A Healthy Diet For PCOS

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting up to 12% of American women of reproductive age. In most cases, PCOS presents with a spike in androgens, male hormones that can impact ovulation and cause uncomfortable symptoms.¹

Insulin resistance is common in women with PCOS, making you more prone to developing type 2 diabetes. However, nutritional tweaks and overall lifestyle changes can profoundly affect PCOS symptoms.

If you don’t adequately manage PCOS symptoms, the condition may lead to:

• Hypertension

• Diabetes

• Stroke

• Sleep apnea

• Heart disease

Causes of PCOS

While the exact cause of PCOS remains unknown, genetic and environmental factors play a significant role in the condition. For example, if any of your parents have PCOS, your chances of getting the condition increase.

High levels of androgens are associated with PCOS and cause some symptoms, such as ovarian cysts, enlarged ovaries, and infertility.

Other prevalent symptoms of PCOS include:

• Pelvic pain

• Irregular periods

• Hirsutism (excess hair growth)

• Depression

• Difficulties losing weight 

• Acne 

• Fertility problems

Diagnosis

Diagnosing PCOS is not a straightforward process, as there is no one test to give a comprehensive diagnosis. The following are the standard PCOS diagnosis procedures:

• Blood tests: Your health provider will take a blood test to check your androgen, cholesterol, and thyroid hormone levels.

• Pelvic exam: Your health provider will perform a pelvic exam to check for signs of high androgen levels.

• Pelvic ultrasound: This test checks for ovarian cysts and the condition of the endometrium.

• Physical exam: Your health provider will measure your BMI and blood pressure. They may also look for signs of acne, abnormal hair growth on the face, and skin discoloration.

Moreover, because other conditions may be responsible for these symptoms, your physician should carry out a thorough examination to rule out all other possible underlying issues.

The relationship between PCOS and insulin

People with PCOS have insulin resistance and high insulin levels. Insulin allows your cells to pick up glucose from the bloodstream to produce energy. Unfortunately, when you have PCOS, your cells do not respond well to insulin, leading to the build-up of the hormone in the blood. This is called insulin resistance.

This insulin resistance makes you more likely to develop diabetes in the long term. However, diet and exercise effectively decrease insulin resistance and prevent other secondary diseases, such as high blood pressure and heart disease.

The relationship between PCOS and weight

Although PCOS can affect anyone, being overweight may worsen the symptoms. Unfortunately, insulin resistance and constant food cravings can make it hard for people with PCOS to lose weight. So, instead of taking up very restrictive diets, try and focus on consuming balanced meals and adopting a healthy lifestyle. 

How diet affects PCOS

As the PCOS management guidelines suggest, good nutrition and lifestyle changes often play the most critical roles in managing PCOS. Therefore, you should use these as the first line of treatment before introducing medications. 

A PCOS diet can control glucose levels and efficiently manage body weight, decreasing insulin resistance.

While PCOS has no known cure, research shows that specific dietary and lifestyle changes can manage the condition.²

Therefore, your healthcare provider may recommend a personalized PCOS diet plan to control your symptoms. This will also prevent the onset of secondary complications linked to inflammation, hormonal imbalance, and insulin resistance. 

What to eat

The following are efficient nutritional strategies for people with PCOS:

1. High-fiber foods

Consuming high-fiber foods can lower insulin resistance by improving gut health and reducing the effect of sugar in the blood.

They also have a low glycemic index (GI), which aids in regulating blood sugar levels by balancing the body's insulin levels. A low GI diet does not mean consuming a low-carb diet. On the contrary, it means getting to enjoy your favorite healthy carbohydrates while effectively managing your PCOS symptoms.

Other examples of high-fiber foods include:

• Fruits: Berries, figs, kiwis, and oranges 

• Nuts and seeds: Sunflower seeds and almonds

• Whole grains: Brown rice, whole wheat, and oats

• Legumes: Kidney beans, lentils, and soybeans 

• Vegetables: Sweet potatoes, broccoli, and kale

Being attentive to carbohydrates portion sizes while pairing them with healthy fats and lean proteins is effective in keeping insulin levels under control. 

