There are lots of lifestyle, diet, and nutrition recommendations online for managing polycystic ovary syndrome (PCOS)– such as eating healthy and being more active. But they all come with little explanation of what these really involve for people living with PCOS.
If you search on Google, you will find several recommendations for all types of eating plans on earth. This raises an important question: Is there anything like a “PCOS diet” or an eating plan that is most effective in managing PCOS symptoms?
Sadly, modern medicine is yet to find an exact cure for polycystic ovary syndrome (PCOS). Hence, medical science rather focuses on lowering likely future problems, such as diabetes, infertility, endometriosis, and endometrial cancer.
Moreover, PCOS manifests differently from one person to another, making it extremely difficult to develop one particular treatment that works for everyone.
But there’s a way to control the factors
However, two out of the three signs of PCOS, anovulation (a lack of ovulation) and increased androgen levels (elevated levels of males hormones), are basically known to be due to hormonal imbalances. And this is where nutrition comes into the picture. Moreover, we all know that foods do impact your fertility health.
Since your diet is one of the things you can control, we will be looking at three key points from the research on nutrition and PCOS.
- Lower carbohydrate consumption (this does not mean you should cut out carbs completely from your diet; just try to take a small portion per meal). Go for complex, unrefined carbs that are rich in fibers – for example, whole grains like brown rice or wheat bread.
- Opt for “anti-inflammatory foods,” including lean proteins, berries, veggies, and fats derived from nuts, avocado, or olive oil.
- Minimize alcohol, caffeine, processed foods, and saturated or trans fats.
The role of nutrition in the management of PCOS
According to the American Society for Reproductive Medicine, diet, nutrition, and exercise are recommended as the first-line of treatment for polycystic ovary syndrome (PCOS).
This recommendation stems from a growing body of research claiming that nutrition plays a significant role in lowering insulin resistance and inflammation, which helps bring down androgen levels and eventually improves undesirable symptoms and adverse effects of PCOS (such as infertility and menstrual irregularity).
When it comes to reducing inflammation and insulin resistance in order to balance sex hormone levels, nutrients like magnesium and vitamin D are only essential after you have established a PCOS-friendly food pattern. The most well-researched of these eating patterns is based on low carbohydrate/high protein and an anti-inflammatory nutrition approach.
Low-carb nutritional approaches
Unlike fats and proteins, carbohydrates increase the levels of sugar in the blood. Increasing blood sugar levels induce the pancreas to synthesize insulin – a peptide hormone that helps “unlock” cells and allows your blood sugar in.
Problems occur when the levels of blood sugar are too high, too often. When this happens, the pancreas is over-stimulated to produce insulin, setting off a cumulative effect of hormonal imbalance.
After some time, cells become insensitive to the continuous blast of the insulin hormone – a health condition referred to as “insulin resistance.” Basically, this implies that insulin can no longer transport sugar from the bloodstream into the cells where it is required.
Consequently, sugar and insulin continue to circulate in the bloodstream, raising the risk of having type II diabetes and a condition known as hyperinsulinemia.
Why is all of this important?
Hyperinsulinemia is one of the main causes of the increased androgen levels, a hallmark of polycystic ovary syndrome (PCOS).
Insulin resistance induces excessive production of androgens, impedes ovulation and follicle development, and affects the production of luteinizing hormones in the pituitary gland – and unfortunately, roughly 70% of PCOS patients with ovaries have it.
While there are several environmental and genetic factors beyond our control, insulin resistance is believed to be largely controllable through healthy lifestyle changes – which takes us back to carbohydrates.
What research says about PCOS and low-carb diet
Clinical trials have shown that controlling insulin resistance improves female hormonal balance enough to bring back menstrual regularity.
More studies, such as a meta-analysis of 8 clinical trials, concluded that taking a low-carb diet for a minimum of four weeks improved insulin sensitivity, brought down testosterone levels, and increased the ratio of FSH to LH.
Does this mean PCOS patients shouldn’t take carbs?
No! A lot of the clinical trials in the above-mentioned meta-analysis noticed benefits in patients who are still obtaining up to 40% of their calories from carbohydrates.
Remember that the typical American diet usually has 50% or more of the total calories coming from carbohydrates.
The point here is, you can improve insulin resistance and ultimately reduce androgen levels by cutting down your carbohydrate consumption. And no, you do not need to eliminate all of the pasta and bread. Instead, you should begin by eating one source of carbohydrate per meal (for example, take either pasta or bread, not both in one meal).
