While lifestyle & diet recommendations, such as eating healthy and moving more, can go a long way in managing polycystic ovary syndrome (PCOS), there’s usually little information about what is really involved.
You can find loads of recommendations online for all kinds of eating plans you can think of. And this raises the question: is there a diet specifically designed for PCOS or a way of eating that is most effective in managing its symptoms as well as balancing hormone levels?
Unfortunately, modern science does not presently have a cure for polycystic ovary syndrome.
Hence, medical professionals focus on reducing the likelihood of future problems like diabetes, endometrial cancer, and fertility challenges. Moreover, PCOS presents differently in patients, making it very difficult to find a cure that’s effective for everyone.
Okay, then is there a solution or not?
Thankfully, two of the three criteria for PCOS diagnosis (increased androgen levels and anovulation) are known to be caused by a hormonal imbalance – and this is where nutrition can help.
Considering that diet is one of the things within our control, we will discuss three take-aways from studies on nutrition and polycystic ovaries syndrome (PCOS).
- Reduce carbohydrate consumption (no, this does not mean that you should eliminate carbs completely – as discussed in the latter part of this article). Opt for complex, unprocessed carbohydrates containing a lot of fiber – say whole grains, such as brown rice or wheat bread.
- Choose anti-inflammatory foods like berries, proteins, veggies, and fats sourced from olive oil, avocado, or nuts.
- Cut down processed foods, caffeine, alcohol, and saturated or trans fats.
The role of nutrition in PCOS management
Nutrition diet and exercise are the first-line of treatment for polycystic ovary syndrome, according to the American Society for Reproductive Medicine.
This is based on a considerable body of research showing that nutrition plays a key role in lowering inflammation and insulin resistance, which, in turn, helps reduce high androgen levels and eases the symptoms and side effects of PCOS (like fertility challenges and menstrual regularity).
However, when it comes to lowering insulin resistance and inflammation in order to balance the levels of sex hormones, nutrients like vitamin D and magnesium retain the potential only when you have established PCOS-friendly food habits. The most extensively studied of these PCOS-friendly diets is based on an anti-inflammatory approach and low carb – high protein.
1. Low carb nutritional approaches
Carbohydrates – unlike fats and proteins – increase the amount of sugar present in the blood. Rising blood sugar levels stimulate the pancreas to produce insulin, which is a hormone that helps “open up” cells and allows sugar from the blood to enter.
Problems arise when the levels of blood sugar are extremely high. When this happens, the pancreas reacts by increasing its production of insulin, eventually resulting in hormonal imbalance.
After a while, the cells become desensitized to the continuous blast of insulin, causing a medical condition known as “insulin resistance.” In essence, this implies that insulin is no longer able to shuttle sugar from the bloodstream into the cells where it is needed.
As a consequence, insulin and sugar remain in blood circulation, increasing the chances of developing type II diabetes and leading to hyperinsulinemia (too much insulin).
Why is all this important?
It’s because hyperinsulinemia is a key driver of increased androgen levels – one of the main signs of PCOS.
Insulin resistance stimulates excess androgen production in the ovaries, affects ovulation and follicle development, disrupts the production of luteinizing hormone (LH) – and sadly, approximately 70% of PCOS patients with functioning ovaries have insulin resistance.
While there are many environmental and genetic factors out of our control, insulin resistance can be controlled through lifestyle changes – which points us back to carbohydrates.
What do researchers suggest about low-carb diet and PCOS
Many clinical trials have indicated that controlling the body’s resistance to insulin improves hormonal balance enough to bring back normal ovulation and menstrual regularity.
Further studies, including a meta-analysis of several clinical trials, found that eating a low-carbohydrate for four weeks improved insulin sensitivity, reduced high testosterone levels, and increased the ratio of FSH (follicle-stimulating hormone) to LH (luteinizing hormone).
Does this mean PCOS patients cannot eat carbs?
No, not exactly. A lot of meta-analysis trials, including some mentioned above, saw great benefits amongst subjects who are still getting 40% of their total calories from carbs. Remember that about 50% or more of the typical American diet’s calories come from carbohydrates.
So, the take-away here is that it’s possible to improve insulin resistance and, consequently, reduce androgen levels by lowering the amount of carbs you take. You don’t need to remove pasta and bread completely from your diet. Instead, consider eating only one source of carbohydrate per meal; for example, you can take either pasta or bread (not both in one meal).
