Five things all women with PCOS should know when it comes to diet and lifestyle
September is Polycystic Ovarian Syndrome (PCOS) awareness month. PCOS is a hormonal condition that affects around 1 in 10 women. It is generally associated with increased levels of two hormones in the body – insulin and androgens (male-type hormones). High levels of both of these hormones can cause symptoms such as irregular or absent periods, excessive facial and body hair, acne and weight gain. It may also increase the risk of developing a range of health conditions.
In this month's blog our resident nutritionist Nicole unpacks five things all women with PCOS should know!
1. Weight loss can help but it shouldn’t be your entire focus
It’s estimated that up to 85% of women with PCOS, including those who are a healthy weight (lean PCOS) have insulin resistance (IR) which means the body blocks glucose (sugar) from going into cells. This causes the body to make more insulin which can drive weight gain and increase sugar cravings in women with PCOS. Because of this many women struggle with their weight and are often told by their doctor to lose weight and it will magically fix their problems.
Reducing body weight in women with PCOS who are overweight CAN be helpful. Research shows that a 5-10% weight loss in women with PCOS who are overweight can improve insulin resistance, hormone levels, menstrual cycles, fertility and quality of life.
2. You don’t have to cut out all carbs
There is no ONE ideal or perfect diet when it comes to PCOS. It is really about finding an eating pattern that you enjoy, this is sustainable and that is going to improve your health markers.
Because a lot of women with PCOS have insulin resistance people jump to the conclusion that they should cut out all their carbs. However, reducing your intake of high GI, refined and/ or highly processed sources of carbohydrates like cakes, white bread and instant noodles is a smart thing to do from weight management and blood sugar perspective.
It is also important to have smart portions of low GI carbohydrates at meals and to balance them with a good source of protein and fibre.
3. Protein is important
Insulin resistance can leave many women with PCOS with carbohydrate cravings, feelings of fatigue and feeling hungry more often. Protein is more satiating than carbohydrates or fats, so having a good amount of protein throughout the day can help with keeping insatiable hunger at bay.
Combining protein with fats and carbohydrates at meal and snack time can help to keep blood glucose levels stable in comparison to a carbohydrate-heavy meal. This helps with lowering cravings, keeping you feel satisfied and giving you energy all day long, rather than having peaks and troughs.
Protein is generally more satiating than carbohydrates or fats so having a good amount of protein throughout the day can help with keeping the insatiable hunger and sugar cravings at bay. Combining protein with fats and carbohydrates at meal and snack time can help to keep blood glucose levels stable in comparison to a carbohydrate-heavy meal which helps with lowering cravings, keeping you feel satisfied and giving you energy all day long.
Good sources of protein include high protein bread, greek yoghurt, cottage cheese, protein powder, eggs, chicken, fish, seafood, lean meat, tofu and legumes.
4. Load up on anti-inflammatory foods
PCOS is commonly associated with high levels of stress, low mood, anxiety, depression, poor body image and disordered eating. In fact some studies show people with PCOS are about three times more likely to experience depression and anxiety than people without PCOS. This is most likely due to a range of factors including:
- Poor body image and self-esteem: Many women with PCOS struggle with weight gain, excess body hair, acne and male-patterned baldness
- Fertility concerns: Many people with PCOS report feeling frustrated and anxious about their ability to become pregnant
- Insulin resistance (IR): 65-70% of women with PCOS have insulin resistance which is associated with an increased risk of depression and sometimes also anxiety
- Inflammation: Women with PCOS have significantly increased levels of inflammation compared to women without PCOS. We know inflammation plays a role when it comes to brain health and mood and people with depression often experience higher levels of inflammation
5. Move your body for the right reasons
It is easy to give up on your exercise regime if you feel like you aren’t losing weight or your body shape isn’t changing at the rate you’d like it, but the reality is most of the health benefits you get aren’t ones you can easily see or measure. Regular exercise in women who have a diagnosis of PCOS has been shown to
- Reduce symptoms of depression and anxiety
- Reduce body image distress
- Improve quality of life
- Increase lean muscle mass
- Improve weight management
- Reduce waist circumference
- Improve menstrual regularity
- Improve blood sugar control
So how much exercise should women with PCOS be aiming for? In line with the physical activity recommendations for the general public, individuals with PCOS should aim to undertake between 150 to 300mins of moderate-intensity or 75 to 150mins of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week.
Additionally, muscle-strengthening activities on two non-consecutive days per week are recommended to maintain health and prevent weight gain. For further health benefits and to achieve modest weight loss, individuals with PCOS should aim for a minimum of 250mins of moderate-intensity or 150mins of vigorous-intensity aerobic activity per week, or an equivalent combination of both spread throughout the week, plus muscle-strengthening activities on two non-consecutive days per week.
Adolescents with PCOS should aim for a minimum of 60mins moderate- to vigorous-intensity activity each day, incorporating muscle- and bone-strengthening activities three times per week.