Why is diet important for PCOS balancing?

If you recently got diagnosed with PCOS, you might be wondering what I should be eating for PCOS? Before we get started, here is why it’s important to manage your diet with this condition:

• Helps mitigate the risks of PCOS like diabetes, cardiovascular problems, depression, anxiety, and endometrial cancer.
• Helps manage regular PCOS symptoms such as ovarian cysts or growths, reduced or no periods, an increase in androgen hormones (ie. testosterone), insulin resistance, body weight, blood sugar levels, and oxidative stress (which increases the risk of inflammation and cancer)

Now it might help to know what category your symptoms generally fall under to narrow down dietary changes for your needs.

Different types of PCOS

What type of PCOS do you have? Or types?

That’s right! Many people experience more than one symptom from multiple types of PCOS. There are 2 main players that are dysregulated with PCOS – insulin and androgens (such as cortisol, testosterone, DHEA etc). These hormones are related to each other as part of a feedback loop. For example, if insulin increases, it creates fertile ground for testosterone, DHEA to also increase and the cycle continues.

Consult your doctor to see if you’re prone to conditions like diabetes, or have sensitivities such as gluten, dairy which will have a larger impact on your lifestyle and diet.

Overall PCOS can lead to irregular periods, infertility, high production of androgens, weight gain, hair loss or thinning which is due to a dysregulated system which cannot be fixed by one pill or diet alone.

Here is a breakdown of the different types of PCOS and their symptoms:

Insulin-Resistant or Metabolic PCOS

This is when your body can’t use up the insulin it makes, causing it to float around or be stored leading to high blood sugar. Your body is becoming less sensitive to insulin. This can put you at risk for type 2 diabetes.

When this happens your body starts storing more fat than normal, especially around the waist.

• Symptoms: belly weight and general weight gain, fatigue, cravings, skin changes

Adrenal or Reproductive PCOS

This is when your adrenal glands (located on top of your kidneys) make too many hormones such as DHEA-S, testosterone, and/or cortisol

• Symptoms: irregular periods, hair growth/loss, acne, insulin resistance, weight gain

Inflammatory PCOS

Inflammation happens when your immune system is active and trying to fight off a threat. In some people low grade persistent inflammation has been linked to PCOS and causes polycystic ovaries to produce androgens and sometimes increased insulin. This type can occur alongside insulin or adrenal induced PCOS.

Inflammation is caused due to stress, toxins of the environment, and inflammatory foods like gluten, sugar, dairy products. Give your body a boost of good fats like omega-3s.

• Symptoms: insulin resistance, hair growth/loss, autoimmune disease, infection, fatigue, skin disorders, joint pain, headaches, or Vitamin D Deficiency

Post-Pill PCOS

When you come off of birth control you could get post-pill PCOS. The pill manipulates your estrogen and progesterone levels after all, so it’s no surprise that you’re left with hormonal imbalance afterwards which are most likely to be temporary.

• Symptoms: acne, irregular periods, and excess hair growth

If it feels like you have a little bit of everything, don’t get so hung up on labeling it. It’s more important to discover specific sensitivities like gluten, dairy so you can eliminate them from your diet.

Consult your doctors to find the symptoms and potential causes through blood tests.

Types of Diet

Based on if you’re tackling insulin regulation, balancing your cycle, or losing weight you might want to go with one diet over another. Or a couple of them.

If you’re looking for an overall improvement of everything, check out the next section.

A Low Glycemic Index (GI) Diet

This diet focuses on eating foods that have a minimal impact on blood sugar levels which can help manage insulin resistance.

Foods with a high GI are rapidly digested and absorbed, leading to a rapid increase in blood sugar levels. Examples: processed foods such as candy, breads, cake, and cookies

Foods with a low GI are digested and absorbed more slowly, resulting in a gradual and sustained increase in blood sugar levels. Examples: whole foods such as unrefined grains, non-starchy vegetables

Balance it out! Focus on eating low GI carbs, along with a balanced meal that includes protein, healthy fats, and fiber.

