaining scores.
Despite the fact that nicely-becoming between adults and youngsters is identical, it is not exactly the similar for both equally groups. Little ones are even now escalating, and various things require to be taken into account when analyzing children’s well being.
A single place of fascination is the affiliation in between diet and children’s psychological properly-being. A new study, which appears in the journal BMJ Diet, Prevention & Well being, indicates that kids who eat much more fruits and vegetables are far more probably to have a improved perception of psychological nicely-remaining than those who take in less.
“Being mentally balanced during childhood usually means reaching developmental and psychological milestones and discovering healthier social techniques and how to cope when there are challenges. Mentally healthful little ones have a good quality of daily life and can perform nicely at home, in faculty, and in their communities.”
Psychologist and effectively-currently being specialist Lee Chambers further more stated the affect of children’s mental very well-becoming to Health care Information Now:
“Mental very well-staying in small children performs a critical part in more than their health outcomes. Constructive psychological perfectly-getting is affected by a range of things, and, in transform, impacts a selection of results, from instruction to health [and from] friendships to determination making.”
Chambers carries on, “It also gives the platform to acquire resilience, cope with stressors, and grow to be rounded and wholesome grownups. It is also pivotal in their ability to be harmless and for balanced interactions.”
“In an more and more dynamic and unsure planet, mental nicely-being provides the foundations for little ones to create upon, to explore and find out, to engage in and have fun, and to navigate the challenges and adversity that arrive with staying human.”
Investigation is ongoing when it arrives to understanding the factors that affect mental health and fitness and very well-getting. The connection in between nourishment and psychological health and fitness is an space of fantastic interest — notably concerning how nourishment is linked to the mental very well-staying of small children.
The authors of the current study notice that:
“Nutrition, a modifiable component at both equally an specific and societal level, is an significant affect on health in the course of the everyday living training course, is intricately included in [the] growth and standard working of the overall body, and thus has the opportunity to have an affect on both actual physical health and fitness and psychological perfectly-currently being.”
The the latest examine was a cross-sectional study that examined the affiliation in between children’s intake of fruits and veggies, their food decisions, and their psychological properly-staying.
Researchers collected facts from a lot more than 50 faculties, including major colleges, secondary schools, and further more schooling schools.
In the United Kingdom, major college young children are aged 5–11 several years, and secondary college children are aged 11–16 yrs.
Based on the U.K.’s process, the oldest youngsters involved in the review would be the equal of seniors in United States high universities. The youngest young children included in the analysis had been 8 years outdated.
These knowledge arrived from The Norfolk Small children and Younger People’s Health and fitness and Wellbeing Survey 2017. A full of 10,853 youngsters crammed out this study.
Equally of these assessments use a program whereby a greater rating indicates a higher degree of well-getting.
The study also requested about the children’s consumption of fruits and veggies and the forms of breakfasts and lunches they ate.
The researchers also gathered facts on other covariates, these types of as:
nourishment, together with alcohol intake, free of charge faculty food status, and weight gratification
demographics, which includes age, ethnicity, and degree of deprivation
wellbeing, such as very long-phrase sicknesses and disability standing
residing scenario, like no matter if or not children had their possess rooms and whether or not or not their mothers and fathers or caregivers smoked
adverse ordeals, including difficulties such as experience harmless and bullying
Some of these covariates, these kinds of as alcoholic beverages use, were not provided in the study for primary faculty youngsters due to the fact the researchers deemed them inappropriate.
The analyze discovered that better amounts of fruit and vegetable usage ended up associated with larger mental very well-currently being scores amid secondary faculty small children.
It also found that, in secondary school kids, only consuming an strength consume as a substitute of breakfast was related with decreased mental very well-staying scores than not taking in breakfast at all.
For both of those principal and secondary university young children, the researchers uncovered that mental very well-currently being scores ended up higher for these who experienced breakfast or lunch than for kids who did not eat these meals.
