Polycystic Ovary syndrome (PCOS) effects 5-10% of women of reproductive age, and impacts those with the condition in a number of different ways. In fact 25% of people with PCOS may not show any symptoms.
PCOS is an endocrine disorder, and diagnosis includes having at least two of the following: irregular periods, androgen excess (high levels of male sex hormones), and cysts on the ovaries. Other conditions that may cause these symptoms should also be ruled out first.
Women with PCOS may experience insulin resistance, weight gain/difficulty losing weight, increased facial or body hair, acne, metabolic syndrome (leading to an increased risk of CVD and type 2 diabetes), infertility, higher risk of gestational diabetes, and increased risk of miscarriage.
So how does nutrition come into it?
Some of the features are obesity, insulin resistance and metabolic syndrome (high lipid levels, high blood pressure, high blood sugar levels); therefore what we eat can play a significant role in the health for PCOS women. The main goals of nutrition are usually to improve insulin resistance and reduce androgen excess.
A 5-10% weight reduction can improve the androgen excess symptoms and improves fertility chances. How you go about this weight loss could come in many different ways, but making sustainable changes and keeping a positive relationship with food are important.
Both the type and amount of carbohydrate are important in managing insulin resistance. We are clear on what the type of carbohydrate should be – less refined carbohydrate, lower GI and lower glycemic load. How much, is still a debatable topic. Cutting all carbohydrates out is most likely a little drastic, and for many not sustainable long term; but given the westernised diet, I would say many do need to make a change to their carbohydrate intake.
Think moderate portions of whole-grains such as oats, quinoa, freekah, barley, wheat bran, spelt etc. While minimising your intake of biscuits, cakes, crackers, lollies, white bread, and added sugar in food and drinks.
EAT MORE! You cannot have too much of the non-starchy varieties.
One in three New Zealanders do not get in the minimum 3 serves a day. Vegies are high in important vitamins, minerals, fibre and antioxidants. They are useful for filling up without providing an excess of calories in those trying to lose weight.
There has been some research suggesting that omega-3 may help with lowering testosterone, help with insulin resistance, and lower triglyceride levels. More research is needed to make this a firm recommendation particularly around supplementation levels, but in the meantime consuming regular oily fish in place of meat to increase your intake of omega-3 is good for you, even outside of having PCOS. Other good sources of omega-3 are walnuts, chia seeds and flaxseeds.
Exercise is not only good for your mental health, but helps improve insulin resistance and will be important in helping with weight loss.
We should be aiming for a minimum of 150mins of exercise a week with a mixture of cardiovascular and resistance training. This doesn’t have to be in a gym, there are plenty of home-based exercises you can do.
Finally there is also some interesting research and approaches going on in the areas of magnesium, chromium, vitamin D, resveratrol, isoflavanoids and inositol. Watch this space, and I think I’ll write about some of these individually, but perhaps some of you with PCOS may need extra support in these areas.
How a PCOS friendly day might look:
Porridge made with oats and milk. Topped with some chopped walnuts and berries
Chopped up carrots, cucumber and celery with hummus
Tinned salmon tipped onto leftover roast veggies, spinach and quinoa. Topped with some feta, and chopped almonds, and a lemon juice or olive oil vinaigrette dressing.
Piece of fruit and yoghurt
Chicken, chickpea and vegetable curry on brown rice
If you suffer from PCOS and want some support and advice on a way forward in managing your nutrition in this condition then get in contact with me to talk.
Are you thinking about trying for a baby? Be it your first or your fourth; Here are 5 diet and lifestyle aspects to consider when starting this journey.
Find your healthy weight
Did you know your fat cells produce oestrogen? So if you have too little fat you may not be getting enough, and if you have too much fat you might be producing too much. Neither of which is helpful for a woman’s chance of falling pregnant.
Higher than normal oestrogen levels in men due to high body fat levels may also impact on sperm quality and count.
What to do? Restrictive crash dieting to lose weight, or eating lots of high fat/sugar foods to gain weight, is not the way to go! I would suggest talking with a professional about safely ensuring you are eating not only for the weight loss/gain goal but also getting in adequate nutrition to maximise your fertility chances.
Start your lifestyle changes early
If you perhaps are not living the healthiest of lifestyles and are thinking you would like to start a family in the not too distant future, then it might be worth starting to make changes now.
Did you know that sperm cells take 72 days to mature? So the one swimmer fertilising your partners’ egg today, was actually a product of your lifestyle a few months ago. Is it the best swimmer it can be?
This is also why any changes to diet and lifestyle may take a number of months to be effective in terms of increasing fertilisation chances.
Watch your alcohol intake
Alcohol has been shown to negatively impact both male and female fertility. We do not know how much alcohol exactly that is though, which makes recommendations for safe limits hard.
Do you need to cut out alcohol completely? Probably not, but if you want the best chances you shouldn’t be out there binge drinking. Minimise your alcohol intake as much as you can, but don’t guilt yourself over the glass of bubbles at your mums birthday either.
Look at your iron and selenium intakes
Iron needs double during pregnancy. So if you are already low pre-conception, make sure you get yourself replete before getting pregnant – the quickest way to do this may be an iron supplement, but you should discuss this with your GP.
Red meat is the highest and most bioavailable source of iron in the diet. We should be aiming for a couple of serves a week. If you do not eat red meat there are other ways to achieving a good iron intake, it can just take a bit more thought and planning to ensure there is enough.
Selenium may have a role to play in male sperm quality. We have naturally low levels in our NZ soil, so the amount we get from food may be reduced. Maximise your intake with regular high selenium containing foods like brazil nuts, tuna, turkey and chicken.
Take your folic acid
Folic acid supplementation has been proven to reduce the risk of neural tube defects that can occur during the first trimester. In NZ, recommendations are that you should be taking 800mg of folic acid daily a month before falling pregnant and up to 12 weeks gestation. There are some instances where the recommendation is more though. As soon as you start thinking about trying for a family, then go and see your GP to discuss your folic acid needs.
Good food sources of folate are green leafy vegetables (such as spinach and broccoli), citrus fruits and juices, wholemeal bread and legumes. It can be difficult to get the increased folate needs for preventing neural tube defects from diet alone though, which is why we recommend supplementation on top of a good diet.