Over the last century not only has there been a steady increase of PMT in Western societies, but many dietary and lifestyle changes also. The consensus is that diet plays a major role in the cause and perpetuation of most cases of PMT and that most women will experience at least a degree of relief with dietary changes.
Nutrition is a contentious subject and while there is no general agreement on the correct dietary program for sufferers of PMT, it is believed that sufferers over-consume refined sugar, salt, animal fat and dairy products, and it is this belief that forms the basis of most recommended dietary programs. What stands out most amongst the plethora of recommended programs is that while certain foods may be beneficial, it is more about what not to eat.
If dietary issues are part of the causation of PMT, one should see a marked improvement by adhering to the following dietary guidelines.
1. LIMIT INTAKE of SIMPLE SUGARS
Sugar, chocolate, cakes, sweets and artificial sweeteners are to be avoided as they create blood sugar imbalances and may contribute to fluid retention and insulin resistance. Resist those cravings and try natural sweeteners such as Stevia and Agave.
2. CUT OUT or REDUCE CAFFEINE
This includes all caffeine containing foods and beverages such as coffee, tea, cola and chocolate - these foods can aggravate many PMT symptoms including moods swings and behavioural changes, and contribute to fluid retention. Caffeine can also inhibit zinc and iron absorption particularly if consumed around meal times.
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3. REDUCE SALT INTAKE
A high intake of salt may often exacerbate fluid retention and breast tenderness; during the premenstrual period a build up of oestrogen occurs which binds salt to the body which in turn binds to water.
4. AVOID REFINED CARBOHYDRATES
Fast releasing sugars, particularly white flour products such as bread and cakes, and starchy carbs such as pasta and potatoes will aggravate all manner of symptoms. Choose low glycemic foods and complex carbs such as legumes, wholegrain foods and brown rice, as studies have shown they can help relieve PMT symptoms especially mood swings. Remember, the more sweets eaten, the more insulin is released, the lower the blood sugar drops and the more sweets are craved - avoid this vicious cycle by resisting cravings and making smarter food choices.
Reduce or limit consumption of saturated fats particularly animal fat, fried foods, dairy foods and processed margarines and spreads, as these will disturb the metabolism of essential fatty acids, contribute to weight gain and hormonal imbalances. Select fats that supply essential fatty acids such as nuts, seeds, cold pressed oils and fatty fish to assist with oestrogen and essential fatty acid metabolism, which will have a positive effect on PMT symptoms.
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6. FLUID INTAKE
Drink two litres of plain water daily to help draw salt out of the body and reduce bloating. Sip slowly and drink away from meals to avoid kidney stress. Herbal teas, and fresh fruit or vegetable juices may be beneficial but fruit juice should be diluted and ideally not consumed in the lead up to the period as it may exacerbate symptoms. Avoid processed fruit juices, cordials, soft drinks, energy drinks or flavoured water. The only fluid that contributes to your daily water intake is plain water.
7. DIETARY FIBRE
Including good sources of dietary fibre such as oats, legumes, wholegrains, and fresh fruit and vegetables in your diet will assist in the digestion and absorption of nutrients, metabolism of toxins and hormones, and increase the intestinal clearance of oestrogen.
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8. EAT SMALL, FREQUENT MEALS
Eating small, frequent high protein or complex carbohydrate meals will help maintain blood sugar levels and reduce cravings, particularly in the lead up to menses. Beneficial protein foods include quinoa, lentils, pulses, lean organic white meats and fish.
9. EVENING PRIMROSE OIL
Although there is little scientific evidence to support the theory that EPO alleviates PMT symptoms, there is no end of anecdotal evidence, my own experience included. One does not want to have to rely on any type of supplementation permanently however, so EPO may be used to provide beneficial temporary assistance while lifestyle and dietary issues are addressed.
10. VITAMINS and MINERALS
All necessary vitamins and minerals are attainable through a healthy and balanced diet but if dietary changes need to be made slowly, supplementation may assist in the interim. It is inadvisable to take single vitamin or mineral supplementation, a women's multi is a good place to start and should be continued for three to six months before evaluating the effect on PMT. It is recommended however to consult a doctor or naturopath to ascertain if any vitamin or mineral deficiencies are present before beginning supplementation.
Of particular importance in the treatment of PMT are B6, zinc, magnesium, calcium and essential fatty acids. Select from the following beneficial foods:
Vitamin B6: fish, eggyolk, wholegrain cereal, banana, avocado, seeds, bell peppers, squash, spinach, tuna and salmon.
Zinc: oysters, crab, ginger root, wholegrains, eggs, liver, peanuts, pumpkin seeds, dried watermelon seeds and split peas.
Magnesium: green leafy vegetables, nuts, molasses, tahini, seeds, oat and rice bran.
Calcium: tofu, tahini, herring, dairy, eggs, nuts and seeds, pulses, green leafy vegetables and molasses.
Essential fatty acids: oily fish (salmon, herring, mackerel), wild rice, black beans, walnuts, seeds, hempseed oil, flaxseed oil, olive oil and edamame.
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Making dietary changes can be overwhelming so best to take it one step at a time and remember to be kind to yourself during the process. For more general information on treating PMT naturally read Ten Tips for Treating PMT Naturally. Consult a health professional if problems persist.