How to start managing PCOS: Diet and Exercise

Before you start thinking about taking medications for PCOS, it’s worth noting that the greatest overall impact to your health and the greatest benefits will come from ensuring you are eating a PCOS friendly diet and exercising in the right way. Whilst this can sound overwhelming, it is actually fairly straightforward if you understand which macronutrients you are getting from your food. Depending on your current diet this may mean a significant lifestyle change, or small strategic changes. What I have found has worked for me is:

• ensuring every meal has a good source of protein, complex carbohydrates and healthy fat - understanding macronutrients of food will make this so much easier in practice.

• if you are a beginner, I would suggest making a list of foods that fit these three groups with a strong focus on whole foods (i.e. unprocessed foods), as far as possible.

• eating meals at the same time every day

• eating breakfast every single day

• having my last meal of the day at least 90 mins - 2 hours before I sleep (giving my digestive system time to digest food)

• focusing on my daily protein intake - whilst 45g-65g is enough for most women, some women with PCOS can need up to 100g of protein per day. Protein will help to keep your blood sugar stable so it is absolutely key.

• aim for 25g of fibre per day

• keep it simple! Food does not have to be complicated to be PCOS friendly

• understanding which foods and drink can directly support PCOS and help to regulate hormones

• pay attention to how your body feels after eating food - see if you notice any patterns. For example, I found that whilst I am not allergic to gluten, I do have a sensitivity to it which causes serious bloating. I don’t however, have an issue with dairy, which some people with PCOS can experience.

• I do not calorie count or restrict myself from food that I want to eat - however, if your PCOS has led to weight gain (typically around the abdomen), you may wish to eat in a slight calorie deficit. Please be careful that this is only a slight deficit (no more than 200 calories reduced per day) as PCOS tends to react very strongly to extreme dieting and it never sticks.

How to think about food

Food is fuel and you need to eat properly to manage PCOS. My routine includes waking up at 8am, breakfast (around 9am), lunch (around 1 pm), one snack (around 5.30-6pm) and dinner (around 7-7.30pm). This does change on some days and I might eat an extra snack for example - or the portion of my meal might be bigger or smaller than it was the day before. Keeping it flexible and eating intuitively has helped.

A typical food day for me would be:

• Breakfast - 2 eggs, either hard boiled or fried (using a cooking spray or minimal oil); a slice of toast or half a bagel with avocado and hemp seeds; a protein shake (frozen banana, milk, chia seeds, a mix of flax, sunflower and pumpkin seeds, and maca powder. Protein powder of choice - mine is usually one scoop from Form Nutrition here in the UK).

• Lunch - varies. It might be a sandwich, a stew and rice, a bowl of some sort. The focus is always on ensuring there is some sort of good protein (hummus, beans, chicken, fish or tofu are my go-to’s); complex carbs (rice, sweet potato, gluten free pasts/noodles, bread etc); and healthy fat (avocado, olive oil, nuts/seeds etc). My plate typically consists of the main meal on one half, with the other half made up of vegetables (either salad or cooked vegetables).

• Snack - varies. If I have something left over from lunch (a few bites worth), then I’ll finish this. Or have some milk and fruit, or cheese and fruit or nuts. Some days I will just eat a chocolate bar and crisps (which definitely isn’t the best option but it’s also one moment in an overall day of eating well and keeping an overall focus on health instead of nitpicking every bite, is important).

• Dinner - usually some kind of stew or curry with gluten free flatbread, rice, or pasta. Vegetables/salad in addition.

Most importantly, at NO point with PCOS, should you be extreme dieting or drastically reducing calorie intake. Experience (and the science, as far as I am aware) tells me that this will only create a stress response, and as soon as your cortisol levels are out of sync, any excess weight will only get worse.

In general, my opinion is that the focus should always be on overall health, diet and movement. I have generally tried not to focus on excess weight alone (which I definitely have some of), because exclusively looking at weight/weight loss is not going to give you the long term results you will need if you want to properly manage PCOS.

Exercise

I keep exercise simple. The one big change I made was moving from the conventional wisdom of significantly increasing cardio exercise to a gentler, steadier focus of strength training at a slower pace. Basically, I would recommend avoiding running any marathons. Exercise is very personal however, and you need to find what works for you.

My own routine tends to involve some kind of strength training 3-4 times per week because lifting weights helps with blood sugar control. It doesn’t need to be an excessively long session - 45 mins of focused work is good. Instead of running or any ‘stressful’ cardio, I just focus on walking and acheiving a general step count of 5000-7000 per day. Consistency will pay off and I enjoy walking but hate running so I avoid it.

I also have a weak core so a couple of pilates classes each week are also helpful.

In summary - focus on your macros (get enough protein, healthy fat and compex carbohydrates). Do not restrict calories - a moderate deficit will be helpful if you are also trying to lose some excess weight but do not starve yourself - you need to eat enough food. Eat strategically (meal times / snack times). Move your body - walk and lift weights. Do not try to do excessive cardio - gentle cardio and increased strength training is a better option.

Part 3 will focus on supplements and lifestyle changes

Disclaimer: I am not a health professional of any description. The content of this article is based purely on my personal experience and research. Whilst this may be helpful as an overall guide, it is not intended to replace any medical advice. Please speak to your doctor before making any changes.