Having a healthy lifestyle has been shown to be the most effective approach to managing PCOS and reducing the severity of symptoms.
The types of diet to follow, and information on the role of carbohydrates, protein and glycaemic index, are discussed. What to eat, when to eat, types of exercise and how much exercise to do are also explored.
The eating guidelines that assist with PCOS management are the same as recommended for the general population and for people with other metabolic conditions such as diabetes or high cholesterol.
Diet – what you eat – plays an important role in the management of PCOS. The most important focus of diet is weight management: first, preventing weight gain then, over time, losing some excess weight if you are overweight. This helps with the regulation of hormone levels, which in turn helps to improve symptoms such as acne, excess hair growth, cycle regularity, ovulation and fertility.
In the long term, a healthy diet aims not only to prevent weight gain, but also to reduce the risk of related health conditions such as type 2 diabetes and cardiovascular disease.
Eating a healthy diet is more effective than exercise alone in achieving a healthy weight. For women with PCOS aiming to lose excess weight, reducing your overall intake of food (calories or energy) is recommended as the most successful approach, rather than following any specific diet. There is no one diet – for example, a high-protein diet or a low-fat diet – that has been shown to be more successful in weight management or weight loss for women with PCOS. Research shows that a diet that results in weight loss improves the signs and symptoms of PCOS.
The recommended way for women with PCOS to lose weight is to reduce overall food intake, so long as healthy food choices are made and the food is nutritionally balanced. Find an approach that works best for you, with the focus being a plan that you can continue with in the long term.
Support is available from your doctor or other health professionals, such as a dietitian, to help you find the best approach to suit your needs. The key to successful changes in your diet is to improve the quality of what you are eating and work towards nutritious food choices and correct portion sizes.
Small dietary changes that can be maintained in the long term can result in many health benefits, not just achieving or maintaining a healthy weight.
It is recommended that women with PCOS eat regularly to help stabilise their insulin levels. It is suggested that they eat every three to four hours, which for most women means having three meals (breakfast, lunch and dinner) and a snack between each. Many women find it difficult to use appetite signals reliably, so a good start is to eat often but reduce the portion size.
Generally, meals and snacks need a balance of protein and high-fibre and/or low-glycaemic index (GI) carbohydrates, as well as plenty of vegetables and fruit.
The GI in carbohydrates is important because carbohydrates with a low GI produce lower glucose levels and insulin levels in the blood after they are eaten compared with carbohydrates with a high GI. For instance, rolled oats have a lower GI (51) than corn flakes (80).
The meal and snack suggestions below will help to guide you. For lunch and dinner, it is ideal for about half of the food you eat to be vegetables and salad.
Some helpful tips:
Watch the video below where dietitian Terrill Bruere talks about lifestyle and gives diet advice for the management of PCOS. Terrill explains that your weight isn’t a simple equation of energy in equals energy out. She talks through trigger points for emotional eating, explores the issues of dieting, and provides helpful and practical tips.
Regular exercise seems to be most effective in improving insulin resistance, even without any noticeable change in weight or body fat measurement.
Improving insulin resistance is very important as this is the cause of many of the symptoms of PCOS.
Regular physical activity will help to:
These improvements are achieved even when weight loss doesn’t occur.
Research has shown any type of regular exercise is effective in improving PCOS symptoms. Whether it is moderate or vigorous aerobic exercise or resistance (using weights) exercise, women’s PCOS symptoms will improve.
A variety of exercise is good to maintain interest and motivation, but it isn’t essential to achieve the benefits. As long as you are moving and enjoying it, the type of exercise is not so important. Remember, physical activity includes walking, activity at work and household chores as well as sports and planned exercise.
The best thing to do is to aim to include some type of physical activity every day for 30 minutes, and build this up over time. This can also be broken up into smaller 10-15-minute sessions spread out over the day, and can include both structured exercise and incidental exercise.
Usually a mixture of exercise that builds both cardiac fitness and muscle strength is recommended.
Recommended guidelines for exercise include:
1. For women with PCOS who want to prevent weight gain and maintain health:
2. For women aiming to lose a moderate amount of weight (without dieting), prevent weight regain or achieve greater health benefits:
Some examples of moderate and high intensity exercise:
|Moderate intensity||- Brisk walking - Digging in garden - Medium-paced swimming or cycling - Aqua aerobics - Moderate dancing - Tennis, volleyball, badminton - Jobs that require an extended amount - of time standing or walking|
|High intensity||- Team sports (football, squash, netball, - basketball) - Aerobics, circuit training - Speed walking, jogging, running - Hard/hill cycling - Swimming laps, water jogging - Brisk rowing - Karate, judo - Vigorous dancing - Jobs that require heavy lifting and rapid movement|
Start by looking at what you are doing already. Try using a pedometer to measure your steps each day. The National Heart Foundation recommends 10,000 steps a day for heart health. When you know your average daily steps, you can set goals to increase slowly to this level. If you already do this many steps, it could be you need a different type of exercise as well to increase your strength or cardiovascular fitness.
Research shows that women with PCOS can have a lower level of confidence when exercising. This might be due to issues such as poor body image, self-consciousness about excess weight, and negative past experiences.
Support is available if you are lacking the confidence to get started. It might be helpful to join an exercise group that you feel comfortable with to assist with motivation. Or, working with an exercise specialist can help you build your confidence to do regular exercise.
Do you like to walk alone or meet with a friend and walk with company? Do you like a class or an individual workout? Could you build a walk around the park into your usual coffee shop visit? Can you walk to work from a car park or a tram stop a bit farther away, or use the stairs rather the lift? What do you like to do in winter and what do you like to do in summer? Do you have an electronic system at home such as a Nintendo Wii system (or similar) that you could use to do a Zumba workout or dance program on a regular basis?
Finding a physical activity you like will help make it easier for you to include it as part of your daily and weekly routine. Alternating the type of exercise you do will also help with motivation.
It is important you try to make physical activity a key priority in your life as it will affect your long-term health.
There are many barriers to exercise that can arise. Some people are self-conscious about their bodies and are reluctant to be seen exercising for this reason. Others are hesitant because they don’t have the right clothes to be comfortable. Some people have concerns about their ability to participate in exercise because of injuries.
If you don’t know where to start or feel you might be at risk of injury, consider seeing a physiotherapist or exercise physiologist for further advice and support.
Remember, you can change your activity plans any time you want to help stay motivated.
Remember that progress is not always straightforward. Many things in our lives can stop our best efforts to be healthy, such as stress and emotional challenges. These can be hard to predict and can seem overwhelming at times. The important thing is to keep your eye on your goals and to keep going. Some days you will succeed in meeting your goals, and other days you will not do as well, but in the end, you will make progress.
Read more on PCOS in our booklet 'Understanding polycystic ovary syndrome: All you need to know'
This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at September 2019.