PCOS: How to use food & supplements to your advantage

Did you know that polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age?

It is a complex condition, characterized by chronic anovulation and hyperthyroidism and affects 6-10% of the population. We unpacked more about PCOS in this blog post, if you are interested.

In this article we are going to look at how you can use food and supplements to take charge of your symptoms. We’ll focus on the relationship between diet and PCOS. You can make a huge difference in the severity of your PCOS and sometimes even reverse your diagnosis, by getting to the roots of imbalance in this complex hormonal and metabolic condition. 

What to eat?

Following a Mediterranean-style diet has been found to steady blood sugar, reverse insulin resistance and is most effective for weight loss.

Every meal should include:

Hormone healthy proteins

Improving protein intake throughout the day improves blood sugar levels, lowers testosterone levels, increases satiety and reduces PCOS symptoms, even without other measures like reducing carbohydrates or increasing exercise. Replacement of carbohydrates with protein improves weight loss and improves glucose metabolism by an effect that seems to be independent of the weight loss and thus seems to offer improved dietary treatment for PCOS women.

• Include animal protein such as poultry, eggs, and fish
• Eating legumes two to three times/week is ideal
• Avoid all processed meats and excessive red meat intake 

Healthy fats

Healthy fats help us to feel satisfied and full after meals, maintain steady energy and blood sugar and control sugar cravings. A healthy dietary fat intake has also been shown to reduce abdominal fat, improve insulin sensitivity and reduce testosterone levels along with associated symptoms. Importantly, low omega 3 and high omega 6 levels (true for 80% of people) are associated with insulin resistance and PCOS. 

• Emphasize olive oil, avocado, nuts, seeds, occasional ghee and coconut oil
• Eating cold-water fatty fish (approximately 113g) rich in essential fatty acids 3 times weekly, including salmon, mackerel, anchovies and sardines
• If you’re not into fish or are unable to eat it this often, take fish oil or an algae-based omega-3 supplement daily

Slow Carbs

A reduced carbohydrate diet is important for improving fertility, endocrine/metabolic parameters, weight loss and satiety in women with PCOS. But a word of caution: very low-carb diets aren’t the answer.

• Healthful grains: brown rice, millet, oats (rolled and steel-cut), quinoa, wild rice, red, pink or black rice are all great choices. Buckwheat (technically a seed not a grain) may be especially helpful in improving blood sugar balance and reducing insulin resistance.
• Including starchy “energy” vegetables such as parsnips, potatoes, squash, winter squashes (pumpkin, acorn, spaghetti, butternut etc.) and sweet potatoes is also beneficial.

Eat more plants

This doesn’t mean that you have to be a vegan or vegetarian, in fact, fish and other forms of animal protein are an important part of a PCOS-healthy meal plan. But it does mean increasing your intake of vegetables, fruits, nuts, seeds and plant-based protein sources like legumes as the base of your diet for important anti-inflammatory, gut supportive and blood sugar balancing nutrients, particularly fiber. Studies show a strong connection between low fiber intake and insulin resistance and strong evidence shows us that high dietary fiber intake can improve insulin sensitivity. We also know that fiber is important for improving satiety when we eat, preventing us from overeating, supporting weight loss and supporting the health of the gut microbiome. 

• Aim for 8-10 servings of vegetables daily with a rainbow of colours to support nutrient diversity
• Especially emphasize greens like bok choy, broccoli, broccoli sprouts, brussels sprouts, cabbage (all varieties), cauliflower, collard greens and kale
• While fresh fruit is a healthy option, with PCOS, keep it to two servings daily and stick to the low glycemic choices such as blackberries, blueberries, raspberries and strawberries

Go organic

It’s more than just what you eat – it’s what comes along with your food, including herbicides and pesticides, as well as plastic compounds that leach into our food from packaging and storage containers. For example, studies have shown higher BPA (bisphenol A) levels in women with PCOS and has been associated with higher markers of inflammation. BPA stimulates androgen production and interferes with testosterone lowering mechanisms. This is problematic since high testosterone levels is a hallmark of PCOS.

