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The PCOS diet: How to manage symptoms and complications with food

20 February 2023 dot 6-minute read
Healthy Body PCOS Diet and nutrition Listicle Eat Well
Avoid skipping meals, including breakfast, if you have been diagnosed with PCOS. (Credit: Shutterstock)
Polycystic ovary syndrome (PCOS) affects up to 20 per cent of women worldwide, yet the exact cause is still unknown. Studies show that what you eat, along with daily physical activity, makes a significant impact on managing symptoms. What constitutes a PCOS diet?
 
Before making a list of foods to eat, it's essential to understand the conditions associated with your PCOS first.

What happens to your body with PCOS

Doctors and scientists don't know what causes PCOS. They suspect genetics and environment may be contributing factors. Research proves hormonal imbalance is behind most PCOS symptoms and leads to certain conditions.
 
Problems with the gonadotropin-releasing hormone (GnRH) are common in people with PCOS. A GnRH issue may prevent your ovaries from releasing mature eggs and affects oestrogen and progesterone production. As a result, you may experience irregular or absent periods. The unreleased eggs may form as follicles or cysts, making the ovaries polycystic.
 
Insulin resistance is also a PCOS-related issue. Too much insulin drives the production of the male hormone androgen, resulting in tell-tale PCOS signs such as:
 
  • cystic acne
  • hair growth on the chin, chest and inner thighs
  • extra weight on the abdomen
PCOS is also associated with chronic inflammation. The cell damage further opens the body to insulin resistance and high androgen levels.
 
Hormonal imbalances and inflammation can lead to weight gain and increase your risk of certain chronic diseases, particularly diabetes and heart disease.
 
Weight loss can be challenging for those suffering from PCOS. One study by Australian researchers showed that mice with PCOS-induced traits put on more weight than those without PCOS despite eating the same amounts of food. More research is required to understand the cause of weight gain.
 
Doctors do know that five to 10 per cent of weight loss in obese women with PCOS can help restore ovulation and improve hormone levels. That's why doctors prioritise lifestyle modification in PCOS treatment.
 

What's in a PCOS diet

Doctors prescribe a healthy diet with emphasis on fruits and vegetables. Aside from controlled portion sizes, they recommend cutting back on processed food, sugar and refined carbohydrates.
 
An international guideline for assessing and managing PCOS recommends an intake of 1,500 calories daily if the goal is weight loss. Still, little evidence supports that a low-calorie diet benefits those suffering from PCOS.
 
A review of seven studies published in Maedica shows women with PCOS can benefit from a diet that contains non-starchy fruits and vegetables low in the glycaemic index. Here are some examples:
 
  • artichokes
  • asparagus
  • bean sprouts
  • broccoli
  • cauliflower
  • brussels sprouts
  • celery
  • cucumber
  • eggplant
  • mushrooms
  • onions
  • peppers
  • salad greens
  • spinach
  • tomato
  • turnips
  • zucchini
  • melons
  • berries like strawberries, raspberries, blackberries and blueberries
  • citrus fruits like oranges, tangerines, grapefruit and lemons, peaches, plums, apricots, cherries, and pears
Aside from plenty of fruits and vegetables, you can eat:
 
  • fish rich in omega-3 fatty acids
  • legumes
  • whole grain products
  • nuts and seeds
  • healthy sources of fat like olive oil, walnuts, almonds and avocados
  • nut butter, tofu, beans, lentils and low-fat dairy products as a source of protein
  • lean red meat and chicken in small quantities
  • low-fat or fat-free dairy

Dietary approach for PCOS

Fill your meals with fruits and vegetables low in carbohydrates and glycaemic index. (Credit: Shutterstock)
If you prefer to follow an eating plan, consult your doctor and nutritionist about the Mediterranean, DASH and ketogenic diets. Studies show these diets may potentially alleviate PCOS symptoms.
 
Two PCOS-related studies published in Nutrients showed Mediterranean and DASH diets resulted in significant weight loss among women with obesity. These diets also reduced inflammatory responses, increased glucose regulation and improved the appearance of ovaries.

