PCOS and Nutrition: Don’t Ditch Your Cultural Foods

How does nutrition affect PCOS?

Insulin resistance — a condition in which the body’s cells are less sensitive to the blood sugar-lowering effects of insulin — affects 75–95% of people with PCOS (1).

Along with inflammation, insulin resistance worsens the metabolic and reproductive disorders associated with PCOS and increases the risk of developing noncommunicable diseases such as type 2 diabetes (1, 4, 6, 7).

Diet and nutrition can either improve or worsen inflammation and insulin resistance — and, in turn, their symptoms and risks.

For instance, excessive intake of simple sugars — especially sugar in sodas, juices, and packaged snacks — is associated with chronic inflammation and insulin resistance (5, 7, 8).

Studies suggest that women with low grade inflammation tend to consume less of many foods and nutrients with anti-inflammatory potential that may aid blood sugar control.

These include dietary fiber, complex carbs, unsaturated fats, seafood, nuts, and legumes like peas and beans (2, 5, 6, 7, 9).

Research also suggests that people with low grade inflammation commonly consume excess saturated and trans fats (6).

Dietary patterns that worsen inflammation and insulin resistance in those with PCOS are associated with improper functioning of the ovaries and an increased risk for infertility (1, 10).

Thus, you may want to treat nutrition as an integral part of a PCOS management plan (4).

Summary

People with PCOS may find that their inflammation and insulin resistance worsen when their diets include excessive simple sugars, saturated fats, and trans fats. Inflammation and insulin resistance can increase the risk of infertility.

Diet tips for PCOS

Tailoring your diet to your calorie and nutrient needs is associated with improved endocrine and reproductive functions and reduced risk of heart disease and type 2 diabetes (2, 5, 6, 10, 11).

Combining dietary changes with exercise may produce even greater positive outcomes (4, 5, 6, 7, 12).

Although PCOS is associated with excess abdominal fat and obesity, it is also common in people without overweight or obesity (1).

Nonetheless, studies suggest that a diet designed to achieve moderate weight loss — just 5–7% of body weight — in those with PCOS may improve insulin resistance and PCOS symptoms (4, 6, 12).

Cultural foods can be a part of your PCOS diet. Here are some key nutrients and foods to consider.

Complex carbs

Carbohydrates are a macronutrient and one of the body’s primary sources of energy.

The excess consumption of simple carbs and sugars is associated with an increased risk of developing insulin resistance, type 2 diabetes, and heart disease (6, 13).

However, complex carbs — which provide starches and dietary fiber — may improve hormonal imbalances and inflammation in people with PCOS (1, 2, 6, 7, 11).

Choose more complex carbs, such as:

• Whole grains: oatmeal, brown rice, quinoa, barley, sorghum, popcorn, stone-ground grits
• Legumes: black beans, pinto beans, lentils, black-eyed peas, garbanzo beans (chickpeas)
• Non-starchy vegetables: taro leaf, pumpkin, tomato, watercress, purple cabbage
• Root tubers: taro (dasheen), sweet potato, yucca, yam
• Starchy fruits: breadfruit, plantain, green fig (banana)

Healthy fats

Dietary fat is another macronutrient. It’s a concentrated source of energy for the body. However, all fats are not created equal.

A diet high in the less-healthy fats found in some animal foods — trans fats and saturated fats — is associated with increases in inflammation, insulin resistance, and risk of developing diseases, including cancer (14).

Swapping these fats for healthier monounsaturated and polyunsaturated fats has proven benefits for those with PCOS, including decreases in insulin resistance and fat buildup in the liver (1, 7).

Here are some healthy fats you can include in your PCOS diet:

• Nuts: walnuts, Brazil nuts, cashews, pistachios, almonds
• Nut butters: peanut butter, almond butter, cashew butter
• Seeds: chia seeds, flaxseed and flaxseed meal, sunflower seeds, pumpkin seeds
• Oils: olive oil, coconut oil, sunflower oil, safflower oil, canola oil, peanut oil
• Fatty fish: salmon, sardines, herring (smoked herring), mackerel (King fish)
• Fruits: avocado, olives

High quality protein

Some studies have found that elevated testosterone levels — a trigger for inflammation in PCOS — are lowered when the quantity of protein in the diet is increased (2).

