What is the role of diet in the management of PMS 1. Quality and quantity of carbohydrates
Cut down on excess sugar and white refined carbohydrates such as pizza and white bread. These carbohydrates cause a rapid release of blood glucose, which may affect mood swings and cravings as well as contributing to weight gain, making your PMS symptoms worse. Carbohydrates that release glucose more slowly are classified as low glycaemic index (GI) carbohydrates. Useful switches include changing white bread for heavy wholegrain rye bread, white rice for basmati rice, potatoes and chips for pulses, beans or sweet potatoes. In addition filling your plate with low glycaemic index vegetables such as salad or greens rather than high GI starches such as potatoes or white rice, is a good way to reduce the glycaemic index of your diet. Eating a little and often can also help keep blood glucose levels stable.
2. Getting enough of the right nutrients
a) All of us should be eating two portions of oily fish every week for a healthy heart. In addition the essential fats in fish have been shown to improve PMS mood symptoms and pain. Good sources include salmon, mackerel and sardines. The fats in linseeds and pumpkin seeds will give you some of the benefits if you don’t want to eat fish.
b) Green vegetables are an important source of both magnesium, which is often deficient in women with PMS and also folic acid, which is important for hormone balance. In addition we have some data to suggest having a high fibre diet with lots of vegetables can help improve PMS symptoms.
c) B vitamins are important to help the body’s neurotransmitters function properly and diets low in B1 and B2 particularly, are associated with a higher occurrence of PMS; B1 (thiamine) can be found in fortified cereals, legumes and nuts (2/3 servings a day are recommended); B2 (riboflavin) can be found in cow’s/soya milk, red meat, green vegetables (6/7 servings a day); B6 can be found in watercress, cauliflower, cabbage, peppers and bananas and folic acid in green leafy vegetables, fortified cereals and beans.
d) Women whose diet is rich in calcium and vitamin D are less likely to suffer from PMS. Four servings of low-fat dairy products are recommended each day to supply enough of these nutrients. In addition calcium can be found in green vegetables like cabbage, kale and broccoli and vitamin D is made by the skin in response to sunlight.
e) It has been suggested that phytoestrogens such as soy isoflavones in soya foods and lignans in linseeds, may help reduce physical PMS symptoms such as headaches. Our data on this is limited however, women in Asia, who have high levels of phytoestrogens in their diet do have fewer PMS symptoms. Sources include linseeds, soya foods, legumes, fennel, celery, hops, wholegrains and rhubarb.
3. Alcohol, coffee & salt
Alcohol may contribute to anxiety symptoms and hormone imbalance and is best consumed in moderation. A high caffeine consumption has also been associated with an increased incidence of PMS, may make breast tenderness worse for some women so limit consumption each day. In addition salt encourages water retention so it is important to follow the national guidelines of less than 6mg/d.