Following the diagnosis of PCOS, did your doctor prescribe you weight loss or hormonal birth control as your only options?

I truly empathise with you – as this is something I hear from so many of my clients. Let’s delve into what ACTUALLY works when it comes to managing your PCOS symptoms.

How does diet affect my PCOS?

Let’s get this straight – weight loss is not the only thing that will help with your PCOS symptoms.

Many of my clients with PCOS feel gaslighted after leaving their doctors office, as they have not been given proactive steps to help alleviate their symptoms. In my experience, it is much more helpful to focus on dietary interventions that can help alleviate symptoms and make you FEEL better.

As a result of eating better, making appropriate lifestyle changes and addressing the route cause of your symptoms you will find that the weight will drop off as a result.  

Which diet is best for my PCOS?

1. The Western Diet

The Western diet is the typical diet of those in Australia, America and other developed countries, however, is gaining popularity in developing countries as well. It is characterised by a high intake of red and processed meats, high sugar foods and drinks, refined carbohydrates, and high-fat foods.

Not surprisingly, the Western diet seemingly promotes the occurrence of conditions such as obesity, type 2 diabetes, insulin resistance and PCOS (1).  Therefore, steering away from a Western diet would be beneficial when it comes to reducing symptoms of PCOS.

What diet should you follow instead?

2. Low-Calorie Diet

It breaks my heart to see women with PCOS come to my clinic in distress as they are following an extreme low-calorie diet in attempt to alleviate their symptoms…

Did you know that an extreme low-calorie diet may be promoting weight gain for PCOS?

This is in part due to your thyroid – the controller of your metabolism. When your body perceives it is in a state of an extreme caloric deficit (i.e., diet alert!), it is detected by your thyroid gland which slows down metabolism. This is due to a physiological mechanism in the body to hold onto body fat in times of famine.

Needless to say, this is counterintuitive to any weight-loss goal you may have but can also contribute to fatigue, poor recovery from exercise, depression, poor cold tolerance and poor memory.

So, if low-calorie diets are out of the picture, what about the keto diet?

3. The Keto Diet

The ketogenic diet (or more commonly known as the keto diet) has been given more publicity over the last few years. Essentially, it is a very low-carbohydrate diet where you obtain the majority of your caloric intake from fats – limiting many fruits, vegetables, wholegrains and protein.

Implementing keto diets for PCOS first came about as lower carbohydrate diets have been suggested to reduce insulin resistance (2). In fact, multiple studies have confirmed this as short-term keto diets have shown significant reductions in insulin levels, other metabolic markers and lead to weight loss (2, 3).

In saying this, it should be noted that managing both PCOS and a ketogenic diet correctly is a tough accomplishment. In addition to this, it may enhance the risk of nutritional deficiencies, a reduction in gut bacterial diversity and will restrict you in many social events and situations.

It is simply unnecessary to eliminate all carbs whilst managing your PCOS symptoms – so is there an easier and more sustainable option?

What to do instead…

If dieting isn’t the answer, what the hell do you do instead?!

The answer is simply balance.

Restriction is not the answer when it comes to PCOS, in fact it can worsen particular symptoms, enhance weight-gain and perpetuate an unhealthy relationship with food.

Instead of cutting calories and carbs, let’s implement some strategies to create a more balanced diet that can be sustained for life.

1. Pair carbohydrates with protein, fibre & healthy fats

Instead of cutting out carbohydrates altogether, focus on the addition of protein, fibre and healthy fats to slow digestion and prevent a rapid spike in blood glucose levels.

Love toast in the morning? Instead of cutting it out of your diet, add some eggs, avocado and sauteed vegetables.

What about a hearty bowl of porridge? Simply add some nuts or seeds, fibre-rich fruit (my favourite is Kiwi!) and a dollop of Greek yoghurt to make in a more balanced meal.

There are so many ways to balance your meals to make them more supportive for your PCOS, so get creative in the kitchen and forget about the restriction!

2. Focus on Low-GI Carbohydrates

Although the power of food combination can ensure that you are slowing the absorption of carbohydrates, it is beneficial to focus on lower GI carbohydrates to prevent any rapid blood sugar spikes.

Choosing good quality wholegrains which are high in fibre will help to support healthy energy levels, ensure you are getting adequate micronutrients and promote a bigger variety of plant-based foods which support your gut health.

3. Enjoy an abundance of Fruit & Veg

Oxidative stress in those with PCOS is often prevalent due to characteristics such as increased weight carried around the abdominal area, androgen excesses and the presence of insulin resistance Hence, it is not surprising that increased antioxidant rich fruits and vegetables have been shown to have positive effects in the management of PCOS women (4).

Try to include an abundance of antioxidant-rich plant foods in your diet such as blueberries, purple cabbage, broccoli, artichokes, kale and a variety of herbs and spices.

4. Supplementation

Supplementation can be helpful in some situations, supporting a healthy balanced diet. There are a fair few supplements which have been suggested to help manage the symptoms of PCOS, however keep in mind that they are generally only beneficial where there is a deficiency or inadequate intake. Therefore, it may be useful to try one supplement for a period of time to see whether it helps you personally. Alternatively, booking in with a nutritionist to determine what nutrients you are in fact lacking in.

Here are a few supplements that may help you with your PCOS symptoms:

  • Inositol: For those with insulin resistant PCOS, Inositol can be extremely beneficial in controlling blood sugar and lowering insulin levels (5). This means that women with PCOS may experience more regular ovulatory cycles and improved fertility with inositol supplementation.
  • Omega-3: Time and time again, studies show that omega-3 supplements improve insulin resistance, total cholesterol, testosterone and improve inflammatory and antioxidant markers (6). If you are not getting at least 2-3 serves of fish or seafood in your diet, then it may be helpful to supplement with omega-3 to support your PCOS.
  • N-Acetylcysteine (NAC): When compared to baseline levels, NAC supplementation shows improvement in blood glucose levels, insulin sensitivity, testosterone, and weight loss in addition to pregnancy and rates of ovulation (7). Although the research is promising, it should be noted that further research is needed in this area.
  • Zinc: Zinc is an essential trace element responsible for healthy functioning metabolism and is integral for the function of over 300 enzymes. Further, zinc is crucial in insulin maintenance and metabolism – therefore insufficient intakes may drive symptoms of PCOS (8).
  • Vitamin D: Vitamin D deficiency has been suggested to be a predictor for insulin secretion and sensitivity, therefore integral in the management of insulin resistant PCOS (9). Up to 85% of women with PCOS are deficient in vitamin D, therefore it is important to regularly get your levels checked – particularly in winter (10).

Note: Keep in mind his is just a few of the supplements that can be found to help improve symptoms of PCOS. An abundance of vitamins, minerals, antioxidants and anti-inflammatory foods are needed in conjunction to best support PCOS.

What to do now?

The fact is, each individual will respond differently to each type of diet and supplementation mentioned. Therefore, I always emphasise to take all information you are presented with, and make your own judgements according to your preferences, lifestyle choices and prior health history.

If you need help with figuring out the dietary, supplementation and lifestyle modifications that will best support you and your type of PCOS, book an Initial Nutrition Consultation so that we can treat your PCOS holistically.

Written by:

Mollie Caughey-Wade,

Clinical Nutritionist (BSc).

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