“When I feel hungry, I like munching on cookies and potato chips.”
“I love burgers, ice-cream, chocolate and sweets. Eating these foods with my friends is fun. Whenever we go out, we enjoy eating these foods together.”
“I don’t like milk, yogurt and oatmeal because I don’t like the taste.”
“I hate fish because they are smelly‼
“I only eat fruits and vegetables if I am forced to!”
These were the responses I got with regards to H’s dietary habits when we talked about how to manage her weight.
She was a 15-year-old plump adolescent who had irregular periods for the past one year. Her first menses (menarche) was at the age of 11. Initially, her cycles were slightly irregular occurring once in 30 to 45 days and lasting for 3 days. They became more regular at monthly intervals when she was 12. For the past one year, her menses became erratic. They were getting longer and longer, occurring once in 2 to 3 months. The bleeding could be scanty with spotting or heavy with clots at times. The duration of menstruation could last up to 2 weeks occasionally. Her BMI was high at 28 and her hormonal investigations indicated that she was suffering from polycystic ovarian syndrome or PCOS (please refer to the article PCOS and its health implications in this website).
How does diet affect PCOS?
Many patients with PCOS have increased levels of insulin, a hormone produced by the pancreas that helps regulate sugar in the body. In these patients, the body is resistant to insulin. This results in the pancreas producing more insulin in order to maintain a normal blood sugar level. High levels of insulin will cause the ovaries to produce more male hormones (androgens) and body fat, the hallmarks of PCOS. As a consequence, patients are usually overweight and have difficulty controlling their body weight. A diet that promotes good insulin production will help in the management of PCOS.
What are the foods to eat? Foods that help PCOS patients include:
A low glycemic index (GI) diet
GI is a rating system that measures how much and how quickly a food raises blood sugar levels after being eaten. With a low GI diet, the body digests the foods at a slower pace. As a result, blood insulin and sugar levels will rise and fall gradually instead of in erratic spikes. Patients will feel full for a longer period of time. Appetite is thus better controlled and body weight becomes more manageable. Foods with a low GI diet include whole grains, legumes, nuts, seeds, fruits, and vegetables.
Foods that boost our immune system will lower the risk of inflammation in our body. They are found to be beneficial in PCOS patients. They include berries, fatty fish, leafy greens, olive and other vegetable oils.
The DASH (Dietary Approaches to Stop Hypertension) diet
This is an eating plan to lower or control high blood pressure. It is useful in PCOS women who are obese. Research studies have shown that it helps to reduce insulin resistance and belly fat. The DASH diet includes many vegetables, fruits and low-fat dairy products, as well as whole grains, fish, poultry and nuts. It has limited small portions of red meats, sweets and sugary beverages.
What are the foods to avoid? Foods that may cause an inflammatory response in our body include:
· Refined carbohydrates, such as white bread and pastries
· French fries and other fried foods
· Sugary beverages and snacks
· Excess red meat (burgers, steaks) and processed meat (hot dogs, sausage)
· Margarine, shortening, and lard
Like most adolescents, H had an inactive lifestyle with very little exercise. She would sleep late and often skipped breakfast as she had to rush to school early in the morning. It was challenging initially to coax her to exercise and change her dietary habits. However, with parental support and encouragement, she began to eat a balanced and healthy diet and took up dancing as a form of exercise. Her menses are getting more regular now.