Study co-writer Prof. Ailsa Welch highlighted the next conclusions to MNT:
“In a course of 30 secondary faculty kids, we observed that [four] had absolutely nothing to eat or drink in advance of starting off lessons in the early morning, and [three] had nothing to take in or drink ahead of the afternoon. Only 25{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of youngsters ate [five] or additional fruits and veggies a day, and 1 in 10 ate none.”
“These stats are concerning, as weak nourishment is possible to effects on academic overall performance at college as nicely as development and growth,” Prof. Welch included.
“The decreased mental nicely-getting scores of individuals who had no breakfast and of those people who experienced no lunch were being of the very same scale as individuals who witnessed frequent arguing or violence at house on a frequent foundation.”
– Prof. Ailsa Welch
The researchers notice a couple restrictions to their examine. For starters, because the small children only took the questionnaires once, the scientists could not monitor changes in effectively-becoming and diet regime over time.
Secondly, the data collection relied on self-reporting from small children, which has the opportunity to be inaccurate. They also observe that some of the thoughts associated to the children’s diet programs were simplistic.
Based on past research and the study’s results, the examine authors advocate for educational institutions to work to make certain that that healthy food items is offered to all children.
Prof. Welch emphasised to MNT that:
“Good quality nourishment demands to be offered to all young children of faculty age to optimize psychological properly-getting and empower children to satisfy their full likely. The associations found between diet and psychological properly-becoming in our research mean that approaches to strengthen nutrition in university kids need to have to be investigated and applied.”
Prof. Welch also famous that we need to have to comprehend the causes that some college students are not consuming meals. She informed MNT:
“Further investigations are expected to uncover the good reasons why some kids are not possessing breakfast, and/or lunch, or are consuming electricity drinks only. These may possibly involve social, cultural, expertise, and financial aspects, such as provision and obtain to [fruits] and veggies getting constrained in locations of deprivation.”
Over-all, this hyperlink in between nutrition and mental nicely-becoming emphasizes the great importance of addressing the nutritional demands of little ones when considering their psychological perfectly-being.
In the United States and the United Kingdom, polycystic ovary syndrome (PCOS) affects 1 in 10 women. This condition disproportionately affects Women of Color. To find out more, Medical News Today spoke with three Women of Color living with this condition to learn how the disorder has affected their health. We also sought the opinions of two medical experts.
Share on PinterestHow does PCOS affect Women of Color? We investigate. Image credit: Jasmin Merdan/Getty Images
PCOS can cause the ovaries to become covered with small cysts or fluid-filled sacs, sometimes leading to symptoms such as irregular periods, weight gain, and acne.
Moreover, racial bias in medical settings, as well as sociocultural taboos around infertility and weight gain — two of the effects of PCOS on health — can also negatively affect the way in which doctors perceive PCOS and treat the condition in Women of Color.
Medical News Today has spoken with three women living with this condition to learn more about their experiences of getting a diagnosis and navigating PCOS despite receiving little or no treatment. We also found out about the subsequent impact on their health.
For an expert outlook on the misconceptions surrounding PCOS and how it affects certain people, we spoke with Dr. Cindy Duke and Dr. Dominique Warren, both of whom are certified obstetricians and gynecologists.
Many people regard PCOS as an invisible illness because it sometimes — particularly in Black and Asian groups —produces “silent” metabolic symptoms, such as insulin resistance and impaired glucose metabolism.
This can be an issue for these groups because, as some studies have shown, from a biological point of view, PCOS may manifest differently for them, which can complicate the process of receiving a correct diagnosis.
Dr. Duke explained to MNT: “There are many [doctors] who use metabolic syndrome as part of their criteria for diagnosing PCOS, which is inaccurate and goes against diagnostic guidelines. Those who may not demonstrate the usual [symptoms] or happen to be on the leaner side have what looks like normal glucose metabolism, and depending on the type of test you’re told to have done, you could be incorrectly told you don’t have PCOS.”
Without early interventions, PCOS can lead to serious long-term health conditions, partly due to the complexity that causes misdiagnosis and lack of care.
