Most women with PCOS have insulin resistance - which means you are more sensitive to the effects of sugar and your body is less able to deal with it (remove it from your blood stream). This is why one of the most effective ways to improve your experience of PCOS and reduce associated symptoms and health risks is to choose a low sugar lifestyle.

When you ingest sugary foods or drinks your blood sugar increases. Insulin helps to reduce your blood sugar back to ideal levels - your body likes to keep many things within a certain range for optimal health such as your blood sugar and blood pressure. Over time a sugary diet will require more and more insulin to keep your blood sugar in check - and you can become insulin resistant when insulin loses its power - you need more and more to have the same effect.

Uncontrolled blood sugar can have many damaging impacts on health and has been associated with an increased risk of infertility, weight gain, gestational diabetes, miscarriage and pregnancy complications. Even if you are not planning on having children, insulin resistance puts you at an increased risk of obesity, diabetes and heart disease.

However insulin resistance is something you have a huge influence over through the food and drink choices you make.

While official health guidelines recommend 6 teaspoons of sugar per day - I’d say the less you can have the better especially if you are trying to improve insulin and blood sugar imbalances. If you focus on including quality protein, fat and a variety of vegetables - what our bodies are designed to thrive on - you will feel satisfied and find it easier to reduce sugar.

Many women may not be aware just how much sugar they are consuming as it can be hidden in many products - especially those that are marketed as being ‘healthy’. This is why it’s imperative to read nutrition labels, as the wording on packaged foods can be very misleading.

A simple way to check sugar content is to know that 1 teaspoon of sugar is about 4g sugar.

Check the nutrition label under ‘sugar’ to see how many grams are in a ‘serve’ or ‘per 100g’ - then you can work out how much you will be consuming. So if a product has 12g sugar per serve (and the serve is what you would actually eat - sometimes you’d eat more than 1 serve - you need to check how big the serving size is!) then you’d be consuming 3 teaspoons sugar from that product (12g divided by 4g per teaspoon = 3 teaspoons)

Here’s some examples -

Generally if sugar per 100g is under 5g it is a low sugar product. Dairy such as milk and yoghurt naturally contain lactose, so allow around 4g or 1 teaspoon of lactose per 100g/100ml. Also check ingredients to see if they have added other sugars. I don’t advise drinking a lot of milk to my clients (and if you like milk I recommend A2 milk from guernsey and jersey cows as this can be less inflammatory and easier to digest, also look for brands that are less processed), however fermented dairy such as yoghurt and quality cheese are generally ok depending on your tolerance. Hard cheese, butter and ghee have minimal lactose. As with any group of food look for quality over quantity and work out what suits YOU best.

Ingredients are listed in descending order - so the first ingredient makes up the bulk of the product. If sugar is one of the first ingredients - that’s not a great sign.

Also look for foods that contain real ingredients - if you can’t understand the ingredients and there’s lots of numbers and additives - then it’s not good enough for you.

Sugar can appear in many forms including glucose, fructose (other words ending in ‘ose’), syrups, agave, honey and fruits.

Avoid low-fat and diet products with artificial sweeteners - these are chemicals which have been linked to an increase in weight and appetite! Some people prefer stevia and xylitol (from birch) and these can have less impact on your blood sugar, however I prefer to use unprocessed local honey if I need a little sweetener.

‘Natural’ sugars such as honey, maple syrup, dried fruits and coconut nectar are still sugar to your body - so just because it’s ‘natural’ doesn’t mean you can eat a heap of it. Sugars are also found in products such as sauces, dressings and other savoury products where you might assume there would be none.

Here’s another example of nutritional labels on breakfast foods.

If you feel like you can’t live without sugar maybe there are other underlying hormonal imbalances, nutritional deficiencies, poor meal choices, low fat or low calorie diet, or emotional reasons you’re reaching for the sweet stuff? Making sure to include some protein and fat at each meal to help keep you full for longer and help reduce sugar cravings. Deficiencies in iron, B12, vitamin D and an under-active thyroid are common in women and cause fatigue - which is why many women reach for sugar as a quick energy boost.

Supplements such as magnesium, B vitamins and chromium can also help reduce cravings. Some women find going cold turkey is the best way to break their addiction, while others just gradually crowd out the sugary options with more savoury foods. I recommend checking out Sarah Wilson’s books if you need help quitting sugar.

Including fibre from a variety of vegetables will also help regulate blood sugar, as will including some fermented vegetables such as sauerkraut (if tolerated) to support your gut bacteria, which has also been associated with improvements in insulin sensitivity. Cinnamon has also been shown to help regulate blood sugar - you can add this to smoothies, porridge and on top of sweet potato.

Including 1-2 pieces of fresh fruit per day is ok but you may be advised to avoid initially until your insulin resistance improves. Some fruits are lower in sugars such as berries, fresh figs, grapefruit, guava and papaya, while dried fruits are more concentrated and higher in sugars.

Below are some low sugar meal and snack ideas:

Eggs (fried, poached, boiled, scrambled) with butter and pan fried vegetables. Or an omelette with vegetables and feta or goats cheese.
Avocado and eggs on 1 piece of sourdough or sprouted bread - with 1-2 forkfuls of sauerkraut.
Smoothie with berries, avocado, 100% whey or pea protein, hemp/chia seeds on unsweetened milk of choice.
Overnight oats with berries, nuts/seeds and unsweetened full fat yoghurt.
Slow cooker meals with meat on the bone and vegetables.
Roast or steamed vegetables with pesto and protein of choice.
Hearty salads, Buddha or Nourish bowls with protein and fats/dressings.
Handful tamari almonds or nuts/seeds.
Olives and cheese
Apple slices with tahini or nut butter.
Boiled egg with sugar free, whole egg mayo (avoid vegetable oils when possible, though this can be hard when buying packaged products).
Vegetables or nut/seed crackers with hummus or cashew cheese.
Berries with unsweetened full fat dairy or coconut yoghurt.

NOTE - Look for pasture raised meat/poultry/eggs/dairy products and wild, local fish when possible.

Other lifestyle factors that can improve insulin include

reducing/managing stress and cortisol,
getting enough sleep (lack of sleep can increase cortisol),
movement or exercise, and
avoiding sugary alcoholic drinks.

If you would like more individualised help treating PCOS, Hormone Imbalances or improving your Nutrition, I’d love to help you.