Insulin resistance is the underlying problem in PCOS. Insulin is a hormone, produced in the body by the pancreas, which helps to regulate blood glucose levels. When you have insulin resistance, your muscles and cells are resistant to the effects of insulin so the body needs to produce increasing amounts of this hormone to keep the blood glucose levels under control. These high levels of insulin act on the ovaries to cause increased production of male hormones, which disrupts the normal ovulation cycle and causes many of the symptoms of PCOS.
The good news is that improving insulin resistance through lifestyle changes, including diet, exercise and modest weight loss (around 5-10% of your weight), can significantly improve all or most of the symptoms associated with PCOS, by reducing male hormone levels and restoring ovulation. This will also help to reduce the risk of gestational diabetes (diabetes in pregnancy) and the long-term risks of diabetes and heart disease, which are more common in women with PCOS. Medication may also be needed but is only effective if used in combination with lifestyle changes.
A healthy PCOS eating plan should focus on lowering insulin levels and improving the body’s sensitivity to insulin, while also helping with weight loss if you are carrying extra weight. This can be achieved by:
• Eating small regular meals and snacks across the day and avoiding eating big meals to prevent large rises in blood glucose and insulin levels.
• Balancing your plate at meals with half non-starchy vegetables and salads, one-quarter lean protein and one quarter low GI high fibre carbs including wholegrains, legumes and starchy vegetables
• Choosing healthy fats from foods such as nuts, seeds, avocado, extra-virgin olive oil and fish, and limiting intake of saturated and trans fats by choosing lean meats & poultry, eating more fish and legumes, and avoiding high fat snack foods and fast foods.
• Basing meals around high-fibre, low GI carbohydrate foods including dense wholegrain bread, traditional rolled oats, barley, freekeh, quinoa and legumes (eg lentils, chickpeas, dried beans) and avoiding more processed grain foods including white bread, puffed/flaked breakfast cereals, most cracker biscuits and many snack foods.
• Choosing nutrient-dense snacks including fresh fruit, natural yoghurt with berries, a handful of raw nuts or hummus with raw vegetables in place of high fat/high sugar snack foods.
Restrictive diets and rapid weight loss are not appropriate if you are trying to conceive.
For best results, you healthy eating plan should be combined with regular exercise, and other lifestyle changes including adequate sleep and managing stress levels.
Consider seeing an Accredited Practising Dietitian who specialises in the dietary management of PCOS who will be able to help in to develop an eating plan to suit your individual needs. To find an APD in your area visit the Dietitians Association of Australia (DAA) website www.daa.asn.au and look under ‘Find an APD’. An endocrinologist can help you with the medical management of your PCOS.
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