PCOS has been in the headlines lately, largely because many celebrities have come forward to share their experiences of dealing with the syndrome. Keke Palmer, Lea Michele and Christina Hall have all been vocal about their experiences. But celebrities aren't the only people plagued with PCOS.
In fact, polycystic ovary syndrome (PCOS), it turns out, is not exactly rare. Seven to 10% of women are affected by PCOS, typically beginning in their childbearing years. There are medical interventions for PCOS, but most experts also recommend dietary and lifestyle changes.
Here's everything you need to know about how to use diet to manage PCOS.
What is PCOS?
PCOS is a hormone disorder that primarily impacts women of childbearing age. According to the Endocrine Society, PCOS affects five to six million women in the U.S. and is the most common form of infertility. But estimates about how prevalent PCOS is are just that — estimates — because a lot of women don't know that they have it.
Women with PCOS produce excess insulin and androgen — hormones that, when imbalanced, can cause difficulty ovulating. These imbalances can lead to irregular periods, fertility problems, small ovarian cysts, acne, thinning hair and insulin resistance. There’s also a link between PCOS and being overweight, but scientists aren't sure whether PCOS causes weight gain or vice versa.
Ultimately, women with PCOS can develop serious complications, such as high cholesterol, high blood pressure, type 2 diabetes and heart disease.
Since women with PCOS often experience insulin resistance, managing PCOS may involve making changes to your diet and lifestyle habits, as well as taking medications to regulate ovulation and insulin levels. Diet and exercise can help your body regulate insulin, which in turn can help your body regulate hormones. That's why nutrition and lifestyle strategies tend to be part of the lifelong approach to treating PCOS.
How to treat PCOS with diet
Here are three ways to improve your diet for PCOS.
Manage your weight
As many as 80% of women with PCOS are very overweight, weight loss is often advised to help mitigate the symptoms of PCOS. Losing weight has been shown to help manage many PCOS symptoms, including helping to regulate periods, improve insulin levels and reduce acne.
While there’s constant debate about what type of diet is the best for weight loss, a review of multiple studies found that any sustainable approach can be helpful for managing PCOS symptoms. However, there may be some additional advantages for women who follow a low-carbohydrate diet.
What’s the best diet for PCOS? A low-carb diet is often recommended to manage insulin resistance, which is why it may be helpful for PCOS. One review of seven studies suggested that a diet that supplied no more than 45% of calories from carbs led to better hormonal balance and an improvement in pregnancy rates among overweight women with PCOS.
While weight loss is often advised, women with PCOS may have a difficult time losing weight, so in addition to focusing on nutrition strategies, adopting other healthy lifestyle habits can also be helpful. For example, learning how to manage emotional and environmental triggers (such as a bad day or strolling past a pizza joint) can support the process. Similarly, the symptoms of PCOS can be emotionally challenging and cause added stress, so finding ways to cope with these aspects of the condition is an important part of managing PCOS — and may also aid weight management.
Include anti-inflammatory foods
Inflammation is thought to be at the root of some of the longer-term health risks related to PCOS, such as heart disease and type 2 diabetes. A Mediterranean-style diet that includes foods like fish, vegetables and pulses, and limits pro-inflammatory foods, such as those high in added sugar and refined grains, may be particularly helpful in reducing health risks among women with PCOS. In a small, 12-week study, participants who followed this eating plan lost an average of 7% of their weight and experienced improvements in body composition, inflammatory markers, blood pressure levels, period cycles and blood sugar regulation. In the short study period, there was also a 12% uptick in pregnancy rates.
Focus on fiber
Fiber-filled foods promote feelings of fullness, which means that you may be able to go a longer stretch after a fiber-rich meal — or snack — without feeling hungry, and that can help you manage your weight better.
In one year-long study, simply focusing on getting 30 grams of fiber a day through foods like veggies and fruits led to about a five-pound weight loss, as well as improvements in participants’ response to insulin — a result that could translate to a lower risk of type 2 diabetes. Here's the kicker: While the advice was to eat 30 grams of fiber per day, participants averaged around 19 grams of fiber, so they experienced benefits even though they were falling short of the target.
A fiber-rich diet can also lead to improvements in insulin sensitivity. In a 2019 study among women with PCOS, there was an inverse relationship between fiber intake and insulin resistance, meaning that compared with women who were eating more fiber, those with lower fiber intakes had a stronger likelihood of having insulin resistance, whereas those who ate a high-fiber diet were less likely to experience this metabolic complication.
What to eat for PCOS
We designed a sample menu to help you put these dietary strategies into practice. You’ll notice that this sample day provides fiber and carbs from wholesome sources, such as non-starchy and starchy veggies, fruits, whole grains and pulses. It also provides heart-healthy, anti-inflammatory foods, like fish, avocados and extra virgin olive oil. There’s even a snack and a treat. Overall, this sample day supplies about 1,700 calories.
It's important to note that some women with PCOS may need more calories and others may need fewer. About 35% of these calories come from carbohydrates and this menu has 39 grams of fiber.
A PCOS diet meal plan
Sweet potato toast
Cut a sweet potato in half, then cut that portion into slices and roast until cooked. Divide an avocado in half, slice that portion, and on a piece of toast, alternate the avocado slices with the roasted sweet potato slices, and top with 2 eggs cooked any way you like.
Greek chicken and chickpea salad
Combine a mixture of chopped grape tomatoes, cucumbers and red onions (for a total of 2 cups) with 1/4 cup kalamata olives, 1/3 cup chickpeas, 4 ounces pre-cooked chicken and 2 teaspoons extra virgin olive oil, 2 teaspoons red wine vinegar and 1 teaspoon Greek or Italian seasoning.
Sheet pan salmon
Whisk together 1 teaspoon honey, 1/4 cup coconut aminos or soy sauce, 1 teaspoon each garlic powder and ginger powder and 1 teaspoon sesame oil. Lay a salmon filet (about 1 pound) on a sheet pan lined with parchment paper and use a brush to season the salmon with the marinade mixture. Toss 4 cups broccoli florets with the remaining mixture. Transfer to the sheet pan, organizing the broccoli around the salmon. Bake at 450 degrees for 7 to 10 minutes — or until the salmon is cooked through. Once the salmon is done, remove from the sheet pan and continue to roast the broccoli until it’s to your liking. Serve with a mixture of 1/2 cup cooked brown rice and 1/2 cup cooked riced cauliflower. Makes 4 servings.
- 1 apple, sliced and smeared with nut or seed butter
- Chocolate mousse made by blending 1/3 cup unsweetened vanilla almond milk with 2 tablespoons of each chia seeds and cocoa powder, 2 teaspoons almond butter, ½ teaspoon vanilla extract and 1 1/2 teaspoons maple syrup. Chill and serve.