Walking the Health Tightrope - PCOS, Pre-Diabetes and the Challenge of Healthy Weight Gain

Yesterday I went to Pantai Hospital Ipoh to review my medical report with the family physician at the Health Screening Department.

Besides one issue that needs yearly (or even bi-annual) monitoring, the doctor pointed out something else — I am underweight. At 41kg, she advised me to put on a little weight to reduce the risk of low bone mass. Osteoporosis is more common in thinner individuals due to lower peak bone mass and decreased mechanical loading on the skeleton. Prevention, she emphasized, is key.

She encouraged me to continue my brisk walking and to incorporate weight lifting and squats. I smiled quietly because between daily house chores and my regular workouts, I already do plenty of squats! She also advised me to drink milk daily — which I am already doing.

Then came the more complicated part.

My fasting blood sugar was 4.9 mmol/L — comfortably within range. However, my HbA1c crept up to 6.0, which falls into the pre-diabetic range. As someone with PCOS — an insulin-resistance disorder — I already carry a higher risk of developing Type 2 diabetes.

Last year, my KL gynae suggested starting metformin if I wanted to continue enjoying sweet treats for “a sweeter life.” I chose instead to cut down further on sugary foods. My HbA1c improved to 5.8 — better, but still not ideal. I would like it to be at 5.7 or lower.

If I’m honest, the recent spike may have been self-inflicted — thanks to Chinese New Year cookies, bak kwa and festive goodies. Indulgence has consequences.

So here I am, standing at a nutritional crossroads.

On one hand, I need to gain a little weight to protect my bones.

On the other hand, I need to cut down further on carbohydrates to protect my pancreas.

More than two decades ago, when I was first diagnosed with PCOS, I stopped eating rice, noodles, and significantly reduced white flour products (though not completely eliminating them). With age catching up, perhaps I need to tighten the discipline even more — or consider medication if lifestyle measures are no longer enough.

For now, I will:

Increase the intensity and duration of my brisk walks

Add more structured weight training

Cut back further on sweet foods (even fruits) - which is very hard as I am already controlling my sugary foods now.

Repeat my blood test in three months

Health, it seems, is always about balance — sometimes a delicate and frustrating one.

But I am determined to keep walking this tightrope carefully. 

So what can I eat now if I have to cut back on fruits, biscuits, breads and cakes for breakfast and snacks?

The answer seems to be: more nuts!

I already eat walnuts, chia seeds and ground flaxseeds daily, but now it looks like I need to stock up on an even wider variety of nuts and seeds.

Last night at 9:30 pm, I ordered a 1kg pack of groundnuts from Shopee. To my surprise, the parcel was delivered this morning at 9 am! I must say I am very impressed with how fast the seller and Shopee managed the delivery.

Next on my list: pumpkin seeds and sunflower seeds to add to my growing stash of healthy snacks.

Looks like my snack drawer is about to become a nut-and-seed bar. 😄

Kacang Menglembu Cap Pemancing is by far the best brand for the tastiest roast groundnuts. The seller (Farmer Boy on Shopee) is from Ipoh, thus the speedy delivery.  It's also the cheapest on Shopee and Lazada at RM29.87 for a pack of 1kg.
I love snacking on groundnuts with my dad and mum at the dining table after breakfast and lunch.