PCOS and Nutrition – By Jamila Imani RDN

Many women of childbearing age are victims of Polycystic Ovarian Syndrome (PCOS). PCOS in a nutshell is characterized by hormonal imbalances with symptoms that include painful or irregular periods, acne, hair loss, facial hair, weight gain, and difficulty losing weight. PCOS is also the leading cause of infertility however some women with PCOS do however conceive easily but develop complications after birth.

PCOS is firmly linked with overweight and obesity, hypothyroidism, acne, insulin resistance. All of which are also risk factors of PCOS and therefore I call it a vicious cycle of PCOS.

The first-line therapy for PCOS is a diet and lifestyle makeover with the primary goal of improving the body’s sensitivity to insulin.

Ways to improve insulin sensitivity  

This will automatically lead to weight loss. Even a 10% loss in weight, though may sound small, will further help with PCOS symptoms by reducing acne, facial hair and improving menses. Here are 3 ways to start on a virtuous path.

1. Lose weight

For those that are overweight or obese, even a small amount of weight loss with PCOS goes a long way in helping with the associated symptoms.  Note that you want to lose weight at a pace you can maintain long-term. Crash diets that produce fast weight loss followed by the inevitable rebound weight gain do more harm than good.

2. Be more active

Exercise is also a great way to reduce insulin resistance and improve insulin sensitivity. It also helps rebalance reproductive hormones as well as helps with weight loss. can also help with weight loss. 30 mi of brisk walking every day together with strength training works best in alleviating PCOS symptoms.

3. Eat an inflammatory diet low in refined sugars

Insulin resistance in PCOS women is due to higher androgens which in turn stimulate more insulin production that contributes to weight gain which only causes more inflammation.  A diet high in carbohydrates is associated with a pro-inflammatory response and therefore PCOS women should rather cut down on sugars and eat a complex whole-grain carbohydrate diet instead. This will also be high in fiber to further help with weight loss. Eating an anti-inflammatory diet may counteract some of the inflammation in women with PCOS and help improve both metabolic and reproductive aspects.

A proposed anti-inflammatory diet should be a whole grains-complex carb diet, low in omega-6 fatty acids and rich in omega-3 fatty acids. For every gram of fat consumed, consume 2 grams of protein, and 3 grams of carbohydrate.

Anti-inflammatory foods include foods such as fish, legumes, nuts and seeds, olive oil, herbs, spices, and green tea.

4. Drug therapy

Most women with PCOS are prescribed metformin to help with insulin resistance as well as promoting weight gain and relieving other symptoms associated with PCOS. Metformin together with birth control pills is also given to help with the problem of cyst development around the ovaries. However, like every medicine, metformin also has its side effects. Prolonged use can make your pancreas dependent and therefore increased the risk of diabetes if used in long term. Your aim therefore should be to get off medications as soon as you can through lifestyle and dietary modifications.

PCOS and Pregnancy

If you’re diagnosed with PCOS, it may be more difficult to become pregnant. And if you’re able to become pregnant, you’re at risk for more complications during pregnancy, labor, and delivery.

Women with PCOS are three times more likely to have a miscarriage, as compared to women who don’t have PCOS. They are also more likely to develop preeclampsia, gestational diabetes, and have a larger baby and premature delivery. This could lead to difficulty during delivery or cesarean delivery. The most important thing to know about PCOS and pregnancy is that complications are very real. That’s why it’s more important than ever to take steps to have a healthy pregnancy.

Diet Do’s for PCOS

1. Incorporate more high biological value proteins in your diet
2. Give allowance for fruits and vegetables in your meals
3. Increase fiber intake by including fiber-rich sources such as broccoli, leafy vegetables, chia seeds in your diet
4. Restrict intake of oils to 3-4 teaspoons per day
5. Increase intake of omega 3 rich foods such as fatty fish, nuts and seeds
6. Have each meal and snack with a complex carb and a protein source e.g., milk with nuts
7. Always stay hydrated
8. Do not skip meals
9. PCOS women have high estrogen and therefore include estrogen lowering foods such as bananas, cabbage, shellfish and walnuts to counteract this

Take-Home Message

Many of us think of PCOS as a lifetime disease, but it is not. With correct diet and lifestyle changes, not only will you be able to reverse the symptoms of PCOS but also get off medications and prevent chronic lifestyle diseases associated with it. Do not be ignorant about the symptoms you are facing. It is always best to seek professional guidance if facing any PCOS symptoms so as to treat it at an early stage and avoid long-term complications.

Disclaimer: Every woman with PCOS faces different symptoms, it is therefore best to seek professional advice for customized dietary and lifestyle approaches as per what you as an individual is experiencing.

For more queries and personalized guidance, I offer online consultancy which is customized to help you achieve a positive lifestyle change through nutrition.

Article written by:

By Jamila Imani (RDN)

T: +254737265452

E: nutritionbyjamila@gmail.com

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IG: @nutritionbyjamila

References

Faghfoori Z, Fazelian S, Shadnoush M, Goodarzi R. Nutritional management in women with polycystic ovary syndrome: A review study. Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S429-S432. doi: 10.1016/j.dsx.2017.03.030. Epub 2017 Apr 5. PMID: 28416368.

Farshchi H, Rane A, Love A, Kennedy RL. Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management. J Obstet Gynaecol. 2007 Nov;27(8):762-73. doi: 10.1080/01443610701667338. PMID: 18097891.

Roos, N. (2011, October 13).Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. British Medical Journal, 343. Retrieved from bmj.com/content/343/bmj.d6309

Salama, Amany Alsayed et al. “Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome.” North American journal of medical sciences vol. 7,7 (2015): 310-6. doi:10.4103/1947-2714.161246

Trikudanathan, S. (2015, January). Polycystic ovarian syndrome. Medical Clinics of North America, 99(1), 221–235 ncbi.nlm.nih.gov/pubmed/25456652

What is polycystic ovary syndrome? (2015) pcosfoundation.org/what-is-pcos