2. Magnesium-rich foods

Most women with PCOS tend to be deficient in magnesium. In addition to lowering stress levels, magnesium also plays a role in reducing insulin resistance. Foods rich in magnesium include:

• Soy milk

• Black beans

• Pumpkin seeds

• Cashew nuts

3. Lean proteins

While lean protein sources are not rich in fiber, they are very filling and good choices for weight management. Great examples of lean proteins for people with PCOS include:

• Chicken

• Tofu

• Fish

4. Healthy fats

Healthy fats are a great part of a PCOS diet because they regulate blood sugar, slow digestion, and taste good. The following are common sources of healthy fats for PCOS:

• Nuts and seeds: Research has linked regular intake of nuts and seeds to a lower risk of heart disease, especially for women with type 2 diabetes.

• Avocados: Avocados are rich in monounsaturated fats, which increase the body's good cholesterol levels while lowering harmful cholesterol levels. They are also rich in vitamin E, a great antioxidant.

• Extra virgin olive oil: This lowers oxidative stress and the risk of heart disease.

• Fish oil: A common source of fish oil is omega-3. 

5. Anti-inflammatory foods 

Women with PCOS often have low-grade chronic inflammation. According to research, this is in part due to insulin resistance and being overweight. Anti-inflammatory diets are very beneficial to women with PCOS as they can boost metabolism and fertility.³

Examples of anti-inflammatory foods include:

• Tomatoes

• Grapes

• Avocados

• Green tea

• Salmon and tuna

• Mushrooms

Research has discovered that certain spices have anti-inflammatory properties, so you should also include these in your diet:

• Turmeric

• Garlic

• Cayenne

• Cinnamon

• Ginger

Foods to avoid if you have PCOS

In general, people with PCOS should avoid foods commonly seen as unhealthy, as they increase inflammation and insulin resistance. Examples of such foods include:

• Refined carbohydrates: Mass-produced pastries, white bread, cakes, other baked goods, and sugary, processed food

• Excess red meat: Beef and pork

• Processed meat: Bacon, hot dogs, and sausages

• Fried food: French fries and other categories of fast foods

• Sugary drinks: Energy drinks and sodas are high in added sugars, and constant intake of sugary beverages can worsen insulin resistance, leading to inflammation

• Solid fats: Margarine

Meal timing

To get the best results from your PCOS diet plan, consider spreading your meals evenly throughout your day, preferably every three to four hours. For most people, this means having three main meals and two snacks in between. 

Additional lifestyle changes for people with PCOS

While diet can go a long way in helping people with PCOS get the condition under control, you should combine it with other lifestyle changes to get the best results. These changes include:

Regular exercise

It is common knowledge that exercise breaks down excess fat in the body. Combining exercise with a reduced intake of refined carbohydrates and a low-inflammation diet can fight insulin resistance and improve weight management.

Stress management

The various symptoms of PCOS can lead to stress, which can cause depression if not well-managed. Stress-reduction techniques such as daily meditation and yoga can calm the mind. Exercise also produces endorphins (happy hormones) which lower stress levels.

Getting sufficient sleep

Most people with PCOS complain about chronic fatigue. Poor quality sleep is associated with inflammation. It also impacts insulin resistance for women with PCOS. Good quality sleep can reduce inflammation, manage stress levels, and promote good heart health.

Working with your healthcare provider

If you have a PCOS diagnosis, you should work with a supportive healthcare provider who:

• Understands that proper diet and lifestyle changes are the first-line treatment

• Understands what you are going through and connects with you a dietician or therapist

• Can devise a long-term plan to manage your PCOS and carry out frequent check-ups

The lowdown

If you have PCOS, you may often feel overwhelmed and frustrated, especially as there is no known cure. Embracing a PCOS-friendly diet and making the recommended lifestyle changes may boost your mood and manage most symptoms of the condition. This is true whether you want to get pregnant, lose weight, or improve your overall well-being.

Frequently asked questions

Should I avoid alcohol?

From a nutritional perspective, it’s best to avoid alcohol. Alcohol can lead to excessive weight gain, which can impact insulin's role in your body. That said, if you cannot completely cut out alcohol, limit your consumption as much as possible.

Is the PCOS diet the same as the keto diet?

The PCOS diet is not the same as the keto diet. Your carbohydrate intake needs to be less than 5% to attain a ketosis state. However, when it comes to the PCOS diet, the required carbohydrate intake is 20–30%, far higher than a keto diet. 

Will fasting alleviate my PCOS symptoms?

There is no substantive research concerning the relationship between PCOS and fasting. While fasting may benefit some people, many physicians warn against this strategy as it can lead to eating disorders and deprive the body of the required nutrients, doing more harm than good.