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What is the Best Diet for PCOS (Polycystic Ovarian Syndrome)?

Updated: Mar 8, 2023

Learn more about how eating well can help you manage your PCOS symptoms.


Polycystic Ovarian Syndrome (PCOS) is one of the main areas of focus in my practice as a Registered Dietitian. Clients often come to me feeling very confused by all the information that is available online about diets for PCOS. Do you need to go gluten free, dairy free or completely eliminate carbohydrates to manage your PCOS? In most cases, the answer is no.


Diet and exercise can be very effective in managing PCOS and because of this, researchers have been exploring which diets are best for PCOS. In this article, I will highlight some examples of research backed dietary patterns and strategies that can help you manage your PCOS symptoms.


Let’s start first by defining what PCOS is…


Polycystic Ovarian Syndrome (PCOS) is a condition that affects hormone balance in women. Male hormones (called androgens) are typically present in small amounts in women. In women with PCOS, the ovaries produce more androgens than usual.


Symptoms of PCOS include…

  • Irregular periods

  • Weight gain, most commonly around the belly

  • Excess facial or body hair (also called hirsutism)

  • Thinning hair or male pattern baldness

  • Skin tags

  • Acne

  • Infertility


How is PCOS diagnosed?


PCOS is diagnosed by a Medical Doctor who will ask you some questions about your symptoms and may run some tests including blood tests and ultrasounds. If you meet 2 out of the 3 criteria below, you may be diagnosed with PCOS:

  • Missed, infrequent or few periods

  • Too much androgen (signs of this include acne, excessive body or facial hair, hair loss or high levels of testosterone)

  • Polycystic ovaries. Because you do not ovulate, your ovaries may become enlarged and contain fluid filled sacs called cysts


What causes PCOS?


We still don’t know exactly what causes PCOS. Some things that may contribute to PCOS include:

  • Genetics- If your immediate family members have PCOS, you are more likely to also have PCOS

  • Inflammation- Low-grade inflammation in the body can cause ovaries to produce more androgens

  • Insulin resistance- Insulin is a hormone made by your pancreas. It signals your cells to use sugar (glucose) as energy. Women with PCOS often have insulin resistance. This means that their bodies don’t respond to the signal that insulin sends to the cells to use sugar as energy after meals. As a result, blood sugar levels rise. This causes the body to release more insulin to bring down the sugar levels in the blood. Excess levels of insulin circulating in the blood lead the ovaries to release more androgens


What are the long-term complications of PCOS?


Women with PCOS are at higher risk of:

  • Type 2 diabetes

  • High cholesterol

  • High blood pressure

  • Cancer of the uterine lining (endometrial cancer)

  • Infertility

  • Diabetes in pregnancy (gestational diabetes)

  • Miscarriage

  • Anxiety and depression

  • Sleep apnea



Can PCOS be managed with diet?


Very often, the first piece of dietary advice women with PCOS hear is to “just lose weight”. Weight loss can be very difficult with PCOS so this can be frustrating advice for some. Although some weight loss can help improve PCOS symptoms, it can also be possible to improve PCOS symptoms without a significant amount of weight loss.


Eating well for PCOS involves focusing on nutritious and balanced meals that are enjoyable and satisfying. Here are some examples of dietary patterns and strategies that can help you manage your PCOS.


The Low Glycemic Index Diet


The Glycemic Index is a measure of how much a carbohydrate containing food will raise your blood sugar. High glycemic index foods will raise your sugar levels more than lower glycemic index foods.


Examples of high glycemic index foods include:

  • White bread

  • Instant rice

  • Instant mashed potatoes

  • Corn flakes and Special K cereals

  • Fruit juice

  • Sugar and honey

  • Baked goods


Examples of low glycemic index foods include:

  • Spelt bread

  • Sourdough bread

  • Steel cut oats

  • Barley

  • Bulgur

  • Sweet potato

  • Lentils, beans and chickpeas

  • Berries

  • Apples

Recall that women with PCOS often have insulin resistance. When too many high glycemic index foods are eaten, blood sugar levels rise. The body responds by producing large amounts of insulin to manage these high blood sugar levels. Excess levels of insulin in the blood can then lead to more production of androgens (male hormones), which can cause PCOS symptoms.


Eating high glycemic index foods often can also lead to more sugar cravings in women with PCOS. This is because when the body produces a lot of insulin, the excess insulin may lead blood sugars to drop a bit too much. This can lead to hunger and cravings for sugar and carbohydrate rich foods.


In women with PCOS, the low glycemic index diet has been shown to (2, 3, 4):

  • Help regulate periods

  • Improve fertility

  • Reduce cholesterol levels

  • Reduce androgen levels

  • Reduce weight

The Mediterranean Diet


The Mediterranean Diet has gained a lot of popularity over the past few years because of its benefits for heart health and healthy aging. Research also shows that the Mediterranean Diet can lower inflammation and androgen levels in women with PCOS (5,6).


