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WHAT IS PCOS?

Polycystic ovary syndrome (PCOS) is a complex genetic disorder that results


in an excess of androgen hormones. Androgens are steroid hormones that
stimulate or control the development and maintenance of male characteristics; for
example, testosterone. PCOS also results in ovulatory dysfunction, and polycystic
ovaries. PCOS affects 6-10% of women worldwide.
If you have received a diagnosis of PCOS, you are likely insulin resistant. You
are diagnosed as insulin resistant when your body does not
produced in the
respond to normal amounts of insulin produced in the body. In
pancreas. It
order to get blood sugar (glucose) into the cells the body
promotes the
makes the hormone insulin. In those with insulin resistance,
metabolism of
the cells dont respond as they should to the presence of
carbohydrates
insulin, and as a result glucose cant be transported into cells
and fats by
for energy. The body then will produce more insulin, due to
promoting the
the high levels of circulating blood glucose, which also is
absorption of
unable to perform its function. This results in too much insulin
blood sugar
circulating in your system.
from the
bloodstream, to
muscles and fat
tissue where it
can be used for

In PCOS, the ovaries produce an increased amount of


androgens due to this increased amount of insulin. Excess
androgens throw off the balance of female to male hormones.
This imbalance keeps eggs that should be released by the
ovaries from maturing. Instead, they become small, fluid-filled sacs or cysts that
surround your ovaries, (hence, poly cystic ovary).

What are the Results of Increased Androgens and Insulin


Resistance?
Excessive androgens in women can cause: excessive hair growth on the face and
body, balding, acne and other skin problems, all of which can negatively affect
your body image and self-esteem.
Not only does increased insulin result in increased androgens, it also promotes
weight gain. This weight gain mostly occurs above your belly button and is
referred to as a spare tire. If you are gaining a lot of weight without significant
changes to diet and exercise, excess insulin could be the culprit. Insulin resistance
also causes skin tags, reddened rough hair follicles on upper arms; dry, rough
elbows or dirty looking patches of skin called acanthosis nigricans.
Hypoglycemia (low blood sugar) can occur if you wait too long to eat. It can
also occur if you have a meal or snack that contains mostly simple or refined
carbohydrates and too little protein. Low blood sugar can cause headaches and
leaves you feeling hungry, fatigued, nauseous, irritable or feeling dizzy. When
your blood sugar is low, you have may have a strong craving for carbohydrates

and sweets. This is due to your body telling you that it needs energy and you
need to eat now! Refined and simple carbohydrates provide a quick supply of
glucose to the cells and therefore quick energy. However, the more simple
carbohydrates you eat, the more you crave! It is important for those with PCOS to
eat balanced, frequent meals and snacks to prevent low blood sugar and out of
control cravings for nutritionally poor food choices.

Your PCOS Lab Results:


Your diagnosis of PCOS was determined by certain lab test results. These same lab tests,
allow your doctor to monitor your PCOS over time. You can use the following form to
keep track of your lab results over time and to provide to health care providers if you
move or change providers.
Test
Total
Testosteron
e
Lutenizing
Hormone
(LH)
Follicle
Stimulating
Hormone(F
SH)

Optimal
Levels
< 50
ng/dl.
---------

---------

LH:FSH

1:1

Vitamin D

>35 ng/dL

Thyroid
Stimulating
Hormone(T
SH)

.4-2.5
IU/mL

hsCRP

<3 mg/L

Blood
Pressure

<120/80
mmHg

Fasting
Glucose:Ins
ulin

>4:5

Fasting
Insulin

<10 IU/mL

HA1C

<6%

Date:

Date:

Date:

Date: Date:

Date:

Date:

Date:

Fasting
Glucose

70-99
mg/dL

Triglyceride
s

<150
mg/dL

Total
Cholesterol

<200
mg/dL

LDL

<100
mg/dL

HDL

>55
mg/dL

Common Medications in PCOS:


Oral Contraceptives: Method of birth control taken in pill form.
Oral contraceptives can regulate menstruation, improve acne and
balding due to hormone regulation. Side effects are insulin
resistance and increased triglycerides in some brands. Blood clots
are another dangerous side effect and are more prevalent in those
who smoke or who are over age 35.
Anti-androgens: eg. Flutamide, Spironolactone. These work by
decreasing the amount of male sex hormones in about 3-6
months. They can improve hair growth and acne.
Spironolactone has been shown to cause birth defects.
Women who are trying to conceive should not use this
medication.
Metformin: Insulin lowering medication. This is the most common
medication used to treat PCOS. Metformin improves blood
pressure, lowers blood glucose, insulin and testosterone and helps
with weight management.

