Eating a PCOS diet is actually straightforward: 13 tips from a doctor

From Cosmopolitan

PCOS - polycystic ovary syndrome - is one of the most common hormonal disorders for women. But did you know that you can improve symptoms by following a PCOS diet?

According to the research, 5 to 10% of women have PCOS, although one in five may have polycystic ovaries (me included!).

Why is it important to distinguish between having PCOS and having polycystic ovaries, you ask? Mr John Butler, consultant gynaecological surgeon at The London Clinic, explains: “Having polycystic ovaries (PCO) means, during ultrasound, you can see multiple cysts on your ovaries. This is common and normal. Polycystic ovarian syndrome (PCOS), on the other hand, is a condition affecting some women with PCO. Symptoms include a hormone imbalance which can result in excess hair growth, skin changes including acne or weight gain, and irregular periods," he explains.

New research has even linked PCOS with an increased risk of developing mental health conditions, like depression and anxiety.

What do I do if I think I have PCOS?

No matter how severe your symptoms, (as above, excess hair, acne, irregular or absent periods and weight gain), it can be really hard to know what to do next.

First things first—always visit a doctor for a medical opinion. They'll be able to professionally advise on the best course of action.

It's also important to remember that although PCOS is related to your hormone levels, and insulin production, it's not your 'fault' if you have it. The symptoms can sometimes, however, be managed - and hopefully improved - through following a PCOS diet and exercise.

PCOS and weight loss (or gain) is also a bit of a catch 22. It can be linked to insulin resistance, which can lead to weight gain, and then because excess body fat causes the body to produce even more insulin, this can make PCOS symptoms worse, creating a vicious cycle.

But information online is totally overwhelming when it comes to PCOS diets. Is losing weight the answer? Should you totally ditch all foods that raise your blood sugar? Will exercise help?

If you are overweight, with a BMI of over 25, Mr John Butler, Consultant Gynaecological Surgeon at The London Clinic advises that "even a small reduction in weight can significantly improve symptoms, including a low mood or depression (which is often a symptom of PCOS)".

"Generally, you want to focus on 'being healthy' – so try to consume lots of fruit and veg, avoid high GI food, take regular meals so your blood sugar levels aren't going up and down too much, try to do 30 minutes of exercise a day, and stop smoking".

"Polycystic ovarian syndrome is your body's way of saying you can't handle high sugar levels - so your diet is a chance to really change things – and this can help you in your later life, pre-menopause and before and during pregnancy. By keeping your weight stable, your pregnancy is likely to be more straightforward health wise".

Daria Tiesler, a registered nutritional therapist, personal trainer and performance coach at Ultimate Performance Mayfair, regularly trains clients with PCOS, and agrees that diet and exercise can really help with managing the condition.

Here are seven ways she advises her clients to overhaul their lifestyle.

Foods to include in a PCOS diet

Daria advises veering away from fad diets, and eating with a focus to fuelling your body, managing stress and balancing your hormones. For her clients, the key is to address insulin resistance and to reduce cortisol (stress hormone) levels by packing their diet with anti-inflammatory foods.

On her shopping list are lots of leafy green vegetables, blueberries, pineapples and a focus on whole foods and sources of protein like fish, eggs and chicken breast, and good fats like nuts and avocado.

Daria's also a big fan of spices like turmeric, cinnamon, fenugreek, and ginger, that are anti-inflammatory and believed to help with insulin resistance.

One of Daria's favourite foods for balancing hormones is flaxseed, which is rich in fibre and Omega 3s. She tells her clients to eat two tablespoons per day in on salads, or sprinkled on porridge or in smoothies.

How to lose weight with PCOS

Reducing foods in your diet that cause spikes in blood sugar is crucial to managing your PCOS, and ultimately not suffering from PCOS weight gain. If you've already gained a few pounds and are looking to lose weight, opting for wholegrain sources of carbohydrates over anything with a high GI could help.

Daria advises reducing your consumption of white pasta, white rice, and anything super-processed (including processed meats).

