Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder which is not fully understood. Most patients with PCOS are obese & insulin resistant. Obesity, particularly abdominal obesity, is mediated by the development of insulin resistance. It is closely linked to the development of PCOS & its clinical features, particularly menstrual irregularities & increased androgen levels. Lifestyle modifications particularly focusing on diet & exercise are considered the preferred first line treatment for PCOS management. Several studies have shown that weight loss of 5-10% of weight in PCO patients via energy restriction can reduce circulating insulin levels & hyperandrogenism.
Traditional Indian diets:
These are high in carbohydrate, moderate in fat & protein, typically hypercaloric. To add to the problem, modernization has led to sedentary lifestyle which actually demands decreased caloric intake.
What is an ideal Diet?
- The daily carbohydrate intake should be 50-60% of total calorie intake.
- The primary sources of complex carbs should be cereals (whole wheat, brown rice), millets (bajra), finger millet (ragi), great millet (jowar), pulses, red gram, green gram, soya, legumes etc.
- Complex carbs should be preferred over refined carbs (whole grain roti over white bread, biscuits or toasts)
- Low glycemic index foods like oats with bran, unpolished rice, parboiled rice, whole pulses, beans & legumes (moong, matki, masur) should be preferred
- Simple carbs like sugar, jaggary, honey, fruit juices &sabudana (sago) should be avoided
- Consume about 4 servings of vegetables & 2 servings of fruits every day.
- Dietary fiber is that part of food that is not digested by the gut & is considered as unavailable carb.
- Fiber is present in vegetables, fruits & legumes.
- Fenugreek seed is effective in controlling blood sugar & serum lipids than the insoluble fiber present in cereals & millets. Long term consumption of fiber also improves glucose tolerance.
- The recommended dietary intake of proteins is 0.8 g/kg body weight. 10-20% of energy intake should be proteins.
- Proteins of high biologic value should be given consideration, though protein should be included from both animal & vegetable sources.
- Every meal should contain one serving of protein in the form of dal, sprouts, pulses, curd, milk, eggs or non-vegetarian food.
- Dietary fats are important component of diet, providing energy & essential fatty acids, linoleic acid & serving as a transport for fat soluble vitamins like A, D, E & K. Fats improve texture & palatability of foods & have an important role in inducing satiety.
- Polyunsaturated fats are present in sunflower oil, kardi oil & safflower. High intake of polyunsaturates have been suggested to be potentially damaging, relating to increased production of lipid peroxides.
- Diets should include moderate levels of monosaturates like olive oil, ground nut oil, rice bran oil.
Meal Replacers:
Meal replacers like liquid formulas are a popular weight loss diet, but their short-term use does not substitute for a long-term healthy eating pattern, which must be followed for a lifetime to achieve & maintain a healthy weight.
“Diet for PCOS is not very different from a normal ideal balanced diet. The important pointers are inclusion of proteins, fibres in the form of vegetables, fruits & minimizing potion sizes”
Dr. Preeti Y Bhandari.
MRCPI (Ireland), MS, DNB, MICOG, DRM (Germany)
Specialist Gynecologist.
Abu Dhabi.