Polycystic ovarian syndrome, also known as PCOS, has been a common problem that I have come across here in the Middle East. It affects women of reproductive age (between late adolescence & menopause) and is characterised by a combination of problems:
- Irregular periods (usually less frequent)
- Acne
- Excess body or facial hair
- Obesity – most commonly abdominal obesity
- High insulin levels
The cause remains unclear as to why women may develop PCOS but it could be a mixture of both environmental and genetic factors. PCOS can run in families where there is often a history of type 2 diabetes. Lifestyle factors include unhealthy eating (i.e. high intake of fats, processed foods and refined sugars) & lack of physical activity. One factor that is quite common in women with PCOS is the abnormal functioning of insulin, where insulin levels in the blood become high. Insulin resistance usually develops where the body does not respond appropriately to insulin and in order to compensate for the resistance, the body produces more insulin.
Diagnosis of PCOS includes obtaining a thorough medical history, an ultrasound and a blood test that measures hormone levels in the blood. Confirmation of a diagnosis requires the following characteristics:
- Polycystic ovaries found on an ultrasound of the ovaries.
- Irregular and often infrequent periods. When they do occur, they may be very heavy or painful.
- Increased male hormone production. Normally, the ovaries produce large amounts of the female hormone oestrogen & lesser amounts of the male hormone testosterone. In PCOS, testosterone levels are often mildly increased. The effects of the male hormones is usually noticed on the skin such as acne and excess body hair.
The following are a list of symptoms experienced by women diagnosed with PCOS:
- Acne
- Excess body or facial hair
- Unexplained fatigue
- Low blood glucose levels (hypoglycaemia after meals, which causes sweating, a lightheaded feeling, sudden fatigue or butterflies in the tummy)
- Excess weight (body fat) around the waist
- Infertility
- Mood swings
Not all women will experience all symptoms. Improving your diet and exercise program by making lifestyle changes may reduce your risk for developing chronic diseases associated with PCOS such as diabetes, heart disease and endometrial cancer.
What would treatment include?
Management of PCOS involves a number of factors which include medication and lifestyle changes. The medication that may be prescribed by a doctor is metformin (glucophage) which helps increase insulin sensitivity. It works by reducing the amount of glucose produced by the liver and increasing the ability of body cells to absorb glucose.
Is there a special diet for PCOS?
Currently there is no scientific evidence to support one particular diet for PCOS. Evidence-based recommendations suggest that women with PCOS should focus on balance and moderation. This also includes Low GI carbohydrates which help maintain blood sugar control. The key lifestyle changes to embark on are the following:
- Weight loss of 5-10% if overweight in 3 months.
- Decreased caloric intake if weight loss is desired.
- Decreased intake of enriched carbohydrates (focus more on complex carbohydrates).
- Increased fiber intake including fruits, vegetables, and beans.
- Decreased fat intake, particularly saturated and trans fat.
- Small, more frequent meals (every 3-4 hours) to help control blood glucose levels.
- High activity levels – ideally, 4 to 5 times per week of moderate to vigorous activity for one hour.
Dietary tips for managing PCOS
Consume a wide variety of whole foods
- Foods in their most natural form (fresh, frozen, or dried).
- Fruits, vegetables, beans, legumes, whole grains, fish, lean meats, nuts, and seeds should be eaten daily.
Limit sugars and enriched carbohydrates – Focus on LOW GI carbohydrate:
- Complex carbohydrates take longer than enriched carbohydrates to digest and absorb. These carbohydrates are known as Low GI carbohydrates.
- Choose whole grains instead of enriched grains (brown rice, whole wheat breads and pasta, oats, barley, etc.). Look for the word “whole” as the first ingredient on the Nutrition Facts Label.
- Choose the following fruits: Apples, Pears, Oranges, Plums, Peaches, Kiwi fruit, Strawberries, Berries, Plums
- Incorporate starchy vegetables such as sweet potatoes and corn.
- Include legumes such as kidney beans, lentils, chickpeas and soybeans.
- See your Dietitian to calculate the appropriate number of carbohydrate servings you need per day
Limit salt intake
- Use lemon juice, mustard, vinegar, pepper, herbs and spices instead of table salt to season foods.
- Limit foods such as cured and smoked meats, salted nuts, canned and processed vegetables, meats, marinades and sauces.
- Minimize intake of processed foods.
Choose unsaturated fat:
- Avoid saturated fats by choosing low fat or fat free dairy products and spreads, white meat and fish, and lean cuts of red meat.
- Look for unsaturated oils such as olive, sunflower, or canola oils.
- Use nuts rich in monounsaturated and polyunsaturated fats such as almonds, walnuts, pecans, flax seeds, sunflower and pumpkin seeds.
- Eat fish three times a week. Fish such as tuna, salmon, herring, sardines, and trout can improve heart health.
- Bake, grill, broil, boil, steam and microwave foods instead of frying them.
If you do suspect that you may have PCOS, please see your local GP or gynaecologist. As mentioned, dietary intervention can help you get your lifestyle on track in order to make sure your blood sugar levels are stable, your body composition is within target and overall, to help you feel good from the inside and out!
Secondly, despite the fact that losing your belly fat is the most important part but that does not indicates you should be going on crush diets which is starvation. Metabolism rate goes down and body fat will probably be stored as backup for energy. Anyway, going on crush diet is really unhealthy and your body will probably be weaker and deficiency of vitamins occur.