Q. What foods are best to eat if you have polycystic ovarian syndrome?

A. Polycystic ovarian syndrome is a hormonal imbalance leading to growths called cysts on the ovaries. PCOS can make it difficult for a woman to become pregnant. Over time, if not treated, it can lead to diabetes and heart disease. PCOS affects approximately 10 percent of women of childbearing age. Often symptoms begin during the teen years.

Many women with PCOS experience excess weight gain and difficulty losing weight. Many of the foods we eat break down into sugar after digestion. Normally insulin is released by the pancreas so the sugar can be used for energy. However, many women with PCOS also have insulin resistance, which can cause the levels of sugar and insulin in the blood to be too high. This extra insulin often leads to weight gain, while the extra sugar may cause diabetes.

A diet that minimizes insulin resistance and is also heart healthy is recommended for women with PCOS. Exercise also decreases insulin resistance.

Cravings for sweets can be intense in women with PCOS. Refined carbohydrates such as white rice, sweets and sodas break down to sugar quickly, which can aggravate the problem by causing high levels of insulin. Low-carbohydrate diets are not recommended, but neither are high-carbohydrate diets. One that is moderate in carbohydrates, stressing high-fiber, low-sugar foods such as whole wheat bread, brown rice, beans, fresh fruits and vegetables is best.

Small, frequent meals and snacks eaten every three to four hours are helpful. Each meal and snack should contain a high-fiber carbohydrate plus protein and/or fat. This may decrease sweet cravings, while increasing energy levels. Snacks such as whole grain crackers with tuna, edamame (contains carbs and protein) and apples with peanut butter are good choices.

Proteins that are low in saturated fat such as skinless chicken, tofu and fish are best. Choose heart-healthy fats such as nuts, avocados, olive, or flaxseed. Since hormonal imbalances can weaken bones, two to three cups of milk, yogurt, or a calcium supplement should be used. A fish oil supplement is also recommended.

To learn more about diet and PCOS, go to www.PCOSnutrition.com.

Amy Tousman is a registered dietitian and certified diabetes educator with Nutrition Unlimited in Kailua. Hawai'i experts in traditional medicine, naturopathic medicine and diet take turns writing the Prescriptions column. Send your questions to: Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Honolulu, HI 96802; islandlife@honoluluadvertiser.com; or fax 535-8170. This column is not intended to provide medical advice.