Polycystic ovary syndrome (PCOS) is a relatively common gynecological condition that affects the normal functioning of the ovaries. It has been shown that a healthy diet combined with increased physical activity can improve the symptoms of the syndrome. There are three characteristics that lead to the diagnosis of PCOS, and the presence of only two of the three is enough to confirm a diagnosis.
The three features are:
- A number of follicles surrounding the eggs within the ovaries (despite the name "polycystic ovaries' follicles are not cysts).
- The eggs are not normally released from the ovaries (ovulation), something that causes oligomenorrhea (less than nine periods a year) or amenorrhea (no period).
- The person has higher levels of male hormones in the blood, or male hormones are more active than normal, causing acne, hirsutism etc.
If you have PCOS you may present several of the following symptoms:
- irregular or absent menstruation
- excessive hair growth especially on the face, chest or stomach
- thinning of the hair or male pattern alopecia
- difficulty in maintaining a healthy body weight
- insulin resistance
- fertility problems
Long-term health consequences associated with PCOS include cardiovascular disease and type 2 diabetes, especially if the person presents any of the following:
- High blood lipids
- High blood pressure
- Is overweight or obese, and especially if there is increased visceral fat (body fat deposits around the waist)
These symptoms can be controlled through a combination of healthy lifestyle changes, cosmetic therapies and appropriate medication.
A healthy diet combined with regular exercise can help improve the symptoms of PCOS and prevent the onset of heart disease and diabetes in the future. Healthy eating simply involves eating a variety of fruits and vegetables, nuts, seeds, legumes, and lowering consumption of foods rich in saturated and trans fats (i.e. animal based products) and sugar. If you are trying to conceive, it is particularly important to get all the nutrients you need to meet your nutritional requirements and you may also need to take a folic acid supplement. Discuss with your doctor the possibilities of taking any supplement.
Low glycemic index diets (Low GI Diets)
Glycemic index (GI) is a useful "tool", which indicates how quickly blood sugar rises after eating any food containing carbohydrates. Foods consumed in low-glycemic index diets cause a slow increase in blood sugar levels, something that has been shown to help reduce the symptoms of PCOS. This is because the consumption of low-GI foods helps to better regulate the levels of insulin in the blood. Insulin is a hormone that helps to produce energy in the body from the food we consume. Many women with PCOS are resistant to the effects of insulin something that makes the body produce a lot more insulin in the blood. Insulin increases the concentration of testosterone in the blood. Although testosterone is often seen as an exclusively male hormone, all women need to have a small amount of it in their blood. However, having even slightly higher levels of testosterone than normal can disrupt the balance of sex hormones in the body, and lead to symptoms such as acne, hirsutism and irregular periods. Alternating medium and high GI foods (e.g. sweets, chocolates, white and brown bread, boiled, baked or fried potatoes, corn flakes etc.) for low-GI foods (e.g. 100% stone-ground whole wheat or pumpernickel bread, muesli, porridge, al dente pasta, sweet potatoes, lentils, peas, beans, all non-starchy vegetables and most fruits including apples, pears etc.) can enhance the body's ability to respond to insulin in women with PCOS. A low GI diet combined with some caloric restriction can also help stabilize period.
Can body weight affect PCOS symptoms?
If you are overweight or obese, it is worth it to know that even a small weight loss rate of 5-10% can improve the symptoms of PCOS, including fertility. The loss of 0.5-1 kilogram per week is a safe and realistic goal. The best way to maintain a healthy weight over the long term is to set realistic goals, follow a healthy and balanced diet and avoid FAD or chemical diets that promise you to lose weight fast and easy. Many women with PCOS have difficulty in losing weight and often end up indulging in episodes of emotional or compulsive overeating. The most important thing to do is to follow a well-balanced, varied and moderate diet that covers your needs in energy and nutrients, without becoming obsessed with losing weight. You also need to know that there are many benefits to be gained from the integration of adequate physical activity in your daily routine, such as improved response of your body to insulin. All you need to do is to find an activity that you enjoy and fits into your lifestyle and stick with it.
Six basic nutritional goals
- Meet daily energy, nutrient and fluid requirements if BMI falls within the normal range (18.5-24.99kg/m2). Aim for a daily negative energy balance if your BMI is ≥25 kg/m2 but be careful and set realistic and sustainable goals. Consult your dietitian for more information.
- Instead of medium or high GI foods (GI> 70) including sweets, chocolates, white and brown breads, boiled, baked or fried potatoes, corn flakes etc. consume low GI foods (GI <55) including 100% stone-ground whole wheat or pumpernickel bread, muesli, porridge, al dente pasta, sweet potatoes, lentils, peas, beans, all non-starchy vegetables and most fruits including apples, pears etc.
- Consume at least 5 portions of fruits and vegetables per day. Each portion corresponds to 80gr of fruits or vegetables.
- Maintain salt intake at 5-6gr per day (2-2.4g sodium per day). Learn how to read food and drink labels correctly.
- Increase physical activity (moderate aerobic exercise for at least 30 minutes, 5 times a week) and reduce time spent on sedentary behaviors (e.g. watching TV) to enhance weight loss, improve metabolism of glucose and insulin sensitivity, and reduce the symptoms of PCOS. Exercise will also help prevent central obesity (apple body type), which has been directly linked to insulin resistance, dyslipidemia, heart disease, diabetes and metabolic syndrome.
- Consider taking omega-3 fatty acid supplements, as this may help regulate androgen hormones in your blood. Discuss this option with your current doctor.