Lifestyle exercise and diet for PCOS women

Medical Q&A [Moderated]
1

Good morning,

I am writing after acknowledging that many dears in my life are diagnosed by PCOS.
The first-line treatment is diet and exercises lifestyle changes, not considering drug treatment like metformin and other type used in T2D.
I found these studies related to hyperandrogenism and insulin resistance and other factors of PCOS.
Obviously, I know there is no magic solution and no cure, as stated by the latest research. I was interested in a more general lifestyle changes to have a better life with all these factor that are known from many years and maybe experience comes in hand. I saw you had two thread on Cholestorole, should that help?

I can like the studies I found about exercise:

Hutchison SK, Stepto NK, Harrison CL, Moran LJ,
Strauss BJ, Teede HJ (2011) Effects of exercise on
insulin resistance and body composition in over-
weight and obese women with and without poly-
cystic ovary syndrome. J Clin Endocrinol Metabol
96(1):48–56

Harrison CL, Lombard CB, Moran LJ, Teede HJ
(2011) Exercise therapy in polycystic ovary syn-
drome: a systematic review. Hum Reprod Update
17(2):171–183

About diet:
“Over the past 30 years, a significant increase in the prevalence of insulin resistance (IR) has been observed.
It is associated with more frequent occurrence of impaired glucose tolerance, diabetes, excessive weight,
cardiovascular diseases, and endocrine disorders. The results of current studies do not indicate a necessity
to exclude dairy products from the diet of insulin-resistant individuals. In addition, it has been found that
moderate amounts of alcohol as part of a balanced, low-energy diet do not have a negative effect on insulin
sensitivity. The authors of recent studies emphasize the importance of reducing the intake of simple sugars,
especially from sweet drinks, sweets and excessive fruit juice consuption. Many studies have demonstrated
the beneficial effects of consuming complex, low-glycemic-index carbohydrates that are rich in dietary
fiber. An insulin-resistant patient’s diet should be rich in whole grains and high amounts of non-starchy
vegetables and raw fruit. The beneficial effect of the Dietary Approaches to Stop Hypertension (DASH diet)
and the Mediterranean diet has been confirmed. The positive correlation between low-carbohydrate and
very-low-carbohydrate diets requires confirmation in long-term studies with the participation of insulin-
resistant patients. Research shows the benefits of increased calorific intake during the first half of the day,
especially from a high-energy and low-glycemic-index breakfast. Furthermore, many researchers indicate
that slow and mindful eating is a significant component of an appropriate diet for insulin-resistant individuals”

abstract from:
Dietary support in insulin resistance: An overview of current scientific reports
Gołąbek, Katarzyna et al in Advances in Clinical and Experimental Medicine (2019) pp. 1577-1585

Latest reviews on PCOS:
An update on polycystic ovary
syndrome: A review of the current state
of knowledge in diagnosis, genetic
etiology, and emerging treatment options
Hiya Islam 1 , Jaasia Masud 1 , Yushe Nazrul Islam 1
and Fahim Kabir Monjurul Haque 2

Any input appreciated, thanks

2

Hi,

Can you clarify what your specific question is here?

3

Hi Austin,
You’re right, I missed the point :o
My specific question is about exercise and diet: what to do more than “normal” guidelines about them. Regarding diet, the abstract and the linked sources clarify a bit on what to do specifically for PCOS clients (diet and food for IR), about exercise I found contrasting sources: e.g. do light weighting exercises with long pauses which do not fit into any “strength” “bodybuilding” “cardio” pattern as far as I know.

The thing is, I know exercising and diet has some pillars, e.g. exercising is better than no exercising at all BUT women affected from PCOS tend to have more problems seeing results due to their multi-factorial features, e.g. one should change their lifestyle and wait a longer time compared to “normal” people before seeing improvements.
I feel lost as to what to measure and keep track of, just BMI and other things and what kind of template to run, if there are some specific settings about exercises to be aware of or what to have in mind when programming exercising for PCOS women because medical papers do not dwell into details and I think your expertise and experience could help a lot.

4

My specific question is about exercise and diet: what to do more than “normal” guidelines about them

I don’t think there is compelling evidence to suggest that individuals with PCOS need a unique approach to dietary pattern or exercise. Ideally, they should eat a health-promoting dietary pattern that supports activity and a healthy body weight. They should also meet or exceed the the physical activity guidelines. Their are many ways to do both of these things and in general, do not require unique management.

do light weighting exercises with long pauses which do not fit into any “strength” “bodybuilding” “cardio” pattern as far as I know.

This is not an evidence-based recommendation.

BUT women affected from PCOS tend to have more problems seeing results due to their multi-factorial features,

This is not reliably true regarding weight management, dietary pattern adherence, or exercise participation. I do understand that this is a common belief, but that doesn’t make it true.

I feel lost as to what to measure and keep track of

If there is a unique measurement that, upon it changing, would affect how you program for an individual, then track it. I do not think such a measurement exists for PCOS.