PCOS: Nutrition Basics

Diet and exercise are important parts of managing PCOS (Polycystic Ovary Syndrome). This is because young women with PCOS often have higher levels of the hormone insulin in their blood, and many have trouble maintaining a weight that will help them meet their physical health potential. Knowing the right types of foods to eat as well as the kinds of food to limit can improve the way you feel and may help you meet your body’s intended weight. Eating well, staying active, and maintaining your weight (or losing even a small amount of weight if appropriate for your body) can improve PCOS symptoms.

What do I need to know about insulin and carbohydrates?

The insulin level in your blood goes up after you eat. It goes up the most after you eat or drink something that contains carbohydrates. Carbohydrates are found in grains (such as bread, pasta, rice, and cereal), most snack foods (such as chips, cookies, and candy), sugary drinks such as soda and juice, and fruits and vegetables.

Are all carbohydrates the same?

No. Even if you eat two foods that have the same amount of carbohydrate, they may have a different effect on your insulin level. This effect has a lot to do with the type of carbohydrate in the food. Carbohydrate foods with fiber such as whole grains, fruits, and vegetables are usually the best to eat if you’re trying to keep your insulin level down. Carbohydrate foods that are sugary or refined (such as soda, juice, white bread, and white rice) can cause insulin levels to go up higher. Foods and drinks like this are also not very filling, which means you may feel hungry shortly after eating them. Try to choose high–fiber, low–sugar carbohydrate foods most of the time.

Do I need to buy special foods?

No. You don’t need to go out of your way to buy special foods. Just like with any healthy eating plan, your meals should include a balance of vegetables, fruits, whole grains, plant–based protein, lean meats, and healthy fats. Most foods fit into a healthy eating plan for PCOS, but you should read food labels to help you pick out the healthier choices. Look for high–fiber grains such as brown rice, whole–wheat pasta, and whole–wheat bread rather than low–fiber grains such as white rice, pasta, or white bread.

Don’t be fooled by fat–free treats. They usually have a lot of added sugar. Also, some sugar–free foods (such as baked goods) are made with refined grains such as white flour and can raise your insulin levels the same way that sugar can. Other sugar–free foods are carbohydrate free. These foods, sweetened with artificial sweetener, may be a good alternative if they don’t upset your stomach. There is currently no scientific data that suggests moderate amounts of artificial sweetener are harmful to our health. However, these foods and drinks are processed. Try to stick to the most natural, whole form of each food (ie, lemon sliced in water instead of diet lemonade).

Try these healthy food “swaps” if you’re looking for alternatives to refined carbohydrates.

Instead of:

• Sweetened juice, canned fruit in heavy syrup, or sweetened applesauce
• Starchy vegetables such as potatoes, corn, and peas
• Refined grains made with white flour such as white bread and pasta, bagels, or white rice
  Sugared cereals such as Lucky Charms®, Fruit Loops®, or Frosted Flakes®, and other sweetened grains such as cereal bars (Nutrigrain Bars®), breakfast pastries (PopTarts®), and donuts
• Sugary drinks such as soda or juice
• Sugary foods such as cookies, cakes, and candy
• Snacks such as potato chips, Fritos®, Doritos®, and tortilla chips

Choose:

• Fresh fruits or frozen/canned fruit without added sugar, or unsweetened applesauce
• Non–starchy fresh vegetables or frozen/canned vegetables such as broccoli, spinach, tomato, mushroom, peppers, and carrots
• Whole grains such as whole wheat pasta, brown rice, oats, quinoa, and whole wheat bread
• High fiber cereals such as Kashi®, shredded wheat, and All Bran®. (Look for cereals that have at least 5 grams of fiber per serving or sprinkle ½ cup of bran cereal or unprocessed bran on a low–fiber cereal to increase the fiber)
• Water or seltzer, flavored with fruit if desired, unsweetened iced tea
• High fiber baked goods made from whole wheat flour and oats
• Crackers and snacks with fiber such as Triscuits®, Wasa®, or popcorn

Are “carbs” unhealthy?

