What is PCOS?

PCOS, short for Polycystic Ovarian Syndrome, is a commonly occurring hormonal disorder affecting innumerable women across the world. It is believed one in ten women in the child bearing/ reproductive age have PCOS. An imbalance in reproductive hormones causes a wide range of symptoms including fertility issues, irregular menses, cysts on the ovaries, acne, weight gain, excess hair growth in unwanted places, hair loss, infertility, mood swings etc.,

How does PCOS originate in the body? What are the signs of PCOS?

While research is yet to point out the exact cause, what we do know is PCOS affects every individual differently. Though it is a lifelong condition, early diagnosis and treatment along with weight loss can aid in effective management of symptoms, along with nutrition and diet which play a crucial role. PCOS, if not managed well, can cause long term complications such as Type 2 diabetes, heart disease and infertility. The most revealing signs of PCOS include:

• Disrupted Ovulation: Individuals may have periods frequently or the duration of menses may last many days.
• Excess Androgens: The presence of high levels of these “male hormones” can cause excessive facial & body hair, acne, irregular periods.
• Insulin Resistance: Women with PCOS tend to have higher levels of insulin in the bloodstream which leads to weight gain and other symptoms.

What factors affect PCOS? How can Diet and Nutrition Help with Management of PCOS?

Food can play a critical role in helping one manage symptoms of PCOS effectively.By focusing on the following factors, PCOS can be tackled efficiently:

• Insulin Resistance
• Weight Management
• Fertility Management
• Hormonal Balance
• Lifestyle Factors

Insulin resistance

Insulin resistance is a major concern in people with PCOS, controlling one’s blood sugars plays a critical role. This can be achieved through the following means:

Complex Carbohydrates

Carbs such as:

Whole grains – whole wheat, unpolished rice – red & brown rice, oats, quinoa, millets such as bajra, jowar, ragi also called fox tail millet.

Legumes – Beans & Lentils – chick peas, red beans (rajma), cow peas, green gram etc., are rich sources of plant protein and fibre.

Vegetables

• Cruciferous varieties – broccoli, cauliflower, Brussel sprouts,
• Leafy Greens – spinach, kale, red leaf lettuce,
• Red, Yellow and Green peppers,
• Tomatoes, pumpkin, squash
• different gourds, zucchini

Fruits – apples, plums, grape fruit, pears, citrus fruits like sweet lime & oranges, cherries, berries like blue berries, straw berries, black berries. These fruits are known for their low glycemic index.

All of the above food sources are also fibre rich and hence release glucose slowly which hinders rapid spike in blood sugar levels.

Protein:

Lean Protein such as Fatty Fish high in omega3 fatty acids – salmon, sardine, mackerel, tuna.

Chicken & eggs from poultry reared at homes or farms where the poultry are fed purely on grains and natural chicken feed, (no antibiotics or hormones administered) can be taken in limited amounts.

Plant Based Sources – Soy beans, Tofu, Tempeh, beans, lentils

Proteins promote satiety – a feeling of fullness, and stabilize blood sugars.

Healthy Fats:

• Nuts – almonds, walnuts, pistachios
• Seeds – Flax seeds, Pumpkin seeds, sunflower seeds
• Olive Oils
• Avocados

All the above foods improve insulin sensitivity, are excellent sources of good fats, protein and fibre.

Prebiotic and Probiotic Foods: Artichoke, garlic, onion, leek, asparagus, beetroot, cabbage, sauerkraut & kimchi.

Low GI Diet: Glycemic index is a ranking system, showing how quickly your blood sugar rises after eating different carbohydrates. A low GI (glycemic index) diet which causes blood sugars to rise slowly, can be useful to reduce the symptoms of PCOS. Such foods can improve insulin levels and reduce insulin resistance.

Portion Control: Overeating can lead to blood sugar spikes. It is advised to eat smaller balanced meals at regular intervals to maintain steady energy levels, keep blood sugar levels stable and reduce insulin resistance.