Thiazolidenediones (TZDs): Insulin lowering drugs. Can be


used with Metformin to improve insulin levels, reduce male sex
hormones, and male pattern hair growth. These medications help
the insulin receptors on cells work better.
Byetta: Controls blood glucose levels. Not indicated for PCOS, but
some physicians prescribe this along with Metformin, or TZDs to
improve insulin levels and help with weight loss.

Your Medications:
In your journey with PCOS, it may be likely that you will have several health care providers. They
all may prescribe medications for PCOS along with other conditions you may have. Use this form
to write down all medications you are currently taking. Show this list to healthcare providers so
they know what, and how much you are taking. This will prevent physicians from prescribing
something that may interfere with a prescription you are already taking or allow them to monitor
and change prescriptions over time. Since many prescriptions have known food and drug
interactions, this list should be provided to your dietitian as well.

Medication
Name

Date prescribed

Prescribing
provider

Dosage

Side Effects?

Use this space to write questions you may have for your provider concerning
medications you are taking:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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__________________________________________________________________________________________________

What is the difference between simple, refined and


unrefined carbohydrates?
Simple Carbohydrates: These carbohydrates are already broken down
into very tiny glucose particles. They enter the bloodstream quickly,
causing a rapid rise in blood sugar levels, which causes a rapid increase in
insulin. This rapid rise in insulin can contribute to weight gain.
Refined Carbohydrates: These are similar to simple carbohydrates, but
require more processing by your body in order to be used as glucose for
energy. These include whole grains that have the outer layers of the grain
removed, and are labeled as refined. The outer layers of the grain contain
most of the vitamins and minerals, and importantly fiber. Without fiber, the
food is digested quickly and the resulting glucose is readily available.
Unrefined Carbohydrates: These choices are unrefined or Whole Grain
carbohydrates. They contain all three layers of the grain (bran, endosperm,
and germ), and thus all the phytochemicals and antioxidants nature
intended. Consuming whole grains has been shown to improve insulin
resistance and can lower cholesterol and triglyceride levels. This makes
them an important part of the PCOS eating plan.

Whole grains take longer to digest and keep you feeling full, longer.
Consuming whole grains is important in weight management for this reason.
U.S Dietary Guidelines suggest that whole grains make up of your grain
intake. However, women with PCOS should choose whole grains 100% of
the time. Servings of whole grains should be spaced out evenly over your
daily meal pattern.

What are examples of simple, refined and unrefined


carbohydrates?
Candy

Simple

Refined
White bread

Baked Goods

White pasta

Soda, sweet tea


Juice

White rice
Breakfast cereals
like:
Cornflakes, Froot
Loops,
Rice Krispies, Apple
Jacks
Granola bars

Honey
Sugar

Unrefined
Look on the
ingredient
list for the words
WHOLE
GRAIN.
Oatmeal
Popcorn
Rye, Barley, Spelt,
Millet
Quinoa

Your total whole grain servings will be 6-10 a day, spaced out evenly over
your daily meal pattern. You should consume your whole grain servings
with protein, to slow the release of insulin into the blood.

What other food groups contain carbohydrates?


Fruit, starchy vegetables and dairy products also contain carbohydrates.
Fruit- a serving of fruit contains 15g of carbohydrate. A serving of fruit is cup. This
equals a small apple or orange, a handful of grapes, a banana, 4 oz. of juice, or cup
dried fruit. Fruit also contains vitamins, minerals and antioxidants your body needs.
Importantly, it contains fiber as well. As previously mentioned, fiber slows the digestion
process and slows the release of glucose into the bloodstream.
Starchy Vegetables- a serving equals cup, and contains 15g of carbohydrates.
Examples of starchy vegetables include: green peas, corn, potatoes and lima beans.

