4 Nutrition Tips for PCOS Sufferers

Nutrition Diva listener Angie writes:

“I was recently diagnosed with PCOS and I've been trying to learn about it. There seems to be a lot of confusing advice out there and a few sources suggest that a healthy diet for someone with PCOS is different than a healthy diet for someone without this condition. Is this true?"

What Is PCOS?

Unfortunately, Angie, you've got plenty of company. Polycystic ovarian syndrome, or PCOS, is a condition that affects up to 1 in 10 women of child-bearing age. Our own House Call Doctor recently did an episode on PCOS, which includes a thorough explanation of the medical aspects of this syndrome. In a nutshell, PCOS is characterized by hormonal imbalances, involving not just the reproductive hormones, like estrogen and testosterone, but also hormones that regulate blood sugar, fat storage, and appetite.

Symptoms of PCOS may include painful or irregular periods, acne, abnormal hair growth, increased appetite, weight gain, or difficulty losing weight. Women with PCOS often develop metabolic syndrome, which increases your risk for heart disease and diabetes. And the reverse is also true: Women with metabolic syndrome are more likely to develop PCOS.  PCOS is also a leading cause of infertility.

PCOS is strongly linked with obesity—and as obesity levels have risen, PCOS has become a more common diagnosis. But there are also lean women who suffer from PCOS. Almost all women with PCOS, however, have some degree of insulin resistance, which is also known as “pre-diabetes.”

See also: What is High Glucose?

With PCOS, it's a little hard to tell the chicken from the egg: Does weight gain lead to hormonal imbalance or does hormonal imbalance lead to weight gain? Either way, it quickly becomes a vicious cycle.

The first-line therapy for PCOS is a diet and lifestyle makeover—with the primary goal of improving the body’s sensitivity to insulin. With any luck, this can interrupt the vicious cycle and start a virtuous cycle instead. 

Here are 4 ways to start on a virtuous path:

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4 Ways to Improve Insulin Sensitivity

Tip #1: Lose weight (if you need to). Weight loss improves insulin sensitivity--and you don’t necessarily have to reach your goal weight to get this benefit. Even a modest amount of weight loss can begin to reverse symptoms of PCOS. For example, if you are 50 pounds overweight, losing 10 pounds can make a big difference in your PCOS symptoms, even though you might still be significantly overweight.

See also: How to Lose Weight Without Dieting

For people who have a significant amount of weight to lose, a good strategy is to lose weight in a stepwise fashion. Lose 5-10 pounds and then practice maintaining that new weight for 2 months before taking the next step down.

Tip #2: Be more active. Exercise is also a great way to improve insulin sensitivity. It also helps rebalance reproductive hormones. As a bonus, it can also help with weight loss. (A combination of aerobic exercise (anything that gets your heart up for 30 minutes a day) and strength training will work best.

See also: Get-Fit Guy's Quick and Dirty Tips to Slim Down and Shape Up

Tip #3. Eat a low glycemic diet. Whether or not you need to lose weight, the best diet for PCOS appears to be one that is lower in carbohydrates (especially sugar and grain-based foods), higher in protein, vegetables, and fiber, and moderate in fat. In fact, I think that’s a great dietary prescription for just about anyone.

See also: Do Low Carb Diets Work? and How Much Protein Should You Eat?

Tip #4. Eat regularly but not too frequently. Although some people claim that eating every 2-3 hours is ideal, spacing your meals out more can help improve insulin sensitivity. Instead of having a small meal or snack every few hours, try to get used to eating a more substantial meal and then waiting 4-5 hours before eating again. For tips on how to choose foods that will keep you full longer, please review my episodes on satiation and satiety.

See also: How Often Should You Eat?

Nutritional Supplements for PCOS

Most of you know I’m not a big fan of vitamin supplements; I’d prefer that you get your nutrition from foods. But there are times when targeted supplementation can be useful, and PCOS is appears to be one of them. Although the diet and lifestyle changes I just outlined are by far the most important things you can do, the following nutrients could be a useful addition to your regimen.

• Vitamin D3.  Women with PCOS tend to have low vitamin D levels—especially when they are also overweight. Some preliminary studies have shown that taking high dose vitamin D as a supplement improves symptoms of PCOS. The doses used in these studies are more aggressive than I would recommend taking without a doctor’s supervision. If you have PCOS, ask your doctor whether her or she would recommend a vitamin D supplement and how much. I’ve included links to the relevant studies below if you want to take them to your appointment with you.

• Myo-Inositol. Inositol is a family of nutrients--often lumped together with the B vitamin family. One particular form, called myo-inositol, has been found to help women with PCOS improve insulin sensitivity and other symptoms. You can buy myo-inositol as a bulk powder online or from a vitamin store. The recommended amount is two tablespoons a day. Try adding it to your morning smoothie.

See also: How to Make the Perfect Smoothie

There are also some drugs that may help, which Dr. Sanaz Majd discusses in her episode on PCOS. 

The good news is that PCOS is treatable--and often without medication! But a lot of it is up to you--and making lifestyle changes can be challenging. For extra support from women who know what you're going through, check out the groups and forums at PCOSupport.com and PCOSFoundation.org.

References

^{Farshchi H, Rane A, et al. Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management. J Obstet Gynaecol. 2007 Nov;27(8):762-73. Link to study}

^{Irani M, Seifer D, Minkoff H, Merhi Z. Vitamin d normalizes abnormally elevated serum antimüllerian hormone levels usually noted in women with polycystic ovary syndrome. Obstet Gynecol. 2014 May;123 Suppl 1:189S. Link to study}

^{Moran LJ, Ko H, et al. Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. J Acad Nutr Diet. 2013 Apr;113(4):520-45. Link to study}

^{Unfer V, Carlomagno G, et al. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol. 2012 Jul;28(7):509-15. Link to study.}

Healthy diet bag, diabetes sign, and woman with stomachache images courtesy of Shutterstock.