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Diet and PCOS

Diet and PCOS

How can diet help with PCOS?

Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions amongst women and can put them at greater risk of heart disease due to glucose sensitivity and is also a leading cause of infertility.

Research has suggested that many women are not even aware they have the condition which may be due to misdiagnosis or a lack of awareness about PCOS. There is no cure for PCOS and whilst access to information about the disorder has become more freely available, many women still feel unsupported and confused about the best way to manage the condition.

What is PCOS?

This is a health problem that affects women of childbearing age and is considered to be the most common hormonal condition.  Women with PCOS have a hormonal imbalance and problems with their metabolism which can affect their overall health and appearance.

What causes PCOS?

Exactly what causes PCOS is not fully clear but the majority of experts believe that genetics have a role to play in the development of the condition.  PCOS is linked to abnormally high levels of androgens (hormones such as testosterone that regulate the development and maintenance of male traits in the body) which can prevent the ovulation every month and cause extra hair growth and acne.

The condition is also associated with high levels of insulin which is the hormone that helps to regulate blood sugar levels. Many women with PCOS are resistant to the activity of insulin and so their body compensates by producing more.  The effect of this is that it increases the production and activity of testosterone which exacerbates the symptoms associated with PCOS.  Being overweight or obese also increases the amount of insulin the body produces.

Who is affected by PCOS?

Estimates have suggested that the global prevalence of PCOS falls between 6% and 10%.  In the UK it has been estimated that around 1 in 10 women are affected by PCOS.  Prevalence in the US is thought to be similar to the UK although it could vary significantly by region.

US prevalence figures are tricky to gather effectively as a result of the conflicting criteria used to diagnose the condition.

In a study published in the American Journal of Obstetrics and Gynaecology  the authors concluded that women with PCOS are more likely to than those without PCOS to be 25-34 years old, be from the Southern States, be infertile, have metabolic syndrome and have been seen by an endocrinologist (1).

This same study estimated a much lower national prevalence in the US of just 1.6% but admitted that this was likely to be a significant underestimation given the retrospective nature of the study and the fact that PCOS is often undiagnosed.

What are the symptoms of PCOS?

Signs and symptoms of PCOS normally become apparent during late teens and early 20’s and include:

  • Irregular periods (or none at all)
  • Difficulty getting pregnant (due to irregular periods)
  • Excessive hair growth (hirsutism) on the face, chest, back or buttocks
  • Weight gain
  • Thinning hair or hair loss
  • Oily skin
  • Acne

How is PCOS diagnosed?

If any rare causes of the same symptoms of PCOS have been ruled out and you meet at least 2 of the following criteria, then a diagnosis of the condition is normally confirmed as being PCOS.

  • You have irregular or infrequent periods – indicating that your ovaries are not regularly releasing eggs (anovulation).
  • Blood tests indicate high levels of “male hormones” such as testosterone.
  • Scans indicate you have polycystic ovaries.

 How can you treat PCOS?

Fertility medications are available to help treat the symptoms of PCOS such as excessive hair growth, irregular periods and fertility problems.

Making changes to your diet and losing weight can also have a significant impact on the effects of the condition.

Losing weight may help to lower your blood glucose levels and improve the way your body reacts to insulin.  Just a 10% loss in body weight has been shown to improve the regularity of periods and chances of pregnancy in some women with PCOS.

What should women with PCOS be choosing to eat?

The two key ways that diet can help with PCOS is through weight management and blood sugar control (insulin production).  Managing insulin levels is the best way women with PCOS can use food to help manage their condition.

A few different diets are often recommended for PCOS and they all share a similar set of foods which are rich in fibre and protein to help balance out blood sugar levels and lessen the production of insulin.  These diets can also be used as a way of managing or losing weight and are all cardioprotective.

A low glycaemic index diet (GI)

Foods with a low GI are digested more slowly which means they do not cause insulin levels to spike in the same way as they do with other carbohydrate foods such as sugar.

Low GI foods include wholegrains, beans, pulses, lentils, fruits, vegetables, starchy vegetables (sweet potato, yam, corn), basmati rice, quinoa and dairy foods.  Some foods do not have a GI value but are also included such as meat, fish, nuts, oils, herbs and spices.

Many people recommend monitoring the glycaemic load of a food as unlike the GI this takes into account the amount of food eaten (portion size).

The anti-inflammatory diet

This is a balanced diet that includes foods that may help to quell inflammation such as berries, oily fish and extra virgin olive oil.  Many of these foods form a key part of the Mediterranean diet.

