Top 10 most common questions regarding nutrition and exercise for PCOS (polycystic ovary syndrome)
Sophie Pratt is a CORU registered dietitian and a member of the Irish Institute of Nutrition and Dietetics. Based in the Canta Clinic in Carlow (Sims IVF satellite clinic), her areas of expertise include infertility (e.g. Polycystic Ovary Syndrome, male infertility), weight management and sporting performance. www.sophiepratt.ie
- Is there a specific PCOS friendly diet?
There is no specific PCOS diet, however, a healthy balanced diet incorporating whole grains, lean meats such as chicken and turkey, fish, fruit, vegetables, nuts and seeds is advised. It is important to limit the consumption of foods that are high in added sugar, saturated fat and salt. Too much of these foods can exacerbate PCOS symptoms and also further increase the risk of long-term health conditions such as diabetes, high blood pressure, high cholesterol, cardiovascular disease and fertility problems.
2. Is it normal for women with PCOS to crave sugar?
Sugar cravings are common among those with PCOS. This is due to the increased insulin levels in the body. Insulin is a hormone produced in the pancreas that allows our cells to use glucose from the food we eat, for energy. Women with PCOS are often insulin resistant which can lead to a heightened desire for sugary foods. There are multiple strategies that can be implemented to deal with these cravings. Firstly, ensuring a regular meal pattern will help to control appetite. Secondly, consuming well-balanced meals incorporating whole grain carbohydrates (e.g. bread, rice, noodles), quality protein (e.g. chicken, turkey, fish, eggs) and healthy fat (e.g. avocado, nuts, seeds) will help to keep a more consistent blood glucose level and prevent large spikes which can cause sugar cravings. In that regard, where possible, limit high sugar foods and choose lower sugar versions instead. For example, choose a zero/diet fizzy drink instead of the full sugar alternative.
3. Is it okay to eat chocolate with PCOS?
The short answer is yes, in moderation. However, as chocolate contains sugar it should be limited. Excessive sugar intake can increase insulin levels and lead to an elevation of male hormones, thereby exacerbating PCOS symptoms. If you would like chocolate to be part of your diet, a lower sugar version such as 70% dark chocolate should be chosen instead of milk or white chocolate. Additionally, pair the chocolate with a protein source such as a yoghurt, or a healthy fat source such as nuts or seeds as this will help blunt the blood glucose level response and subsequently reduce the insulin spike. As always, try and keep to a small, appropriate portion size at one sitting.
4. Should fruit be avoided by women with PCOS?
Fruit is a crucial component of a healthy diet as it can provide fibre, vitamins, minerals and water. However, it is important to note that fruit contains sugar in the form of fructose. Therefore, eating a piece of fruit will increase blood glucose levels and lead to a corresponding increase in insulin levels. As previously mentioned, this can hinder PCOS due to the elevated male hormones. Nonetheless, fruit should not be avoided. Consuming two portions of fruit, and three portions of vegetables per day is advised in order to make up the recommended five-a-day. A portion of fruit is one medium sized fruit (e.g. apple, orange) or two small fruits (e.g. plum, apricot) or 150ml of fruit juice. To help reduce the blood glucose response, aim to have the fruit with a source of protein or healthy fat as referred to above (e.g. fruit salad with yoghurt, apple with nut butter).
5. Should carbohydrates be avoided in those with PCOS?
Carbohydrates are a crucial source of energy, providing approximately half of our daily energy/food intake. Additionally, carbohydrates provide fibre and other vitamins/minerals and therefore, should not be excluded. However, it is important to consider the type and quantity of carbohydrate consumed by those with PCOS. Complex carbohydrates such as brown rice, pasta, noodles and bread should be included instead of refined (white) carbohydrates as they are less processed and frequently contain less sugar. If possible at meal times, adhere to a serving size that equates to a closed fist-full, or approximately one quarter of your plate.
6. Is intermittent fasting beneficial for women with PCOS?
Intermittent fasting is when food consumption is confined to a specific time period (e.g. 10am to 6pm), with the remainder of the day a fasting period. While evidence regarding the benefits of intermittent fasting is conflicting, there is support for the use of intermittent fasting in improving insulin resistance and for weight loss, primarily due to a calorie deficit. Bearing that in mind, it may be helpful for those with PCOS who are also trying to lose weight and would benefit from a time restricted eating window. However, it is not suited to everyone.
7. Are there any supplements that should be taken for those with PCOS?
There is promising evidence to suggest that low vitamin D levels may be associated with increased insulin resistance, although more research is needed to further illuminate the strength of the relationship. In Ireland, due to a lack of sunlight exposure, vitamin D supplementation is recommended for all adults, irrespective of PCOS. While it is not an obligation, vitamin D supplementation should be strongly considered considering its preservative role in maintaining bone, immune and nervous system health.
8. How much exercise should I be doing a day to aid PCOS?
While there is no specific exercise recommendation for PCOS, adults are advised to perform at least 30 minutes of moderate activity five days per week (or 150 minutes per week). Moderate activity is when your breathing and heart rate increases, yet you are still able to hold a conversation. For those that have been very inactive for a prolonged period of time, the level of exercise should be increased slowly. For example, it may be useful to intersperse small bouts of exercise such as 5-10 minute walks or a 15 minute cycle throughout the day.
9. Is resistance training helpful for PCOS?
Resistance training also known as strength training can be very beneficial for many people not just women with PCOS. Indeed, resistance training can greatly help improve body composition by maintaining or increasing muscle mass and decreasing fat mas. Further still, resistance training has been repeatedly shown to improve insulin resistance, and release endorphins, a chemical that triggers feeling of happiness and positivity. Unsurprisingly therefore, incorporating resistance training into your lifestyle may be greatly beneficial. Resistance training can be performed in a gym, or at home using household objects as weights. Start with basic exercises, light weight and ensure correct form.
10. Is it possible to lose weight with PCOS?
Hormonal fluctuations in women with PCOS make it difficult to lose weight, however it can certainly be achieved with dietary and lifestyle alterations. Considering a calorie deficit is needed for weight loss, it is particularly important to assess the food types and portions sizes being consumed. Initially, making small changes such as swapping full fat foods for low fat foods (e.g. full fat vs low fat milk and/or yoghurt) and reducing portion sizes can make a notable difference. In addition to such dietary changes, increasing activity levels may help to further facilitate the acquisition of a calorie deficit, thereby promoting weight loss.