Furthermore, a diet higher in protein with a modest reduction in carbs may support improved insulin resistance and glucose metabolism if you have PCOS (1).

As with carbs and fats, the quality of protein consumed is important. Complete protein foods — those that provide all nine essential amino acids — are considered high quality (15).

Eating protein may also assist in weight management (16).

Choose lean cuts of meat to reduce your saturated fat intake.

Good sources of high quality protein include:

• Meat: beef, lamb, pork
• Fish: salmon, cod, catfish
• Poultry: chicken, turkey, eggs
• Legumes: tofu, edamame, beans, peas, nuts, seeds
• Dairy: milk, yogurt, cheese

Dairy and PCOS

Dairy — cow’s milk and the products made from it, including cheese and yogurt — often gets a bad rap. To some, dairy is a controversial food group.

Cow’s milk may be associated with the increased occurrence of acne. Thus, people with PCOS — of which acne may be a symptom — may be advised to avoid dairy (17).

However, yogurt and cheese have not been shown to trigger acne, and avoiding dairy completely may not be necessary. Dairy provides protein and essential B vitamins (B12, B1, B2, and folate) (17, 18).

Some studies indicate that low fat dairy foods have a positive effect on insulin resistance and may reduce your risk of developing diabetes (19).

Furthermore, a recent study suggests that dairy may have anti-inflammatory benefits, which may reduce your risk of heart disease, high blood pressure, and even Alzheimer’s disease (18).

Therefore, unless you are lactose intolerant, you probably don’t need to remove dairy from your diet if you have PCOS.

Here are some low fat dairy options for a PCOS-friendly diet:

• low fat or fat-free yogurt, especially Greek yogurt
• low fat or fat-free cheese, such as cheddar, cottage, mozzarella, Parmesan, and feta
• low fat (1% or 2%) or fat-free milk

Summary

A high quality diet supports improved insulin resistance and reduced inflammation in people with PCOS. Aim for a balanced diet including complex carbohydrates, healthy fats, high quality protein, and low fat dairy.

PCOS and gluten

Gluten is a family of storage proteins found in wheat, barley, and rye that has been shown to trigger an inflammatory response in people with celiac disease or wheat allergies (20, 21, 22).

Given gluten’s inflammatory potential, people with PCOS are often discouraged from eating it — similarly to dairy.

However, unless you have a gluten sensitivity or intolerance, you probably don’t need to avoid gluten completely (23).

Studies suggest that the health benefits attributed to a gluten-free diet in people without a medical need may occur because gluten-free diets often prompt people to choose more wholesome foods and fewer processed foods, such as simple sugars (23).

The benefits don’t come from the avoidance of gluten itself (23).

Naturally gluten-free foods include:

• starches such as root tubers, corn, and corn products
• nut-based flours such as almond and coconut flour
• oatmeal — although it may become contaminated with gluten depending on processing practices
• non-starchy vegetables and fruits

Summary

Gluten is a family of proteins that triggers an inflammatory response in people with celiac disease or wheat allergies. You probably don’t need to avoid it with PCOS unless you have another medical condition.

Other lifestyle factors

Poor sleep and psychological stress are associated with inflammation, weight gain, and poor heart health (24, 25, 26).

Aim for 7–9 hours of uninterrupted sleep each night. And try to manage your stress levels through mind-body practices such as meditation and yoga or with the help of a licensed therapist.

Additionally, exercise may reduce inflammation and depression (27).

Aim for at least 150 minutes of moderate-intensity exercise per week, including weight-bearing exercises at least 2 days per week.

Summary

Poor sleep and high stress levels are associated with increased inflammation and increased risk for heart disease. To fight inflammation, aim for 7–9 hours of sleep and adequate exercise and manage your emotional health.

The bottom line

PCOS is the most common endocrine disorder and leading cause of infertility among premenopausal women.

Diet and lifestyle play major roles in PCOS management and can either improve or worsen inflammation, insulin resistance, and long-term risks of developing diabetes and heart disease.

Try to eat more complex carbs, healthy fats, high quality protein, and low fat dairy products — including your cultural foods! — and get enough uninterrupted sleep and exercise to adequately manage your PCOS.