Ethnic Issues in PCOS and Insulin-related Disorders

Ethnicity can mean a higher risk for PCOS and insulin-related disorders. Native Americans, Hispanics, Canadian First Nations, the Inuit Indians and Asian/Pacific Islanders are among those most discussed, although there are indications that these health issues are also starting to be seen in other Asian populations as well.

In the US, because of extensive intermingling of cultures such as Native Americans and Hispanics, ethnicity has become blurred. Some sources say that full-blooded Native Americans have a greater risk of diabetes than those of mixed heritage. Hispanics whose ancestors include some Native American or indigenous Mexican Indians may also have inherited a greater predilection for diabetes, but, it appears that the dominating issue is not genetics, it's life environment.

Environment

Obesity and a sedentary lifestyle appear to be the most common denominators in this conversation. In most studies relating to PCOS, diabetes, cardiovascular disease and hypertension, obesity is cited as a significant causal factor. It's becoming more and more evident that with weight gain comes an imbalance in biochemistry that is capable of disrupting the metabolism to the degree that the body's major systems don't function optimally.

The Pima Indians in Arizona are used as a classic example of the effect of environment on the incidence of disease. As they left the life of hunter/gatherers and adopted a European-style, carbohydrate-rich diet, diabetes blossomed. Through the years, lack of exercise and a diet of high carbohydrate foods have triggered extensive weight gain. Obesity is now a problem for even the youngest in this tribe where diabetes inflicts a full 50% of people over 35. Their PCOS rate is about 21% to 22% according to a 2004 study. (1)

The Pima Indians in Mexico, however, are a different story. Their diet is also high in carbohydrates, but their diabetes rate is much lower. Why? Their lives are more active, and the carbohydrates are locally grown vegetables.

And among the First Nation Tribes in Canada, despite having higher rates of obesity, and increasing incidence of diabetes, PCOS is rare in adolescent girls. According to the Canadian Paediatric Society, "The physical signs of insulin resistance and metabolic syndrome (Acanthosis Nigricans, polycystic ovarian syndrome (PCOS), hypertension, dyslipidemia and steatohepatitis) are not causative factors, but are associated with glucose intolerance and early-onset type 2 diabetes mellitus." (2)

Genetics

When we see health issues manifesting in ethnic communities, we assume that there must be a genetic predilection. Genetics does play a role, but perhaps not as directly as once thought. While certain genes are associated with certain forms of diabetes, researchers generally believe that you don't 'inherit' diabetes; at best, you may inherit an increased chance.

According to one study on Taiwanese women with PCOS, there might also be racial differences in the certain gene sites that affect insulin resistance. "Indeed, such a result also enhances the suspicion that the screening value of insulin resistance as a possible marker for PCOS would likely be population-specific." (3)

The complexity of the genetics story is likely exacerbated by the biochemical impact of lifestyle. One source cited the possibility of a genetic configuration in indigenous peoples like the Pimas that once allowed them to store high quantities of carbohydrates in order to survive the infrequencies of meals as a group of hunter-gatherers. These foods were native plants that were seasonal and more complex in their structure. When finally relegated to a restricted reservation life, they were fed corn, flour and alcohol. Because genetics doesn't change as quickly as lifestyle, that carbohydrate-storing survival gene caused increased obesity and the insulin-related mechanism. Now, a little over 100 years later, the entire population has a high risk for a variety of severe diseases.

Ongoing studies of PCOS, metabolic syndrome and diabetes now clearly recognize the importance of race as a factor. In fact, the array of symptoms surrounding these diseases has a tendency to be so individualized that it is sometimes difficult to determine the exact cause or connection. That said, one indicator common to the predominance of insulin-related issues is excess weight which, as challenging as it is for most women, is the good news because it is the one thing that we can actually do something about on our own. Though genetically predisposed, it is possible to contain that predilection through a reliable nutritional regimen and exercise.

Most importantly, we can minimize our symptoms and model a better lifestyle for our daughters.

– Chris Thomas