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your fancy. For the best benefit, drink the juice as soon as you have made it, as contact with the air destroys vital vitamins and minerals. The downside of juicers is that they extract the pulp so you don’t get the benefit of the fibre slowing down the release of sugar into your bloodstream. To get fibre, try using a blender to make smoothie-type drinks using berries and soft fruits such as pears, and soya milk or organic low-fat yogurt. You can also add in a teaspoon of Omega-3-rich oils such as hempseed or linseed (see page 40).

      Eat whole fruits and whole vegetables wherever possible. These foods contain more fibre and generally have less of an effect on your blood-sugar than do refined, processed and juiced foods. A whole apple is better than apple juice, for instance, but fresh-pressed apple juice is better than juice from concentrate – and certainly better than nothing at all!

      The way you prepare your fruits and vegetables will maximize their goodness. Heating, re-heating and storage often destroy nutrients, so try to eat as many as possible raw and fresh. Steaming or stir-frying are the best cooking methods to seal in the vital nutrients. If you do boil your vegetables, keep the water for a stock or a soup, as this is where all the nutrients will have gone.

      Once a fruit or vegetable is picked or cut, it starts to lose nutrients. There is no telling how long fresh vegetables have lingered in the shop or warehouse (some are put in cold storage for as long as six months; others are picked long before they ripen to their most nutrient-rich state so that they can be flown across the world to another country before they go bad). Frozen vegetables are frozen immediately they are picked, so can sometimes be even better than fresh ones.

      Ideally you should avoid peeling as much as possible, because vitamins often lie just beneath the skin of fruit and vegetables, but washing thoroughly or peeling is recommended for non-organic produce because of the potentially toxic effects of pesticides and fertilizers.

      3) Eat Complex, Low-Glycemic Index (GI) Carbohydrates

      Research is still ongoing about the optimal amount of carbohydrates for women with PCOS, but experts tend to agree that in general around 50 per cent of your total calories should come from carbohydrates, mostly in the complex form.

      In addition to the carbohydrate in fruit and vegetables (see above) which counts towards this daily 50 per cent, try to eat four portions of wholegrains, such as brown rice, a day. One serving is one slice of bread or half a cup of cereal, cooked rice or pasta.

      Why?

      Carbohydrates are your body’s prime energy source. They enable your body to use protein for growth and repair. Your body also uses carbohydrates, or starches, to make blood-sugar (glucose), which provides fuel used by the brain and muscles, including the heart.

      In a balanced state your bloodstream contains about 2 teaspoons of glucose. The carbohydrates that you eat easily supply this amount of glucose, and it’s all too easy to exceed the amount you need. The blood-sugar your body doesn’t use as fuel is stored as body fat, under control of the hormone insulin. With your body’s blood-sugar requirements so easily met, you don’t want to be eating foods which rapidly turn into glucose and cause sharp rises in your blood-sugar level, followed by a sharp rise in your insulin level, followed by storage of excess blood-sugar as fat – in other words, the familiar PCOS symptoms of insulin resistance and weight gain.

      We aren’t telling you to eat fewer or more carbohydrates here. We’re saying eat the right kind of carbohydrates. That is, complex and with a low GI (glycemic index). The key is to get enough blood-sugar over a sustained period of time, rather than a roller-coaster of highs and lows. Complex carbohydrates tend to take longer to convert into glucose, giving you sustained energy. Simple sugars tend to raise blood-sugar and worsen insulin resistance, exacerbating the hormone imbalances and fatigue typical in PCOS. Low-glycemic index foods also take longer to break down in the stomach and release their sugars. That’s why you need to change the type of carbohydrate you eat rather than cutting them out altogether, and to make sure you combine them with protein – another way to help slow down the release of the sugars. Not eating carbohydrates is not healthy for women with PCOS in the long run. (At present, low-carb diets are fashionable. In Chapter 7 we’ll discuss this in more detail.)

      How?

      Carbohydrates aren’t just comfort foods, the sort of flour-based, stodgy cakes and breads we often turn to for a fix when we are feeling low. Fruits and vegetables are carbohydrates, too. So when we say 50 to 60 per cent of your daily intake comes from carbohydrates, this doesn’t mean two-thirds of your diet should be bread and pasta. It means that you should eat more fruit and vegetables, while the rest of your intake should come from complex, low-GI carbs.

      Because they break down into sugar slowly, complex carbohydrates like legumes, wholewheat bread and oats are generally better for you than simple carbohydrates found in sugary cereals, pies, cakes, cookies and other processed food made from white sugar and/or white flour. Complex carbohydrates such as a fruit salad snack, a bowl of vegetable and lentil soup, or a handful of dried apricots and nuts, also provide more vitamins, minerals and dietary fibre than simple sugars.

      In the glycemic index, carbohydrate foods are classified into three main groups according to how quickly they are turned into blood-sugar by the body. The higher a food appears on the index, the faster it induces insulin and therefore the greater its undesirability if you have PCOS. The lower a food’s GI factor, the more slowly the food will convert into blood-sugar, promoting a weaker insulin response. Lowering blood-sugar levels will help balance your energy, reduce carbohydrate cravings, reduce insulin and testosterone levels and help you lose weight.

       The Glycemic Index

      The Glycemic Index was developed by David Jenkins in 1981 to express the rise of blood glucose (sugar) after eating a particular food.¹ The standard value of 100 is based on the rise seen with the digestion of glucose. The glycemic index ranges from about 20 for fructose and whole barley to about 95 to 98 for a baked potato. The glycemic index is used as a guideline for dietary recommendations for people with hypoglycemia or diabetes. Basically, a good starting point for people with PCOS (as for those with blood-sugar problems) is to avoid foods with high values and choose those with lower values. However, as we shall see, the glycemic index should not be the only dietary guideline on which to base your food choices.

       Glycemic Index of Some Foods

Sugars		Fruits		Vegetables
Glucose 100		Apples 39		Beetroot 64
Maltose 105		Banana 62		Carrot, raw 31
Honey 75		Oranges 40		Carrot cooked, 36
Sucrose 60		Orange juice 46		Potato baked 98
Fructose 20		Raisins 64		Potato boiled 70

      Most vegetables and many fruits have low GIs. The following have such low GIs that they can be eaten

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