Choosing “healthier” carbohydrates
Aside from controlling the amount of carbs you take, you also need to consider the type of carbohydrate in your diet. Complex, unrefined carbs containing a high amount of fiber do not suddenly increase the levels of blood sugar as unrefined ones do.
The glycemic index (GI) ranks foods according to how fast they can increase your blood sugar. A food with a high glycemic index, such as white rice, spikes blood sugar levels more rapidly than a low glycemic index food, like lentils, does.
In a clinical trial of 100 PCOS patients, researchers found that after twelve months, participants taking low glycemic index foods experienced a more improved menstrual regularity and insulin hormone sensitivity compared to those who are following a macronutrient-matched “healthy” diet.
How to use these learnings in your life
You don’t need to commit the glycemic index to memory. All you need to do is opt for foods in their least refined, most fiber-rich forms:
- Think more brown bread and rice and less of white ones
- Think more corn on the cob and less corn syrup
- More baked potatoes and less of their fried counterparts
- More rolled oats and less oatmeal
Eating Anti-inflammatory Foods
Carbohydrates are not all that matter. New studies also favor an anti-inflammatory nutrition approach.
Insulin resistance and PCOS are characterized by long-term minor inflammation. Lowering inflammation with the help of anti-inflammatory foods has been proven to improve PCOS biomarkers, including improved hormone balance and insulin sensitivity.
Although there are few control trials showing the benefits of this dietary approach specifically for PCOS treatment, several studies have indicated that an anti-inflammatory diet is good for the body.
But wait before filling your plate
Before going any further, we would like to provide some clarification. “Anti-inflammatory diet” and “Mediterranean diet” are often used interchangeably.
Although the “Mediterranean diet” is by far the most well-researched version of an anti-inflammatory diet approach, it doesn’t need to be confined to a particular place or culture.
People from anywhere around the globe can follow the anti-inflammatory principles we outlined below while maintaining their own culture’s culinary practices.
Another great thing about an anti-inflammatory nutrition approach is that there are a few mundane rules to adhere to or any long lists of food to cram.
How to use these learnings in your life
Take lots of:
- Fresh, colored veggies. Think 8 to 10 servings of veggies per day in different colors, such as red pepper, yellow squash, pink grapefruit, dark. leafy greens, purple cabbage, blueberries, and purple cabbage.
- Fats derived from olives, avocados, seeds, and nuts.
- Whole fiber-rich grains.
- Lean protein like beans, eggs, legumes, fish (cold-water varieties, i.e., salmon), and lean cuts of turkey and chicken.
- Antioxidant-rich foods, such as turmeric, ginger, berries, garlic, green tea, and cinnamon.
Take a little amount of:
- Saturated or trans fats from red meat, dairy, and packaged baked goods.
- Processed foods. Pick one or two squares of 70 % dark chocolate over M&Ms, and take eggs or oatmeal instead of sweetened yogurt or sugary cereals.
- Caffeine and alcohol. This may be a bit difficult but bear in mind that it is not an all or nothing matter. A small amount of caffeine or alcohol is unlikely to result in severe inflammation– especially if you pair it with high-antioxidant foods.
What does weight have to do with all of this?
Medical professionals often recommend weight loss as a way of managing PCOS. This may be the reason why most of the studies cited in this post mention weight loss as a way of measuring how successful a diet or nutrition plan is regarding PCOS.
This recommendation originates from the simple fact that fat tissue is typically more insulin resistant than muscle. Plus, research has continued to show that a 5 to 10% weight loss can help improve PCOS symptoms, from acne to type II diabetes to cardiovascular disease.
The issue is that food and exercise are not the only things that determine weights – and weight is not always entirely within one’s control.
With that being said, although the aforementioned dietary strategies are shown to help reduce the percentage of body fat, these eating plans focus on improving metabolic markers of health, such as cholesterol and blood sugar levels – not the number on the scale.
Nutrition is just a piece of the puzzle in PCOS management
There is no particular way of eating that can help people with PCOS manage the symptoms and side effects. If there’s one, everybody would be following it.
Sadly, nutrition is not a one-size-fits-all thing – and it is just one of the ways to treat PCOS with a diet. Other treatment options for PCOS you can consider involve medications such as contraceptive pills to control hormones and metformin to manage elevated blood glucose levels.
A Word From Coastal Fertility
Remember that managing PCOS is a lifetime commitment, and any food modifications you make today to manage PCOS won’t have an immediate impact on the condition.
If you would like to know more about how nutrition could help manage PCOS or have any questions about your fertility, please contact Coastal Fertility today to schedule a consultation.
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