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It gets complicated and confusing when it comes to what to eat with PCOS and how different foods affect PCOS and its symptoms.
When you google: “best diet for PCOS”, the first results are: low carbohydrate diet, and the ketogenic diet. Are these diets really the best for PCOS?
According to the International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2018), there is no specific diet that is recommended for PCOS.
There are hundreds of diets out there created and applied for different purposes. Many of those diets aim at weight loss or managing a specific symptom, and you may see it recommended or used in PCOS.
As you may know that nutrition and lifestyle are essential parts of treating and managing PCOS. Read my previous blog on treatments for PCOS.
Note that diet or nutrition is only one part. Lifestyle and other treatments also are important.
In this blog, I discuss the diets that I’ve seen used or recommended for PCOS.
PCOS Diet Goals
Most of the time, people follow a “diet” to lose weight. Even in PCOS, diets are recommended for weight loss, which is not enough to make a difference in PCOS symptoms.
Diet and nutrition interventions goals are more than that. They include:
- Ensure adequate nutrients intake
- Improve insulin sensitivity, manage blood sugar, and reduce insulin levels
- Reduce inflammation
- Improve egg quality and fertility
- Reduce risks/complications of PCOS
- Improve gut health
- Manage symptoms of acne, hair loss, cravings
- I also like to add:
- Incorporate cultural foods and practices
- Includes joy and fun
Let’s Define The Word: Diet
When you hear the word diet, what first comes to your mind?
According to the Oxford Languages Dictionary, there are two definitions:
“1. the kinds of food that a person, animal, or community habitually eats.
2. a special course of food to which one restricts oneself, either to lose weight or for medical reasons.”
This article will classify the commonly suggested diets for PCOS into two groups based on the above definitions: restrictive diets, and eating patterns.
Commonly Suggested Diets for PCOS
Here are some examples of diets that you see commonly suggested to people with PCOS. I have seen those recommended by physicians, dietitians, on the internet, and other publications. I have also seen many clients who tried one or more of these diets to manage their PCOS.
The purpose here is not to promote a diet as there is no diet that is approved for PCOS, but the purpose is to look critically at each of these diets and to see that there is a life beyond diets while still managing PCOS.
1. Restrictive Diets
The following diets are usually recommended for PCOS, and they’re restrictive. The goal of these diets is mainly weight loss, which according to those diets affect other health markers.
With that goal, you might see any diet promoted for weight loss to be promoted as “the best diet for PCOS”. Please be aware that I do not recommend any of the diets in this section for PCOS.
The Ketogenic Diet (The Keto Diet)
The keto diet is a very low carbohydrate and high fat diet. The name of the diet comes from the main process in metabolism that uses ketone bodies from fat to use them for energy instead of glucose from carbohydrates. It is a great diet therapy for children living with epilepsy. This is how I first learned about this diet when I visited a rehab hospital for children.
The keto diet gained popularity in the space of weight loss and insulin resistance.
There are some small limited time studies that concluded that the keto diet can benefit people with PCOS, but what about long term and side effects?
The ketogenic diet is very low in carbohydrate, which may affect the body negatively and will affect the relationship with food. Side effects may include constipation, headaches, nutrient insufficiencies or deficiencies, and negative effect on of the gut microbiome.
Gluten and Dairy Free Diet
Gluten and dairy free diet for PCOS is all over social media and many books targeted for PCOS. There’s no research studies that looked into this diet for people with PCOS.
It claims that gluten and dairy are inflammatory and have an impact on insulin resistance, but there has been no proof of that.
Many times, it was found that some types of dairy products have a protective effect against inflammation.
Some individuals may benefit from a gluten and dairy free diet if they had another condition that indicates the use of this diet.
Dairy free may benefit some individuals who deal with acne.
Intermittent fasting is related to time-restricted eating. It has different forms, and the most popular one is 16 hours of fasting and 8 hours of eating.
Fasting has some favourable effects on insulin resistance and insulin levels, but I always ask how sustainable is the fasting? And does it lead to nutrient deficiencies? And how is your relationship with food on this diet?
