The Role of Nutrition in PCOS

The role nutrition plays in PCOS (Polycystic Ovary Syndrome).

By Dr. Dylan Cutler, Ph.D. in Obstetrics & Gynecology, PCOS Fighter (IG @dr.dylancutler)

What is PCOS?

PCOS is short for polycystic ovary syndrome. PCOS is the most common hormonal condition in women impacting our reproductive, metabolic, and psychological well-being. Evidence shows PCOS affects up to 18% of women, as well as trans men and non-binary folks, worldwide (1).

What are the symptoms of PCOS?


Since PCOS is a heterogenous syndrome, symptoms can vary from person to person. The most common symptoms include irregular or absent cycles, acne, excess facial and/or body hair, hair loss from our head, unexplainable weight gain along with difficulty losing weight, skin tags, excessive sweating, insomnia, sleep apnea, and more.


How is PCOS diagnosed?

According to the most widely used diagnostic criteria, a diagnosis is made when any 2 of the following 3 criteria are present:


  • Hyperandrogenism (diagnosed by elevated blood androgens OR excess facial/body hair)

  • Irregular periods or no periods (likely meaning we are not ovulating)

  • Polycystic ovaries visible via ultrasound (not to be confused with ovarian cysts)


What are the long-term risks associated with PCOS?


If PCOS is unmanaged there is an increased risk of type 2 diabetes, heart disease, and endometrial cancer (2). In addition, people with PCOS are more likely to experience infertility, anxiety, depression, poor body image, low self-esteem, eating disorders, and a higher suicide rate (3,4).


Can nutrition support PCOS?


Lifestyle management is the recommended first-line approach for PCOS (5). Specifically, nutrition, physical activity, and stress management have been shown to improve reproductive, metabolic, and mental health (6,7).


Blood sugar and insulin regulation are key factors in PCOS management. Nutrition is one way we can manage blood sugar levels. Not only can blood sugar and insulin regulation help improve symptoms of PCOS, but this also helps to prevent type 2 diabetes.


Another factor often involved in PCOS is inflammation (8). Women with PCOS have been found to have increased levels of C-reactive protein, an inflammatory marker. Many diseases are associated with chronic inflammation, including type 2 diabetes and heart disease (9, 10).


Therefore, filling our plates with anti-inflammatory foods can help reduce our risks. Anti-inflammatory foods include turmeric, garlic, berries, leafy greens, nuts, avocado, broccoli, tomatoes, green tea, and dark chocolate (>75% cacao). In addition, reducing inflammatory foods can help reduce chronic inflammation (meat, dairy, many processed foods, fried foods, refined carbohydrates, and sugar-sweetened drinks/candies, etc.).


What about plant-based nutrition?


Research shows whole food, plant-based nutrition is associated with a lower prevalence of type 2 diabetes, metabolic syndrome risk factors, and death from all causes (11, 12, 13, 14, 15).


One reason that plant foods are effective is because they are great sources of fiber. Food high in fiber, like whole grains, fruits, vegetables, and legumes, has countless benefits, particularly for PCOS (16). Not only can fiber help combat insulin resistance, but fiber also can help improve cholesterol levels, support digestion, promote a healthy gut microbiome and reduce the risk of heart disease.


Another supportive factor of whole food, plant-based nutrition for PCOS is that it is low in saturated and trans fats. Both saturated and trans fats can increase the risk of heart disease and type 2 diabetes (17, 18, 19). Saturated fat may also increase inflammation, insulin resistance and hyperandrogenism in women with PCOS (20). Food high in saturated fats include animal products, such as meat and dairy, palm oil, and coconut oil, while trans fats are often found in vegetable shortening, partially hydrogenated oils, baked goods, and fried foods.


Finally, with disordered eating being so common in people with PCOS, plant-based nutrition offers many an escape from the caloric and macro-centric mind traps of diet culture. Research has shown it is not necessary to track caloric intake when consuming a whole food, plant-based diet, even when the desired outcome studied was weight loss (21). An unrestricted abundance of fruits, vegetables, legumes, whole grains, nuts, and seeds nourishes and satiates while supporting our quest for the healthiest, happiest body and mind.


Disclaimer: This is information, not medical advice. Please consult with your healthcare provider regarding PCOS diagnosis, management, and treatment.


Dr. Cutler’s Website: www.phruitfuldish.com


References:

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  2. Månsson, Mattias, et al. "Women with polycystic ovary syndrome are often depressed or anxious—a case control study." Psychoneuroendocrinology 33.8 (2008): 1132-1138.

  3. Veltman-Verhulst SM, Boivin J, Eijkemans MJ, Fauser BJ. Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and metaanalysis of 28 studies. Hum Reprod Update. 2012;18:638-651.

  4. Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia. 2009;13(2):90.

  5. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. Monash University, Melbourne, Australia 2018.

  6. Lin AW, Lujan ME. Comparison of dietary intake and physical activity between women with and without polycystic ovary syndrome: a review. Adv Nutr. 2014;5:486-496. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. Monash University, Melbourne, Australia 2018.

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  16. Cutler, D., Pride, S., & Cheung, A. (2019). Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Science & Nutrition, 7(4), 1426-1437.

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  20. González F, Considine RV, Abdelhadi OA, Acton AJ. Inflammation Triggered by Saturated Fat Ingestion Is Linked to Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2020 Jun 1;105(6):e2152–67. doi: 10.1210/clinem/dgaa108. PMID: 32140727; PMCID: PMC7150616.

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