Polycystic ovary syndrome (PCOS) and Nutrition Community Weight Management Team © G15100201W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015. Document for issue as handout. Unique Identifier: CS64(15). Review date: October 2017 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. 1 Body not responding to insulin properly Body produces more insulin to compensate Weight gain Higher levels of insulin in the blood May encourage fat storage and increase cravings for sweet foods More testosterone produced Symptoms: Excess hair, acne, irregular periods, difficulty in conceiving weight = insulin resistance = PCOS symptoms weight = insulin resistance = PCOS symptoms Insulin resistance can be made worse by: Insulin resistance can be improved by: l Poor diet l Regular exercise l Lack of exercise lSmoking l Eating a healthy diet and following a regular meal pattern l Carrying excess weight around your waist l Choosing lower GI foods where possible (see page 6) l Losing weight REMEMBER: Just losing 5% of your weight can improve symptoms of PCOS © G15100201W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015. Document for issue as handout. Unique Identifier: CS64(15). Review date: October 2017 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 3 Low Glycaemic index (GI) Foods 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. 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 All types of beans, lentils, chickpeas and pulses have a low GI 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 Limit sugary food and drink such as sweets, cake, sweet biscuits, fizzy drinks, chocolate etc l It is not necessary to limit any fruit and vegetables as long as you control your portion size 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 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 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 © G15100201W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015. Document for issue as handout. Unique Identifier: CS64(15). Review date: October 2017 4 *Foods high in calories therefore should be limited if you are trying to lose weight Food OK Better Best Bread High fibre white Wholemeal White Bagels Baguette Pitta bread Croissant, plain* Crumpets Poppadum Rye bread Mixed grain e.g. granary/multigrain Pumpernickel Chapattis Fruit loaf/Raisin bread Sourdough French fries* Mashed Baked/microwaved Instant New potatoes Potato crisps* Sweet potato Yam Roast potato* Potatoes Pasta Rice and other grains Instant rice White/brown rice Millet Tapioca Semolina Noodles Basmatic rice, white Cous cous Taco shells Gnocchi Rice noodles Breakfast cereal Rice crispies Special K Muesli Cornflakes Granola Weetabix Puffed wheat Coco pops Bran flakes Instant porridge, made with water Ice cream* Milk and dairy Biscuits and crackers Rice cakes Plain scone* Ryvita Arrowroot biscuits* Plain scone Most pasta Ravioli, meat filled Basmatic rice, brown Bulgar wheat Pearl barley Quinoa Buckwheat Noodles Vermicelli All Bran Porridge oats made with milk Meal and Snack Ideas Low GI Midday meal ideas: Use herbs and spices freely to flavour your food. These will not affect GI or calorie intake. lJacket potato and salad with nTuna mixed with low fat mayonaise nBaked beans Low GI Breakfast ideas: lBaked beans on 2x slices of toasted multi-grain / pumpernickel / granary bread lPorridge made with semi skimmed milk lLow fat soup made with beans or lentils with 2x slices of toasted multigrain / pumpernickel / granary bread lAll bran with semi skimmed milk l2x slices of toasted multigrain / pumpernickel / granary bread with low fat spread lBaked beans or poached eggs on 1x slices of toasted multigrain /pumpernickel / granary bread lTuna or chicken with salad and low fat salad dressing with 1x wholemeal pitta bread lBrown rice and dahl 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 5 © G15100201W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015. Document for issue as handout. Unique Identifier: CS64(15). Review date: October 2017 6 Low GI evening meal ideas: Low GI snack ideas:: Please contact us on: lFish or chicken with new potatoes or sweet potato and vegetables l2x rich tea biscuits Weight Management Dietitians lChicken or fish or sea food with brown pasta and tomato based pasta sauce with extra vegetables lChilli con carne made with beans and vegetables (with or without meat) with brown rice lStir fry chicken or fish with vegetables and noodles l1x toasted multi-grain/ pumpernickel/granary bread with low fat spread l2x ryvita with: nSliced boiled egg nLean slice of cooked meat nLow fat houmous nCottage cheese / low fat cheese spread lLow fat yoghurt l Small handful of unsalted nuts lFish or chicken with brown rice and vegetables or salad l1x slice of fruit loaf or raisin bread with or without low fat spread lBrown rice OR chapattis with tomato based curry l1x portion of fruit: n1 apple / 1 orange / 1 pear / 1 small banana / 1 peach n2 plums / 2 kiwi Useful websites 0161 206 1223 Weight Management Dietitians, Department of Nutrition and Dietetics, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD www.verity-pcos.org.uk www.nhs.uk/Conditions/ Polycystic-ovarian-syndrome www.glycemicindex.com Notes 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 n7 strawberries n10 grapes n15 cherries n1 inch slice of melon Pure fruit juice - limit to 1x small glass per day (approx. 150mls) 7 © G15100201W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2015. Document for issue as handout. Unique Identifier: CS64(15). Review date: October 2017 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 If you need this interpreting please telephone Copies of this information are available in other languages and formats upon request. 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. 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