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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.
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
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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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.
Simple
Refined
White bread
Baked Goods
White pasta
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.
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.
dairy products
along with grains
when adding up the
carbohydrate
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).
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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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.
MY FOOD JOURNAL:
Date:
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
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
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
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.
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?
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What are some ideas for combating emotional eating that may work for
you?
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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. _____________________________________
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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!
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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.
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Example:
1 Fruit
1-3 Grains/Starch
1 Fat
tsp Cinnamon
Lunch:
1-2 Grains/Starch
3 Proteins
2-3 Vegetables
1 Fruit
2 Fats
Snack:
1-2 Fats
1 T peanut butter
1 Protein
apple
1 Fruit
tsp cinnamon
Dinner:
3-5 Proteins
mozzerella
2 Vegetables
1-2 Fats
1-2 Grains/Starches
1600-1800 Calories
Breakfast:
Example
1 Fruit
1 cup cantaloupe
1-2 Proteins
2 eggs
1-2 Grains/Starches
1-2 Fats
Snack:
1 Protein
1 Grain/Starch
Lunch:
2-3 Vegetables
veggies
3 Proteins
1-2 Fats
2 Grains/Starch
croutons
Snack:
1 Protein
1 Fruit
cup peaches
Dinner:
4-6 Proteins
2 Vegetables
1-2 Fats
1-2 Grains/Starches
Snack:
1 Fat
1 Fruit
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
Snack:
1 Grain/Starch
Lunch:
1-2 Grains/Starch
3 Proteins
2-3 Vegetables
1 Fruit
1 cup grapes
1-2 Fats
Snack:
1 Protein
1 Fruit
peach
1 Fat
Dinner:
2 Grains/Starches
5 Proteins
2-3 Vegetables
1-2 Fats
veggies)
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.
Pomegranate seeds
Edamame
Glucerna or Boost Glucose Control shakes and bars
Cheese = 1 ounce
Fruit = cup