Do you have PCOS?
Did you know that changing your diet may be the first step in treating and managing PCOS?
But which diet is the best for PCOS? How do you determine what you should or shouldn't be eating?
This post will help guide you understand the importance in treating PCOS with diet, which diets are most effective, which foods you should be avoiding, which foods you should be eating, and how to lose weight if you have PCOS.
Let's jump in:
PCOS Basics & Why Diet is Important
PCOS, or polycystic ovary syndrome, is an endocrine disorder characterized by specific symptoms such as infertility, irregular menstrual cycles, weight gain and hair growth.
PCOS is incredibly common and estimates put the incidence of PCOS at around 15-20%.
That's anywhere from 22.5 to 31.4 million women in the United States alone.
With that many women suffering from this condition we have to take the symptoms seriously and we have to seriously take a look at the available treatment options.
But what exactly is PCOS?
PCOS is the manifestation of hormone imbalances in the female body.
These hormone imbalances create the symptoms associated with the condition.
But which hormone imbalances create PCOS?
You can't blame just one particular hormone imbalance, instead, it's a combination of hormone imbalances.
These hormone imbalances include:
- High testosterone (or elevated androgens) -> Androgens tend to cause acne, hair growth, and masculine features
- High insulin (or insulin resistance) -> Insulin increases your weight, increases androgens and alters estrogen/progesterone levels
- High estrogen (estrogen dominance) -> High estrogen promotes weight gain in the hips/thighs/butt, promotes breast tenderness and menstrual irregularities
- Low progesterone -> Progesterone helps balance estrogen and low levels result in mood disorders, bloating and weight gain
These are the primary culprits behind PCOS.
But what causes these hormone imbalances?
The exact cause of PCOS is not well understood but it is believed to be secondary to environmental and lifestyle changes.
One of the difficulties in treating PCOS stems from the fact that it is not a condition caused by one problem.
This means that what works for one woman may not work for another and so on.
But there is good news:
Lifestyle includes the use of specific and certain diet and food groups (along with other factors such as exercise and stress reduction) which is the topic we are going to discuss today.
With the basics out of the way let's jump into how diet may alter the course of your disease.
Can PCOS be Cured with Diet? How to Approach Diet in PCOS
Is it possible to cure PCOS with dietary changes?
The answer is yes, potentially, but it is probably not sufficient for all patients.
What that means is that some women will experience greater results by changing their diet when compared to others.
In most cases (I would say 50+%) diet is a necessary but insufficient treatment if used by itself.
What do I mean?
If you want to control your symptoms then you MUST alter your diet.
And by diet, I am talking about lifestyle changes, not just altering your food intake for a few weeks and then calling it a day.
If you have PCOS then you have to realize that you will most likely always have a propensity to develop hormone imbalances.
Dieting usually refers to a temporary change in the foods you consume, whereas lifestyle refers to a permanent change in how you look at and view foods.
You want to adopt a long-term and sustainable lifestyle as it relates to the foods that you consume.
How do the foods that you consume fix or alter the course of your disease?
Whether you realize it or not, the foods that you consume play an important role in the regulation of certain hormones in your body.
Hormones such as leptin, insulin and even estrogen levels can be altered based on the foods that you consume.
Perhaps the most important hormone regulated by your food intake is insulin.
Insulin is a hormone which is secreted by your pancreas in response to the consumption of carbohydrates (carbs) and sugars.
Consuming certain carbs such as refined sugars, bread, pasta and so on may trigger a rapid release of insulin in your body.
Your body does this to help "store" and manage extra sources of food for later use.
Insulin, when secreted, tells your body to store the calories that you consume in fat cells.
If you are constantly consuming rapidly absorbed sugars (such as sugars from bread, pasta, soda pop and so on) your body may develop insulin resistance.
Insulin resistance results in a state where your body has elevated insulin in the blood-stream at all times.
If insulin promotes the storage of food in your fat cells, you can imagine how having high levels of insulin is bad for your body.
The extra weight caused by insulin promotes inflammation (otherwise known as adiposopathy) which causes further hormone imbalances such as leptin resistance.
If you continue to eat foods that trigger insulin then this cycle continues and may get worse over time.
The food you eat promotes insulin resistance which promotes weight gain which promotes inflammation which promotes further insulin resistance and further weight gain.
But what if you could stop this cycle and block it at the beginning?
That's where diets step in and this is why you should view diet as a therapy for treating PCOS.
Your diet should be the tool you use to help break the cycle and bring some normalcy to your hormones.
Diet usually isn't sufficient to completely reverse this cycle, but it does provide a way to slow it down and reduce the positive input into the system.
Other therapies may be required to reverse severe hormone imbalances such as leptin resistance and severe insulin resistance.
So with these basic ideas in mind, we can talk about how to approach your diet.