Spacing meals evenly throughout the day and practicing portion control to prevent overeating can stabilize blood sugar level.

The DASH Diet

This diet is rich in fruits, vegetables, whole grains, and low-fat dairy products and low in saturated fats, cholesterol, refined grains, and sweets.

A sodium intake of 2,300 milligrams (mg) a day is recommended. This amounts to 1 teaspoon of table salt.

It should be easy to follow because you don’t have to track carbs or calories as extensively. This can be highly beneficial for controlling hypertension, insulin resistance, and belly fat accumulation.

Mediterranean Diet (An Anti-Inflammation Diet)

According to studies, this is by far the most effective in correcting the symptoms of PCOS. It encourages high consumption of olive oil (serving as the primary source of fat), fruit, vegetables, legumes, nuts and seeds, and fish rich in omega-3 fats and poultry rather than red meat.

The individual foods and nutrients of the Mediterranean diet helps reduce inflammatory conditions which decreases other PCOS symptoms.

So What Should I Eat?

What’s worked for me is not necessarily following one diet and getting hung up on names – I focus on increasing my intake of good, simple, individual whole food items every day. Here’s what to add:

• Fruits and vegetables with a low GI and usually non-starchy
• Low-fat or full-fat dairy in small quantities and with moderation
• Fish rich in Ω-3 fatty acids
• Lean red meat and poultry in small quantities
• Fatty acids – ie. pumpkin seeds
• Legumes
• Whole Grain Products
• Alcohol in moderation (150 mL of red wine per day or less)

That’s it. Eat these as part of a well balanced meal that contains more low GI foods while limiting high GI ones. It’ll help you feel more satiated and limit snacking and binging. I’m not trying to get pregnant or lose a large amount of weight at once, so if you are you might want to work with a doctor and nutritionist to make overall diet changes.

Quick notes before making any diet changes:

• Make sure not to make drastic changes to your diet overnight because this can cause other unwanted symptoms. For example, eating foods low in carbs can spike cortisol levels which can impact hormones.
• Overall be careful to not make sudden and drastic changes to your diet. There is no one main PCOS diet but individual foods mentioned above can help mitigate the risks.

If you must pick a diet – go with a combination of a reduced-calorie Mediterranean and DASH diet.

What Should I Avoid or Reduce?

Regardless of the type you have, here’s a rule of thumb for food to limit or remove gradually:

• Sugar
• Highly processed foods (fried food)
• High salt
• Starchy vegetables (white potatoes, corn, peas)
• Refined carbohydrates (mass-produced pastries and white bread)
• Alcoholic beverages

Build a switch habit to avoid going cold turkey on your favorite snacks. For example, switch out sweet baked goods with small doses of dark chocolate.

The PCOS Plate – 25% 25% 50% Rule

According to some dietitians and nutritionists there’s a rule of thumb for creating a balanced plate for a healthy meal

This simple rule for each meal says:

• ¼ of your plate should be protein, typically 25-30 grams
• ½ of the plate should be loaded with non-starchy vegetables such as leafy greens, tomatoes, cucumbers, bell peppers.
• ¼ of the plate can be starchy vegetables or whole grains
• A source of fat such as a tablespoon of olive oil. This will make you full longer and overall good for people with PCOS.

Is a Diet Change Enough?

As with most things in life, no, it’s not that simple.

A good diet will help a ton but it must be consistently balanced with exercise, some supplementation (more on this next week), or medication depending on the situation.

Here are some habits to develop over time:

• Honoring your daily rhythms
• Waking up at the same time
• Eating every 3-4 hours regulates cortisol spikes or mood swings

PCOS and The Gut

Studies have tested the connection between abnormalities of the Gut leading to PCOS or exaggerating it. This means that your diet is that much more important to balance the microbiome.

Probiotics, yogurt, sauerkraut and other gut friendly foods should be incorporated in your diet for managing PCOS symptoms.

Stay tuned next week for what east asian cultures say about hormone balancing.