Polycystic Ovarian Syndrome or PCOS is an endocrine disorder that affects up to 10% of reproductive age women. It is often associated with infertility due to an imbalance of reproductive hormones that affect the ovaries. Many times, women with PCOS are initially misdiagnosed.

PCOS results in higher levels of androgens (male hormones) and insulin in the body.

As a result, women with PCOS may struggle with their weight and are at a higher risk for developing impaired glucose tolerance, Type 2 Diabetes, and metabolic syndrome. Women with PCOS often have additional cardiovascular disorders including hypertension, elevated cholesterol (high triglycerides / low HDL) and elevated blood sugar related to insulin resistance.

The insulin resistance seen in PCOS is somewhat unique. It may occur in women of normal body weight, and it is not always corrected with weight loss. The insulin resistance results from a defect in the actual cell, rather than the impaired ability of insulin to bind to the cell receptor.  Often times, medication such as metformin is prescribed to help with insulin resistance and restore ovulation.

Signs and Symptoms of PCOS include:

  • Infertility / Impaired ovulation
  • Menstrual irregularities / Amenorrhea
  • Hirsutism (unwanted hair growth, such as on the face)
  • Acne
  • Sleep apnea
  • Weight gain / Difficulty losing weight / Obesity
  • Cystic ovaries

Dietary Guidelines

The following are some simple dietary guidelines that can help women with PCOS manage blood sugar and support healthy weight management:

  • Consume small frequent meals within the appropriate calorie range. It’s important to understand that each person’s calorie range is unique. Calories are based on a person’s height ,weight, age, gender, physical activity level, and goals. So, if someone you know is following a 1200 calorie diet (hint – which for most people is WAY too low), this may not be right for you.
  • Consume a high fiber diet. I recommend at least 25g of fiber per day. Foods that contain fiber can be found in many types of healthy complex carbohydrates. These include fruits, vegetables, beans, legumes, and whole grains. Fiber will support digestion, help keep you fuller longer, help to lower cholesterol, and support overall health and weight loss.
  • Choose complex carbohydrates that are low on the glycemic index and will not cause rapid spikes in blood sugar. Complex carbs include fruits, starchy vegetables, beans and legumes, and whole grains.
  • Avoid processed foods and foods with added sugars. Sugar has no nutritional value and will only make matters worse by increasing your caloric intake and cravings.
  • Consume a diet rich in protein. Ideally strive for a diet that is at least 25-30% protein. Choose lean proteins such as poultry, cold water fish, lean cuts of meats (preferably organic or grass fed), eggs, or plant based protein such as miso or tempeh.
  • Avoid skipping meals. This will impair your metabolism and lead to blood sugar crashes that will cause intense cravings for carbohydrates. The exact opposite of what you need to support PCOS and insulin resistance.
  • Consume healthy Omega 3 rich fats such as nuts, seeds, avocados, and olive oil. Fats will help keep you satiated and they will not spike your blood sugar. Unsaturated fats will also support healthy cholesterol levels.
  • Avoid inflammatory foods. Sugar and processed foods are obvious, but sometimes even healthy foods can be inflammatory in certain individuals. This list might look different for everyone, but if you know that certain foods cause an inflammatory reaction in your body then it’s best to avoid them. A common example would be dairy causing lactose intolerance. The idea here is to reduce inflammation not create it. Keeping a detailed food journal and working with a qualified dietitian can help you identify which foods might be inflammatory to you.
  • Consume plenty of anti-inflammatory foods that are rich in nutrients and anti-oxidants. Examples include: Cinnamon, flax, oats, berries, apples, pears, dark leafy greens, ginger, turmeric, fenugreek, and green tea.

Nutritional Supplements:

Studies show that certain nutritional supplements (along with medication) can support fertility, insulin resistance, and weight management issues associated with PCOS.

  • D-chiro-Inositol and D-pinitol or Myo-Inositol– Has shown to improve insulin resistance, dyslipidemia, hypertension, weight loss, androgen lowering, and fertility.
  • Vitamin D3 – Supports proper metabolism of carbohydrates.
  • Chromium – Promotes insulin sensitivity by helping to reduce body fat and increase lean muscle.
  • N-Acetyl Cysteine (NAC) –Has been shown to improve insulin resistance, androgen lowering, dyslipidemia, weight management, menstrual regularity.
  • Magnesium  – Has been shown to improve insulin resistance, improve sleep, lower blood pressure, and support healthy digestion.
  • Cinnamon – Anti-inflammatory and helps to lower blood sugar.
  • Omega 3 Fatty Acids – Helps to reduce inflammation and improve cholesterol levels, lower blood pressure, and improve insulin resistance.
  • Fenugreek –Has been shown to improve insulin resistance.
  • Probiotics – To support overall gut health, mood, and weight management. 

In addition to implementing dietary strategies I recommend getting plenty of exercise. Engage in cardiovascular activity 3-4x per week and weight bearing exercise at least 2-3x per week such as strength training in order to reduce body fat and build muscle.

In my practice I work with women all the time who are struggling with PCOS and weight management. If you are seeking guidance and support for PCOS, you can contact me here. I would love to work with you.

References:

Gaby, Alan R., MD. Nutritional Medicine. Alan R. Gaby, M.D., 01/2011. VitalBook file.

Nutrition Care Manual Polycystic Ovarian Syndrome / eatright.org

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Grassi, A. (2013). PCOS; the Dietitian’s Guide (2nd ed., Vol. 1)

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