Before you decide to pick ANY diet you must realize that all of the diets I'm about to list follow some basic guidelines.
They often avoid certain food groups and they add in other specific food groups.
Where they differ is in how much emphasis they put on certain food groups and the percentage of macromolecules recommended (how much protein you should eat relative to carbohydrates and fats, etc.).
These specifics such as the changes in macromolecule ratios and certain food groups may be helpful for some people more than others.
You may have to experiment, through trial and error, to find which diet works best for you (more on that below).
But with this in mind let's talk about some basics that you need to understand before you decide to pick a specific diet.
Foods to Avoid & Eliminate if you have PCOS
Your first step is to eliminate the bad input and signals that come from specific food groups.
You can think of food as information and the information that you put into your body sends signals to activate or inactive certain genes.
In this way, food is more important than just a product which helps you survive, it is a product which helps you thrive.
Food (or information) helps impact various systems in your body by promoting inflammation, by altering the concentration of bacteria in your gut and so on.
If you can eliminate negative information (unhealthy food groups) then you are one step closer to feeling better.
I've compiled a list of foods which should be avoided if you have PCOS because they are considered negative input/negative information to your body.
All diets for PCOS should avoid the following foods (or at least severely limit them):
- Refined carbohydrates & Foods made with white flour - This includes pasta, bagels, pizzas, bread, rolls, cereals, snacks, sweets, pastries and so on. These all contain white flour which is rapidly absorbed and promotes insulin resistance.
- Excess sugar - Do your best to avoid foods with ADDED sugar. You can find the amount of sugar in food by looking at the nutrition label under the tag "sugars". Keep the total amount of sugar that you consume below 30 grams per day.
- Processed foods - Processed foods include foods which are boxed or packaged and contain multiple ingredients. You should be able to easily identify what your food is made of. For instance: an apple doesn't need a nutrition label because it is made up of an apple. A pre-made pizza contains probably 15+ ingredients which are all processed.
- Inflammatory fats - Inflammatory fats include fats which are created through processing. You want to avoid fats such as canola oil, cottonseed oil, corn oil, soybean oil, safflower oil, sunflower oil and so on.
- Soda & Other sugary drinks - Sugar drinks, even fruit drinks, can impact insulin levels and lead to insulin resistance. Avoid these even if they are diet or do not contain added sugar.
- Alcohol/beer/wine - Avoid all three of these.
You will find that almost all healthy diets follow these basic guidelines.
Foods to Eat if you have PCOS
But what about the foods that you should be eating?
Changing your diet should include healthy food groups along with the avoidance of unhealthy ones.
Focus on this list of foods to eat if you have PCOS:
- Brassica Vegetables - Brassica vegetables such as broccoli, cabbage, Brussels sprouts and so on can help improve estrogen metabolism.
- Healthy fats - Look for oils which are cold pressed and NOT processed. Oils such as extra virgin olive oil and coconut oil are great.
- Spices & Herbs - Spices and herbs have very high ORAC values and naturally flavor your food. Create an herb garden and use loads of spices in your cooking. Spices such as turmeric have been shown to have tremendous anti-inflammatory benefits.
- Other high fiber vegetables - Pretty much every vegetable is healthy and on your quest to eat healthy foods make sure you add variety to the vegetables that you consume.
- Fruits - While fruits do contain more sugar than vegetables, they also contain phytochemicals which help normalize hormones and sensitize your body to insulin. If you are worried about the sugar content then you can focus on berries.
- Eggs - Contrary to popular belief, eggs can be very healthy for you.
- Nuts & Seeds - Focus on healthy nuts such as almonds, cashews, Brazil nuts and so on.
- Protein-rich meats - Protein-rich meats of all kinds should be used based on your taste preference and your macromolecule ratios.
Do your best to eat foods which contain only 1 ingredient and if you decide to make a meal then create it from scratch as often as possible.
Diet, Weight Loss & PCOS - Is there a Secret?
Before we dive into diets that can be used for PCOS let's briefly touch on weight loss.
Is changing your diet enough to cause significant weight loss in patients with PCOS?
The answer is probably not, but maybe.
Up to 30-50% of people will notice some weight loss when changing their diet but that leaves up to 50% of women with PCOS who will not lose weight with dietary changes alone.
Why doesn't diet cause weight loss in every patient?
It has to do with two important factors:
#1. The cause of weight loss (which is usually multi-factorial)
Weight gain is usually caused by a combination of factors and not just one single problem.
The weight gain equation is more complex than simply eating more than you exercise.
These all occur without altering the amount of food being consumed, so other factors play a role.
We know that hormones probably play a very important role in weight gain (especially insulin and leptin) which may confound the calorie in-calorie out model of weight loss/gain.
And #2. The impact that diet has on hormone balance.