The Mediterranean Diet includes:

  • Fruits

  • Vegetables

  • Whole grains

  • Nuts and seeds

  • Legumes like beans, chickpeas, and lentils

  • Fatty fish like salmon, trout, sardines and mackerel

  • Olive oil


The DASH Diet


The DASH diet stands for Dietary Approaches to Stopping Hypertension. This dietary is commonly recommended to people with high blood pressure. Research shows that the DASH diet may also be helpful in reducing androgen and inflammation in women PCOS (7). Similar to the Mediterranean Diet, the DASH diet includes whole and minimally processed foods like fruits, vegetables, nuts and seeds, legumes, whole grains and calcium rich foods like dairy and non-dairy alternatives.


Balancing Your Meals


How you balance your meals is also important when it comes to managing PCOS. Research studies have looked at what balance of carbohydrates, protein and fats is effective in women with PCOS.


For example, reducing the amount of carbohydrates and increasing the amount of protein eaten per day can help reduce blood sugar levels (8, 9). One simple way to plan balanced meals is to use the PCOS plate method:

  • 1/2 plate non-starchy vegetables like leafy greens, cabbage, cauliflower, cauliflower, asparagus, mushrooms

  • 1/4 plate low glycemic index carbohydrates like sweet potatoes, barley, brown rice, quinoa, beans, chickpeas, lentils, or steels cut oats

  • 1/4 plate protein like fish, chicken, tofu, tempeh, lean beef or pork


How often you eat meals and snacks per day can also be important (10). You may benefit from having smaller meals throughout the day to balance your blood sugar balance and limit cravings.


Your PCOS dietitian can help you plan meals that are balanced and satisfying.


Restrictive Diets


PCOS can be frustrating to manage sometimes and it can be tempting to try restrictive diets that promise fast results. More often than not, restrictive diets cause more harm than good and are hard to maintain in the long run.


Bottom Line


Diets that include balanced portions of nutritious foods like low glycemic index carbohydrates, fruits, vegetables, nuts and seeds, lean proteins, and healthy fats can help you manage your PCOS symptoms.

If you are struggling to find a pattern of eating that works for you, reach out to a PCOS dietitian who can support you to find ways to manage your symptoms while eating the foods you enjoy.


If you would like to work with me to manage your PCOS, you can book an appointment here



References



2. Saadati, N., Haidari, F., Barati, M., Nikbakht, R., Mirmomeni, G., & Rahim, F. (2021). The effect of low glycemic index diet on the reproductive and clinical profile in women with polycystic ovarian syndrome: A systematic review and meta-analysis. Heliyon, 7(11), e08338. https://doi.org/10.1016/j.heliyon.2021.e08338


3. Kazemi, M., Hadi, A., Pierson, R. A., Lujan, M. E., Zello, G. A., & Chilibeck, P. D. (2021). Effects of dietary glycemic index and glycemic load on Cardiometabolic and reproductive profiles in women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition, 12(1), 161-178. https://doi.org/10.1093/advances/nmaa092


4. Marsh, K. A., Steinbeck, K. S., Atkinson, F. S., Petocz, P., & Brand-Miller, J. C. (2010). Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. The American Journal of Clinical Nutrition, 92(1), 83-92. https://doi.org/10.3945/ajcn.2010.29261


5. Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., Pugliese, G., Colao, A., & Savastano, S. (2019). Adherence to the Mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients, 11(10), 2278. https://doi.org/10.3390/nu11102278


6. Che, X., Chen, Z., Liu, M., & Mo, Z. (2021). Dietary interventions: A promising treatment for polycystic ovary syndrome. Annals of Nutrition and Metabolism, 77(6), 313-323. https://doi.org/10.1159/000519302


7. Azadi-Yazdi, M., Karimi-Zarchi, M., Salehi-Abargouei, A., Fallahzadeh, H., & Nadjarzadeh, A. (2016). Effects of dietary approach to stop hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: A randomised controlled trial. Journal of Human Nutrition and Dietetics, 30(3), 275-283. https://doi.org/10.1111/jhn.12433


8. Gower, B. A., Chandler-Laney, P. C., Ovalle, F., Goree, L. L., Azziz, R., Desmond, R. A., Granger, W. M., Goss, A. M., & Bates, G. (2013). Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS. Clinical Endocrinology, 79(4), 550-557. https://doi.org/10.1111/cen.12175


9. Sørensen, L. B., Søe, M., Halkier, K. H., Stigsby, B., & Astrup, A. (2011). Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome. The American Journal of Clinical Nutrition, 95(1), 39-48. https://doi.org/10.3945/ajcn.111.020693


10. Papakonstantinou, E., Kechribari, I., Mitrou, P., Trakakis, E., Vassiliadi, D., Georgousopoulou, E., Zampelas, A., Kontogianni, M. D., & Dimitriadis, G. (2016). Effect of meal frequency on glucose and insulin levels in women with polycystic ovary syndrome: A randomised trial. European Journal of Clinical Nutrition, 70(5), 588-594. https://doi.org/10.1038/ejcn.2015.225



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