Included in this group are also legumes which are lentils, beans and peas. Legumes are
a fantastic source of fiber and have protein as well.
Dairy- Milk has carbohydrates in the form of the milk sugar lactose. 8 ounces of milk
has 12 g of carbohydrates. Hard cheeses are low in carbohydrates. One ounce contains
one gram of carbohydrate. This can vary however, so make sure you read the label.

Examples of Food and their Carbohydrate content:


The following list provides a basic idea of the carbohydrate count in common foods.
Each portion below
Remember to
counts as one carbohydrate choice (15 grams of
carbohydrate). Check the American Diabetic
count fruit, starchy
Associations website for a large list of foods and
vegetables and
their carb counts!

dairy products
along with grains
when adding up the
carbohydrate

How should I spread out my carbohydrate exchanges


throughout the day?
You can meet with a Registered Dietitian who can help you plan a meal pattern,
unique to your own needs, and with foods you enjoy. Usually a meal plan will be 40%
carbohydrate, 30% protein and 30% fat. Planning a meal pattern will help you keep blood

sugar in check, can help manage your weight and can keep hunger at bay. Lets assume
your dietitian has advised you eat 30-45 grams of carbohydrate at each meal and snack.
These numbers, of course, may go up or down and may be different for different meals,
but will be used for explanation purposes here. To use the table below, record the
amount of each food group you ate at each meal. Remember to keep in mind what a
serving size is. For example, at breakfast you had: 1 piece of whole grain toast, 2
tablespoons of peanut butter, 8 ounces of skim milk, and cup of blueberries. These
values have been put into the table for you. The peanut butter will count as a low protein
meat and a high fat exchange. These values are not as important right now as you are
learning to count the carbohydrate (CHO) content of your meals, but you should
acknowledge that they are providing calories and need to be kept within certain limits to
avoid weight gain. (See section on calorie amounts in each food group).

QUICK CARBOHYDRATE COUNTING REFERENCE


GUIDE:
1 serving grain (1 ounce, or 1 piece of bread), starchy vegetables
(1/2 cup) = 15g CHO
1 serving fruit (1/2 cup) = 15g CHO
1 serving milk (8 ounces, 1 cup) = 12g CHO
Your

1 serving non-starchy vegetables (1 cup raw or cup cooked) =


5g CHO

breakfast had:
One starch or grain serving = 15g CHO
One fruit serving = 15g CHO
One milk serving = 12 g CHO
The total CHO content of this meal is = 42g CHO

Bfast

Snack
Lunch
Snack
Dinner
Snack

Starch

Fruit

Milk

1
(bread
)

1
(berrie
s)

1
(skim)

Veggi CHO
e
COUNT
43

Next,
a midsnack of
of cheese, and 3 ounces of turkey rolled up in a lettuce leaf.

you had
morning
1 ounce

The CHO count for this snack is 0. Do you remember why this is undesirable? Review
the section on hypoglycemia and its effect on hunger and energy levels.
Here are a few tables you can use to record your eating patterns. Make a copy of this
page and use it along with your food journal. The first one shows what a meal pattern
that has around 30-45g of CHO at each meal and snack will look like. Spreading out your
carbohydrate choices evenly, eating enough carbohydrate, and eating the correct type of
carbohydrate will keep your blood sugar level.
YOU SHOULD BE EATING EVERY 3-4 HOURS

Bfast
Snack
Lunch
Snack
Dinner
Snack

Starch

Fruit

Milk

Veggi CHO
e
COUNT
42
1
35
1
35
42
1
47
2
37
Veggi CHO
e
COUNT

1
1
2
1
2
1
Starch

1
1

Fruit

1
1
1
Milk

Starch

Fruit

Milk

Veggi CHO
e
COUNT

Starch

Fruit

Milk

Veggi CHO
e
COUNT

Bfast
Snack
Lunch
Snack
Dinner
Snack

Bfast
Snack
Lunch
Snack
Dinner
Snack

Bfast
Snack
Lunch
Snack
Dinner
Snack

Now that you know what foods contain carbohydrates, use the
space below to write down examples of carbohydrates that you
love, and eat often. Take this list to your dietitian to see how these
foods can still work in your diet.
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__________________________________________________________________________________________