Diet can certainly help improve your hormone balance but in most cases, it is not sufficient to normalize your hormones by itself.
Therapies such as supplements, medications, meditation, intermittent fasting and so on can be added to dietary changes to boost weight loss and hormone balance.
These therapies can and should be targeted to the known hormone imbalances in YOUR body.
If you have insulin resistance then you can focus on a diet which targets insulin (such as a low carbohydrate diet), supplements which help sensitize your body to insulin-like Berberine and ALA and consider medications which can help reverse insulin.
When you combine these therapies together with dietary changes, the impact is far greater than doing any one therapy alone.
This is how you achieve long-lasting weight loss in PCOS.
Diets you can Use to Treat PCOS
Now that you understand how diet impacts weight and hormone balance, which foods to eat and which to avoid, we can talk about specific diets you can use to treat PCOS.
There are many more options when it comes to diet than just these, but these 3 diets have been shown to be effective at treating PCOS and represent a great starting point if you aren't sure what to do or where to start.
#1. Whole Food Based Diet (Whole30)
- Easy to follow with lots of information readily available online.
- Doesn't require a nutritionist or other help to get started.
- Many people who start this diet notice improvement in other factors such as energy and weight loss.
- Helps lower inflammation and treat other issues you may be dealing with.
- Relatively inexpensive compared to other diets.
- Will require altering of macromolecules to fit your needs.
- Very basic diet (meaning it will require some personalization).
- May require a significant lifestyle change for some people.
The first diet to discuss is the whole food based diet.
This diet hits all major criteria while helping you avoid poor food choices such as processed foods.
The whole food diet is exactly as it sounds while eating this diet you only eat WHOLE foods and use whole food ingredients.
The whole food diet is higher in non-starchy carbs and low in refined carbs and processed foods.
This diet is a great starting point for beginnings because it is relatively easy to follow.
The whole food diet is easy to follow, high in vegetables, naturally anti-inflammatory and nourishing to your gut.
#2. Paleo Diet
- Many free resources available including recipes and meal plans.
- Naturally helps avoid inflammatory foods.
- More wiggle room for personalization.
- Research exists which back health claims made by this diet.
- May help treat other conditions such as acne, gut issues and so on.
- This diet tends to be low in carbohydrates from fruits which may cause energy issues in some people.
- May be too restrictive for certain individuals.
- Expensive compared to other diets.
- May endorse excessive fat consumption which may not be optimal for everyone.
- Some individuals may have trouble maintaining weight on this diet.
The paleo diet is another diet which can be used effectively to treat PCOS.
The paleo diet is more balanced when compared to whole food based diets and tends to have a higher fat and protein concentration.
This diet tends to be higher in fat and protein compared to carbohydrates vs the whole food diet which is high in healthy carbs vs the ketogenic diet which tends to be higher in fat.
These small macromolecule changes can make a big difference depending on the digestion and genetics of the individual.
The paleo diet can be personalized and there is plenty of free information regarding how to get started and how to personalize your diet to your body online.
#3. Ketogenic Diet
- May be very helpful in treating insulin and leptin resistance.
- Usually VERY effective when it works.
- Generally more effective for weight loss when compared to other diets.
- May help reduce inflammation.
- May also help cognition and focus.
- May cause paradoxical weight gain in some individuals.
- May not contain enough anti-oxidants and nutrients for certain individuals.
- May cause gastrointestinal upset.
- May requires monitoring of ketones/glucose.
In this state, your body creates ketone bodies which can be used as an alternative source of energy.
The physiologic changes that occur with this diet may dramatically reduce insulin resistance and may help with weight loss.
The ketogenic diet is usually VERY high in fat with a macromolecule percentage as high as 70%.
Protein consumption is usually moderate at around 20% while carbohydrate consumption (even vegetables and low fructose fruits) is very low at around 10% or less of daily calorie intake.
This diet is obviously less balanced compared to the paleo and whole food based diets, but that may be the reason that it works so well for certain people.
The ketogenic diet may require monitoring of blood glucose and ketone levels in some individuals which increases the time requirements for this diet.
Conclusion & Final Thoughts
If you suffer from the symptoms of PCOS then altering your diet should be something that you seriously consider.
Dietary changes, when done correctly, can help reduce the hormone imbalances that occur as a result of PCOS.
Dietary changes have been shown to be effective in helping reduce insulin resistance, leptin resistance and may even promote better estrogen metabolism.
In many cases, altering the food that you consume, may also help with some weight loss.
Not all PCOS patients will experience weight loss with dietary changes, but in almost every case, dietary changes should be part of your weight loss regimen.
Now I want to hear from you:
Are you suffering from PCOS?
Are you unsure which diet to use?
Have you had a positive experiencing changing your diet?
What has worked for you? What hasn't?
Leave your comments below!
This post was most recently updated on August 23rd, 2019