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Can your diet help manage PCOS symptoms? Nutritionist offers advice

When you're living with PCOS, diet can make a big difference in your symptoms and preventing complications. Here are some foods to try, along with a sample meal plan.
Diet can help manage some of the symptoms of PCOS.
Diet can help manage some of the symptoms of PCOS.TODAY Illustration / Getty Images

Polycystic ovary syndrome (PCOS) is a hormonal condition that affects millions of women in the United States. Recently, PCOS has made headlines because several celebrities have come forward to share their experiences of dealing with the disorder, such as Keke Palmer, Lea Michele and Christina Hall.

The endocrine disorder is not rare. About 7% to 10% of women in the U.S. are have PCOS, typically beginning in their childbearing years. There are treatments and medical interventions for PCOS, but many experts recommend diet and lifestyle changes to manage symptoms.

Here's everything you need to know about how following a PCOS-friendly diet.

What is PCOS?

PCOS is a common hormonal condition that primarily impacts women of childbearing age. According to the Endocrine Society, PCOS affects about 5 to 6 million women in the U.S. and is the most common cause of infertility. But estimates about the prevalence of PCOS are just that because a lot of women don't know they have it.

PCOS affects how the ovaries work. The ovaries are small glands located on either side of the uterus, which produce hormones and eggs for menstruation and pregnancy, per the Cleveland Clinic.

In people with PCOS, the ovaries produce excess hormones — specifically, an abnormally high level of androgens, or male sex hormones. This causes a hormonal imbalance, which can result in difficulties ovulating, irregular periods, fertility problems, small ovarian cysts, acne, thinning hair and insulin resistance.

Insulin is a hormone made by the pancreas and helps regulate blood sugar levels. Insulin resistance occurs when the cells in the muscles, fat, and liver do not respond well to insulin and can't easily take up glucose from the blood, according to the National Institutes of Health.

There is an association between PCOS and being overweight, but scientists aren't sure whether PCOS causes weight gain or vice versa.

People with PCOS can develop serious complications, such as high cholesterol, heart disease, high blood pressure, Type 2 diabetes and endometrial cancer.

Since many PCOS sufferers experience insulin resistance, managing PCOS often involves making changes to your lifestyle habits in addition to medications to regulate hormones.

Diet and exercise can help lower blood sugar and regulate insulin levels, which in turn can help the body regulate hormones, such as androgens. That's why nutrition and lifestyle strategies tend to be part of the lifelong approach to treating PCOS.

PCOS diet: How to treat PCOS with food

Your doctor will determine how to best manage PCOS symptoms through diet, but here are three possible changes to make:

Maintain a healthy weight

In the U.S., some studies suggest that as many as 80% of women with PCOS are overweight. This is why weight control programs are often recommended to help mitigate the symptoms of PCOS. 

Losing weight has been shown to help improve many PCOS symptoms. Weight loss can help lower insulin and androgen levels, and may help regulate periods and restore ovulation, per the Mayo Clinic.

There’s a lot of debate about the best diet for weight loss, but a review of multiple studies found that any sustainable approach can be helpful for managing PCOS symptoms.

While many different factors can influence an individual’s weight, the main strategy that lends to weight loss is being in a calorie deficit, TODAY.com previously reported. This means you are consuming fewer calories than you are burning.

The best diet for PCOS will depend on the individual, but it typically starts with a nutritious, balanced diet. A popular option is a Mediterranean-style diet, which emphasizes healthy fats, vegetables, fruits, whole grains, legumes and seafood.

There may be some additional advantages that come with a low-carbohydrate diet, which is often recommended to manage insulin resistance.

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, PCOS may create 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 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

Research shows that people with PCOS have a type of low-grade, long-term inflammation in the body, according to the Mayo Clinic. Inflammation results from the body's defenses kicking into gear to heal and fight off infection, but when it goes on for too long, this can cause a host of problems, TODAY.com previously reported.

Inflammation is thought to be at the root of some of the longer-term health risks related to PCOS, including heart disease, blood vessel problems and Type 2 diabetes.

An anti-inflammatory diet focuses on eating more foods that can help reduce inflammation, including those rich in nutrients like antioxidants, phytochemicals and omega-3 fatty acids. Examples of anti-inflammatory foods are: leafy greens, avocados, beans, applies, cherries, fish, flaxseeds, nuts and olive oil.

Foods that increase inflammation should be avoided; these include foods that are overly processed, fried, high in added sugar, as well as refined carbohydrates, red meat and seed oils.

In a small, 12-week study, participants who followed an anti-inflammatory 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.

The Mediterranean diet may also be particularly helpful in reducing inflammation-related health risks among women with PCOS.

Focus on fiber

Fiber-filled foods promote feelings of satiety or fullness, which means that you may be able to go a longer stretch after a fiber-rich meal — or snack — without feeling hungry. A high-fiber diet can also help with weight loss and lower blood sugar.

Adults should get between 25 and 38 grams of fiber every day, according to the U.S. Department of Agriculture, but most fall far short of that, TODAY.com previously reported.

Adding fiber-rich foods to your diet, including cruciferous vegetables like broccoli and cucumber, sweet potatoes, carrots and beets, is a delicious and easy way to up your fiber intake.

In one year-long study, researchers found that getting 30 grams of fiber a day through foods like veggies and fruits led to about a 5-pound weight loss, as well as improvements in response to insulin, which could translate into 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.

Foods to eat for PCOS

We designed a sample menu of meals and snacks 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. Overall, this sample day supplies about 1,700 calories.

It's important to note that some 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

Breakfast

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.

Lunch

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.

Dinner

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.

Snacks

  • 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, 1/2 teaspoon vanilla extract and 1 1/2 teaspoons maple syrup. Chill and serve.