Use the following space to record carbohydrate cravings. Write


down how you feel, what time of day the craving occurred, and
what you ate that day. Record what you did in response to the
craving. Was this the best option? What could you have done
differently?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Make and Keep an Accurate Food Journal


Write down what you eat, the time you ate, and portion sizes. Another
important aspect of a food journal is notations on how you felt before and
after you ate. Were you really hungry, were you experiencing any type of
craving, how did eating make you feel, how long until you were hungry
again, did you experience nausea, vomiting, diarrhea, or constipation? You
can also record where you ate, who you were with, and any barriers to
success you encountered. Were you with friends that pressured you into
having a slice of cheesecake? Did your office order from the restaurant
down the street again that you love, but have no idea what is healthy on the
menu? Was there a special occasion and you over indulged on cake and ice
cream (and if you did, it is OKAY. Record why your numbers were high and
enjoy the cake, just not every day!)
By keeping excellent food records you can see patterns in how you feel
based on what, and when, you ate. You can also see where barriers to your
success occurred and make a plan for the next time you are in the same
situation! You can use the food journal template on the next page or make
your own!

Counting Calories:
Calorie counting can be a daunting process! Especially when dining out or
eating at someone elses house. You can use a smart phone application like
My Fitness Pal to help you keep track. The following calorie counts can be
used to determine a calorie count that will be fairly close to your actual
consumption, as long as you use correct portion sizes and account for
hidden sources of calories. Hidden sources may be oils used for sauting or
marinating, and butter or meats in vegetables. Dont forget to include that
candy you took from the candy dish, or that bite of cheesecake you had a
lunch.

Calories in 1 serving of:


Starch/Grain/Bread (1/2 cup cereal, 1 ounce, 1 slice of bread) = 80 calories
Protein (1 ounce) = Very lean = 35 calories, Lean = 55 calories, Medium fat =
75 calories, High fat = 100 calories
Starchy Vegetables (1/2 cup) = 80 calories

Non-starchy Vegetables (1/2 cup cooked, 1 cup raw) = 25 calories


Fruit (1/2 cup fruit or fruit juice, cup dried fruit) = 60 calories
Milk (8 ounces) = Skim = 90 calories, Low-fat = 120 calories, Whole = 150
calories
Fat/oil (1 tsp) = 45 calories
Other fat sources worth 45 calories = 8-10 olives, 1 oz. avocado, 6 almonds or
cashews, 10 peanuts,
4 pecan halves, 2 tsp peanut butter, 1 Tbs regular salad dressing, 2 Tbs
reduced fat salad dressing

MY FOOD JOURNAL:

Date:

Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special


Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
_
How I felt before I ate:________________How I felt after I
ate:______________________________________
Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special
Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
_
How I felt before I ate:_________________How I felt after I
ate:_____________________________________
Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special
Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
_
How I felt before I ate:_________________How I felt after I
ate:______________________________________

Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special


Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
How I felt before I ate:_________________How I felt after I
ate:______________________________________
Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special
Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
How I felt before I ate:_________________How I felt after I
ate:______________________________________
Time:_______ Meal:________ Where: _______ Who Was With Me: __________Special
Occasion?_________
Food:____________________________________________________________________________________
__________________________________________________________________________________________
How I felt before I ate:_________________How I felt after I
ate:______________________________________
Today I felt I did this
well_____________________________________________________________________
Next time I will do this
instead_________________________________________________________________

Omega 3 and Omega 6 Fatty Acids


For women with PCOS, Omega-3 fats are ESSENTIAL! They help improve mood, lower
cholesterol and triglycerides, improve insulin, lower blood pressure, and improve the
quality of hair and skin.
Fatty fish is a great source of Omega-3 fats. However, even if you eat fatty fish two
times a week, you should still take a fish oil supplement daily that consists of 1000 mg of
EPA and DHA Omega-3 fatty acids. Do not exceed 4000 mg daily and talk to your doctor
before taking a fish oil supplement if you have high cholesterol, high triglycerides, or if
you are taking a blood thinning medication. Vegans and vegetarians can take flaxseed
oil which contains the Omega-3 fatty acid ALA.
Sources of Omega-3 Fatty Acids:

Canola oil
Walnuts, Almonds
Fish oil
Eggs
Sunflower seeds
Flaxseeds
Fatty fish (Tuna, Salmon, Trout, Halibut)

Omega-6 Fatty acids are essential for the treatment, prevention, and maintenance of
inflammation, common to those who suffer from PCOS. Too much Omega-6 has been
linked to vascular disease, cancer, and bone and joint disease. Americans consume far
too much of this fat. The optimal ratio of Omega-6 to Omega-3 should be 4:1, the typical
American diet has a ratio of 10:1.
Sources of Omega-6 Fatty Acids:
Unsaturated vegetable oils like: palm, soybean, corn, safflower, cottonseed,
sunflower
Margarine
Some meat and poultry
Baked goods
Breads, crackers
Salad dressings

Take Home Message:


Women with PCOS need to limit
their Omega-6 intake and
increase their Omega-3 intake
Smart Eating Out
Eating out is part of daily life, and it can be a fun, enjoyable social experience. Certainly,
you can still enjoy eating out at your favorite restaurants. Just play it smart! Many
restaurants post their nutritional information online, so check before you dine! In
general, restaurant food has too much fat and salt. The portion sizes are often enormous,
and can feed 3 or more, there are not enough fruits and vegetables and grains are
refined.
Did you know.

Chicken sandwiches can range from 360 to 950 calories, & entre salads with chicken
range from 320 to 800 calories. The fancier sandwich shops (Panera) have bigger and
higher calorie items. The average amount of calories in a restaurant meal is 1100!
Tips for eating out:
Dont drink your calories! A 20 oz. soda has 250 calories and coffee drinks may
have 500 calories.
Be careful where you eat. Make sure you pick a restaurant that will give you some
healthy choices.
Get your food made to order. Ask for a baked potato instead of french fries. Ask
for your salad dressing on the side. Hold the mayo! These are the kinds of special
requests you can make. It should be no problem and is getting more common all
the time.
Dont eat too much. Restaurants give you too much food. If you have cleaned
your plate, you have likely eaten too much.
Order an appetizer, salad, or a side order instead of a main dish.
Share your food with your dining partner.
Take half of your food home. Ask for a doggie bag.
Drink lots of water or low calorie liquids. Drink an entire glass of water before your
food comes.
Ask the server not to bring bread or chips
Eat slowly.
Order your food before you look at the menu to prevent temptation
How to watch for fats in the food:
Look for words that mean fat is in the food. For example: oil, butter, sour cream,
cheese, sausage, bacon, fried, golden brown, batter fried, cream sauce, cheese
sauce.
Look for the words that mean lean. For example: tomato sauce, vegetables,
fruits, mustard, vinegar, marinated kabobs, grilled, poached.
If you dont know what is in the food or sauce, ASK!
Dont eat too much protein (meat.)
Many dishes include large servings of meat or seafood that weigh 8-10 ounces.
That is twice as much protein as you should eat at one time. If you get a very large
serving of meat or seafood, divide it in two. Split one vegetarian and one meat or
fish dish with your dining partner. Youll end up with more vegetables and just the
right amount of protein
Alcohol:
Alcohol has lots of calories.
Dont drink too fast. Have water, club soda or diet soda next to you and take turns
sipping from each.
Use low-calorie mixers: water, club soda, diet soda, diet tonic water
High-calorie mixers (stay away from these):
juices, syrups, liquors, regular
sodas, whole milk & cream

Label Reading

Number of total servings in


the package

Use this to
determine what
makes up ONE
serving

The amount of
calories in
Saturated Fat
should be kept as
low as possible,
Trans Fat should

This is the number


you should be
looking at to
determine the
amount of
carbohydrates in the

Look for foods


with more
than 5g of
fiber per

Good rules to abide by:


Look for food that has no more than 3g of total fat
per 100 calories!
The foods you consume should have 0g Trans fat
Keep saturated fats to less than 10% of your total
daily fat intake
Find foods with less than 300mg of sodium per
serving
Keep snacks to under 200 calories

