PCOS: What is it and how does diet play a role?

PCOS is a common condition that many women find themselves struggling with.

And it doesn’t often get the attention it deserves. So, today we’re addressing what PCOS is, the role weight loss can play, and general diet recommendations for women diagnosed with PCOS. 

What is PCOS? 

PCOS stands for Polycystic Ovarian Syndrome. It’s a hormonal condition that affects approximately 1 out of 10 women of reproductive age. 

Without getting too complicated, PCOS involves several symptoms that together affect a woman’s ovaries and ovulation cycles.

These symptoms include: 

• Several small, fluid-filled sacs that grow inside the ovaries, called cysts. 
• Higher than normal production of androgens – a class of hormones. 
• Irregular or missing menstrual cycles. 

Symptoms and potential health effects 

Overall, PCOS results in a hormone imbalance, which can then have numerous side effects on your overall health, including fertility issues and weight gain. 

In fact, many women don’t realize that they have PCOS until they either have difficulty getting pregnant or find themselves confused as to why they’re gaining a substantial amount of weight. 

In addition to difficulty getting pregnant and gaining weight, other common symptoms of having PCOS include: 

• Increased hair growth on the face, chest, stomach, back, thumbs or toes
• Acne, oily skin and dandruff
• Weight gain, especially around the mid-section
• Thinning hair on head
• Pelvic pain

PCOS can also lead to more serious conditions such as metabolic syndrome, sleep apnea, depression, and an increased risk of endometrial cancer. 

As a result, it’s incredibly important to talk with your gynecologist if you have a family history of PCOS or have any warning signs. It’s much better to have the workup done and find that you don’t have PCOS than to say nothing at all. 

What causes PCOS? 

It’s currently unknown what causes PCOS. 

As it can run in families, it’s thought that genetics is one piece of the puzzle with insulin resistance and chronic inflammation also being potential contributors. 

Insulin resistance refers to your cells not being able to use insulin properly. And this is a problem as insulin’s main role is to transport glucose (sugar) from your blood and into your cells for energy. 

In addition to increasing your risk for type 2 diabetes, insulin resistance can also cause your pancreas to try to pump out more insulin. And this excess insulin can actually signal to your ovaries to produce more androgen hormones. 

Weight loss and PCOS 

It’s estimated that anywhere from 38-80% of women with PCOS are overweight or obese. 

Obesity may increase the risk for metabolic diseases and conditions such as type 2 diabetes, high blood pressure, heart disease, and stroke. 

As a result, dietary and lifestyle changes are often the first line of treatment for women with PCOS. 

In fact, research has shown that losing 5 to 10% of your body weight may help some improve PCOS symptoms and reduce the risk for metabolic disease. 

So what does 5 to 10% of weight loss look like? 

For a woman who weighs 200 pounds:

• 5% weight loss = 10 pounds
• 10% weight loss = 20 pounds

To calculate how much weight you would need to lose, simply multiply your current weight by 0.05 for 5% or 0.10 for 10%. 

What to eat 

As with most conditions, an individualized approach is best.

Choosing foods that are lower in carbohydrates (especially refined carbs) may be beneficial for managing insulin resistance. The amount of carbs varies between studies. One review on low carb diets for PCOS defined low carb as less than 45% of calories from carbs per day. Still, the exact amount of carbohydrates to include in your diet is highly personalized.

As a result, it’s best to make an appointment with a registered dietitian to determine the optimal amount of calories and carbohydrates for your individual needs. They can also assist you with choosing better-for-you carbohydrate choices that will regulate your blood sugars better.

Here are some general guidelines on what to eat more of and what to limit or avoid if you have PCOS. 

Foods to focus on

• Vegetables: emphasis on non-starchy vegetables like broccoli, zucchini, leafy greens, and cauliflower. But still good to include moderate amounts of starchy veg like sweet potatoes, peas, and corn. 
• Fruits: berries, apples, pears, peaches, etc. Aim for a variety. 
• Fatty fish: salmon, mackerel, sardines, cod, herring, light tuna. 
• Lean proteins: chicken, turkey, bison, shellfish, pork loin, lean beef, plain Greek yogurt, eggs and egg whites. 
• Legumes: beans, lentils, peanuts, natural peanut butter, whole soy (like edamame) 
• Whole grains: quinoa, oatmeal, farro, freekeh, brown rice, barley, amaranth, etc. 
• Healthy fats: avocado, extra-virgin olive oil, avocado oil, olives, flaxseeds, chia seeds, hemp seeds. 
• Nuts: almonds, pecans, walnuts, cashews, etc. 

Foods to limit or avoid

• Highly processed snack foods: snack cakes, chips, cookies, many brands of crackers, some granola and protein bars. 
• Other refined grains: white bread, sugary breakfast cereals, white pasta, white rice, etc. 
• Foods and beverages high in added sugars: candy, cakes, donuts, pastries, bakery-style muffins, soda, sweetened fruit juice, sweet tea, energy drinks, mixed drinks like margaritas, and sweetened coffee shop beverages. 
• Processed and fried meats: sausage, pepperoni, salami, pre-packaged deli meats, bacon, hot dogs, corned beef, fast food chicken nuggets, fried chicken, fried fish, etc. 

The bottom line 

Being diagnosed with PCOS can bring a whole range of emotions, including fear, anxiety, and frustration. 

However, there are ways you can adjust your lifestyle to improve your metabolic profile and support the regulation of your hormones. 

While diet plays an essential role, don’t forget about other aspects of health as well. These include regular physical activity, sleep, and stress management. 

Most importantly, know that you aren’t alone. In particular, it can be incredibly helpful to have a team of health professionals to support you, including a registered dietitian and a psychiatrist or psychologist. 

Disclaimer: This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, website, or in any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis, or treatment.

Reviewed 12/2021