Martha Lectures on Polycystic Ovarian Syndrome

City girls …. Irregular periods? Gaining weight or difficulty losing weight? Trouble with your skin, hair loss or too much hair in the wrong places?  If so, you may have a common hormone disorder called Polycystic Ovarian Syndrome (pcos). It affects up to 10% of all women. Check out my previous post for more info.
Pcos and difficulty losing weight  

I presented a lecture this past Saturday Feb 7  on Diet and PCOS at the Greater New York Dietetic Association’s 7th Annual Women’s Health Conference. It was held Manhattan VA Medical Center. We had a attendance of about 50 nutritionists.

Here is a segment of my presentation:

Lifestyle Recommendations for PCOS

• No one diet works for everyone. Each plan must be tailored to suit the individual. In my experience, I have found that women with PCOS who are very insulin resistant, especially if they are obese, often have an easier time losing weight and feel better on a lower carb diet. However this doesn’t mean that every women with PCOS needs to be on a very low carb diet.

• Do not think of this as a short-term diet but rather a healthy eating plan to be followed for the long term. I don’t even like to use the word diet as it implies deprivation and something short- term.

• A priority in treating insulin resistance is weight loss. This is more important than the macronutrient composition of the diet. Even losing 5-10% of body weight will help decrease symptoms of PCOS.

• Exercise is a key factor in decreasing insulin resistance. The ideal program includes an aerobic and resistance training component. The resistance training component should focus on light weights and more repetition.

• All calories count – whether from protein, fat or carbohydrate. This must be emphasized as it is common to see women who feel they can eat unlimited amounts of protein and fat as long as they keep the carbohydrate intake low. A hypo caloric diet must be adhered to if weight loss is to occur. Use the following formula to determine your caloric needs (I took this formula from the chapters I wrote in Dr. Walter Futterweit’s book on PCOS).

For weight maintenance
10 calories per pound for women who are obese, very inactive, or chronic dieters
13 calories per pound for women over age 55 who are very active
15 calories per pound for very active women

If you tend to have a difficult time losing weight and are obese, very inactive, or a chronic dieter, it is possible that you may need to use 8 or 9 calories per pound.

For weight loss
To lose 1 lb a week, subtract 500 from maintenance caloric level
So if your maintenance caloric needs are 2000, you should consume 1500 calories a day to promote a one pound weight loss a week.

• Select lower glycemic index carbohydrates (ie. whole grains, fruit, vegetables, legumes, milk) instead of higher glycemic index carbohydrates such as rice, potato, white bread.

• Consume balanced meals that contain protein/fat and carbs. This will help to control blood sugar, keep you feeling full longer and ward of carbohydrate cravings. For example, a slice of whole grain toast with some natural peanut butter may be a better choice for breakfast as compared to a bowl of cereal with fat free milk for some women. The higher fat and protein content of the peanut butter may satiate you more than the higher carbohydrate content of the cereal.

• Very low fat diets are not recommended as they can lead to increased cravings. In addition, they can worsen insulin resistance. On the other hand, you should not go overboard with your consumption of fats as they are high in calories. For example, 1 T. of olive oil contains 120 calories.

• Select healthy fats. Limit saturated and trans fats as these fats can increase risk of heart disease by raising LDL cholesterol. Substitute unsaturated fat for saturated fat and trans fats. Include omega 3 fats (found in fatty fish, canola oil, leafy greens and walnuts) in the diet to decrease risk of heart disease. These fats may also improve insulin resistance. Other healthy fats include nuts and nut butters, avocado, olive and canola oil.

• Identify problem behaviors and work on making permanent behavior changes. Make small changes at a time. Food records have proven to be a very useful tool in identifying problem behaviors as well as helping you to limit your calories. Who wants to write down that they had 5 chocolate chip cookies?

• Pay attention to how your body feels after eating various foods. Which foods set off cravings or decrease energy levels? Which foods make you feel energized? This is very important to help you determine what kind of eating plan will work best for you.

• Suggested vitamin / mineral supplements: B complex if you are taking metformin,  multivitamin with minerals, calcium 1000 mg – 1500 mg  (if unable to consume enough from the diet). I would also recommend 1-2 grams of omega 3 fatty acids from a supplement if you are not eating fatty fish at least 3 times a week. In addition, make sure to get your Vitamin D levels checked as low levels are linked to PCOS. You will need to supplement if your levels are low.

• Practice stress management. Being stressed can raise cortisol levels, which in turn, can worsen insulin resistance. I’m sure we have all heard of high cortisol levels linked to “belly fat”. And, no – those pills such as cortislim don’t lower cortisol levels nor do they get rid of belly fat!

• Get adequate sleep. Being sleep deprived can worsen insulin resistance, make weight loss more difficult and can intensify your carb cravings.

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I especially love problem-solving, whether it’s helping women defeat issues plaguing them for years, helping a busy executive find practical ways to get heart healthy, or providing tips to help you reverse diabetes. That’s why I’m on a constant quest to expand my knowledge by staying on top of the latest research.

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