Be a Trans Fat
Detective!
Food products may say
they have 0 grams of
Trans Fat, but that may
not be accurate.
Manufacturers only
have to list them on
the label IF they have
over .5g per serving.
To check if the product
you are eating has
Trans Fat look at the
ingredient list. If you
see anything that says

Mindful Eating
Low Blood Sugar- We previously mentioned how high insulin levels will
result in low blood sugar, which in turn will create a strong desire for
carbohydrate rich foods. When you consume refined, or simple
carbohydrates your blood sugar increases and you feel better. However,
once you start consuming these quick sources of energy it is hard to stop. If
you consume too much of these foods at one sitting, low blood sugar can
occur again as the result of an over production of insulin to get the glucose
into cells. When this happens you feel bad again and want more simple
carbohydrates to raise blood glucose levels again. See how this turns into a
vicious cycle?
Mindful eating- Preventing yourself from getting too hungry can prevent
poor food choices. This means eating at regular intervals throughout the
day. By keeping a food journal you will learn when you are typically hungry
and when you typically tend to make poor choices. By knowing this, you
can eat before you are starving, you can plan ahead to have a snack that
includes a complex or whole grain source of carbohydrate and protein
handy. Eating a snack like this will slow the release of glucose into your
blood and keep blood sugar levels steady. This will prevent out of control
hunger, fatigue, dizziness, irritability, and poor food choices leading to
weight gain.
Imbalance of Hormones- Women with PCOS do not have normal levels of
ghrelin and leptin. These hormones tell us when we are hungry and when
we are full. The result of having an imbalance of these hormones causes
you to eat when you are not hungry and continue eating even though you
are full.
Mindful eating- Again, keeping a food journal and recording your emotions
relating to the food you eat, and how you felt before and after eating will
help you distinguish when you are eating because you are actually hungry
and when you are eating for other reasons, like boredom or as a coping
mechanism. Learn to recognize hunger and satisfaction cues and record
them in your journal.
Emotional Eating- Stress levels can have a huge impact on our eating
habits. Sometimes women turn to food to zone out, to provide a distraction,
or to self soothe. There are countless emotional reasons people turn to
food. Take a moment to think about what emotions trigger a desire to snack
and record them below.

When I feel __________ I eat


___________________________________________________
____________________________________________________________________________
When I feel__________ I eat
____________________________________________________
____________________________________________________________________________

When you begin to understand what emotions or events


cause you to overeat or eat less nutritious foods, you can
come up with an action plan for the next time you feel or
experience that trigger.
Example: When I get home from work and finish my daily chores, I am
exhausted. I sit on the couch and zone out watching TV. I will grab a bag of
pretzels from the pantry with the intention of eating a handful, by the time
my shows are over, the whole bag is gone. I didnt even realize I was doing
it.
Answer: This could be as simple as making single portion snack bags. But,
when it comes to emotional eating, nothing is ever easy. Lets expand on
this idea. Pretzels are easy to eat and the crunch is addictive and satisfying,
is that why you chose them? If so, maybe you could switch to baby carrots
and dip them in hummus or low-fat ranch dressing. This is a more complex
form of carbohydrate and will make you feel full quicker. Pairing it with
hummus or ranch dressing provides protein and/or fat which slows digestion
and also contributes to feeling satisfied.
Answer: The bag of pretzels is easy to take to the couch. No preparation
needed. Is this why you chose them? Instead grab a bag of air-popped
popcorn. You can have 3 cups of this as a carb serving! Popcorn is a whole
grain! Eat it one piece at time. Have a glass of water handy and take
frequent sips of water. Sometimes we eat so fast, our bodies dont have the
chance to tell us it has had enough food! Learn to recognize cues that you
are full before you are uncomfortably full. If you eat slowly, there is a better
chance you will notice the signal.
Example: My job is so stressful. Sometimes I dont even get a chance to go
to lunch and I am starving around 2:00. The break room always has cookies
and donuts and I run in there and grab a couple of each to tide me over.
Then, an hour later, I grab a bag of M&Ms from the vending machine
because I feel so tired and need something to keep me going. When I get

