Is dieting the answer to PCOS?

PCOS – Poly Cystic Ovarian Syndrome, a hormonal & endocrine disorder estimated to affect 1 in 10 women (1).

One of the most common recommendations to support the impacts of PCOS is dieting for weight loss. This is often down to the insulin resistance that is thought to be in association with the condition (2), which can disrupt how effectively cells use insulin and contribute to higher androgens in the body, which then aggrevates symptoms. With this in mind, it’s not a huge surprise that obesity or higher weight ranges are often associated with PCOS.

However, 20-50% women who have PCOS, fall in to the healthy weight range (3), suggesting there is much more to look at here, beyond the vague guidance of ‘weight loss’. Focusing on weight loss can often be unhelpful, especially in women who have a long history of dieting, plus common weight loss methods can adversely affect PCOS symptoms. On top of this, rates of eating disorders are found to be higher in women suffering with PCOS (4), showing higher rates of anorexia nervosa, bulimia nervosa and binge eating disorder when compared with women without PCOS (5), with particular attention needed in women with higher BMIs (6) . Which begs the question; why are we talking about dieting at all…?

Inclusion over exclusion

When figuring out where to start with managing PCOS, it’s pretty easy to find long lists of all the things to avoid, but what about all the things to include? An inclusion approach focuses on what to add in to your diet & lifestyle, rather than remove. There are many nutrients that have been found to be useful for supporting symptoms.

Magnesium

Magnesium is often found to be low in women with PCOS, and contributes to many systems in the body; regulating insulin levels, blood pressure, sleep, energy production, hormone production and mood (7, 8) . Magnesium is found in:

  • Pumpkin seeds
  • Brazil nuts
  • Almonds
  • Cashew nuts
  • Peanuts
  • Sunflower seeds
  • Soya beans
  • Spinach
  • Marmite
Zinc
Zinc deficiency is also common in PCOS sufferers, adequate levels have been found to support several PCOS symptoms such as; hair loss, hirsutism (excess body hair), facial hirsutism & PMS (8, 9) . Zinc is found in :
  • Oysters
  • Shellfish – especially crab and lobster
  • Red meat
  • Cashew nuts
  • Chickpeas
  • Baked beans
  • Fortified breakfast cereals

Anti inflammatory foods

There’s evidence to suggest that anti inflammatory foods can help to reduce inflammation and manage PCOS symptoms (10). These include:

  •  Berries
  • Green leafy veg
  • Avocados
  • Oily fish
  • Turmeric
  • Extra virgin olive oil
  • Tomatoes
  • Almonds
  • Walnuts
  • Seeds
  • Wholegrains
Lifestyle
One of the best places to start when managing PCOS is lifestyle (11). Whilst diet plays a big role, if we’re stressed out & barely sleeping, it doesn’t matter how hard we try with our diet – we need to be looking at all the pieces involved in the puzzle!
 
  • Movement – that feels good! Whatever feels good to you is the best place to start.
  • Stress – cortisol can play havoc in our hormone balance, try managing stress through calming actives such mindfulness, yoga, meditation, reading, journalling (12)
  • Sleep – you need to prioritise your 8 hours. An under slept body is a stressed body! (13)
  • Hydrate – A minimum of 2 litres a day is what keeps your body where it wants to be.
 
Whilst these are all general recommendations for supporting yourself through PCOS, there is so much more that can be done when individualised to you. PCOS manifests differently in every woman. Supplemental, dietary & lifestyle support varies for each individual, and you may have other symptoms or conditions that need managing too. If you want to know what to do to best help your body specifically, look for a registered Nutritional Therapist, who works with a food freedom/non diet approach, to re establish harmony with your body, and to find peace with food.
 
 
References
 
  1. NHS, 2021, PCOS (https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/)
  2.  International evidence-based guidelines for the assessment and management of Polycystic Ovary Syndrome (PCOS). https://www.monash.edu/medicine/sphpm/mchri/pcos/guideline.
  3. John E. Nestler, Daniela J. Jakubowicz, Lean Women with Polycystic Ovary Syndrome Respond to Insulin Reduction with Decreases in Ovarian P450c17α Activity and Serum Androgens, The Journal of Clinical Endocrinology & Metabolism, Volume 82, Issue 12, 1 December 1997, Pages 4075–4079.
  4. Bernadett M, Szemán-N A. Evészavarok prevalenciája policisztás ováriumszindrómás nok körében [Prevalence of eating disorders among women with polycystic ovary syndrome]. Psychiatr Hung. 2016;31(2):136-45. Hungarian. PMID: 27244869.
  5. Lee I, Cooney LG, Saini S, Smith ME, Sammel MD, Allison KC, Dokras A. Increased risk of disordered eating in polycystic ovary syndrome. Fertil Steril. 2017
  6. Pirotta S, Barillaro M, Brennan L, Grassi A, Jeanes YM, Joham AE, Kulkarni J, Couch LM, Lim SS, Moran LJ. Disordered Eating Behaviours and Eating Disorders in Women in Australia with and without Polycystic Ovary Syndrome: A Cross-Sectional Study. J Clin Med. 2019
  7. Sharifi F et al. (2012) “Serum magnesium concentrations in polycystic ovary syndrome and its association with insulin resistance” Gynecol Endocrinol.
  8. Afshar Ebrahimi F, Foroozanfard F, Aghadavod E, Bahmani F, Asemi Z. The Effects of Magnesium and Zinc Co-Supplementation on Biomarkers of Inflammation and Oxidative Stress, and Gene Expression Related to Inflammation in Polycystic Ovary Syndrome: a Randomized Controlled Clinical Trial. Biol Trace Elem Res. 2018
  9. Abedini M, Ghaedi E, Hadi A, Mohammadi H, Amani R. Zinc status and polycystic ovarian syndrome: A systematic review and meta-analysis. J Trace Elem Med Biol. 2019
  10. Salama et al. (2015) “Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome” [accessed via: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525389/]
  11. Patel S. Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. J Steroid Biochem Mol Biol. 2018
  12. Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ. Depression, anxiety and perceived stress in women with and without PCOS: a community-based study. Psychol Med. 2019
  13. Lim AJ, Huang Z, Chua SE, Kramer MS, Yong EL. Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study. PLoS One. 2016 

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