What is polycystic ovary syndrome?
Polycystic ovary syndrome is an endocrine disorder (hormonal condition). Polycystic ovary syndrome develops when the ovaries produce excessive amounts of androgens (male hormones, similar to testosterone). This is characterised by higher than normal levels of insulin and male hormones and is the most common hormonal condition in the world for pre-menopausal women.
Researchers have proposed that the overproduction of androgens occurs with insulin resistance. A higher than normal level of insulin in the blood stream triggers the ovaries to produce more male hormones. This process leads to a number of symptoms that are experienced by individuals with PCOS e.g. acne, excessive hair growth (hirsuitism) or hair loss.
How does polycystic ovary syndrome affect the body?
Polycystic ovary syndrome encompasses a range of symptoms and is therefore different to those who suffer only from polycystic ovaries. It usually (but not always) results in the formation of tiny cysts on the ovaries – these cysts are actually eggs that have not been able to mature and release from the ovaries.
Image sourced from: eMedicineHealth
Polycystic ovary syndrome affects numerous domains of the body including:
- Reproductive system – Infertility or decreased fertility, irregular menstrual cycles, excessive production of male hormones
- Metabolic systems – Insulin resistance, increased risk of developing type 2 diabetes, gestational diabetes and cardiovascular disease
- Psychological wellbeing – Risk of anxiety, depression and reduced quality of life
Not all of the above complications will present for each individual. In fact, it is rare that any two women with PCOS will have the exact same symptoms. The below diagram illustrates the aetiology (cause) and clinical presentation of polycystic ovary syndrome.
Image sourced from The Medical Journal of Australia (1)
What is insulin resistance?
Insulin is a hormone produced by the pancreas. Its role is to regulate blood glucose levels. When you have insulin resistance, your body needs to produce more of it to manage the buildup of glucose in the blood stream. If not managed through diet, insulin resistance can increase your risk of lifestyle diseases such as diabetes (type 2 and gestational) and heart disease.
The diagram below demonstrates insulin resistance. As you can see, in the insulin resistant cell, a lot more glucose has remained in the blood stream instead of entering the cell. More insulin will then be produced to counteract the excess glucose in the blood – this is what causes polycystic ovary syndrome and other complications down the track. Image sourced from: pcospregnancy.net
Why does polycystic ovary syndrome promote weight gain?
Studies have shown that women with polycystic ovary syndrome have a lower basal metabolic rate (BMR) than those who do not have the condition. This affects how efficiently your body uses energy, even at rest. If your BMR it is lower, it will burn energy at a slower rate and therefore will more easily encourage weight gain. Exercise is one way to increase BMR.
How can diet help?
You can not cure polycystic ovary syndrome with diet but it can be very effective in managing symptoms. It is of particular importance to eat right as insulin resistance and obesity are commonly linked with PCOS and strongly influenced by diet. By managing your diet well, you can reduce the risk of lifestyle related disease developing later in life.
For individuals with polycystic ovary syndrome, diet plays an important role in weight loss. The benefits of losing some excess weight and falling within the healthy weight range include an increase in fertility and improvement of symptoms. This can occur even with a marginal loss of weight.
Interesting facts that research has shown (1):
• Weight loss of only 5 – 10% body weight can significantly reduce insulin resistance and PCOS symptoms
• A weight loss of over 5% in overweight individuals can reduce the risk of diabetes by up to 50 – 60%
What should I eat?
Unfortunately there is no definitive diet for polycystic ovary syndrome. However, it is known that a balanced diet that encourages a healthy weight and that focuses on stabilising blood glucose levels over the day is important. Use the following tips as a guide:
√ Making selections that are high fibre and low Glycaemic Index (GI) is important e.g. choosing wholegrain options where possible. This will make a big difference in the management of your blood glucose and insulin levels.
• See my blog articles about ‘Glycaemic index’ and ‘Increasing your fibre intake’ for more information.
√ Limit intake of high fat foods, particularly saturated and trans fat. This can be achieved by removing any visible fat on food, removing the skin on chicken, choosing lean cuts of meat, choosing fat reduced dairy options and limiting your intake of ‘discretionary’ foods e.g. hot chips, baked goods and chocolate.
• For more tips and information, see my blog on ‘Fat’.
√ Try and include as many vegetables as possible at lunch and dinner. As a guide, half of your plate should consist of a variety of vegetables and salad ingredients. The other half can be made up of ¼ protein (meat) and ¼ carbohydrate (rice, potato, pasta etc). Below is a visual guide.
Following this guide will control the quantity of carbohydrate rich foods you are consuming and the vegetables and meat (being low GI) will reduce the overall GI of the meal.
√ Instead of 3 large meals in a day, try eating smaller meals and snacks every few hours. This will prevent large spikes in your blood glucose and insulin levels and will keep them at a more steady level across the day.
√ Limit snacks and foods high in fat and sugar. Good snack foods include nuts, fat free yoghurt or a piece of fruit.
√ Don’t skip meals. This will slow the metabolism (encouraging weight gain) and increase fatigue. Additionally, it may be tough to meet all of your nutrient requirements if you skip 1 or more meals.
√ Limit alcohol and sugary drinks. These drinks can add a substantial amount of calories/ kilojoules to your daily energy intake and they provide no nutritional benefit. Water is best!
In general, you want to be eating lots of vegetables, 2 pieces of fruit, and moderate amounts of whole grains, fat reduced dairy and lean meats.
Contact us for results focused nutritional advice
This article about polycystic ovary syndrome was written by our dietitian Belinda Elwin who is a Dietitian Association of Australia member and Accredited Practising Dietitian.
If you have questions about healthy eating choices or PCOS, contact your local doctor who will arrange for you to see a nutritionist in Sydney. For healthy eating advice, Contact us today!
References
- Teede H, Misso M, Deeks A, Moran L, Stuckey B, Wong J, Norman R, Costello M. Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline. Medical Journal of Australia: 2011; 195 (6): 65. Available from: Medical Journal of Australia
- Polycystic Ovary Syndrome Association of Australia. What is PCOS?. Polycystic Ovary Syndrome Association of Australia. 2012. Available from: Polycystic Ovary Syndrome Association of Australia Inc (POSAA)
To find out more about recommended nutritional requirements, click here:
Healthy eating for adults – National Health and Medical Research Council