Selecting “better” carbohydrates
It’s not all about controlling your carb intake – the type of carbohydrate also matters. Complex, unprocessed carbohydrates with a high amount of fiber don’t spike blood sugar levels like their refined counterparts do.
The glycemic index (GI for short) is a rank of foods based on how quickly they increase the levels of sugar in the blood. A high GI food (i.e., white rice) raises your blood sugar quicker than a low GI food (i.e., lentils) does.
In a clinical trial involving 100 PCOS patients, researchers found that those primarily taking foods with a low glycemic index experienced more improved insulin sensitivity and menstrual regularity compared to participants following an otherwise “healthy diet.”
How to apply these learnings to your life
You don’t have to memorize the glycemic index of foods. Just choose foods in their least refined, fiber-rich forms:
- Think more rolled oats and less oatmeal
- More cooked potatoes and fewer potato chips
- More brown rice and less white ones
Then, is controlling your carbohydrate intake all that matters?
No! There is also promising research in support of an anti-inflammatory nutrition approach.
2. Anti-inflammatory eating
Both insulin resistance and PCOS are characterized by chronic inflammation. Studies have shown that lowering inflammation through anti-inflammatory foods improves PCOS biomarkers, including improved insulin sensitivity and enhanced hormone balance.
Though there’s a lack of randomized control trials showing that this nutrition approach is specifically good for PCOS treatment, many studies have shown that an anti-inflammatory diet does the body a lot of good.
Another good thing about an anti-inflammatory approach is that you don’t have to follow any mundane rules or memorize a long list of foods.
Note: Anti-inflammatory diet is sometimes used interchangeably with the “Mediterranean diet.” While the Mediterranean diet is the most studied anti-inflammatory diet approach, it does not have to be culturally confined. Individuals from all around the world can follow the above-mentioned anti-inflammatory principles while still maintaining the culinary traditions of their culture.
How to apply these learnings to your life
Eat lots of:
- Fresh fruits and veggies. Think eight or more servings of vegetables in different colors, such as pink grapefruit, red pepper, purple cabbage, yellow squash, blueberries, and dark leafy greens.
- Fats obtained from avocados, olives, seeds, and nuts
- Whole grains containing a lot of fiber
- Lean proteins, such as legumes, eggs, beans, fish, and lean cuts of chicken and turkey
- Foods that are rich in antioxidants like cinnamon, turmeric, ginger, green tea, and berries
Eat less:
- Trans or saturated fats from dairy, red meat, and packaged baked goods
- Choose a square of 70% dark chocolate instead of M&Ms and eat eggs or oatmeal rather than sweetened yogurt or sugary cereals.
- Alcohol & caffeine. This may be hard to do, but remember that it’s not an all or nothing kind of thing. However, a little quantity of either ( a cup or glass per day) won’t cause any severe inflammation – especially if it is paired with high antioxidant foods.
What does weight have to do with it?
Medical professionals usually recommend losing weight as a way of managing PCOS. This is probably the reason why many of the studies cited in this piece mention weight loss as a way of measuring the success of a nutritional plan regarding PCOS. This recommendation is based on the fact that fat tissue is more insulin resistant than muscle.
Besides, studies have shown that 5 to 10% loss of body fat can significantly improve PCOS symptoms, including acne, infertility, type II diabetes, and heart disease.
The problem is: exercise and food are not the only factors that determine body weight – and weight, as you probably know, is not completely within our control.
That said, even though the diet strategies above can help reduce the percentage of body fat, they enable you to focus on enhancing health biomarkers, such as cholesterol and sugar levels – instead of focusing on the number on the scale.
Nutrition is just one piece of the PCOS management puzzle
There’s no one single way to magically improve the symptoms and side effects of PCOS. If there is one, everybody will be following it. Moreover, nutrition is never a one-size-fits-all thing – and it’s only one of the ways to treat polycystic ovary syndrome.
Other treatment options for PCOS involve the use of medications like contraceptive pills and metformin to manage increased blood sugar levels.
Before you leave…
Bear in mind that managing PCOS is a serious, life-long commitment and that any food changes you make to manage PCOS will not have an immediate impact on the condition. If you want to know more about how nutrition could help in PCOS management on your journey to become a parent or have some questions about your fertility, contact us today to arrange a consultation with our medical experts.
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