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No, you don’t have to cut carbs for good.
Polycystic ovary syndrome, commonly known as PCOS, affects .css-7l5upj{-webkit-text-decoration:underline;text-decoration:underline;text-decoration-thickness:0.0625rem;text-decoration-color:inherit;text-underline-offset:0.25rem;color:inherit;-webkit-transition:all 0.3s ease-in-out;transition:all 0.3s ease-in-out;}.css-7l5upj:hover{color:#595959;text-decoration-color:border-link-body-hover;}up to 12% ( as many as 5 million) of American women of reproductive age. It has even impacted celebrities like Keke Palmer, Lea Michele, and HGTV’s Christina Anstead, but the hormone-related disorder is wildly understudied and under diagnosed. This often leaves some confusion for women who suffer from the disorder. The first course of action many medical professionals recommend is lifestyle changes, especially following a PCOS diet that can help manage symptoms. Here, we chat with experts about how diet affects PCOS, what PCOS diet foods you can incorporate into meals, and some foods that may trigger PCOS symptoms more often.
PCOS is an endocrine disorder that impacts hormonal production, reception, and transportation, explains Hannah Alderson, B.A.N.T., registered nutritionist and founder of The Positive Method. It’s most often diagnosed by experiencing at least two of infrequent ovulation (leading to irregular or absent periods), hyperandrogenism (high levels of androgens), or polycystic ovaries, she says. Symptoms of PCOS vary person-to-person but can include:
It may be confusing as to why diet has such an impact on a hormonal disorder, but the fundamental problem with PCOS is there is a tendency to be glucose-sensitive and experience insulin resistance, explains G. Thomas Ruiz, M.D., ob/gyn lead at MemorialCare Orange Coast Medical Center in Fountain Valley.
Insulin is the hormone that processes glucose (a type of sugar) and turns it into energy for the body to use, explains Rebecca Blake, M.S., R.D., C.D.N., senior manager of preventive health at Carrot Fertility. When the body requires more insulin than is considered normal to process glucose and convert it to a usable form, this is called insulin resistance, she says. This leads to higher insulin levels in the body which can lead to health conditions including prediabetes and diabetes in your 40s and beyond, Dr. Ruiz says.
“The risks of PCOS don’t go away once you’re beyond childbearing years. All of the risks we see with PCOS like diabetes, heart disease, and uterine cancer we tend to see that pop up in the 40s,” adds Melissa Groves Azzaro, R.D.N., L.D., integrative and functional medicine dietitian specializing in women’s health and hormones.
Because of this insulin resistance, managing symptoms and losing weight with PCOS can be extremely difficult. Dr. Ruiz explains that following a healthy diet can control the amount of blood glucose circulating and avoid spikes in blood sugar.
Additionally, it’s essential to target the root cause when planning a diet with PCOS because even though the majority of women are impacted by insulin resistance, many are also experiencing symptoms due to gut dysfunction, inflammation, and other imbalances, Azzaro says.
So, if insulin is related to sugar, it’s best to just cut out all sugar, right? Well, not exactly. Most experts agree that a diet similar to the Mediterranean diet is ideal for the long term. Eating anti-inflammatory foods can be helpful, and focusing on balancing your plate with lean protein (like fish and legumes), healthy fats (like salmon and walnuts), and fiber-containing fruits, vegetables, and whole grains can help regulate blood sugar and manage PCOS, Blake says.
Additionally, research has linked diet changes that include fruits and vegetables with a low glycemic index, low-fat dairy, seafood rich in omega-3 fatty acids, lean red meat and poultry, legumes, whole grains, and moderate alcohol intake improved PCOS symptoms and lab results. It’s best to work with a dietitian or your medical provider to determine the best foods for you, but these expert-approved foods are known to support healthy hormones and manage PCOS symptoms.
Foods like farro, bulgur, brown rice, and whole wheat bread have a lot of fiber, causing a lower spike in blood sugar, Dr. Ruiz says. It’s also important to avoid “naked carbs,” meaning even whole wheat grains can spike blood sugar if not paired properly, says Carolyn Brown, M.S., R.D., integrative nutritionist and co-founder of Indigo Wellness Group. She suggests always pairing carbs with good fat and protein to slow the sugar spike and increase long-term satiation.
Though the occasional white potato is acceptable, sweet potatoes are higher in fiber and have a lower glycemic index, Dr. Ruiz says.
Lean proteins
There’s definitely a space in the diet for lean chicken, fish, and red meat periodically, says Dr. Ruiz. And Azzarro agrees, encouraging those with PCOS to increase their protein intake and be sure to spread it out evenly throughout the day. Brown also likes plant-based options like beans and lentils that contain insulin-friendly inositol.
Foods like yogurt, cheese, and kefir contain hormones that most people with PCOS find balancing, says Felice Ramallo, M.S.C.N., R.D., L.D., and Lead Dietitian at Allara. She suggests two to three servings per day or a dairy alternative if it’s not tolerated well.