No! Carbs (carbohydrates) give your body energy. Some people think that eating carbs will make them gain weight, but carbs are essential to a balanced diet. Many other important nutrients like vitamins and minerals come from carbohydrate foods, so cutting out carbs completely is not a good idea. Because high–fiber carbohydrate foods are higher in nutrients and help you feel full longer than sugary low-fiber carbohydrates, it’s best to choose high-fiber carbs as often as possible. If you think you’re eating more carbohydrates than your body needs, try to check in to see if the carbohydrate is taking up more than ¼ of your plate and then reduce your appropriate serving size based on your hunger and fullness if it is much larger than that.

What about foods that have fats and proteins in them?

Protein foods such as beans, hummus, nuts, peanut butter, tofu, eggs, fish, chicken, meat, and vegetarian meat substitutes, and fats such as olive oil, nuts, and avocado are an important part of a PCOS–friendly eating plan. Combining foods that contain protein and/or fat with a carbohydrate will help to slow down the absorption of the carbohydrate and keep insulin levels low. For example, instead of plain rice, have rice with beans and a little avocado.

Keep in mind that some fats are much healthier than others. Healthy fats, also referred to as unsaturated fats, are found in olive oil, canola oil, nuts, avocados, and fish. Try to incorporate healthy unsaturated fats and proteins as alternatives to butter, margarine, mayonnaise, full–fat cheese, creamy sauces or dressings, and red meat.

Do I need to follow a diet that is extra high in protein?

No. Extremely high protein diets (such as the Atkins, Paleo, or Ketogenic diet) are not a good diet option for teens because they can be low in some important nutrients such as fiber, the B vitamins, and vitamin C. It’s also important to remember that even if you limit your carbohydrate intake, overeating fat or protein can cause unintentional weight gain. You should aim for a way of eating that has a balance of protein, high-fiber carbohydrates, and some fat.

What does low glycemic index mean?

Glycemic index is a term used to describe how a food affects blood sugar. The higher a food raises blood sugar, the higher the glycemic index. High–fiber carbs have a lower glycemic index than sugary or refined carbs. Combining a carbohydrate food with another food can lower the glycemic index because it allows your body to absorb the carbohydrate more slowly. For example, if you have a cupcake immediately after a meal it will not raise your blood sugar as high as it would if you ate the cupcake on its own an hour or two after a meal.

What fruits and vegetables have a low glycemic index?

Vegetables such as asparagus, broccoli, carrots, cauliflower, celery, cucumber, green beans, spinach, tomatoes, and zucchini and fruits such as apples, berries, grapes, oranges, peaches, and plums have a low glycemic index. Fruits and vegetables with more sugar or starch have a higher glycemic index (such as dried fruit, tropical fruit, corn, potatoes, squash, and peas).

Should I avoid dairy, sugar, gluten, or soy?

There is no current scientific data to support restricting or avoiding specific food groups or types of foods in order to improve PCOS symptoms. Following the dietary advice presented here, in addition to exercising, are healthy ways to manage weight and decrease symptoms.

If I choose the right foods, do I still need to be worried about the amount of food I eat?

Yes; in addition to what you eat, how much you eat also affects your insulin levels. For example, your insulin will go up much more if you have 3 cups of pasta than if you have 1 cup of pasta, even if the pasta is whole grain. This means it’s usually better to have several small meals and snacks during the day than it is to have a few really big meals. Having more frequent smaller meals and snacks will keep your insulin level lower throughout the day.

What is the Nutrition Facts label?

The Nutrition Facts label explains what nutrients (components of food your body needs to grow and stay healthy) and how much of those nutrients are in found in one serving of the food. It’s located on the outside of most food packages, but isn’t on most fresh foods (such as fruits and vegetables or meats). The Nutrition Facts label can help you make choices about the food you eat.

What will every Nutrition Facts label have on it?

The label will have some or all of the following nutrients listed:

