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42 NUTRITION “Start with the foundations of quality foods and a balanced diet – aiming to eat plenty of colourful fruits and vegetables, healthy fats ... quality lean proteins and quality carbohydrates.” FROM PAGE 41 “Fibre gives us a sense of fullness and helps with digestive tract and gut health, and is good for blood glucose and cholesterol levels,” she said. However, she warned that fibre intake should be increased slowly. “It’s important to increase it gradually because, if we increase it too quickly, our gut doesn’t adjust very quickly, so we can end up feeling really bloated and get a lot of gut discomfort,” she said. “The other thing that we need to do when increasing fibre intake is to also increase our water intake. If we’re not increasing water at the same time, it \\\\\\\[fibre\\\\\\\] can actually bind us up a little bit.” Role of a pharmacy assistant Ms Johnson advises pharmacy assistants, when dealing with women potentially affected by PCOS, to first ask if they’ve spoken to their GP and consulted a dietitian. “They should suggest speaking to a dietitian about the best eating style for them to maintain good overall health and a healthy weight,” she said. “Having a good relationship with a local dietitian is helpful for this.” Ms Smith suggests taking a two-way approach when giving advice, considering those with symptoms but who are not yet diagnosed with PCOS, compared with those diagnosed with PCOS but who are struggling with symptoms and are “wanting to implement some of the lifestyle strategies”. “If it’s someone who is showing signs or symptoms of PCOS, a useful thing would be to refer them to their doctor,” she said. “So, if they’re experiencing irregular periods or if they’re finding it really hard to manage their weight, or they’re getting excessive hair growth, certainly flagging this with them and letting them know to go and speak to their doctor about it, because their doctor can then run some more tests to investigate this further. “If they have PCOS and are struggling with some of the symptoms and are wanting to implement some of the lifestyle strategies, then my recommendation would be to refer them to see an accredited practising dietitian for further dietary advice and support. “A dietitian will be able to work with them to help them look after their health, and their long-term health, reducing the risk of developing those long-term complications with PCOS.” Fertility and Prenatal Dietitian Ms McGrice added: “Every woman with PCOS should have at least one consultation with a dietitian to have their dietary management personally tailored. “They should also see a dietitian if they’re planning to conceive or are struggling to manage any of their symptoms. Women with PCOS are eligible for a team care arrangement through a GP, which provides rebates for up to five dietitian consultations each year.” Reference 1. Boyle J, Teede H. ‘Polycystic ovarian syndrome: An update’. Australian Family Physician, 2012; 41 (10): 752-6. When should I refer to a dietitian? According to Ms Johnson, “referring to a dietitian early is ideal”. “This saves both time and money for women with PCOS and their support team, and can help detect high blood glucose levels and risk of diabetes early,” she said. Ms Johnson advises considering the following factors when deciding on referring a patient to a dietitian – a referral roadmap: • They haven’t spoken to a dietitian yet about PCOS management. • They are thinking of using inositol. • They have been recommended by their GP to take medication such as metformin. RETAIL PHARMACY ASSISTANTS • MAR 2021 For more information about the nutritional management of PCOS, visit: youtube.com/ NourishWithMelanie.