Weight Management

Managing weight is a critical aspect of PCOS management, as excess fat can aggravate insulin resistance and hormonal imbalance. Here are a few ways to combat weight gain and win over PCOS symptoms:

• Regular Meals: Skipping meals can lead to overeating later in the day. Ensure to consume balanced meals and incorporate healthy snacks at regular intervals throughout the day.
• Calorie Control: Be aware of calorie intake and choose a balanced diet that fulfills your energy requirements without overeating.
• Sugary and Processed Foods: Such foods are high in calories and lead to weight gain which exacerbates insulin resistance. Ensure you limit their consumption.
• Hydration: Drinking sufficient water at regular intervals throughout the day ensures your appetite is controlled and supports overall wellbeing.
• Mindfulness: A practice of being aware and conscious of what goes into our bodies during a meal – mindful eating has shown to aid hunger management and prevent overeating.

Fertility Management

Diet and Nutrition plays a crucial role for women with PCOS trying to conceive.Following are key foods to incorporate into one’s diet:

Folates: Folate rich foods are essential for fetal development and prevent birth defects. These include –

• Dals – moong, chana, arhar and urad
• beans – chickpeas, cowpeas, black eye peas, etc.
• Leafy greens – Spinach – palak, lettuce, kale, Drumstick – moringa, etc.

Other sources include – cruciferous vegetables, citrus fruits, whole grains, sesame seeds – – til in the form of ladoo/chikki, peanuts and sunflower seeds.

Iron Rich Foods: Iron plays a vital role in healthy ovulation and fertility. Major sources include beans, leafy greens and meat.

Healthy Fats: Omega 3 Fatty acids aid fertility and reproductive health. Sources include – Flaxseeds, hemp and chia seeds, walnuts and fatty fish – salmon, mackerel.

A balanced diet and good hydration go a long way in ensuring one receives all essential nutrition for a healthy pregnancy.

Hormonal Balance

PCOS often causes hormonal imbalance particularly with male hormones – androgens.Making conscious dietary choices can help address this issue:

• Dairy: A large number of women have found relief from symptoms of PCOS by excluding dairy products from their diet. Alternatives like almond milk, soy milk, oat milk, coconut milk and yoghurts derived from such products can be considered.
• Low GI Foods: Foods, low in GI, such as whole grains and non-starchy vegetables can they regulate insulin levels and in turn androgen levels.
• Cinnamon: This spice may assist insulin sensitivity and help regulate menstrual cycles.

Lifestyle Factors

Though diet and nutrition are crucial factors in managing PCOS, lifestyle factors also play a key role:

• Physical Activity: Regular exercise can assist in insulin sensitivity and aid in weight management. Strive to pursue a fitness regime that involves at least 150 minutes of moderate – intensity exercise per week.
• Stress: Chronic stress can aggravate PCOS symptoms. Breathing techniques, meditation and yoga are proven techniques to help in stress reduction.

What foods are to be avoided to help in better management of PCOS symptoms?

• All forms of simple carbohydrates like sugar and its different forms like jaggery & high fructose corn syrups, & dextrose in all processed foods. Avoid fast foods and limit food from restaurants.
• Foods high in refined carbohydrates like white bread, white rice and all products made from refined flour like cakes, pastries, sugary snacks & drinks
• Inflammatory foods like Red Meats (mutton, beef, pork ) and processed meats like sausages & salami and organ meats like liver ,heart and all tinned and packaged foods
• Fried foods like French fries, samosas, and all fast foods
• Saturated fats such as butter, margarine and dairy products like the different types of cheese & sour cream.
• It is advisable to avoid milk and yoghurt too as most of the cattle are given hormone based medicines to increase their yield (milk or meat)
• Sugary beverages (soft drinks), sodas, sports drinks and alcoholic beverages.

How do I choose the best suited foods for myself?

Always consult a qualified nutritionist /dietician before you decide to go on a PCOS diet. In a nut shell a diet which helps in reducing the symptoms and complications of PCOS is a very simple healthy balanced diet, low in carbohydrates, moderate in fat and protein intake. Choosing to eat foods in their most natural form is the best choice!