What is a PCOS diet and how does it work?

If you’ve been diagnosed with polycystic ovary syndrome (PCOS), your doctor might recommend that you modify your lifestyle. Diet and exercise are the cornerstones of good health, so it’s little surprise that nutrition plays a role in combating chronic illness. What’s less clear, however, is how nutrition interacts with ovarian cysts.

As it turns out, you don’t need to have ovarian cysts to be diagnosed with PCOS. A diagnosis requires the presence of two of three factors — irregular menstruation, high androgen levels, and ovarian cysts. PCOS is a condition that hinges on hormone levels, and diet and exercise play a big role in healthy hormone balance.

That’s why you’ll find so much material about the so-called “PCOS diet” if you ask Dr. Google. Lifestyle changes can be enough to treat some milder cases of PCOS. But be wary of special, sometimes expensive, PCOS diet and exercise plans that sound too good to be true. They likely are just that. For most, while diet and exercise can help manage symptoms, it’s not the miracle cure it’s often reported to be.

Insulin resistance

First off, let’s understand what insulin resistance means. Insulin is a hormone that helps your muscles, fat, and liver utilize glucose for energy. You get glucose, a type of sugar, mostly from the food you eat. It circulates in your bloodstream until insulin delivers it to an area of your body that requires energy. Insulin resistance happens when your body responds poorly to insulin. In that case, glucose builds up in your bloodstream and creates chronically high blood sugars.

There’s a double-whammy with insulin resistance. First, high blood sugar levels spur your body to produce more androgens. That’s how PCOS comes about for some individuals. Once you have PCOS, high blood sugar strikes again by worsening symptoms.

Many, but not all, people with PCOS deal with insulin resistance. More than 50% will develop prediabetes or diabetes by age 40. There are certain risk factors that raise your chances of developing diabetes. These risk factors can also exacerbate PCOS:

Weight — the more fatty tissue you have, especially around your midsection, the greater your chances of being insulin resistant.
Sedentary lifestyle — exercise helps with weight regulation, and makes your body use glucose to fuel its efforts.
Family history — having one or more immediate diabetic family members increases your chances for developing insulin resistance.
Race — for unclear reasons, Black, Asian, Hispanic, and Indigenous people develop diabetes at higher rates.
High blood pressure — a blood pressure of 140/90 increases your risk of diabetes.
Abnormal cholesterol and triglycerides — having low levels of the “good” HDL cholesterol is associated with diabetes. So are high levels of triglycerides, a fat carried in your bloodstream.

The link between PCOS and diet

Since PCOS and insulin resistance are so closely linked, diet interventions focus on lowering and stabilizing blood sugars. If you ask doctors, there’s really no “PCOS diet.” A diet that will reduce PCOS symptoms is much the same as a diet for people with diabetes.

People with PCOS, diabetes, or no health complications all have the same basic nutritional needs. We all require vitamins, minerals, and enough fat, protein, and carbohydrates to stay fueled throughout the day. When creating a diet plan for PCOS, the focus is on foods that don’t spike blood sugar. Over time, healthy foods can regulate blood sugar, help with weight loss (if necessary), and reduce symptoms of PCOS and diabetes to barely noticeable levels.

Foods to eat when you have PCOS

High-fibre foods

Fibre is a powerhouse nutrient for people who are insulin resistant. It can’t be fully digested by your body. You’d think that’d be awful for your health, but it’s actually terrific. Fibre slows the passage of food through your digestive tract, which slows down your body’s absorption of glucose. That means fewer blood sugar spikes.

You’ll also feel fuller after a meal if fibre is giving you that stick-to-your-ribs feeling. A great bonus — fibre is only found in plant foods, most abundantly in fruits and vegetables. When you include high-fibre foods in your diet, you’ll be consuming lots of vitamins and minerals that come in handy plant packages.

Some high-fibre foods are:

Oatmeal
Beans
Lentils
Berries
Citrus fruits
Apples
All vegetables
Brown rice
Nuts

Vegetables

It’s hard to eat too many vegetables on a PCOS diet plan. You should aim to build your diet around whole plant foods. They’re low in calorie density, and high in fibre and essential nutrients. All told, increasing your intake of vegetables is proven to have insulin-stabilizing effects.

Try to eat a wide variety of vegetables in many colours and shades. The pigment of your plant foods shows what vitamins and minerals it contains. For example, red and orange vegetables tend to be high in vitamin C. Dark green vegetables contain lots of iron. Blue and purple vegetables give you a great dose of antioxidants.

