Nutritional Advice For PCOS In a Nutshell:
- 1. Lifestyle:
Weight loss if you are overweight, smoking cessation and decreased alcohol consumption (1 – 2 drinks p/day).
- 2. Physical Activity:
Increase exercise to > 150 min p/week. This can include aerobic exercise such as walking, running, etc. but should also include resistance training.
- 3. Carbohydrate & Fibre:
Choose wholegrains, fruit and vegetables; avoid refined carbohydrates and sugar (e.g. sweets, chocolates, chips, energy- & fizzy drinks). Evenly distribute your carbohydrate intake during the day.
- 4. Lean Protein & Dairy:
Eat lean protein with every meal (meat, chicken, egg & fish) and include low-fat dairy products daily.
- 5. Healthy Fats:
Include more healthy fats such as Omega-9 (avo & olive oil) and Omega-3 (oily fish & flaxseed) and avoid saturated fat (fat from animals) and trans fatty acids (fried & baked goods). An Omega-3 supplement is recommended.
- 6. Supplementation:
A good multi-vitamin and -mineral can be taken. Consult with your dietitian regarding single nutrient supplmentation such as chromium, magnesium, zinc, Vitamin D, Vitamin B12, folate and calcium.
PCOS is a complex condition where small cysts can be observed in the ovaries on an ultrasound, leading to irregular menstrual flow and cycles, excess facial and body hair, acne, male pattern hair loss (due to high levels of androgens/male sex hormones), insulin resistance, anxiety and depression, infertility and weight gain, especially in the abdominal region.
PCOS is furthermore associated with other complications, such as the development of the metabolic syndrome, heart disease, insulin resistance, infertility, type 2 diabetes, high blood cholesterol and blood pressure, depression and anxiety and possibly the development of some cancers.
Healthy eating and physical exercise can decrease the risk of developing these complications associated with PCOS as well as reduce the symptoms associated with the condition such as menstrual irregularities, anxiety and increased male sex hormones.
Factors contributing especially to the development of PCOS and insulin resistance include genetics, aging, a sedentary lifestyle, smoking and a central fat distribution.
The following recommendations are made on how to promote fertility nutrition for PCOS:
- If you are overweight, it is advised that you loose weight. A reduction of 5 – 10% of your body weight or weight loss of 0.5 – 1.0 kg per week can significantly reduce the complications and symptoms associated with PCOS.
- Lifestyle plays a very important role in the management of PCOS. Increasing levels of physical activity to at least 150 minutes of exercise per week is advised. Start by including 10 minutes of physical activity per day and build it up as you increase your tolerance to exercise. Exercise can be aerobic – such as walking, running, cycling, swimming or playing team sports or it can be resistance training.
The latest research shows that increasing the amount of resistance training, e.g. lifting weights, has an even more beneficial effect on weight loss and management of PCOS. Other lifestyle factors, such as smoking cessation and limited consumption of alcoholic beverages, are advised (1 – 2 drinks per day).
- Increase intake of fruits and vegetables. Try to include at least 6 – 10 portions of fruit and vegetables per day. Focus specifically on different bright colored fruits and vegetables. Fruit and vegetables are good sources of fibre and micronutrients. Preferably enjoy fresh fruit and vegetables and try to avoid especially fruit juice (high in sugar) and dried fruits with added sugar.
- Include more low glycemic index (GI) carbohydrates in your diet. This would include carbohydrates that are high in fibre, such as whole grains, wholewheat bread and cereal, brown rice and pasta, vegetables, legumes and fruit. Try to avoid refined or simple starches such as white bread, -sugar, -rice and -pasta, sweets, chocolates, chips and all food containing sugar and white flour – including cakes, pastries, biscuits and other baked goods. Balance your carbohydrate intake during the day (equal amounts with all meals and rather 4 – 6 smaller meals per day than only 3 big meals) and add a lean protein with every meal. The addition of protein to carbohydrate lowers the GI and helps control your blood glucose levels.
- Avoid sugary drinks and beverages such as energy and fizzy drinks. Also watch out for Vitamin water and iced teas, which may contain hidden sources of sugar. Drinks containing caffeine, such as coffee/tea should be limited to a maximum of 2 cups per day.
- Lean proteins are good sources of iron, zinc, Vitamin B12 and other B-complex Vitamins and play an important role in your PCOS diet. Choose lean meat, chicken, fish and legumes. It is important to remove the skin and excessive visible fat before cooking. Do not add extra creamy sauces and gravies that are high in fat. Processed meat like viennas, sausage, polonies, ham and salami are high in fat and should be limited. Milk is also a good source of protein and micronutrients such as phosphorous, B-complex Vitamins, and Vitamins A and D. You should eat or drink a source of dairy on a daily basis. Ensure that you drink low fat or fat free milk, yogurt or dairy products.
- Fats are high in fat-soluble Vitamins (A, D, E and K) and the essential fatty acids which are important to be included in your diet as your body cannot produce this on its own. You should reduce the intake of saturated animal fats (organ meat, meat and chicken fat, cream, full cream milk, butter) as well as trans fat (baked goods & food fried in oil) and foods high in cholesterol (organ meat, meat fat, full cream milk, shellfish & butter). Unsaturated fats, particularly monounsaturated fats (Omega-9) should be included daily in moderation.
This can be found in olive or canola oil, avocado pear and olives. Polyunsaturated fatty acids (Omega-3 and Omega-6) also play a vital role and should be included. Three portions of oily fish (fatty fish like sardines, salmon and mackerel – not fish fried in oil) should be included per week as well as nuts and seeds. An Omega-3 supplement is recommended for the treatment and management of PCOS. It is recommended to only supplement with Omega-3 (not Omega-6 and -9), to make sure the supplement is a good quality, contains at least 400mg EPA+DHA and comes from fish oil (flaxseed if you are vegetarian).
- Cooking methods of foods are vital to reduce total and type of fat in the diet. Rather steam, boil, microwave, roast and bake food and avoid fried and fast foods as far as possible.
- There is little conclusive scientific evidence to support supplementation with single nutrients in addition to your diet. The inclusion of a good multi-vitamin and -mineral which provides at least 100 – 150% of the Recommended Daily Allowance (RDA) is recommended. A registered dietitian can evaluate your nutritional status and dietary intake and recommend other single nutrients, such as:
- – calcium,
- – zinc,
- – magnesium,
- – chromium,
- – Vitamin D,
- – Vitamin B12 and
- – folic acid on an individual basis as deficiencies of these have been linked to increased insulin resistance, resistance to weight loss, menstrual irregularities and high androgen levels with PCOS.
It is, however, not recommended to take these without prior consultation. If your diet is varied and according to the guidelines above, you are likely to reach the recommended intake of these nutrients through the diet. The only exception is Folic Acid, which should be taken as 400 mcg/daily if you are trying to fall pregnant.
For more information contact:
Sunita Potgeiter RD (SA)
Cell: 082 335 3650