Veggies like dark leafy greens, broccoli, and cauliflower are great sources of fiber that can help keep the gut healthy and improve bathroom visits, Brown suggests. Aim for three to four servings of veggies per day, Ramallo adds.
“Colourful vegetables high in antioxidants and phytonutrients, in particular, phytoestrogens are great. Variety is key with a big focus on whole foods,” Alderson agrees.
Dr. Ruiz says fruits lower in sugar, like berries, are especially great to incorporate into a PCOS-friendly diet.
“Vegetables and fruits are excellent sources of fiber and nutrients that are essential for our bodies regardless of PCOS and should be included liberally,” Blake says. “When eating fruits that are high in sugar content, it may be helpful to balance them with a source of protein and/or fat so that those fruits have a milder impact on blood sugar. Think of adding some unsweetened yogurt to your fruit or balancing an apple with a handful of almonds.”
Mono and polyunsaturated fats from nuts, nut butter, avocados, seeds, extra-virgin olive oil, and avocado oil can be helpful with PCOS, Blake says. Brown likes to add two tablespoons of seeds like hemp, chia, or flax to her meals every day for an extra boost.
“Fats are your friend with PCOS because they don’t raise blood sugar,” Azzaro says. “They slow digestion, slow the transit of foods from the stomach to the small intestine, and they taste good.” Additionally, seafood like salmon and mackerel that contain lean protein and healthy fats are great additions to your diet. Brown suggests aiming for incorporating these foods three times per week.
Though research is limited, some experts recommend trying blood sugar-supporting supplements like berberine, inositol, vitamin D, and omega-3, Brown suggests.
It’s important with PCOS to keep blood sugar steady throughout the day, eat regularly, and choose foods that encourage stability and balance. Ramallo encourages avoiding low-carb, keto, intermittent fasting, and other trendy diets, and opting for small, frequent meals throughout the day. When you eat, our experts suggest limiting these foods:
Foods high in uncomplex carbs, like white bread and refined grains, tend to spike blood sugar, Dr. Ruiz says. Additionally, for some people with PCOS, gluten-containing foods (even the whole grain kind) can be inflammatory and exacerbate symptoms. If you find that you feel better by avoiding gluten due to celiac disease, gluten sensitivities, or thyroid dysfunction, Brown encourages opting for gluten-free, whole-grain options.
Any raw sugars can also cause your blood sugar to spike and increase insulin in your blood, Dr. Ruiz says. Blake adds that this includes both foods like cakes, candies, and cookies, but also sugary drinks like juice and soda.
Not only does alcohol cause inflammation in the body, but it can disrupt sleep, impact food choices, and cause gut distress.
Azzaro says highly processed, fried foods that use poor-quality oils, and many packaged snacks can be inflammatory.
“Minimising ultra-processed food is very important as this type of food will drive inflammation in the body, which will exasperate PCOS symptoms,” Alderson says.
Weight loss is often the first line of defense when it comes to managing PCOS, but Ramallo reminds us that a healthy weight is one that’s easy to maintain and stable after three to six months of healthy changes, not what the scale or BMI might say.
Though following a healthy diet can be a great assist in lowering insulin levels, managing PCOS, and controlling hormone fluctuations, Dr. Ruiz adds to those suffering from PCOS that ultimately medication is often the best option. If not handled by a medical professional, PCOS can put patients at an increased risk for endometrial cancer, something diet alone isn’t able to prevent.
Dr. Ruiz says your doctor will often prescribe a birth control pill or IUD with either combined hormones or progestin-only. Other medications can be prescribed to assist in blocking certain hormones. Plus, if a patient chooses they want to get pregnant, there are medications a doctor can prescribe to help with ovulation and encourage fertility, he notes.
Patients with PCOS should also add exercise to their regular routine, Blake says. She suggests easing yourself into daily movement with a five to 10-minute brisk walk after meals to improve the body’s glucose processing. Ramallo encourages working your way up to 150 minutes of moderate to vigorous activity per week. But, It’s also important not to over-exercise, which can add additional stress to the body, Brown notes.
Additionally, research has found that PCOS is related to mental health and stress. Brown encourages practicing meditation, yoga, journaling, and regularly walking. If you’re struggling with weight loss after a PCOS diagnosis, it is essential to work with a medical professional to manage symptoms who is sensitive to your experience and consider seeking mental health support.
Lastly, sleeping a full seven to nine hours per night and maintaining a stable bedtime schedule is crucial to managing PCOS symptoms, Ramallo says.
Arielle Weg is the associate editor at Prevention and loves to share her favorite wellness and nutrition obsessions. She previously managed content at The Vitamin Shoppe, and her work has also appeared in Women’s Health, Men’s Health, Cooking Light, MyRecipes, and more. You can usually find her taking an online workout class or making a mess in the kitchen, creating something delicious she found in her cookbook collection or saved on Instagram.
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