This is what happened to Monica, a 46-year-old Black woman from the U.S., who told us about her experience as a young adult:
“I visited the doctor after having sporadic periods […]. I wasn’t diagnosed with PCOS because then, it [irregular periods] wasn’t enough to be considered a characteristic of PCOS. You had to be overweight.”
Monica continued: “I went to a physician’s office. He handed me a [prescription] for birth control pills [and] told me to prepare for adoption.”
At the time, she weighed 110 pounds — approximately 50 kilograms — and doctors considered her to be underweight. She continued to have irregular cycles before seeking medical advice again at the age of 27.
“I had an adverse reaction to the medication […] and also gained 30 pounds in a month,” Monica told us.
Once a test detected high levels of estrogen, the doctor suspected PCOS and referred Monica to an endocrinologist for a formal diagnosis.
Obtaining a PCOS diagnosis has improved over the years since the Rotterdam Criteria established that a woman might have the disorder if she experiences any two out of the three major symptoms: polycystic ovaries, high androgen levels, and irregular menstrual cycles.
However, Dr. Warren commented, “some primary care doctors may find it difficult to understand the criteria and what to look out for,” as PCOS tends to present as a spectrum of symptoms, and it has had various descriptions over the years.
She explained that “you might have a person that has a period every 5 weeks, so they seem to be quite regular but are just outside the norm. Then, the other spectrum of people don’t have periods at all.”
“Those [with seemingly regular periods] may not realize there is an issue until they try to get pregnant. They [may] go to the [doctor] because they have an issue with acne, facial hair, or weight […] but may be told to go on the pill because they have regular periods.”
– Dr. Dominique Warren
MNT spoke with another contributor, 22-year-old Nikita, who is Asian and from the U.K. In line with Dr. Warren’s insight, she recounted how PCOS symptoms can vary and present differently among individuals.
Nikita had to wait for 7 years to receive a diagnosis.
At the age of 13, after speaking with a family member with diagnosed PCOS, she suspected that she had it, as she had symptoms such as irregular periods and excessive facial hair growth.
However, she stated, “[Over the next few years], I made numerous […] trips [to the doctor], and the doctors weren’t doing anything”. Doctors also told her that the issues with facial hair were due to puberty.
“At one point, I saw my doctor because I was having bad dizzy spells. He asked me what I wanted him to diagnose me with. I was so offended. Then, [at the age of 19], I went back for vaginal discharge issues, and that’s when they [the doctor] looked into it and found bacterial vaginosis.”
She added that “[t]hey did a cervix check and other tests,” which finally confirmed her PCOS diagnosis.
June-Ann, a 32-year-old Black woman, also from the U.K., was the only one of our contributors who received her diagnosis relatively quickly, at the age of 17, despite having regular cycles.
Her doctor referred her for a vaginal ultrasound to investigate the severe pelvic pain she was experiencing during ovulation.
“I was told there were cysts on my ovaries, and the blood test [indicated] PCOS,” she told us.
The experiences of two of the three women we interviewed are consistent with concerns about the impact of “healthcare gaslighting” — the repeated denial of someone’s reality in an attempt to invalidate or dismiss their health concerns.
A study published in Circulation: Cardiovascular Quality and Outcomes in 2015 suggests that delays in diagnosis can also occur as a result of women’s anxiety about doctors construing their complaints as trivial.
It could partly explain the low rates of recorded diagnoses of PCOS among women with at least two of the three Rotterdam criteria.
There is often a misconception that PCOS symptoms only affect physical health. As a result of cultural taboos and stigmas associated with body image and mental health in Communities of Color, metabolic symptoms tend to be overlooked due to their “invisibility.”
This affects how quickly these groups seek medical intervention and consequently increases the risk of other health conditions developing later in life.
Dr. Duke suggested, “[c]linicians themselves sometimes have weird cultural biases and cultural norms because PCOS is poorly or inadequately taught in medical school and training.“
“If you’re an OB-GYN [obstetrician-gynecologist], you may come across it again after medical school, […] but even for most OB-GYN, unless they’re going into a subspecialty that focuses on PCOS, many decide it’s too complicated because there are variations,” she pointed out.
