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Lifestyle Management For PCOS
Angela Grassi, MS, RDN, LDN
PCOS Nutrition Center
www.PCOSnutrition.com @PCOSnutrition
PCOS: Metabolic Disorder With Cardiovascular Risk Factors
I
Cardiovascular Risk Factors % of women with PCOS
High blood pressure 50%
Abnormal glucose metabolism 50-70%
High cholesterol 70%
Obesity 40-80%
Insulin resistance 50-70% Yildiz BO, Knochenhauer ES, Azziz R. Impact of obesity on the risk for polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93(1):162-168 Moran LJ, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Human Repro Update. 2010;16(4):347-363. Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(1):48-53. Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. Amer journal med. 2001;111(8):607-613.
Copyright 2015 PCOS Nutrition Center
Insulin Resistance
• Slower metabolism – store fat and weight more quickly, especially in the belly
• Less energy to get up and go
• Increased levels of hunger and cravings and lower satiation with meals
• Increased risk for gestational diabetes and type 2 diabetes
Copyright 2015 PCOS Nutrition Center
PCOS: An Independent Risk Factor For Type 2 Diabetes
50% of women with PCOS develop pre-diabetes or type 2 diabetes
before the age of 40
Copyright 2015 PCOS Nutrition Center
Pathophysiology of PCOS: A Vicious Cycle
Insulin resistance
High Insulin Weight gain
Grassi A. PCOS: The Dietitian’s Guide. Luca Publishing, Haverford, PA 2013.
Copyright 2015 PCOS Nutrition Center
Diet And Lifestyle Factors Work Synergistically To Support Health!
Activity
Weight
Control
Sleep
Stress
Management
Food
Copyright 2015 PCOS Nutrition Center
Benefits Of A Healthy Diet and Lifestyle
• Improved skin
• Healthier hair
• Better mood
• Healthy immune system
• Improved fertility
• Aid in weight loss
• Support a healthy pregnancy
• Maintain healthy blood pressure
• Reduce risk for diabetes
• Prevent cancer
• Extend your life
Vector-Based Illustration/Getty
Copyright 2015 PCOS Nutrition Center
What Is A Healthy PCOS Diet?
Copyright 2015 PCOS Nutrition Center
Inflammation
• Starchy processed carbohydrates, and high amounts of carbohydrate increase insulin release and trigger inflammation
Examples:
• cereals
• white bread
• white rice
• baked goods
• crackers
• candy
• sugary drinks Copyright 2015 Susan Dopart, MS, RD, CDE
Healthier Carbohydrate-Containing Foods
• Whole Grains
• Fruits
• Vegetables • Starchy
• Non-starchy
• Beans and Legumes
• Milk and yogurt
Copyright 2015 PCOS Nutrition Center
Whole Grains Helpful Tips:
• Unprocessed, high fiber
• Look for ‘whole’ as the 1st ingredient
• Low GI benefits
• Spread throughout day
What counts as a serving?
½ cup cooked:
• brown or wild rice
• rolled or steel-cut oats
• bulgur
• quinoa
• buckwheat
• 1 slice sprouted grain bread
Vanilla Blueberry Walnut Oatmeal from The PCOS Nutrition Center Cookbook Copyright 2015 PCOS Nutrition Center
Tips To Help You Eat Whole Grains
• Substitute whole grain products for refined ones
• Try quinoa or rolled oats for a hot breakfast
• Add whole grains such as faro, quinoa, or bulgur to soups
• Try rolled oats as breading for baked chicken, fish, or veal cutlets
• Mix vegetables with cooked quinoa for a side dish
Strawberry Breakfast Quinoa from The PCOS Nutrition Center Cookbook Copyright 2015 PCOS Nutrition Center
Portion Size Matters!
Copyright 2015 PCOS Nutrition Center
Fruits
How much to eat each day?
At least 2 cups of fruit each day to maximize health
Balance with other carb foods
What counts as a serving?
• 1 small apple • 1 cup of grapes • 1 orange • 1 large peach • 1 cup strawberries • 1 cup cherries • 2 small plums Source: USDA
Copyright 2015 PCOS Nutrition Center
Tips to Help You Eat Fruits
• Keep a bowl of whole fruit on the table or counter
• Buy fresh fruit in season
• Refrigerate cut-up fruit to store for later
• Freeze fresh fruit or buy frozen to blend in smoothies
• Enjoy for snacks
• Add to meals: • Top oatmeal with blueberries
• Grapes or apples to a salad
• Grill pineapple
Burazin/Getty
Copyright 2015 PCOS Nutrition Center
Vegetables
How much to eat each day?
• At least 2½ cups of vegetables each day to maximize health
• Make half your plate veggies
What counts as a serving?