Daria also suggests swapping fruit drinks and smoothies for whole fruit, because they contain more fibre, which is vital for a healthy gut - "most of the ladies I train have problems with gut function", Daria says. Fruits low in fructose are best, like grapefruits, clementines, lime, lemon, raspberries, blackberries and strawberries.

What to eat for breakfast if you have PCOS

"Start with breakfast" Daria says "Don’t leave home with an empty stomach and then grab a sandwich at 12. So many of my clients skip breakfast or have coffee and a croissant - and their bodies struggle to process it".

Try something like eggs, salmon and spinach, or a smoothie with vegan protein, a blend of berries, cinnamon and avocado. Just make sure whatever you're eating stabilises your blood sugar by including protein and fats as well as low GI carbs.

How to include healthy fats in a PCOS diet

Many of Daria's clients with PCOS are scared of fats because they don't want to put on weight, but increasing healthy fats in your diet is a great way to keep you satiated, and can help your body absorb vitamins A, D, E, K and help with healthy female hormone levels.

Just as a reminder, healthy fats mean foods like avocado, salmon, mackerel, sardines butter, and olive oil (free range or organic if possible).

What about a PCOS diet and carbohydrates?

Reducing or "cutting" out processed and high GI carbs is an important part of any PCOS diet, but because everyone is different we need to personalise the amount of complex carbohydrates from fruits , vegetables and pulses - and there is no need to ditch them entirely. Those foods are a great source of phytonutrients, vitamins and minerals as well as fibre.

Daria recommends experimenting. Try removing the processed carbs from your diet, while keeping whole foods, like pulses, lentils and beans in there and seeing how you feel. At the end of the day, a bit of trial and error might be needed to find what works for you.

"For most, a PCOS diet should be a macronutrient split of around 20 percent complex carbs, 40 percent protein and 40 percent fat for my clients" Daria says "but I switch it around and get constant feedback from them as to whether it's working or not for each client".

How do stress and other factors affect PCOS?

In a body that's struggling to balance hormones, the last thing you need are factors in your life that cause more hormonal imbalances, like stress and lack of sleep. Daria advises avoiding 'hormonal disrupters' like plastic bottle and containers that contain BPAs, but also looking at the bigger picture of how stressed out you are day-to-day.

"Review the stress in your life - I train 8 to 10 girls at any one time with PCOS, and many of them are super strong on the outside, but totally stressed on the inside" Daria says.

"Make sure you are getting enough sleep, and good quality sleep, too. I also recommend journalling or breathing techniques to help with relaxation."

If you are going all in with the PCOS diet and lifestyle choices, Daria also advises avoiding stimulants, aka coffee – after 2pm, and swapping it for spearmint tea and green tea. Mainly because a high caffeine intake is going to give you the energy crashes you're trying to avoid and can affect the quality of your sleep, but also because coffee removes magnesium from the body - and magnesium helps the body metabolise carbs, so is pretty vital.

What exercise should I do if I have PCOS?

So, you've got the PCOS diet down. But what about exercise? Daria is a huge advocate for resistance training with weights for women with PCOS. "My first goal with my clients is to manage their insulin resistance - my second is to increase their muscle mass" says Daria, "because the more muscle mass you have means you can better metabolise glucose and can handle carbs better".

Daria uses a mix of weight training with HIIT (high intensity interval training) and LISS (Low intensity steady state cardio, like walking) on her clients. But the key is to make sure whatever exercise you're doing is not too stressful on the body - because over-exercising is not good for your hormonal balance, either.

Often clients will come to Daria and they have previously been doing lots and lots of cardio, along with prolonged low calorie and low fat diets, which she would change to 2 to 3 weight training sessions a week for around 45 to 60 mins, coupled with some swimming, walking or yoga.

Of course, every body tolerates exercise differently, so for women who are better with stress management, Daria also uses HIIT workouts.

Also, Daria notes to not become too obsessed with the number on the scale - many of her clients won't lose huge amounts of weight doing resistance training, but they will become fitter and totally change their body composition, which has a knock-on effect on their health.

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