Mediterranean diet

The Mediterranean diet has a well-established reputation as an anti-inflammatory eating plan. It encourages high consumption of olive oil (serving as the primary source of fat), fruit, vegetables, legumes, nuts and seeds, and fish rich in omega-3 fats and poultry rather than red meat.
 
In an Australian study published in Nature, researchers saw PCOS-induced mice ovulate again after eating a low protein, medium carbohydrate and medium fat diet, similar to the Mediterranean approach.

DASH diet

Doctors recommend the heart-friendly DASH diet to help with hypertension treatment. The Nutrients study showed DASH could also help with glucose control and keep body fat from being distributed around the belly in women with PCOS.
 
A DASH eating plan recommends a sodium intake of 1,500 mg daily with foods low in saturated and trans fats and rich in potassium, calcium, vitamin D, magnesium and fibre.

Ketogenic diet

The ketogenic diet – low on carbohydrates in favour of plant-based fat – showed potential as a PCOS treatment based on an Italian study published in the Journal of Translational Medicine.
 
Twenty-four overweight women with PCOS in the study were allowed to eat unlimited amounts of green leafy vegetables, cabbage, zucchini, cucumbers and eggplants for 12 weeks. They could only eat two eggs, 120 g of meat or 20 g of fish daily. They also took four dietary supplements high in protein and low in carbohydrates.
 
Those on the keto diet saw insulin, cholesterol and triglycerides drop. Androgens and gonadotropin hormones decreased, improving the menstrual cycle. The keto diet used in this Italian research also reduced body weight, body mass index, hip circumference and stored fat.
 
Consult your doctor before starting a keto diet because it is not without risks.

Eating healthy with PCOS

Complement your PCOS diet with 300+ minutes of moderate activity weekly, including two weight training sessions, if the doctor advises losing weight. (Credit: Shutterstock)
One in every 10 women is diagnosed with PCOS worldwide, based on data published in the Journal of Human Reproductive Sciences. The symptoms of PCOS will differ from one woman to another. For example, not all women with PCOS have irregular menstruation. Others can't seem to lose weight despite intense physical activity or a fitness regimen.
 
You may need a doctor's help to pinpoint the causes of your PCOS symptoms and customise a treatment plan, including a proper diet. Most research on PCOS suggests food choices matter. You are at risk of:
 
  • cardiovascular disease
  • type 2 diabetes
  • Infertility
  • obesity
  • obstructive sleep apnoea
  • endometrial cancer
  • depression and anxiety
A low glycaemic, low carb or anti-inflammatory diet can naturally reduce your risk of developing these conditions.
 
There is no one-size-fits-all treatment for PCOS. Find professional help and holistic healthcare for your PCOS in AIA Vitality. Its network of nutrition experts can prescribe the right PCOS diet and connect you with specialists. This wellness programme is the best self-care investment you will make.
 
 
References:
 
Journal of Human Reproductive Sciences. 2020. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. [online]  [Accessed on 26 October 2022]
 
Nutrients. 2021. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review. [online]  [Accessed on 26 October 2022]
 
Maedica. 2021. Dietary Patterns and Polycystic Ovary Syndrome: a Systematic Review. [online]  [Accessed on 26 October 2022]
 
Journal of Translational Medicine. 2020. Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. [online]  [Accessed on 26 October 2022]
 
 
 
The University of Sydney. 2020. Polycystic ovary syndrome treatment may hinge on diet. [online]  [Accessed on 26 October 2022]
 
Nature Communications. 2020. Defining the impact of dietary macronutrient balance on PCOS traits. [online]  [Accessed on 26 October 2022]
 
National University Health System Singapore. 2022. Polycystic Ovary Syndrome. [online]  [Accessed on 26 October 2022]
 
Monash University. PCOS treatment. [online]  [Accessed on 26 October 2022]
 
Monash University. Lifestyle and PCOS. [online]  [Accessed on 26 October 2022]
 
Monash University. 2018. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. [online]  [Accessed on 26 October 2022]
 
NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2022. What causes PCOS. [online]  [Accessed on 26 October 2022]
 
Disclaimer:
This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.