2 cups leafy greens
1 cup
• broccoli (raw or cooked)
• carrots (raw or cooked)
• tomato
• mushrooms (raw or cooked)
• cooked green beans
• squash or zucchini
Lew Robertson/Getty Copyright 2015 PCOS Nutrition Center
Tips to Help You Eat Vegetables
• Buy fresh vegetables in season
• Stock up on frozen vegetables
• Buy vegetables that are easy to prepare
• Vary your veggie choices to keep meals interesting
• Enjoy for snacks
• Add to meals: • Mix into omelets or frittatas • Blend leafy greens in smoothies • Add to stir-fryes or soups • Grill vegetable kabobs • Side dishes Citrus Glazed Carrots from The PCOS
Nutrition Center Cookbook
Copyright 2015 PCOS Nutrition Center
Beans and Legumes
How much to eat? What counts as a serving?
½ cup cooked:
• Black beans
• Chickpeas (garbanzo)
• White beans
• Lentils
Faro Minestrone Soup from The PCOS Nutrition Center Cookbook
Several servings each week
Copyright 2015 PCOS Nutrition Center
Tips to Help You Eat Beans and Legumes
• Purchase canned, dried or ready to eat varieties
• Add to meals: • Salads
• Soups
• Meatless main dishes
• Side dish
Black Bean Cakes from The PCOS Nutrition Center Cookbook
Copyright 2015 PCOS Nutrition Center
Meal Balance and Insulin Resistance
Copyright 2015 Susan Dopart, MS, RD, CDE
The Power Of Protein
• Cage-Free Eggs
• Grass-Fed Meat
• Wild Fish
• Pastured Poultry
• Nuts
• Soy
• Organic Dairy
• Beans and legumes
Copyright 2015 PCOS Nutrition Center
Focus On Healthy Fats
• Olive oil
• Olives
• Nuts
• Nut butters
• Avocados
• Seeds
• Eggs
• Fish
Getty images
Copyright 2015 PCOS Nutrition Center
Tips To Help You Eat Healthy Fats
• Use olive oil for cooking or as a base for home made dressings
• Nuts make great snacks
• Toss nuts into a stir-fry
• Dip fruit in nut butters
• Add avocado to eggs, sandwiches and salads
• Add olives or seeds to a salad
• Eat fish twice a week Salmon with Pineapple Mango Salsa from The PCOS Nutrition Center Cookbook
Copyright 2015 PCOS Nutrition Center
Best Beverages For PCOS
• Water/seltzer
• Green Tea
• Spearmint Tea
• Coffee
• Red Wine
Copyright 2015 PCOS Nutrition Center
Supplements With Insulin-Sensitizing Properties
• Cinnamon
• N-acetyl cysteine (NAC)
• Magnesium
• Vitamin D
• Inositol (DCI & MYO)
• Fish oil
Copyright 2015 PCOS Nutrition Center
Physical Activity For PCOS
Benefits
• Lowers insulin & glucose
• Improves hormones
• Weight management
• Improves mood
• Improves ovulation
• Flexibility
How much to do?
• Aerobic
• Resistance training 2x/week
• Daily movement
• Yoga
Copyright 2015 PCOS Nutrition Center
Activity/Exercise
• Regular consistent exercise - even 30 minutes per day – can lower insulin resistance by as much as 50% for 24 hours
• 10 minute walks
…following a meal
dramatically
Insulin Resistance
Copyright 2015 Sudan Dopart, MS, RD, CDE
Stress Reduction
• Constant high levels of stress increase cortisol, worsen insulin resistance and contribute to weight gain
• Stress reduction techniques: • Yoga
• Exercise
• Coloring
• Mindfulness practice
• Hot bath
• Reading
Copyright 2015 PCOS Nutrition Center
Get More Sleep!
• Lack of sleep contributes to weight gain and insulin resistance
• High carb diets associated with sleep deprivation
• Sleep apnea higher in women with PCOS
Copyright 2015 PCOS Nutrition Center
Putting It All Together
• Synergy of diet and lifestyle factors
• Focus on anti-inflammatory
• Whole over processed foods
• Sensible portions
• Be active
• Start with the easiest to change
• Little changes add up!
• Enlist support
Copyright 2015 PCOS Nutrition Center
To Learn More The PCOS Nutrition Center PCOSnutrition.com
• FREE PCOS Nutrition Tips newsletter, articles, resources • Nutrition counseling available in-person or phone • Books:
• The PCOS Nutrition Center Cookbook: 100 Easy and Delicious Whole Food Recipes to Beat PCOS • The PCOS Workbook: Your Guide to Complete Physical and Emotional Health • PCOS: The Dietitian’s Guide (CEUs available)
Connect with us! • Twitter: @PCOSnutrition • Facebook.com/PCOSnutrition • pinterest.com/PCOSnutrition • Instagram: @PCOSnutrition