Nutrition Tips for National PCOS Awareness Month
Irregular periods? Trouble losing weight? Weight gain for no apparent reason – especially in the abdominal area? Hair growth on your face and/or body (where hair shouldn’t be growing)? Acne? Experiencing hair loss? If you are experiencing some of these symptoms, you may have a common hormone abnormality called Polycystic Ovarian Syndrome (PCOS). It affects between 7-10% of women. Many women don’t even know they have it. Chances are that someone you know (or you!) have it. It remains an under diagnosed and “silent condition”. But thanks to organizations such as PCOS Challenge, PCOS Awareness Organization and advocates like Ashley Levinson aka PCOSGurl (follow her on twitter @PCOSGurl) , people are becoming more aware about it. It’s about time considering up to 10% of women have it! Since September is National PCOS Awareness Month, I thought this was a good time to blog about it.
PCOS is often thought of as a gynecological condition as irregular or missing periods tend to be one of the main symptoms. In
reality, it is metabolic condition that can affect the whole body. Besides fertility problems, complications include risk for developing insulin resistance and prediabetes/diabetes, abnormal cholesterol, and triglyceride levels, heart disease, stroke, endometrial cancer (cancer of the inner lining of the uterus), obesity, and sleep apnea.
I have been specializing in nutrition for PCOS for the past 15 years . Through my experiences in working with these women, I have found the following lifestyle recommendations to be helpful to women with PCOS. (pic is of me lecturing at Westchester Rockland Dietetic Association)
Lifestyle recommendations for National PCOS Awareness Month:
- 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 overweight, 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. (Pic on the right is of me lecturing on Diet and PCOS to staff members at Reproductive Medical Associates – RMA- in NYC).
- Don’t 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.
- Lose weight if overweight. Even losing 5-10% of body weight will help decrease symptoms of PCOS as it improves insulin resistance. Don’t feel that you have to get to the perfect BMI!
- Exercise is a key factor in decreasing insulin resistance, helping with weight loss and promoting overall health. The ideal program includes an aerobic and resistance training component. Incorporating HIIT (high intensity interval training) can also be very beneficial for women with PCOS. In addition, try to get in 10,000 steps a day. Moving more during the day can also help with insulin resistance. Maybe you can’t do all of these things … but just focus on moving more in general!
- All calories count if you are trying to lose weight – 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:
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, prevent insulin spikes, keep you feeling full longer and ward off carbohydrate cravings. For example, a slice of whole grain toast with natural peanut butter is a better choice for breakfast as compared to a bowl of cereal with fat free milk. The higher fat and protein content of the peanut butter will likely stabilize blood sugar/insulin levels longer and ward off hunger.
- Very low fat diets are not recommended as they can lead to increased cravings. In addition, they can worsen insulin resistance when fat is replaced by carbs (especially refined carbs). On the other hand, don’t go overboard with your consumption of fats as they are high in calories. For example, 1 T. of olive oil contains 120 calories.
- Follow a heart healthy diet. Select healthy fats such as nuts, nut butters, avocado, fatty fish, olive oil and fatty fish.
- Consume anti-inflammatory foods. PCOS can be associated with a low grade inflammation in the body. It’s recommended that you increase intake of anti-inflammatory foods including fatty fish, dark green leafy greens, orange vegetables, garlic, tea, berries, shitake mushrooms, ginger, garlic, turmeric.
- Choose hormone free meats/poultry/dairy when possible. If you are having problems with acne, experiment with limiting/avoiding dairy. Studies suggest dairy may worsen acne in PCOS.
- Magnesium rich foods may help with insulin resistance. Food sources include leafy greens, beans, nuts, nut butter, whole grains. See my previous post on Health Benefits of Magnesium
- 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:
-Get your Vit B12 levels checked on a regular basis if you are on metformin as it can contribute to a deficiency.
-Get your Vitamin D levels checked as many women with PCOS are deficiency
-I would also recommend 1-2 grams of omega 3 fatty acids from a supplement – especially if you are not eating fatty fish at least 3 times a week.
-Consider taking NAC (N-Acetylcysteine). This is an amino acid and antioxidant that is a precursor to glutathione. Studies have shown it may decrease weight, hirsutism, fasting insulin, free testosterone and menstrual irregularity as well as lower total cholesterol and LDL.
-Consider taking Myoinositol and D-Chiro-Inositol. My favorite brand is Ovasitol. These supplements are relatives of the B complex vitamins. Some studies have demonstrated they decrease insulin, triglycerides, testosterone and blood pressure. In addition, they may increase HDL and aid in weight loss
- Practice stress management. Being stressed can raise cortisol levels, which in turn, can worsen insulin resistance.
- Get adequate sleep. Being sleep deprived can worsen insulin resistance, make weight loss more difficult and can intensify your carb craving
PCOS can be a frustrating medical condition as many doctors don’t specialize in it. The fertility issues, weight gain and other symptoms can be very upsetting for women. Keep in mind that all women with PCOS don’t get all of these symptoms. Some women have much “milder” cases. But even so, you should be aware that having PCOS may increase the risk for other health issues like diabetes and possibly heart disease as you get older. The good news is that a healthy diet and lifestyle can play a huge role in regulating your menstrual cycle, alleviating your other symptoms and decreasing health risks. Do your research and be your own health advocate. Keep searching until you find a physician who specializes in PCOS.
Contact me if you need education on nutrition for PCOS and help with practical meal planning. If you don’t live in the NYC area, I can do phone/Skype sessions. I’m also a certified wellness coach by Wellcoaches and can give you all the support you need! Here is my website to learn more about how I can help you meet your goals.
PCOS Awareness Organization
A Patient’s Guide to PCOS: Understanding–and Reversing–Polycystic Ovary Syndrome by Walter Futterweit I wrote the 2 chapters on diet and PCOS. Numerous meal plans are included.
PCOS Nutrition – Angela Grassi, RD
PCOS Diet Book – Hilary Wright, RD
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.