health
                                                                                                                                                                                          What is PCOS?                           that are both strongly linked to 
                                                                                                                                                                                                                                  PCoS, too. if you do have PCoS, 
                                                                                                                                                                                         Put simply, PCoS is the result           eating the right foods can help 
                                                                                                                                                  Could I have                           of a hormonal imbalance, which           to improve insulin resistance, 
                                                                                                                                                  PCOS?                                  prevents the ovaries from releasing      potentially reducing your risk 
                                                                                                                                                                                         an egg each month; resulting             of developing long-term health 
                                                                                                                                                 Unfortunately, there is                 in tiny, cyst-like formations on the     problems linked with PCoS like 
                                                                                                                                                 no one, single test used                ovaries. For most women, the             impaired glucose tolerance,  
                                                                                                                                                 to diagnose PCOS. Instead,              underlying cause of this is insulin      type 2 diabetes and heart disease.
                                                                                                                                                 doctors look at blood test              resistance (turn overleaf to read          eating healthily will also help 
                                                                                                                                                 results, ovary ultrasound 
                                                                                                                                                 results and your symptoms               “what is insulin Resistance?”).          you lose weight, which has been 
                                                                                                                                                 before making a decision.                 a large proportion of PCoS             shown to restore ovulation, 
                                                                                                                                                 Common symptoms of                      sufferers will also experience           increase fertility and improve 
                                                                                                                                                 PCOS include:                           symptoms like weight gain, acne,         many of the symptoms of PCoS 
                                                                                                                                                 •  irregular or absent                  sub-fertility (difficulty falling        – even if you only lose a relatively 
                                                                                                                                                   menstrual periods                     pregnant) or infertility, excess hair    small amount of your body weight 
                                                                                                                                                 •  hirsutism (excess hair               growth on their body and face            (around 5–10 per cent).
                                                                                                                                                   growth on the face, chest             and scalp hair loss. Research also 
                                                                                                                                                   and stomach)                          suggests they are at higher risk          What should I be eating?
                                                                                                                                                 • alopecia (scalp hair loss)            of miscarriage and of developing 
                                                                                                                                                 • acne                                  heart disease and diabetes.              despite the known benefits  
                                                                                                                                                 •  acanthosis nigricans 
                                                                                                                                                   (dark skin pigmentation,                exactly why PCoS develops              of lifestyle changes, research into 
                                                                                                                                                   often found at the back of            remains unknown, but it’s                the best type of eating plan for 
                                                                                                                                                   the neck and under the                thought to be a result of the            women with PCoS is lacking, with 
                                                                                                                                                   arms and breasts)                     interaction between genes and            no studies having yet shown any 
                                                                                                                                                 •  obesity and difficulty               the environment. in countries like       significant benefits of one type  
                                                                              &                                                                    losing weight                         australia, where the incidence           of diet over another.
                          food
                                                                                                                                                 •  infertility or reduced               of diabetes and obesity are                as insulin resistance is usually 
                                                                                                                                                   fertility                             increasing, the incidence of PCoS        the underlying problem however, 
        one in every eight                                                                                                                                                               is higher also – in fact, the Jean       an eating plan for PCoS should 
                                                      PCOS                                                                                                                               Hailes Foundation for women’s            focus on lowering insulin levels and 
        australian women                                                                                                                                                                 Health estimates PCoS cost our           improving the body’s sensitivity 
                                   
        struggle to lose weight,                  How diet Can HelP                                                                                                                      economy $40 million in 2006.             to insulin, while also helping with 
        are losing their hair                                                                                                                                                                                                     weight loss. (See “How to eat for 
                                                                                                                                                                                          How food can help                       PCoS” overleaf for more info.)
        and constantly feel tired                 if you’ve never heard of Polycystic     age – that’s one in every eight –  
        as a result of PCoS.                      ovary Syndrome (PCoS) before,           are affected. yet despite these                                                                though it’s unlikely that a poor          Lifestyle factors
                                      
        But as dietitian Kate                     you could be forgiven for thinking      huge numbers, many of us still                                                                 diet alone causes PCoS, it 
                                                  it’s a rare condition affecting very    don’t know a lot about it. if you                                                              can increase your chances of             diet is a major contributor in 
        Marsh reveals, food                       few people – but it’s actually the      suffer from PCoS or think you                                                                  developing the condition if you          managing your PCoS, but other 
        can help – you just                       most common hormonal disorder           might, it may feel like there’s not                                                            are already genetically at risk.         lifestyle changes are essential too. 
        need to know what                         in the world for pre-menopausal         much you can do about it, but                                                                    what you eat can also affect           exercise for example, is proven  
                                                  women. Here in australia, 12 per        there are lots of things that can                                                              your chances of developing insulin       to have a significant impact on  
        to put on your plate.                     cent of women of child-bearing          help – and it starts with food.                                                                resistance and obesity, conditions       the symptoms of PCoS, with a  
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         health
         number of studies now showing                Medications for PCOS
         the benefits of lifting weights for                                                                                                                                                           Case Study
         improving blood glucose and                 while lifestyle changes should                 whaT IS InSUlIn 
         insulin levels. aim to include              always be your first line of                   reSISTanCe?                                                                                        diet really can make a difference. one HFG reader,  
         resistance training (lifting weights)       treatment for PCoS, you may                    Insulin is a hormone                                                                               32-year-old Jane norris, shares her story.
