FOOD FOR THOUGHT

Around one in 10 women have polycystic ovary syndrome, a hormonal condition that can’t be cured. So, exactly how can nutrition help you deal with the symptoms?

Can you ease PCOS symptoms via your diet?

Much like a wedding seating plan or the ratio of Campari to gin in a decent negroni, balance is essential when it comes to your hormones. You know, those chemical messengers that regulate every bodily process from reproduction to hunger. When levels of androgens – which, though commonly referred to as ‘male hormones’, are present in both men’s and women’s bodies – become too high, this imbalance can lead to polycystic ovary syndrome (PCOS). It can disrupt ovulation and cause a cascade of symptoms, such as irregular periods (or no periods at all), fertility issues, excess hair growth on the face or body, acne, weight gain, thinning hair and an excess of ovarian follicles (fluid-filled sacs containing immature eggs).

Alongside genetics (your likelihood of developing PCOS is increased if your mother, sister or aunt has the condition), experts think insulin resistance plays a role in the development of PCOS in 50% to 75% of cases. Insulin is a hormone that enables the body to metabolise glucose so it can be used for energy; insulin resistance is when your body doesn’t respond to it properly, causing the pancreas to overproduce it in an attempt to reduce glucose levels. This surplus then causes the ovaries to release androgen hormones.

There’s no cure for PCOS, so treatment is focused on balancing hormone levels and improving symptoms through lifestyle changes, medication and – for some – weight loss. Managing body weight can be hard for those with PCOS, with evidence suggesting that the condition not only makes weight gain more likely, but that high levels of body fat amplify insulin resistance and, with it, the spectrum of PCOS symptoms. This explains why weight loss – even as little as 5% – can improve insulin levels, period regularity, fertility and androgen levels. And, of course, this is where dietary changes can help.

But while many women with PCOS and insulin resistance have a higher body weight, some don’t, meaning dietary changes that target resistance specifically – as opposed to general weight loss interventions – matter.

Some studies suggest that a low glycaemic index (GI) diet is a helpful approach (GI being a measure of how quickly a carbohydrate-containing food raises blood sugar levels). High-gi foods (such as white bread, sweetened drinks and biscuits) are digested quickly and raise blood glucose rapidly, causing a corresponding peak in insulin, while low-gi foods (think: vegetables, fruits, rye bread, oats, beans and lentils) trigger the opposite effect: a slower rise in blood glucose and a lower insulin peak.

One 2013 study found that a low-gi diet can improve insulin sensitivity, independent of any weight change. While GI isn’t a perfect model (less nutritious foods like ice cream and chocolate are considered low-gi as they contain fat, which slows carbohydrate absorption), there’s also evidence linking low-gi diets with a lower risk of cardiovascular disease and type 2 diabetes, which women with PCOS are at a greater risk of developing.

Another approach shown to improve insulin sensitivity is the DASH (dietary approaches to stop hypertension) diet. Originally designed to counteract high blood pressure, it emphasises fruit, veg, whole grains, lean meat and low-fat dairy. A 2015 trial found it improved insulin levels and abdominal fat in overweight women with PCOS. Both diets prioritise fibre: important, as a low intake has been correlated with an increased risk of insulin resistance in women with PCOS.

The bottom line? While there’s no silver bullet, a focus on good nutrition principles (emphasising a variety of fruit, veg, whole grains, pulses, lean protein and low-fat dairy) can help to balance those hormones. And support your wider health, too.