A 2015 study showed that unconscious bias and other race-related disparities are associated with differences in access to care and the use of treatment.
The change in Monica’s experience since diagnosis is consistent with this finding. She reflected on her experience, noting, “[n]ow that I am overweight, my treatment is very different.”
Due to relocating several times over the years, Monica saw several physicians and revealed that “most were dismissive” of her health concerns and usually commented on her weight but did not provide the appropriate healthcare for her PCOS.
She sought care from an endocrinologist, assuming her treatment would be more robust due to their specialism: “[She] constantly berated me, telling me I needed to lose weight. I remember I went in for one visit […], and she told me I look[ed] like I was eating whatever I wanted to eat. I never went back to her again after that.”
Monica was a U.S. size 8 (U.K. size 12) at the time. “I’m a Black female. I had big thighs […]. I just had certain things that were part of my heritage that I couldn’t get rid of,” she said.
Women of Color frequently report incidents of weight bias during medical consultations. Healthcare professionals often make assumptions about their diets being poor and do not offer them helpful advice on nutrition or exercise.
June-Ann referred to a time she struggled to lose weight, despite making efforts to exercise. “My doctor insinuated that I’m not trying hard enough,” she recalled.
“I never went to the doctor about my sleep apnea because I was scared that they would also correlate it with being overweight [as opposed to PCOS being the cause],” she added.
Assumptions about Black women’s body weight and diet persist despite the fact that their weight is often actually within the range classified as healthy.
Dr. Warren pointed out that “Black women aren’t always associated with obesity. They can be what I would consider a ‘normal’ BMI [body mass index] but with PCOS […].”
This suggests that medical professionals are not always considering the medical history of their patients and the sociodemographic and lifestyle factors that contribute to their health status.
Data published in the Journal of Women’s Health investigated the disparities in the extent to which people belonging to different ethnic groups underestimate their weight. The authors conclude that these disparities are due to differences in weight perception or a knowledge gap in interpreting what constitutes excess body weight.
Dr. Duke reiterated that weight is not necessarily an indicator of PCOS. She further explained how misdiagnosis, when inappropriately applying weight as a diagnostic criterion, occurs.
“[W]omen who present with polycystic ovaries but nothing else [are correctly] told they do not have PCOS [in the eyes of some healthcare professionals] […], yet when [they are] overweight, the doctor decides [they have] PCOS even though they don’t meet any other actual diagnostic criteria,” she noted.
“It’s very complex [when it comes to associating body weight with a health diagnosis], due to what we call ‘phenotypes‘[…]. To keep up-to-date and informed, we need to also have what I call ‘multidisciplinary teams.’”
This involves input from physicians, culturally competent nutritionists, fitness professionals, and mental health practitioners, as the international PCOS guidelines propose.
The impact of PCOS on Women of Color — specifically the way in which it affects their body image, could sometimes also be due to how family members and others within their community perceive and treat them.
Nikita revealed how much emphasis is placed on taking care of your image in her Trinidadian culture. “Bodily hair is so frowned upon […], and [it comes across as] a woman is choosing to not look after herself,” she said.
After family members mocked her during a visit to Trinidad, she said: “I finally paid £1,000 for laser treatment [to remove body hair] […]. I was devastated [when it grew back] because I had saved that money for so long.”
Dr. Duke demystified how cultural taboos inform negative body constructs. “We all grew up knowing of women who have hairy faces […], and instead of a conversation about the [possible] underlying condition, there’s a tease,” she said.
In some cases, the cultural silence and stigma around these issues could be what causes disinformation and prevents Women of Color from seeking healthcare.
Nikita expressed the relief she felt on learning to embrace her facial hair through support from her mother, who had had a similar experience.
Dr. Duke endorsed the importance of normalizing conversations across generations to educate families and communities, emphasizing her hopes for a better-informed future: “30 years from now, I don’t want to hear that young women didn’t know about their PCOS until later.”
A study featuring in Nature Medicine, which looked at the transgenerational risks for PCOS, suggests that facilitating earlier lifestyle and medical interventions could reduce the risk of other health conditions in those with this condition.
