Polycystic ovary syndrome (PCOS) and Nutrition

The symptoms of PCOS are caused by imbalances in hormones and insulin resistance. What is insulin? Insulin is a hormone. It helps the body to use sugar as energy. What is insulin resistance? Insulin resistance happens when the body does not respond to insulin properly. When this happens, the body produces more insulin to compensate. This causes the level of insulin in the blood to become higher than normal. A high amount of insulin in the blood may make it a little harder to lose weight (however, weight loss is not impossible). It also increases the level of testosterone in the blood. Testosterone is a hormone which naturally occurs in small amounts in all women. But in people with PCOS, testosterone levels are higher than normal due to insulin resistance. High levels of testosterone in the blood cause symptoms of excess hair, irregular periods, acne, and difficulty in conceiving. Insulin resistance becomes worse when we gain weight, or are over weight. Body not responding to insulin properly Weight gain May encourage fat storage and increase cravings for sweet foods Insulin resistance can be made worse by: l Poor diet l Lack of exercise l Smoking l Carrying excess weight around your waist weight = insulin resistance = PCOS symptoms weight = insulin resistance = PCOS symptoms REMEMBER: Just losing 5% of your weight can improve symptoms of PCOS Body produces more insulin to compensate Higher levels of insulin in the blood More testosterone produced Symptoms: Excess hair, acne, irregular periods, difficulty in conceiving Insulin resistance can be improved by: l Losing weight l Regular exercise l Eating a healthy diet and following a regular meal pattern l Choosing lower GI foods where possible (see page 6) 1 2

Other health problems Having PCOS means that you are at higher risk of developing heart disease, diabetes and some forms of cancer. Losing weight and making simple changes to your lifestyle can reduce your risk. So what can I do to lose weight, manage my PCOS symptoms, and reduce my risk of developing other health problems? l Eat regularly - never skip meals. Aim to have 3 regular meals per day with low kcal snacks in between if required l Aim to have a small amount of starchy foods such as bread, potatoes, pasta, rice, breakfast cereals at every meal. Try to opt for low GI options where possible (see page 6) l Aim to eat 5 portions of fruit and vegetables per day l Drink plenty of low kcal fluids l Ensure portion sizes are appropriate l Limit high fat high sugar food and drink l Keep alcohol intake to a minimum as it is high in calories Don t forget exercise! There is a wealth of evidence to support the benefits of physical activity in people with PCOS including: helping to reduce insulin resistance, helping achieve weight loss, improving mood, protecting against developing diabetes and heart disease. If you don t do much exercise currently, remember - any exercise which is more than you would normally do is a great start. Low Glycaemic index (GI) Foods l GI is a measure of how quickly starchy carbohydrate (i.e. bread, potatoes, pasta, rice, grains, noodles, breakfast cereal) is broken down into sugar and absorbed by the body l A starchy carbohydrate that is classed as low GI means it is broken down into sugar slowly. This means your blood sugar levels are less likely to rise and fall sharply l Low GI does not mean that the food is low in calories or fat l Adding protein or fat to a carbohydrate will slow down its absorption e.g. adding tuna or beans to a baked potato (high GI) will result in a medium GI meal l All types of beans, lentils, chickpeas and pulses have a low GI l It is not necessary to limit any fruit and vegetables as long as you control your portion size l Limit sugary food and drink such as sweets, cake, sweet biscuits, fizzy drinks, chocolate etc l Pure fruit juices are high in natural sugar and are therefore high in GI. Drink no more than 1x small glass per day l Don t add sugar to hot drinks or food. Opt for sweeteners instead l Alcohol can increase blood sugar levels if drunk in large quantities. Sugary alcoholic drinks such as cocktails, or drinks with sugary mixers (fizzy pop, fruit juice etc) will increase blood sugars even in small amounts 3 4