• Serving Size: Serving size equals one serving of the product. All the other nutrient values listed on the label are based on this amount.
• Servings per Container: This number is how many servings you can get from one package. Some containers have a single serving, but most have more than one serving per package. If you eat more than one serving, all of the rest of the information on the label needs to be multiplied by the number of servings you consume.
• Calories (total): Calories are a unit of energy that comes from carbohydrates, protein and fat. Calories give us energy so we can think and be active.
• Calories from Fat: This number is the amount of calories that comes from fat. It’s not the percent of fat in the food.
• % Daily Value: This value is the percentage of the recommended daily value for a nutrient that you get in one serving. A food that has more than 20% of the Daily Value of a nutrient is an excellent source; however, for some nutrients such as fat, sodium, and cholesterol, the lower the percent, the better.
• Total Fat:Fat is essential for our bodies. There are 4 kinds of fat. Monounsaturated and polyunsaturated fat are the kinds of fat that are healthy for the heart.
• Trans Fat: Trans fat is unhealthy for your heart, and should be avoided.
• Cholesterol:Cholesterol is a substance found only in animal products. Eating too much cholesterol is not healthy for your heart. Some cholesterol is formed naturally inside your body.
• Sodium:Sodium is the amount of salt in the serving of food. People with high blood pressure are often told to follow a low sodium diet. Processed foods, even though that might not taste salty, are often high in sodium.
• Total Carbohydrate: Carbohydrates give your muscles and brain energy. Certain types of carbohydrates are sometimes listed on the label.
• Dietary Fiber: Helps with digestion and keeps you full between meals.
• Sugars: Are important for instant energy, but eating too much added sugar can be unhealthy. Soon the Nutrition Facts label will list naturally-occurring sugar (such as the lactose in milk) separately from added sugar (such as the chocolate in chocolate milk).
• Protein: This nutrient is used to build muscle and fight infections.
• Vitamins and Minerals (A, C, Calcium, Iron): This amount is the percent  (%) Daily Value for vitamin A, vitamin C, calcium, and iron you are getting from a serving of this product. Other vitamins and minerals may be included in this section.

Other nutrients, such as polyunsaturated or monounsaturated fat and other vitamins and minerals, can also be put on the Nutrition Facts label if the company that makes the food wants them listed.

Ingredients are often listed either underneath or nearby the Nutrition Facts label on a product. The ingredients are listed by weight, meaning that the first ingredient listed is the one that is found in the highest quantity in that product. When you’re checking to see if a product is made from whole grains, you want to make sure that the word “whole” or the type of whole grain (such as oats or quinoa) is listed as the first ingredient. Sometimes for marketing purposes a company will list that a product “contains whole grains” but when you look at the ingredient list it is actually not the first ingredient.

What should I look for on the Nutrition Facts label?

The first thing you should look at is the serving size. The amount of each nutrient on the label is what’s found in one serving of that food, not in the whole container. If you don’t know what one serving size is, you won’t know the amount of each nutrient you’re actually getting. For example, a large bag of microwave popcorn has three servings in it. It’s okay to eat more than one serving at a time, but it’s important to know that if you eat the whole bag, you’d be getting three times what’s listed on the label. Eating when you’re hungry and stopping when your full is an important part of healthy eating for PCOS, so keep that in mind.

Do I need to read every Nutrition Facts label?

No. You don’t need to keep track of every nutrient you are eating. Just take a look at Nutrition Facts labels once in a while to help you make healthy choices and choose foods that will give your body the nutrition it needs. For example, if you don’t drink much milk, you should read Nutrition Facts labels to help you find other foods and drinks that are high in calcium. You can also use the Nutrition Facts label to compare two different foods. For example, if you are deciding between two different kinds of bread, reading the Nutrition Facts labels can help you make the healthier choice by choosing the bread that has the highest amount of fiber and least amount of added sugar.

The Nutrition Facts label lists a 2000-calorie diet. Should I be eating 2000 calories?

It’s possible that a 2000-calorie diet may be right for you, but many adolescents need more than 2000 calories as they grow in height, build bones, build muscles, and stay active, and some may need slightly less. The 2000–calorie diet is just an estimate and is used to help calculate the Percent (%) Daily Value listed on the Nutrition Facts label.

Is it important for me to exercise?

Yes! It’s really important that girls and young women with PCOS are physically active, because exercise brings down insulin levels, can help with weight management, is important for cardiovascular health, and can help improve mood. Exercise can be especially helpful in lowering insulin directly after a meal. So, if possible, go for a walk or find an enjoyable way to move your body after you eat a meal. Any increase in activity helps, so find some movement, sport, or exercise that you enjoy. If you aren’t doing a lot of exercise now, start slowly, and build up to your fitness goal. If you only exercise once in a while, try to exercise more regularly. Work towards increasing your physical activity to at least 5 days a week for 60 minutes per day.