         with moderately intensive aerobic           also require medication. Common                produced by the pancreas, 
         activities such as walking, running         medications used to treat PCoS                 which helps to regulate                                                                            Before i was diagnosed with PCoS, i’d never really considered  
         and dancing, in 30–40 minute                can include the following:                     blood glucose levels.                                                                              myself ‘unhealthy’. like most people, i didn’t think twice about the 
         sessions on most days of the week.          • the oral contraceptive pill                  Insulin resistance means                                                                           occasional fast food meal and considered myself an ‘exerciser’ –  
            Similarly, stress, inadequate            regulates menstruation and affects             your insulin does not                                                                              i did walk to the bus stop, after all! 
         levels of quality sleep and smoking         acne and excess hair growth.                   work effectively, so your                                                                            But then i began experiencing symptoms nobody could explain.  
         have all been linked to insulin             • Metformin lowers insulin levels.                                                                                                                i complained constantly about feeling tired, i started losing my hair 
                                                                                                                                                                                                              "
                                                                                                    body needs to produce 
         resistance. to maximise your PCoS           • Spironolactone, cyproterone                  increasing amounts of                                                                              and, over a period of 12 months, i put on about 10 kilos – weight that 
         management program, learn to                and flutamide all block the action             it to keep blood glucose                              Latest research                              wouldn’t budge, even when i started eating more healthily and going 
         manage your stress levels, develop          of male hormones, helping with                 levels under control.                                                                              to the gym. then i was tested for insulin resistance. when the results 
         regular sleep patterns and put              skin and hair problems.                        These high levels of insulin                         • a recent study found that women             came back positive, i was diagnosed with PCoS, put on medication, 
         those cigarettes down – for good!           • Clomiphene stimulates ovulation.             circulating in the blood                             with PCoS had a significantly                 and referred to a dietitian. life hasn’t been the same since. 
                                                                                                    can cause many health                                lower basal metabolic rate (BMR)                Before my diagnosis, i honestly thought eating salad once a week 
                                                                                                    problems, including PCOS.                            than women without PCoS,                      was ‘healthy.’ i’d never even tried a lentil before! So the eating plan  
                                                                                                    Being insulin resistant                              meaning they burn less energy,                my dietitian created for me initially felt a lot like a diet. But then  
                                                                                                    also increases your risk                             even at rest. this could explain              i started to see results – i lost weight, my skin got better, my hair 
            How to eat for PCOS                                                                                                                          why women with PCoS are more                  stopped falling out and i had a whole lot more energy. i began  
                                                                                                    of developing other  
            • Swap processed grain foods              • Fill at least half your plate               health problems, such                                likely to be overweight and seem              to exercise, too. and even though it’s difficult to fit in with a really  
            like white bread, puffed or flaked        at lunch and dinner with a variety            as gestational diabetes,                             to find it harder to lose weight.             busy job, i still make sure i walk at least four times a week.
            breakfast cereals, most cracker           of different coloured vegetables              type 2 diabetes and                                  • a pilot study in overweight and               three years after diagnosis, life is so different. My husband’s life  
            biscuits and many snack foods             or salads and include grilled                 cardiovascular disease.                              obese women with PCoS found                   has changed too; he has so much more energy. we actually decided  
            for higher fibre, low-Gi versions         tomato, mushroom, asparagus,                                                                       that implementing a six-month                 to start trying for a baby a few months ago. i knew it might take a 
                                                                                                                                                         long, self-directed, brisk walking                                                                                            
            like heavy wholegrain bread,              capsicum and/or spinach                                                                                                                          while to fall pregnant so i was prepared for a long wait but, incredibly, 
            oats, barley and cracked wheat.           in cooked breakfasts.                                                                              program resulted in psychological             we conceived within a month! i was in such disbelief that i took four 
                                                                                                                                                         benefits, including improvements              pregnancy tests to make sure. it was such a wonderful feeling. i’ve 
                                                                                                                                                         in body image perceptions.                    been working so hard for a healthy body and to increase my fertility 
                                                                                                                                                         • a February 2008 study found                 levels that it really felt like a validation. 
                                                                                                                                                         replacing animal sources of protein             looking back, i’m amazed at how much i’ve changed. i used to 
                                                                                                                                                         with vegetable sources may reduce             think i had no control over changing my food habits, but now i know 
                                                                                                                                                         the risk of ovulatory infertility. the        that i do. to all those women out there with PCoS, i would absolutely 
                                                                                                                                                         same authors also found small                 recommend paying attention to your diet. Honestly, if i can change, 
                                                                                                                                                         amounts of trans-isomer fats (trans           anyone can. you’ve only got one body. look after it!
            • limit your intake of saturated          • Prevent a large rise in your             • Swap your high-fat, high-sugar                        fats) may increase the risk too.  HfG
            fats by choosing lean cuts of             blood glucose and insulin                  snacks in between meals for 
            meat, eating skinless poultry,            level by switching those three             pieces of fruit, tubs of natural                        For more information about PCOS: • Polycystic Ovarian Syndrome Association 
            eating more fish, and choosing            big meals a day for smaller,               yoghurt with berries, small                             of Australia www.posaa.asn.au • The Jean Hailes Foundation for Women’s                                Kate Marsh is an 
                                                                                                                                                         Health www.jeanhailes.org.au and www.managingpcos.org.au • The PCOS                                   advanced accredited 
            low-fat dairy products over their         regular meals and snacks every             handfuls of raw nuts or slices                                                                                                                                Practising dietitian who  
                                                                                                                                                                                                                                                          "
                                                                                                                                                         Project www.projectpcos.org • The New Glucose Revolution: Managing PCOS                               is currently completing  
            high-fat counterparts.                    three hours or so.                         of wholegrain fruit loaf.                               by Nadir Farid, Jennie Brand-Miller and Kate Marsh (Hodder Headline).                                 her Phd in PCoS.
          38  www.healthyfoodguide.com.au                                                                                                                                                                                                       february 09 HealtHy Food Guide   39