Food OK Better Best Bread Potatoes Pasta Rice and other grains Noodles Breakfast cereal Milk and dairy Biscuits and crackers High fibre white Wholemeal White Bagels Baguette French fries* Mashed Baked/microwaved Instant Instant rice White/brown rice Millet Tapioca Semolina Rice crispies Cornflakes Weetabix Puffed wheat Coco pops Bran flakes Instant porridge, made with water Rice cakes Plain scone* *Foods high in calories therefore should be limited if you are trying to lose weight Pitta bread Croissant, plain* Crumpets Poppadum Rye bread New potatoes Potato crisps* Basmatic rice, white Cous cous Taco shells Gnocchi Rice noodles Special K Muesli Granola Ice cream* Ryvita Arrowroot biscuits* Plain scone Mixed grain e.g. granary/multigrain Pumpernickel Chapattis Fruit loaf/raisin bread Sourdough Sweet potato Yam Roast potato* Most pasta Ravioli, meat filled Basmatic rice, brown Bulgar wheat Pearl barley Quinoa Buckwheat Noodles Vermicelli All Bran Porridge oats made with milk Milk and soya milk Low fat yoghurt Full fat yoghurt* Rich tea biscuits Oatmeal biscuits Digestive biscuits* For more information regarding low GI foods, visit: www.glycemicindex.com Meal and Snack Ideas Use herbs and spices freely to flavour your food. These will not affect GI or calorie intake. Low GI Breakfast ideas: l Porridge made with semi skimmed milk l All bran with semi skimmed milk l 2x slices of toasted multigrain / pumpernickel / granary bread with low fat spread l Baked beans or poached eggs on 1x slices of toasted multigrain /pumpernickel / granary bread Low GI Midday meal ideas: l Jacket potato and salad with n Tuna mixed with low fat mayonaise n Baked beans l Baked beans on 2x slices of toasted multi-grain / pumpernickel / granary bread l Low fat soup made with beans or lentils with 2x slices of toasted multigrain / pumpernickel / granary bread l Tuna or chicken with salad and low fat salad dressing with 1x wholemeal pitta bread l Brown rice and dahl 5 6

Low GI evening meal ideas: l Fish or chicken with new potatoes or sweet potato and vegetables l Chicken or fish or sea food with brown pasta and tomato based pasta sauce with extra vegetables l Chilli con carne made with beans and vegetables (with or without meat) with brown rice l Stir fry chicken or fish with vegetables and noodles l Fish or chicken with brown rice and vegetables or salad l Brown rice OR chapattis with tomato based curry Low GI snack ideas:: l 2x rich tea biscuits l 1x toasted multi-grain/ pumpernickel/granary bread with low fat spread l 2x ryvita with: n Sliced boiled egg n Lean slice of cooked meat n Low fat houmous n Cottage cheese / low fat cheese spread l Low fat yoghurt l Small handful of unsalted nuts l 1x slice of fruit loaf or raisin bread with or without low fat spread l 1x portion of fruit: n 1 apple / 1 orange / 1 pear / 1 small banana / 1 peach n 2 plums / 2 kiwi n 7 strawberries n 10 grapes n 15 cherries n 1 inch slice of melon Please contact us on: Weight Management Dietitians 0161 206 1223 Weight Management Dietitians, Department of Nutrition and Dietetics, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD weightmanagement@srft.nhs.uk Weight Management Team 0161 206 6000 Weight Management Team, Salford Community Health, Sandringham House, Windsor Street, Salford, M5 4DG healthwise@salford.nhs.uk Useful websites Notes www.verity-pcos.org.uk www.nhs.uk/conditions/ Polycystic-ovarian-syndrome www.glycemicindex.com Pure fruit juice - limit to 1x small glass per day (approx. 150mls) 7 8

G15100201W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2015 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: CS64(15) Review Date: October 2017 For further information on this leaflet, it s references and sources used, please contact 0161 206 1223 Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Email: InterpretationandTrans@srft.nhs.uk Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on 0161 206 1779 Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone 0161 789 7373 www.srft.nhs.uk If you would like to become a Foundation Trust Member please visit: www.srft.nhs.uk/ for-members If you have any suggestions as to how this document could be improved in the future then please visit: http://www.srft.nhs.uk/ for-patients