The lack of satisfactory care after diagnosis is also a major barrier for women from historically marginalized groups who live with this condition.
All the contributors spoke with MNT about the lack of treatment and how it caused other issues, affecting their mental health and quality of life.
For her part, June-Ann complained: “There has been no aftercare. I had anxiety and depression, and I was just given medication [birth control pills].”
“I was warned, ‘You may not be able to have kids’ […] so come back [for advice] when you’re ready,” she also told us. As this was not June-Ann’s personal priority at the time, she was left to manage her condition on her own.
To do so, she focused on lifestyle changes such as exercise, dietary supplements, and therapy.
Another observation that all our contributors made was that doctors placed more emphasis on the reproductive problems attributed to PCOS, even though none of the women had mentioned this as a future health concern after diagnosis.
MNT asked both health experts why this was the case, and Dr. Warren suggested that it might be “because you can do something to treat that [infertility] with a baby as an outcome.”
Dr. Duke elaborated on this issue, saying:
“Most of [what] we use to treat PCOS is re-appropriated from other medical conditions. They’re not putting research and development into therapies specific for PCOS because there’s no money in it as a field, [but] there’s money if you’re infertile and you need treatment.”
There were parallels in the experiences of all our contributors, who talked about how the lack of satisfactory aftercare caused their depression.
Both Monica and Nikita, in particular, were transparent about how they experienced other long-term health issues due to the lack of treatment they received, which further decreased their mental well-being.
Nikita recalled the time she sought advice from her doctor, who referred her for cognitive behavioral therapy.
Nikita only had two sessions until she stopped attending. She described her counselor as “dismissive” and “insensitive” whenever she spoke about her period.
Like June-Ann, she is now relying on personal lifestyle adjustments to improve her mental health.
Our other contributor, Monica, referred to the start of the COVID-19 pandemic as the worst period of her depression, saying that “[t]he biggest part [of PCOS] that has affected me is the weight gain and the depression […].”
At the start of the pandemic, she noted, it was “through the roof, and I no longer cared about my health so didn’t seek help. That is how I developed hypothyroidism.”
Their experiences demonstrate that there needs to be a focus on how to support people with PCOS-associated mental health problems, with attention to weight, body image, and fertility, as these are often prevalent taboo topics.
All or most of the contributors who spoke with MNT mentioned healthcare gaslighting, the perpetuation of cultural taboos and stigmas, as well as the lack of treatment as causes behind the inadequate care that Women of Color who live with PCOS continue to experience.
MNT asked all our contributors how they think that PCOS care can be improved. The consensus was that educating the wider PCOS community, receiving empathy and compassion from support networks, and finally allowing people with the condition to feel heard could improve ongoing care.
Both of the medical experts we interviewed explained how beneficial online platforms can be, offering their own advocacy work as an example.
Dr. Warren is the founder of The Ovary Story, an online platform that empowers girls and women to educate themselves about their reproductive system and the health conditions that can occur from puberty through to postmenopause. The platform exists to encourage open conversation.
Dr. Duke talked about My Dynamic Uterus, her online movement reaching 18,100 members, which is “intended to explore the […] often unheard narratives of people born with a uterus or ovaries, or those who care for them, through diverse and guided perspectives; from expert professionals and affected individuals around the globe.”
June-Ann, who remarked that “there are a lot of [resources for] African Americans, but there [aren’t] a lot of British Black people talking about PCOS,” started her own successful Black Broke & Anxious Podcast, born out of her therapeutic journey.
Likewise, “suffering in silence” inspired Nikita to create her Instagram awareness page. Since sharing her journey, she has received messages from women worldwide who say they feel “less alone.”
As a member of the patient advisory board, she is currently part of a project creating a registry to house data in one space so that research is more readily accessible for clinicians and researchers.
In speaking with MNT, she also strongly encouraged Black women to be more vocal about their health concerns: “To be taken more seriously […], we have to [reveal] doctors’ dismissiveness. [Otherwise], nothing’s ever going to change.”