Here are some vegetables to try out for tonight’s dinner:

Kale
Swiss chard
Lettuce
Carrots
Tomatoes
Pumpkin
Eggplant
Zucchini
Beets
Mushrooms
Cabbage
Peppers

Lean protein

Protein is great for helping you feel full and satisfied after a meal. There are lots of essential bodily processes that couldn’t happen without consuming protein. However, the sources you get your protein from are important. And, lots of people currently over consume protein thinking it’s a healthier option than fats and carbohydrates. The current recommendation for protein consumption is 0.8 grams per kilogram of bodyweight per day, or 10-35% of calories.

Some sources of lean protein are:

Poultry, such as turkey or chicken
Fish and shellfish, such as canned tuna, halibut, scallops, and shrimp
Low-fat dairy products such as milk, yogurt, and cottage cheese
Legumes such as beans, peas, and lentils
Eggs
Soy products such as tofu, tempeh, or mock meat

Healthy fats

Dietary fats are essential for good health. There are certain nutrients, like vitamin A, K, E, and D, that your body can only absorb with the help of fats. Consuming healthy fats also helps you keep a balanced hormonal profile.

When crafting your meals, be sure to choose fats that contain omega-3 and omega-6 fatty acids. Fats that come from plant sources are generally healthiest. Plus, they also provide nutrients like fibre, vitamins, and minerals.

Here are some examples of healthy fat sources:

Avocado
Chia seeds
Flax seeds
Fatty fish, such as salmon and sardines
Nuts such as walnuts and pecans
Eggs
Olives and olive oil
Canola oil

Unsweetened beverages

One tip dietitians often recommend to PCOS weight loss patients is to avoid drinking their calories. Soda, juice, iced tea, and of course fancy iced coffees can easily contain a full meal’s worth of calories. And, it’s usually in the form of refined sugar, which will drastically spike your blood sugar.

Think of your beverages as providing hydration rather than sustenance. Hydration is very important for keeping low, stable blood sugar levels. When you’re dehydrated your blood sugar becomes concentrated.

Next time you need a refreshing sip, try one of these drink options:

Water, either plain or flavoured with herbs and citrus.
Herbal tea.
Sparkling water.
Kombucha.
Homemade iced tea, without sugar.

Foods to avoid when you have PCOS

If you’re eating lots of healthy foods, you’ve already made a great start at stabilizing your blood sugar. There are some foods you should try to avoid as much as possible since they’ll counteract your healthful progress. Some items on this list are comfort foods, and you don’t have to cut them out of your life completely. Just make them the occasional treat instead of the foundation of your diet. These foods include:

Red meat
Processed meat
Solid fats, known as saturated or trans fats
Refined carbs made from white flour, such as pastries and white bread
Battered and/or fried foods
Fast food
Sweetened beverages such as pop or juice

What is the best PCOS diet to lose weight?

If you’re overweight and your doctor has recommended that you lose weight, shedding 5-10% of your bodyweight can have a profoundly beneficial impact on your blood sugars. There’s no fast method of weight loss that will be healthy or sustainable long term. Especially since PCOS is a lifelong condition, doctors recommend their patients take a lifestyle-based approach to weight loss.

Weight loss is achieved when the number of calories you consume through food is less than the number of calories you burn through exercise and bodily functions. A diet of whole plant foods, lean meat, and healthy fat provides “high-quality” calories. You’ll feel full and satisfied throughout the day, and will be less likely to require sugary snacks to boost your energy.

To embrace a lifestyle shift, start with small, healthy acts throughout your day. Take the stairs instead of the elevator, snack on fruit instead of potato chips, and practice mental relaxation to deal with stress instead of reaching for comfort food. Whatever you find enjoyable and sustainable will build a new healthy mindset.

A delicious way to manage PCOS

Changing your diet and lifestyle can seem overwhelming at first. We eat every day, and we have many habits and rituals built around food. A healthy lifestyle is one that complements your preferences and needs. Don’t like lettuce? Have a glazed carrot dish instead. Not a fan of chicken? Maybe fish is the way to go.

Diet is a powerful way to regain control over your PCOS. By viewing food as a tool to fuel your body, keep you in good health, and improve your quality of life, you’re on the way to an exemplary PCOS diet.

Make sure that you consult a medical professional to ensure you’re approaching a new diet in a safe and balanced way. Our dietitians and doctors are here to help with PCOS diet support.