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protein intake is not wise if you have PCOS. If you fill up on proteins you have less room for nutrient-rich foods that can help balance blood-sugar levels. If you do eat animal protein, limit your intake to 2 or 3 oz per meal – a serving size no bigger than the palm of your hand. Where possible eat organic animal foods to avoid consuming the growth hormones and antibiotics with which many non-organic animals are routinely treated.

      A sensible balance is two portions of carbohydrate to every one portion of protein, and no less than one portion of carbs to one portion of protein. One portion of protein equals 3 oz of cooked, lean meat or fish, half a cup of baked beans, 3 oz of hard cheese, 2 eggs or three-quarters of a cup of cottage cheese. To avoid a large intake of animal protein and an increase in saturated fat, it is possible to eat vegetarian sources of protein.

      Try to include a range of protein in the form of low-fat cottage cheese, ricotta cheeses, quark cheese, lean red meat, poultry, seafood, fish and egg whites. Other sources of proteins are soybeans, split peas, kidney beans, peas, wheatgerm, lima beans, black-eyed peas, lentils, black beans, spirulina and grains such as quinoa.

      Proteins and fats are digested more slowly than carbohydrates and will slow down the entry of sugar into your blood. Dried beans and peas can lower the effect of other carbohydrate-rich foods on your blood-sugar. When eaten alone, legumes don’t raise blood-sugar very much even though they contain carbohydrate, but when eaten together with other carbohydrate-rich foods they can actually lower the effect these foods have on your bloodstream. For example, when you eat pinto beans with rice, the beans reduce the effect of the rice on blood-sugar. Similarly, if you really want to eat that cake, make sure you eat it as part of a meal that includes beans.

      Ideally your protein intake should be split throughout the day so that at every meal you take in some protein along with carbohydrates from wholegrains, vegetables and fruits. This will help reduce your insulin production levels in response to the amount of carbohydrate eaten. But if you do find it hard to digest food or have irritable bowel syndrome (IBS) or digestive problems, food combining (taking proteins and carbs at separate meals) can often help to ease the problem until you can work up to a diet where you can mix the two (see page 174).

      

       For Vegetarians and Vegans

       When you look at the diets of most vegetarians, protein intake tends to be small. If you are a vegetarian it is very important that you get complete proteins in your meal. Below are some suggestions to help you do this.

      – If you are the only vegetarian in your household, make sure you substitute pulses, beans, wholegrain cereals, dairy products, tofu products or textured vegetable protein instead of just leaving the meat part out of the meal.

      – Choose cereals fortified with vitamins, especially B₁₂.

      – Try to eat a large portion of dark green leafy vegetables every day, and half to three-quarters of a pint of semi-skimmed milk a day to ensure your calcium intake. If you are lactose intolerant you can get your calcium in soya yogurts and milks or nut milks.

      – Eat dried fruits, pulses, green vegetables and whole grains for fibre and iron. Cocoa powder and dark chocolate are good sources of iron, too.

      – Eat at last 30 g of pulses, nuts and seeds every day for protein and EFAs.

      – Eat at least one serving of low-fat cheese or cottage cheese a day for protein and calcium – or a soya pattie or tofu portion.

      – Eat a total of three to four eggs a week.

      – Choose margarine or butter fortified with vitamin D and E in a vegetarian spread. You can get vitamin D from sunlight as well, and vitamin E from nuts and seeds.

      

       If you are a vegan, the risk of nutritional deficiencies is higher. You need to seek expert advice from a doctor or nutritionist. The Vegan Society has lots of useful information (see Chapter 12).

       Your biggest concern as a vegan is to ensure you get adequate amounts of protein and vitamin B12. The American Diabetic Association states that soy protein has been shown to be nutritionally equivalent to animal protein. Nuts, seeds, grains, pulses and vegetables are other good sources of protein. Yeast extracts used as food flavourings are often high in B12; if you are a vegan, eat these foods regularly, together with other products such as cereals, with a guaranteed vitamin B12 content. You can also take a B-complex vitamin supplement which includes B12.

      6) Make Sure You Get Enough Essential Fatty Acids (EFAs)

      As a guideline, calories from fats should contribute 20 to 25 per cent of your total calories in your diet. You should try to obtain as little fat as possible from the saturated, animal fats or transfatty acids found in many commercial foods, and as much as possible in the form of essential fatty acids (EFAs) such as the Omega-3 and Omega-6 fatty acids.

      Why?

      Many conditions, including PCOS, are associated with the metabolism of fatty acids. Our bodies need essential fats to regulate hormone function and strengthen cell walls. Some of the health benefits of special concern to women with PCOS include: improvement in skin, hair and nails, and regular periods. What’s more, high-quality dietary fat slows down the entry of carbohydrates to the system, thus keeping insulin levels lower, and satisfies your hunger. In fact, dietary fat is the best blood-sugar stabilizer. And stable blood-sugar means less depression, greater mental focus and improvement of PCOS symptoms.

      Without sufficient quantities of Omega-3 and Omega-6 fatty acids, your body cannot manufacture many important substances including ovarian and stress hormones. If you are eating a very low-fat diet you won’t be getting enough of these EFAs, and this can affect your menstrual cycle.

      How?

      Nuts, seeds, olive oil, avocado, flaxseed oil and oily fish (mackerel, salmon, herrings and sardines) are rich in essential fatty acids. Aim to eat fish at least twice a week, and nuts and seeds (flax, sunflower, pumpkin, hemp, sesame, almonds, cashews, walnuts) daily, maybe as a snack between meals, take flax oil by the tablespoon or in salad dressings, add hempseed oil to smoothies, or use sesame oil with stir-fries.

      Omega-3 fatty acids are far less common than Omega-6 fatty acids in our modern diets. Omega-3 fatty acids are found in the oils of cold-water fish as well as in some seeds (including hemp seeds and pumpkin seeds) and in walnuts. Omega-6 fatty acids are in many foods, especially nuts, seeds, vegetable oils (such as sunflower, soy, walnut, sesame, olive, coconut and peanut oil) and legumes. The two types of fat are not interchangeable; you need to consume both and keep them balanced.

      If you don’t eat fish, flaxseed oil or flax seeds (also known as linseeds) are excellent sources of Omega-3: 7 grams of flaxseed oil are equivalent to 1 gram of fish oil. Try a daily dose of 3 heaped teaspoons of cold-pressed flaxseed oil or three tablespoons of ground flax seed. Hempseed, pumpkin seed or soybean oil are also good sources. Use only cold-pressed vegetable oils; the bottle should say ‘unrefined’, ‘unhydrated’ or ‘cold-pressed’. Alternatively, grind 1 tablespoon of seeds and mix it into cereals or sprinkle over salads. Sea vegetables (edible seaweed, kelp, etc.) and green leafy vegetables are also good sources.

      It’s best to avoid refined and processed foods, as they contain substances which can block the absorption of EFAs, and limit your intake of excess fatty foods from animal sources such as lamb and pork, high-fat cheeses and cream. Animal fats contain a substance that encourages blood-clotting and inflammation – thus they can exacerbate eczema or other inflammatory conditions. Game is less fatty, as are white meats, poultry and fish. Steer clear of factory-farmed poultry, which often contains hormones and antibiotics that can upset your hormonal, immune and digestive systems.

      You don’t need to avoid animal fat completely, simply keep it to a minimum, but do avoid vegetable oils in the form of the fried, oxidized or hydrogenated fats found in margarine, vegetable

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