Nutrition for PMOS/PCOS
What is PMOS?
The condition PMOS, standing for Polyendocrine Metabolic Ovarian Syndrome, effects around 1 in every 8 women1 in Australia and an estimated 170 million women world-wide2. PMOS has recently been renamed from the previous acronym PCOS (Polycystic Ovary Syndrome) to better reflect the metabolic complexities of the condition.
To receive a diagnosis of PMOS, 2 of the following 3 criteria, known as the Rotterdam criteria, must be met:
1. Lack of ovulation causing irregular menstrual cycles (either <21 days apart, >35 days apart or no cycle at all).
2. Excess male hormone production (e.g. testosterone) detected through a blood test.
3. Cysts on the ovaries as detected via ultrasound
Signs and symptoms of PCOS include; irregular periods, anovulation, excess hair growth or hair loss, acne and increased weight. PCOS is also closely linked with insulin resistance and a higher risk of heart disease or diabetes
Nutrition Guidelines:
There is no specific “PMOS diet”, however, there are some things that we can do to help manage and improve symptoms. Maintaining a balanced diet and healthy lifestyle are the first steps towards managing PMOS. At Dietitians NT, we recommend following the healthy plate model which consists of 50% low carbohydrate vegetables, 25% lean protein and 25% low GI carbohydrate, and small regular amounts of healthy fats like avocado, olive oil and nuts. Two dietary strategies that may help manage PMOS, especially if insulin resistance is a factor are:
1. Following a regular eating pattern. For example; breakfast, morning tea, lunch, afternoon tea and dinner
2. Choosing low GI carbohydrates instead of high GI carbohydrates
It is also important to prioritise adequate sleep and to manage stress. Aiming for 30 minutes of physical activity each day can also help to manage PMOS.
What is the Glycaemic Index?
The Glycaemic Index measures the rate at which carbohydrates are broken down to enter the bloodstream as glucose. High GI carbohydrates are broken down quickly and provide a rapid blood glucose spike and crash. Low GI carbohydrates are broken down slowly and provided a slower release of energy. Prioritising predominantly low GI carbohydrates can be helpful for people with PMOS as this may help to manage blood sugar levels and appetite throughout the day.
Examples of Low vs High GI Carbohydrates
Low GI | High GI |
Boiled Sweet Potato Boiled and Cooled White Potato Wholegrain Bread Apple & Pear Milk, Soy milk & Almond milk Rolled Oats Lentils & Beans Milk & Yoghurt | Baked Potato and Sweet Potato Boiled Potato White Bread Watermelon Rice milk and Oat milk Instant Oats Pastries Soft drink, juice, honey, sugar |
Build a Balanced Plate:
Using the healthy plate method is an easy way to support blood sugar levels and increase satiety:
½ plate: Non-starchy vegetables (broccoli, capsicum, carrots, leafy greens, zucchini)
¼ plate: Lean protein (chicken, fish, eggs, tofu, tempeh, lean beef or legumes)
¼ plate: High-fibre carbohydrates (brown rice, quinoa, wholegrain pasta, sweet potato or wholegrain bread)
Include a source of healthy fats, such as avocado, olive oil, nuts or seeds.
Example Meal Options:
Breakfast:
· Overnight oats with chia seeds, high protein yoghurt and low GI fruits
· Wholegrain toast topped with avocado and poached eggs
Lunch:
· Grilled chicken burrito bowl with brown rice
· Chicken and quinoa salad with roasted vegetables and feta
· Wholegrain wrap with grilled chicken, salad and hummus
· Lentil soup with wholegrain bread
Dinner:
· Salmon and Veg (sweet potato, broccolini and capsicum)
· Tofu and Vegetable stir fry with brown rice
· Lean beef chili with kidney beans, brown rice and avocado
DASH diet and Mediterranean diet for PCOS/PMOS:
The DASH diet and Mediterranean diet have been correlated with promoting improved health outcomes for people with PMOS, including increasing insulin sensitivity, decreasing androgen levels and improving menstrual cycle regularity.
The DASH diet was originally developed for people with high blood pressure and thus has a strong emphasis on reducing sodium, saturated fats, and alcohol. Whilst reducing sodium, the composition of the DASH diet results in increased intake of potassium, calcium and magnesium.
The Mediterranean diet is based on the eating patterns of people from the Mediterranean region and has a strong emphasis on extra virgin olive oil and limiting animal products but does encourage the intake of fish and other seafood at least 3 times per week. The Mediterranean diet also included a small allowance of alcohol, particularly red wine, whilst the DASH diet does not. These dietary patterns are wholefood based, with emphasis on vegetables, fruits, legumes and wholegrains, in addition to limiting red meat and ultra processed foods.
Both the Mediterranean diet and the DASH diet are rich in polyphenols, antioxidants and fibre which may assist with managing chronic inflammation associated with PMOS. Combined with stress management, regular exercise and adequate sleep, these dietary patterns can help with symptom management for people with PMOS.
Teede HJ, Misso ML, Costello MF, Dokras A, Laven JSE, Moran LJ, Piltonen TT & Joham AE. (2023). Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. The Medical Journal of Australia, 219(7), 334–341. https://doi.org/10.5694/mja2.52432
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