• Eat organic strictly for meats and dairy
• Ideally choose organic fruits and vegetables
• Choose low mercury fish (salmon, herring, haddock, anchovies, sardines, shrimp, squid and sole)
• Avoid plastic packaging and food storage

What to supplement?

Nutritional deficiencies are common in PCOS and certain vitamins and minerals are needed to regulate blood sugar.

Numerous studies demonstrate the importance of the following vitamins and minerals:

• Myo-inositol and D-chiro-inositol (4000mg therapeutic dose). These two isomers have been shown to improve cell sensitivity to insulin thus showing significant improvement in the metabolic processes.
• Coenzyme Q10 has beneficial effects on glucose metabolism, serum total and LDL cholesterol levels.
• Magnesium, zinc, calcium, vitamin D and vitamin K co-supplementation have shown beneficial effects on hormonal profiles, biomarkers of inflammation and oxidative stress including insulin metabolism and markers of cardiometabolic risk, serum DHEAS (dehydroepiandrosterone sulfate), free testosterone, plasma TAC (plasma total antioxidant capacity) and MDA (malonaldehyde) levels in PCOS women. PCOS patients are up to 19 times more likely to be magnesium deficient.
• Vitamin B12 (cobalamin) and folic acid levels decrease during metformin therapy and rises HCY (homocysteine) levels which is a long term risk for cardiovascular disease. Methylcobalamin (active vitamin B12) is an easily absorbed form and has improved bioavailability.
• Folate increases peripheral sensitivity to insulin, maintaining folate levels and thus restoring normal homocysteine levels.
• Chromium improves glucose levels and insulin sensitivity in PCOS women.

Insufficiencies in these and other micronutrients are associated with elevated blood glucose, insulin resistance, PCOS and diabetes. While food should always be the foundation of your nutrient intake, we recommend all women with PCOS to include a daily multivitamin and mineral supplement, vitamin D (blood test before supplementation to identify a deficiency) and inositol.  

Beyond what you eat: timing is everything 

Our bodies are meant to have clear times for eating, and clear times for digestion. Eating for steady blood sugar means meals should be balanced and provide the energy you need to feel satisfied.

• Eat regularly and make sure all meals and snacks are blood sugar balanced with the foods mentioned above.
• Eat breakfast every day and make sure your meal includes a good quality protein and fat source
• Don’t go hungry by keeping an emergency food stash in your bag and your desk drawer.
• Keep a food journal. It can be a helpful tool to make food-body connections and recognize satiety, fullness and cravings.

What to avoid?

Sugar and empty carbs

Sugar, processed foods, processed flour products, sodas and even bottled fruit juices wreak havoc on your blood sugar. This is the main dietary culprit contributing to insulin resistance and the cascade of problems that follow.

Dairy 

Many women with PCOS find that eliminating dairy can be beneficial in reducing hormonal symptoms, especially acne.

Alcohol and caffeine

Alcohol may be particularly problematic for women with PCOS. Even small amounts of alcohol consumption have been associated with Non-alcoholic fatty liver disease (NAFLD) in women with PCOS. It breaks down into sugar, adding to insulin resistance and has been associated with increased fat stores. 

Caffeine can increase stress hormones, spike blood sugar and lead to insulin resistance, all of which can aggravate PCOS.

Over-restricting

Restrictive eating is not recommended for PCOS.  Restriction leads to activation of your stress response, which in turn leads to increased cortisol, insulin and insulin resistance. Over time, this can cause weight gain and exacerbate inflammation and confused food signalling.

PCOS is a complex condition. The best approach focuses on addressing each of the root causes. It is best to follow a personalized approach and consult with your doctor and dietitian.

Information supplied by Delfran.

Find out about their nutritional supplement for women with PCOS over here.