Foods that cause inflammation (these foods should be avoided or limited)

  • Refined carbs – sugar, white bread, pasta and pastries
  • Sugary drinks
  • Convenience foods such as chips, crackers and crisps
  • Red and processed meats
  • Spreads and oils rich in omega 6 such as margarine and vegetable oil
  • Alcohol

Foods that help to quell inflammation

  • Vegetables, especially dark green leafy vegetables
  • Fruits, especially deeply coloured varieties such as berries, grapes and cherries
  • Beans, pulses and lentils
  • Wholegrains and psuedograins such as barley and quinoa
  • Extra virgin olive oil
  • Nuts and seeds
  • Oily fish
  • Dried spices

The DASH diet (dietary approaches to stop hypertension)

This is a diet designed to reduce the impact of heart disease and as such is often recommended to women with PCOS who are at greater risk of the condition.  This diet is rich in fruits, vegetables, lean poultry, wholegrains and low-fat dairy produce whilst discouraging foods that are high in salt and saturated fat.

Adopting a healthy approach to the way you eat appears to be beneficial for women with PCOS.  Following an anti-inflammatory way of eating such as that illustrated by the Mediterranean diet is a good place for all women with PCOS to start.

References

  1. Okoroh EM, Hooper WC, Atrash HK, Yusuf HR, Boulet SL. Prevalence of polycystic ovary syndrome among the privately insured, United States, 2003-2008. Am J Obstet Gynecol. 2012;207(4):299.e1-299.e2997.
Summer breakfast salad – Eats and Cheats

Summer breakfast salad – Eats and Cheats

So this is a quick flash back of the cookery videos I recorded with Jackie Wicks.  I had the privilege of working with Jackie on the UK edition of the book.

This is one of the recipes taken from the Eats and Cheats cookbook.

I don’t actually have the recipe from this video but it showcases many of the basic elements to creating a really healthy meal.

The foundations of a salad are the greens so in the summer this may be salad leaves while in the winter you may want to use finely shredded raw kale or cabbage.  Once prepared, massage these leafy greens in olive oil for a few minutes to soften them slightly and make them more palatable raw.

Try and add a few more brightly coloured vegetables in your salad.  My favourites include finely sliced peppers, grated raw beetroot and carrot, and also raw red onion.

Pump up the protein in your salad by adding either lean meat, fish or poultry.  If you’re plant-based then opt for marinated tofu, beans, pulses or lentils.

You may also want to add a carb to give your salad more substance.  Stick to wholegrains (brown rice, pasta) or pseudo grains (quinoa, amaranth, buckwheat), the latter of which are actually seeds and richer in both protein and essential minerals such as magnesium.

Fresh and dried fruits add texture and sweetness to a salad.

Go large on fresh herbs – anything will do, just chuck them in!

Dressing wise – there are many great dressing recipes online.  I like to keep things simple by combining olive oil with lemon juice.  Other favourites include tahini or Asian flavours such as soy and ginger.  My one tips is that olive oil is not always the best oil to use for dressing that include many different flavours.  Good quality olive oil is quite bitter which is OK with lemon juice but can over power other dressings.  My alternative is a light olive oil or groundnut oil.

Does veganism fully live up to its reputation as a healthier and more environmentally friendly way of eating?

Does veganism fully live up to its reputation as a healthier and more environmentally friendly way of eating?

Does veganism fully live up to its reputation as a healthier and more environmentally friendly way of eating?

Even though I’m not a vegan, I try to adopt this way of eating a few days of the week.  Just to be clear, I’m pro-vegan and have always supported and recognised the health benefits of eating this way.  This blog is in no way about slating the vegan diet but an objective way for me to raise my concerns about the direction in which this way of eating seems to be heading.  I also want to talk about the topic of environment; whilst this is a key driver for many people adopting this way of eating the issues involved may not be that clear cut and there may be factors that some people have not considered. This is an opinion piece so feel free to get in touch with your views on the topic.

The benefits of plant-based eating

The common perceived persona of someone following a vegan diet is that they’re health conscious and dedicated to eating well, whilst being concerned about animal welfare and environmental issues.  Once stereotyped as sandal wearing hippies, the image of modern vegans has been redefined, which has been helped along by celebrities and sports people alike.

Research shows that a well-balanced vegan diet is more likely to contain a higher concentration of key nutrients including vitamins, minerals, fibre and phytonutrients.  It has also been shown that plant-based diets may reduce the risk of obesity, heart disease, high blood pressure, type 2 diabetes and digestive issues such as constipation. People who follow a plant-based diet also tend to adopt healthier lifestyle choices by exercising more, drinking less and not smoking.

One of the well versed concerns over veganism that drives me mad is that you cannot glean all the essential nutrients required for good health by cutting out meat, dairy and other animal products.  This concern is misplaced as it’s not the vegan diet that’s at fault here but how an individual’s diet is constructed.