home, I have no energy and usually just eat take-out or order pizza because
I dont feel like cooking.
Answer: You can probably see what is happening here! She has gone too
long between meals and her blood sugar has plummeted. The donuts and
cookies bring it up quickly only to crash again soon after. Then she goes for
another source of simple carbohydrates and the cycle starts again. By the
time she gets home, she is exhausted from constant blood sugar crashes
and has had nothing to help her sustain her energy level. A suggestion for
this individual may be to pack her lunch! If she prepares a big pot of
vegetable soup on Sunday, and divides it into several single servings, she
can bring it for lunch several days. She can pair her soup with half of a
turkey sandwich or a green salad prepared that morning. She can bring an
apple, almonds, yogurt, cheese and crackers or celery with peanut butter as
a midmorning and midafternoon snack. Preparing ahead can prevent poor
food choices. Making casseroles to keep in the freezer, or crock pot dinners
can provide healthy, easy dinners and prevent poor choices at the end of
the day.
What are some alternatives you can think of to suggest to the two women
above?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
What are some ideas for combating emotional eating that may work for
you?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Here are some other habits that lead to mindless eating and mindful eating
suggestions that may work for you. Of course, the ideas you come up with
by yourself or when working with your dietitian will be more individualized,
and will work the best for you!
Eating in front of the TV- Enforce a no eating dinner on the couch rule.
Turn the TV off and set the table. Make mealtimes special. Use your

nice tableware and glasses. Now slow down and enjoy your food.
Notice the flavors, textures and aromas of the food you are eating.
Make it a sensual experience. _____________________________________
_______________________________________________________________________
Eating while driving- Avoid the drive thru. While on the road, a quick
bite is sometimes needed. Leave a little early and stop at a sit down
restaurant and get the salad bar. It will be quicker and healthier than
ordering off the menu. You can also pack a sandwich and a piece of
fruit and stop at a park to get a little bit of vitamin D from the sunshine
as a result. This could be a nice escape from the office!
_____________________________
________________________________________________________________________
Eating a whole bowl of bar nuts- Stop and think about how many
fingers have been in that bowl before yours. Did they wash their hands
after using the bathroom or blowing their nose? Do you want to take
that chance? Instead order your own appetizer like shrimp cocktail,
edamame, a side salad, a baked potato with one pat of butter or
another healthy menu option.
_______________________________________________
________________________________________________________________________
________________________________________________________________________

Sample Menus Based on Calorie Counts


1400-1600
Breakfast:

Example:

1 Fruit

cup blueberries or banana

1-3 Grains/Starch
1 Fat
tsp Cinnamon

1 cup skim milk


1 cup plain oats, cooked with 1 T almonds and

Lunch:
1-2 Grains/Starch

cup roasted chickpeas

3 Proteins

3 ounces grilled chicken

2-3 Vegetables

2 cups spinach with tomatoes, cucumbers

1 Fruit
2 Fats

Mandarin orange sections (1/2 cup)


4 Walnuts, 1 T sesame vinaigrette dressing

Snack:
1-2 Fats

1 T peanut butter

1 Protein

apple

1 Fruit

tsp cinnamon

Dinner:
3-5 Proteins
mozzerella

4 oz. skinless chicken, 1 oz. part skim

2 Vegetables

1/2 cup green beans, cup marinara sauce

1-2 Fats

2 tsp canola oil

1-2 Grains/Starches

cup brown rice

1400-1600 calories, 28% protein, 38% carbohydrate, 34% fat, 7% saturated


fat, 30 grams fiber, 2,100 mg sodium

1600-1800 Calories
Breakfast:

