Polycystic ovarian syndrome also known as PCOS is a common hormonal disorder which affects up to 21% of women of reproductive age in Australia. PCOS is a syndrome that is characterised by three key features and people must tick two out of three to meet the diagnosis:
Cysts that grow in the ovaries
Abnormally high levels of male hormones (Androgens) either in a blood test or physical signs such as excess hair growth
Missed or irregular menstrual cycles
These above can result in a vast array of symptoms which can vary from woman to woman, and can also change over time. These include:
Skin changes, especially acne and darkening in areas
Facial hair growth
Weight gain and
Difficulty falling pregnant
PCOS is also commonly seen alongside other health issues, such as anxiety, depression, sleep apnoea and insulin resistance. In fact, 50-70% of women with PCOS also have insulin resistance, which if left unchecked dramatically increases the risk of developing Type 2 diabetes.
Genetics, hormones and lifestyle factors all play a role in PCOS. We are unsure what exactly causes PCOS but it is more common in people who have a family history. Other factors that are thought to be possible contributing factors include insulin resistance, low vitamin D and inflammation in the body.
Despite an unknown cause, there is a growing body of research that supports the role of lifestyle changes, such as nutrition, stress management and physical activity, in managing PCOS which is why working alongside an experienced dietitian is so important. Lifestyle changes can significantly improve symptoms of PCOS including cycle regularity, increase chance of fertility, reduce risk of long-term health effects such as diabetes and cardiovascular disease and optimise quality of life.
The first line treatment for women with PCOS and BMI >25 is lifestyle management which includes:
Healthy weight management
Regular physical activity
Here are five of our top nutrition tips for improving your symptoms and achieving long term health with PCOS.
1/ Choose Low GI carbohydrates
Carbohydrates (a.k.a. carbs!) provide the body with energy in the form of sugar or glucose. When they are absorbed into our bloodstream, they cause a rise in glucose (sugar levels) in the blood which is then delivered to our muscles for fuel to get us through the day. However not all carbohydrates are created equal.
High GI carbohydrates such as white bread, processed breakfast cereals and Jasmine rice are broken into sugar quickly in the body causing a rapid rise in blood sugar levels and also insulin. On the other hand, low GI carbohydrates cause a low and slow gradual rise in blood sugar levels. This contributes to better blood glucose management, more stable insulin levels, and may also assist with weight management.
More recently, studies have identified that a lower GI diet can also help with making periods more regular in women with PCOS, something many women with PCOS struggle with. Research has also shown that in women with PCOS, following a low GI can lead to weight loss and a 3-fold improvement in insulin sensitivity and therefore symptoms of PCOS.
Here are some simple low GI swaps:
Swap white jasmine rice for brown or basmati rice
Swap white bread for soy and linseed or sourdough bread
Swap white wraps for corn tortillas
Swap corn thins or rice cakes for ryvitas or vita-wheats
Swap cornflakes for rolled oats, natural muesli or all bran
Swap white potato for sweet potato
2. Aim to be YOUR healthiest weight
Weight loss is generally considered an important part of PCOS management, however, it can be incredibly frustrating and challenging for women with PCOS to lose weight. Trying to achieve a normal or healthy BMI is simply unrealistic for many women. The good news is that studies show even just losing 5% of body weight can help improve reproductive function and fertility, improve insulin resistance, reduce testosterone levels and improve problems with excess hair or acne. It can also significantly reduce the risk of developing chronic health issues such as Type 2 diabetes and cardiovascular disease.
Rather than looking for a quick fix for weight loss, opt for a lifestyle pattern that is going to be sustainable in the long run. Often small healthy changes that you can maintain long term far outweigh drastic changes that only last a week. And remember that dieting is a risk factor for weight gain and has a <5% success rate. For personalised advice that’s right for you, make an appointment with an Accredited Dietitian from the Eatsense team.
3. Boost your intake of omega 3 fatty acids
Omega 3 fatty acids are a type of fat which are most abundant in oily fish such as salmon, trout, tuna, mackerel and sardines. These healthy fats are commonly touted for their role in heart health and for easing achy joints, but research is showing us that omega three fats may also be an important dietary component in reducing the symptoms of PCOS.
They have the potential to improve insulin sensitivity, and may even reduce testosterone levels and help restore a regular menstrual cycle. Aim to include 2-3 serves of oily fish per week to achieve the recommended intake of omega three fats. Or if you don’t eat fish, choose a variety of plant sources of omega threes such as linseed, flaxseed oil, walnuts, chia seeds and hemp seeds. It can be difficult to achieve an adequate intake from these plant sources alone, so supplementing with a good quality omega three may be beneficial to assist in meeting these targets.
It is also wise to reduce your intake of saturated fats which are commonly found in meat fat, chicken skin, processed meats, full-fat dairy, coconut oil, butter, ghee, pastries, pies and takeaway foods,
4. Eat the rainbow
Fruits and veggies certainly give us bang for our buck when it comes to nutrient delivery. They are jam packed full of an abundance of essential vitamins, minerals, many of which also have the ability to act as antioxidants. Antioxidants are molecules that can prevent or slow damage to the body’s cells caused by unstable molecules called ‘free radicals’. This damage, known as oxidative stress is frequently seen alongside insulin resistance and carrying extra body weight – both of which are common in PCOS.
Choosing a diet high in a colourful selection of fruits and vegetables is the best way to boost your antioxidant levels. While antioxidants are available in supplement form, recent studies have found that their effectiveness is much less impressive than their wholefood counterparts.
To make sure you are getting enough of the good stuff, prioritise 3 to 4 different coloured veggies on your dinner plate each night, stock the fruit bowl with a variety of different fruits, or tick off the different colour groups as you go through the week (extra points if you get 5 different colours in one day!)
5. Follow a Mediterranean-Style diet
A Mediterranean-style diet is abundant in vegetables, fruits, legumes, wholegrains, nuts and seeds, with moderate amounts of poultry, eggs, dairy and extra-virgin olive oil and a limited intake of red meat and processed foods. This nutrient rich eating pattern provides plenty of fibre, vitamins, minerals, antioxidants and generally includes those low GI carbs discussed above.
The Mediterranean-style diet has numerous benefits for many of the body’s systems, but it may be particularly important for women with PCOS who are trying to conceive. A diet high in antioxidants from colourful fruit and veg, monounsaturated fats such as in olive oil, and omega three fats from fish can assist in reducing inflammation and promote the growth of healthy eggs ready for fertilization. A Mediterranean diet has also been shown to assist in the management of depression and anxiety, which is of particular interest due to the high cross over rates between PCOS and these mental health concerns.
Looking for some one on one tailored nutrition advice? Book in with an Accredited Practising Dietitian and Eatsense today. https://eatsense.com.au/