Many people may go into cycles of fasting and binging due to the restriction period.
2. Eating Patterns
This group includes the Mediterranean diet, the DASH diet, and the low GI diet. They are less restrictive and more descriptive of eating patterns.
The Mediterranean Diet
The Mediterranean diet is a dietary pattern that is rich in vegetables, fruit, whole grains, and healthy fats such as olive oil, fatty fish, nuts and seeds. It also emphasizes plant-based protein sources. It’s not just that, but it also highlights the social aspect of food and movement of body.
The DASH Diet
DASH stands for Dietary Approach to Stop Hypertension. This dietary pattern is rich is vegetables, fruit, whole grain, low fat dairy.
It has shown some positive results when it comes to hypertension and other metabolic markers and reduce inflammation.
The Low GI Diet
GI stands for glycemic index. The GI is a number that is given to foods based on their effect on blood sugar.
The low GI diet is very helpful in reducing insulin production and insulin resistance, promoting satiety, and regulating appetite. Generally, high fibre, protein, and food with fat have lower GI than refined carbohydrates.
The diet presents in classifying foods into low, medium, and high GI food.
I dealt with with this diet a lot and found that you can change the glycemic effect of food by creating food pairs and combinations that reduces glycemic index and effect of the food. For example, when you pair crackers with cheese, you reduce the glycemic effect of crackers due to the cheese protein and fat content.
The Non-Diet Approach for PCOS
I’m so passionate about food freedom and learning how to eat without pressure, even if you live with PCOS. Non-diet does not mean not taking care of your food, nutrition or health. Non-diet approach means that food and food rules does not control you, but you have the ultimate control.
Non-diet approach mainly uses the principles of intuitive eating that improve your relationship with food and body.
Intuitive Eating for PCOS
Intuitive eating is a framework that is anti-diet and strict food rules, which improves your relationship with food and body.
It has 10 principles that are:
- Reject the diet mentality
- Honour your hunger
- Make peace with food
- Challenge the food police
- Discover the satisfaction factor
- Feel your fullness
- Cope with your emotions with kindness
- Respect your body
- Movement – feel the difference
- Honour your health — gentle nutrition
My next blog post is on intuitive eating and how to use it for PCOS.
If you are interested in learning more about it in more details, you can read:
- Intuitive Eating (Book) by Evelyn Tribole and Elyse Resch*
- Intuitive Eating (Workbook) by Evelyn Tribole and Elyse Resch*
- Intuitive Eating Cards by Eevelyn Tribole and Elyse Resch*
The tenth principle of intuitive eating is honour your health with gentle nutrition.
Gentle nutrition is when you listen to what your body wants and your nutrition knowledge and what makes you feel good. Gentle nutrition honours your body’s wants and nutritional needs mentally and physically.
An example is when you choose whole grain versus white bread because fibre makes you feel better. It is when you add protein and healthy fat source such as peanut butter when eating a banana. This will make it tastier, more satisfying, and will reduce the glycemic index of the snack.
So, What to Eat with PCOS?
Yup. It gets confusing when it comes to what to eat with PCOS. Remember the goals of the PCOS eating? We try to implement them while listening to body and understanding its cues with applying gentle nutrition.
- Egg frittata
- Greek yogurt parfait
- Balanced smoothie
- Quinoa veggie and lentils bowl
- Tuna wrap with vegetables
- Pesto chicken quesadilla
- Salmon, potato, and broccoli
- One pan roasted chicken and vegetables
- Hummus pasta
- Sweet potato toast
- Cottage cheese with fruit
- Hummus and veggies
When it comes to the best diet for PCOS, it gets confusing and complicated. I believe that you have the inner wisdom to give your body what it needs, which may take some unlearning and learning.
Some of the dietary patterns that were discussed can also help in gentle nutrition approach to achieve the PCOS food goals.
Teede, H., Misso, M., Costello, M., Dokras, A., Laven, J., Moran, L., … & Norman, R. (2018). International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. National Health and Medical Research Council (NHMRC), 1-198.