Example

1 Fruit

1 cup cantaloupe

1-2 Proteins

2 eggs

1-2 Grains/Starches

1 slice whole grain toast

1-2 Fats

T butter with plant sterols

Snack:
1 Protein

1 oz. low fat cheese

1 Grain/Starch

6 whole wheat crackers

Lunch:
2-3 Vegetables
veggies

1.5 cups romaine lettuce, assorted non-starchy

3 Proteins

3 oz. grilled salmon

1-2 Fats

1 tsp olive oil with 1 T balsamic vinaigrette

2 Grains/Starch
croutons

1 cup low sodium minestrone soup, cup

Snack:
1 Protein

5 oz. Greek yogurt

1 Fruit

cup peaches

Dinner:
4-6 Proteins

5 oz. Pork tenderloin

2 Vegetables

1 cup steamed broccoli

1-2 Fats

1 tsp olive oil

1-2 Grains/Starches

cup sweet potato

Snack:
1 Fat
1 Fruit

cup dark chocolate covered almonds


cup dried fruit

1600-1800 Calories, 27% Protein, 37% Carbohydrate, 36% Fat, 7.5%


Saturated Fat, 30 grams Fiber, 2,160 mg Sodium

1800-2000 Calories
Breakfast:
1-2 Grains/Starch
1 Fruit
1-2 Proteins

Example
cup cooked bulgar
1 small peach
cup skim milk

1-2 Fat

1 T almonds, tsp cinnamon

Snack:
1 Grain/Starch

1 slice whole grain raisin toast

Lunch:
1-2 Grains/Starch

1 whole wheat bun

3 Proteins

1 7% fat turkey burger, 1 oz. low fat cheese

2-3 Vegetables

1 cup garden salad

1 Fruit

1 cup grapes

1-2 Fats

2 tsp olive oil with 1 T balsamic vinegar

Snack:
1 Protein

4 oz. plain vanilla yogurt

1 Fruit

peach

1 Fat

1 T. granola or ground flaxseed

Dinner:
2 Grains/Starches

1 cup brown rice pilaf

5 Proteins

5 oz. chopped skinless, boneless, chicken breast

2-3 Vegetables

1 cup mixed steamed veggies for stir fry

1-2 Fats
veggies)

1 tsp canola oil (use for sauting chicken and

1800-2000 Calories, 24% Protein, 48% Carbohydrate, 28% Fat, 6.4%


Saturated Fat, 35 g Fiber, 2,212 mg Sodium

PCOS: HEALTHY
SNACKING!
Keep Blood Sugar Levels Steady!
In order to keep your blood sugar level, it is important to eat on a regular basis. Meals and
snacks should be eaten every 3-5 hours to prevent blood sugar levels from falling too low.
Snacks including a complex carbohydrate and lean protein or fat will help you feel fuller longer
and will help prevent cravings and binges.

Prep your snacks ahead of time!


Snacks can be made on Sunday, for example, and placed into plastic baggies for the upcoming
week. This will save time during the busy work week! If a healthy snack is always handy, and in
pre-portioned sizes, it will prevent you from making a poor decision at the gas station, vending
machine or fast food drive thru. Keep trail mix, whole grain pretzels, and/or dried fruit in your
car or purse for a quick snack!

Healthy Snack Suggestions:


Fruit and low-fat cheese

Whole wheat fig bars

Apple or celery and peanut butter

High protein, whole grain and low-sugar bars such


as Nature Valley Oats N Honey (1 bar), or Simply
Protein Bar and snack line

Low-fat cottage cheese and fruit


Greek yogurt with ground flaxseed
Hard-boiled eggs
Plain oatmeal and walnuts
Latte with non-fat milk

Instant low-sodium bean or vegetable soups such


as Campbells Healthy Request, or Progresso low
sodium varieties
Whole grain pretzels

Raw nuts such as walnuts and almonds (1/4 cup is


Trail mix of nuts, dried fruit, and dark chocolate
one serving or the size of your palm) or Planters
Harvest Dark Chocolate Forest Blend
Whole wheat crackers with low-fat cheese
Or Peanut butter

Single-serving pouches of tuna

Pomegranate seeds

Dark chocolate (at least 60% coco or higher. Limit


to 1 to 2 squares)

Wasabi dried peas


Mixed Fruit Cup

Hummus and vegetables

Edamame
Glucerna or Boost Glucose Control shakes and bars

Remember to use correct portion sizes!


Whole grains = cup or one piece of bread

Cheese = 1 ounce

Low fat dairy = 1 cup

Nuts and seeds = 1 ounce

Fruit = cup

Raw Vegetables = 1 cup

Protein = 3 ounces (size of a deck of cards)

Cooked Vegetables cup

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