Importance of Diet in Managing PCOS

Our Women’s Health Physiotherapist, Lauren, had a chat with Dietitian Madeleine from the Nourished Edit about the role and importance of diet in managing PCOS (Polycystic Ovarian Syndrome). PCOS is a complex hormonal condition that affects 10-20% of women of reproductive age.

Madeleine is available at PhysioPod Co. Geelong every second Saturday for nutrition and dietetics consultations. You can contact Madeleine at thenoursihededit@gmail.com to book an appointment. 

What role does diet play in PCOS?

Polycystic ovarian syndrome has a range of symptoms that can vary from woman to woman. Lifestyle factors such as diet and exercise can be really important for symptom management and to improve quality of life.

In particular diet can play positive roles in helping with insulin resistance, weight management, regular menstrual cycles, infertility and inflammation. The importance of diet in managing PCOS can not be understated.

For those with insulin-resistance PCOS, reducing or quitting sugar is advised. What are some tips for people to do this easily?

Insulin resistance is thought to be an underlying contributor to PCOS. This is a hormone that is responsible for transporting sugars (glucose) from your blood stream into your cells, where it is used for energy.

Insulin resistance is a when the insulin your body provides is less effective, requiring your body to produce more insulin than normal to help lower sugar levels in your blood. As a result you have higher insulin levels, and likely higher blood sugar levels.

Increased insulin levels also affects ovarian function leading to higher production of androgens (another clinical marker of PCOS).

Two dietary changes can be very effective in managing insulin resistance:

1. Choosing low GI carbohydrates

Low Glycemic Index (GI) carbs are foods that slowly digested by our bodies and slowly release sugars over time. High GI carbs are foods that our body digest quickly which leads to a spike in blood sugar levels (and insulin).

Including low GI carbs into your diet will be beneficial. This can be achieved by making simple swaps such as:

2.Reducing your overall carbohydrate intake

Carbohydrates “Carbs” provide essential nutrients and should be included as part of a healthy balanced diet, however if you have PCOS reducing your overall carbohydrate intake may be beneficial in managing insulin resistance, blood glucose control and for weight management.

Some tips on how to do this:
– spread your carbohydrate intake over the day, having small frequent meals and teaming it with a lean protein source such as egg, meat, poultry, fish, tofu
– choose wholegrain carbs that are high in fibre, as they will help keep you feeling fuller for longer
– avoid highly refined/processed carbohydrates
– incorporate protein based snacks such as boiled eggs, tinned tuna, veggie sticks and hummus, nuts and seeds

For those with inflammatory PCOS, is an anti-inflammatory diet best to help manage this?

You probably have all heard of the Mediterranean diet and its benefits. One of the benefits of this diet is that is considered anti-inflammatory and it has shown to have positive outcomes in women with PCOS as well.

The Mediterranean diet probably deserves its own blog post but the main principle of the diet is that it includes an abundance of minimally processed foods, “whole” foods such as fruits, vegetables, whole grains, legumes, nuts and seeds and olive oil. With moderate amounts of dairy, fish, poultry and lean red meats.

The inclusion of lots of fruit and veggies means that the diet is naturally high in antioxidants. Antioxidants are known to help manage inflammation in the body. The more variety and colour of vegetables and fruit you include in your diet, the more antioxidants you will consume!

Seafood is a good source of omega 3 fatty acids which are beneficial for heart health and inflammation as well as fertility and pregnancy. Including oily fish like salmon and tuna as least twice a week as well as adding in nuts and seeds like walnuts and chia seeds to meals is a good way to ensure you are getting adequate Omega 3’s. Evidence has shown that adequate omega 3 intake can improved insulin response, blood lipid profiles and blood glucose regulation! If fish isn’t your thing, consider an Omega 3 supplement!

For many women with PCOS, struggling with infertility is an ongoing battle. For women who know they have PCOS, should they be adding anything else in to their diet to assist with conception?

Fertility struggles can be quite common for women with PCOS due to high androgens, insulin resistance and irregular cycles. Getting on top of these will be super beneficial in improving chances of conception.

Lifestyle changes such as diet and exercise will help you achieve this:
-include 2 serves of fruit and lots of vegetables, legumes and whole grains into your diet
-aim for low GI carbs
-choose beneficial fats like olive oil and avocado and limit saturated fats
-choose water over sugar sweeten beverages and juice
-aim for 30mins of brisk activity per day
-5-10% loss of weight (for those who are overweight) will assist with symptom management and insulin resistance.

In terms of anything else women can add to their diet, there are a few things:

Cinnamon:

some small but promising studies have shown that including cinnamon may be beneficial.

An 8 week study comparing cinnamon supplementation to a placebo showed that the cinnamon taking women saw a significant reduction in their insulin resistance compared to women who took placebo (Wang et al., 2007)

Another study looking into irregular period showed that after 6 months of cinnamon supplementation compared to placebo, that women who took the cinnamon supplement had more regular period cycles (Kort & Lobo, 2014).

Inositol:

Inositol is a supplement that can help to improve insulin resistance in women with PCOS (Larner, 2002). A more recent study also looking into inositol supplementation and PCOS found that inositol may promote ovulation and regular menstrual cycles. Check with your GP or fertility dietitian to see if this is beneficial for you.

Zinc:

Zinc is an important micronutrient that is essential for male and female fertility. Including good sources of zinc in the diet such as lean red meat, beans and legumes and seafood will help boost your zinc intake.

Metformin:

A medication used to treat insulin resistance, may also help improve ovulation and promote regular menstrual cycles. Check with your GP to see if this will be beneficial for you.

However, for any women with PCOS considering pregnancy or struggling with fertility linking in with health professionals is essential to help get on top of your symptoms. I recommended checking in with your GP and seeing a fertility dietitian who can provide tailored nutrition and supplementation advice to help improve your chances of conceiving and egg quality. Individual nutrition advice is essential for women to learn the importance of diet in managing PCOS.

Reach out to work with me today if you are looking for guidance on improving your PCOS symptoms or need assistance meeting your nutritional needs thenoursihededit@gmail.com

-Madeleine Bowles, APD, The Nourished Edit