Going vegan doesn’t necessarily equate to healthy eating

The lack of access to prepared vegan foods can be a barrier for people trying to stick with this diet, which has historically required a little more thought and preparation.  Whilst the common perception of veganism is that it’s a very healthy way of eating reserved for those dedicated to living a healthy lifestyle, this diet doesn’t exclude sugar, refined carbohydrates and fried foods, which have the potential to cause weight gain and increase the risk of disease.

Vegans are a healthier bunch all-round and typically make healthier food choices as well as leading healthier lifestyles but could the rise in popularity of this diet become it’s Achilles heel?

As veganism becomes more popular so has access to foods appropriate for this diet.  The positive here is that vegans have more access to ready-prepared foods that help to take the pressure off meal planning.  The downside is that innovation has given rise to the vegan junk-food revolution.  Trend reports over the recent years have predicted a rise in vegan junk food, which has the potential to even the playing field with respect to unhealthy eating between plant-based and omnivore diets.

Meat alternatives such as seitan and jack fruit (has a similar texture to pulled pork) are now being used to create kebabs, burgers, pies, tacos and even ‘fish and chips’, which are potentially no less healthy than their meat counterparts.  The food industry has also reacted to the popularity of veganism by producing a wealth of snacks, which are often high in sugar, salt and saturated fats.  Whilst these foods may make veganism more accessible, it does little to retain the reputation of this diet as being superiorly healthy.

Veganism and the environment

Concerns over the environment have always been a valid reason for many people to go vegan.  I have always used this as one of the key reasons to go vegan or eat this way a few days of the week when I write about this diet but reading around the topic recently got me thinking more deeply.

Seasonality can cause challenges to vegan eating as foods may become more limited during certain months. It’s all well and good eating a plant-based diet but if you’re eating tomatoes and other summer vegetables all year round then this will ramp up the carbon footprint of your shopping basket.

Meat production is undoubtedly one of the most damaging environmental factors given the release of methane gases and use of water involved in farming, but the production of plant foods also needs some consideration.  Like omnivores, many of us now expect to be able to access certain foods all year round, but the foods we choose to put in our weekly shopping baskets can take their toll on food mileage.  Vegan foods high in protein such as beans, pulses and lentils are mostly imported from Brazil, Canada and the US, whilst other popular vegetables used extensively in vegan cuisine such as avocados are flown in from Kenya and Mexico.

According to the Vegan Society, the UK has growing conditions that are suitable to producing plant proteins such as beans and pulses for direct human consumption, but it currently assigns only 16 per cent of its agricultural land to growingsuch crops, most of which are used to feed farmed animals.

The demand for on-trend vegan foods also impacts on the country from which they’re sourced.  The popularity of foods such as quinoa has driven their price so high that they’ve become unaffordable to those relying on them in their country of origin.  Social media has helped to drive the popularity of vegan eating and you will struggle to find a single vegan Instagram profile that doesn’t include an avocado.  I use this fruit as an example because they take their toll on the environment by requiring more water to cultivate than any other crop and the demand for this food has even led to extensive deforestation to farm more of them in countries such as Mexico.  The issue of plastic also exists no matter what diet you follow given its excess use in food packaging.

Finding a balance between locally sourced and imported foods

Whilst veganism is at its core healthy, it’s not exempt from many of the environmental concerns of any other diet. Sourcing local food and following the seasons harvest is a good way to reduce your carbon footprint but there also needs to be a balance to insure the welfare of the farmers, whose livelihood relies on exports of their food.  UK producers of foods such as quinoa, lentils and pulses are on the rise but including some imported foods as well as locally sourced can help to support all food producers globally.

I think what I’m getting at here in this blog is that whilst veganism may have a reputation for being healthy and helping to protect the environment, it’s not that clear cut.  The evolution of vegan junk food is set to continue and has the potential to threaten the health of vegans, although the impact may not be that great given the attitudes of most vegans towards health. It may be that the effect of these foods sees a rise in new vegans that find it easier to follow this type of diet with the availability of such convenience foods.  This new breed of vegan may also be defined by a very different health profile to their predecessors.  Putting meat to one side, there are also many other environmental considerations vegans share with omnivores, which need to be equally taken account of.

Whether you’re vegan or omnivore the basic principles of healthy eating still apply and the quality of your diet relies on the food choices you make whilst the responsibility to protect the environment is an issue that should be considered by everyone and not taken for granted just because you choose to follow a plant-based diet.

 

If you liked this blog and are interested in the topic of veganism then have a read of these:

Thinking of going dairy free?

The blokes guide to going vegan

Are you and your daughters lacking iron in the diet?

Foods high in zinc

Quorn, cauliflower and sultana curry recipe 

Supergreen stir-fry with smoked tofu recipe

Raw salad with black garlic dressing recipe

Nutty couscous and veggie salad recipe 

Edamame bean salad recipe