Foods for PCOS or Let thy food be thy medicine – PART 1
Big words but I do believe I can do it. So I’ve compiled some of the foods for PCOS to help you start on the right track too!
To give you some understanding of my nutrition plan, I want to share some of the things I have been reading. First off, I am in the apparent “40%” group of “lean PCOS” women which is slightly more complicated than overweight PCOS women as I do not appear to have insulin resistance according to my blood work. However, it may be (and my gynecologist agree on this) that because I have been eating low/med carbohydrates it may be managing this area. Here is an interesting post for some more about lean PCOS.
There are a number of nutrition recommendations for PCOS because unfortunately we still really don’t know the best way forward; to hopefully save you some time, I have compiled some of the main ones I have found. (There are a lot of links referencing to more info and research studies for those of you who want to explore a little further…I could have spent hours more going into further detail but thought it was already getting rather wordy!) Stay tuned for part 2 of this where I will look at the other part of the equation that is supplements and lifestyle.
Please consult with your doctor or health care practitioner before undertaking any of these – this is simply what I am doing or trying or investigating. Not only am I not qualified to provide medical advice, but every case of PCOS is very different and needs to be addressed individually!
FOODS FOR PCOS:
This one fascinates me but honestly it is not a step I am going to take right now because I don’t see how I can eat a raw food diet, which the majority of energy comes from fruit and vegetables, without keeping my carbohydrates low. I also have major issues with not getting enough protein and do believe we are meant to eat meat. That said, there is one woman who has claimed her raw food diet totally cured her polycystic ovaries…so I am definitely going to try and increase my consumption of raw veggies, possibly including some juices or green smoothies once I get my head around how the carbohydrates are going to work in my day to day nutrition.
Pretty much everything I have read agrees that focusing on whole foods is the best way to provide your body with great nutrition. Avoiding processed foods is key. This is already a given for me, so no problems there! Not only are you getting more nutrients from whole foods, but you are also avoiding the added chemicals, preservatives, sweeteners, artificial flavours, colours and additives that are in most processed foods. Vegetables are a big big part of what to eat – for everyone actually! Leafy greens especially. Fruit in moderation or small amounts (due to carb/sugar content) and think nuts, seeds etc… if it grew out of the ground or in a tree, runs, swims or flys then you can probably eat it!
Fats – Omega 3.
Not all fats are created equal. I’ve posted on this before but in brief you want to be getting omega 3 fats n your diet. This goes for everyone. There are three types of good omega 3 fats basically –
- Alpha-linolenic acid (ALA) are plant based; found in egg yolk, walnuts, flaxseed, hemp and canola oil.
- Eicosapentaenoic acid (EPA) are found in fatty or coldwater fish such as salmon, tuna, trout and halibut.
- Eocosahexaenoic acid (DHA) also found in fatty or coldwater fish.
“Omega-3 fats are essential for women with PCOS. They help improve mood, decrease cholesterol and triglycerides, improve insulin, lower blood pressure and provide better hair and skin quality. Omega-3 foods containing ALA get converted slowly into DHA and EPA in the body. Fish and supplementing with fish oil is the best bet to increase your intake.”
This is a good article on inflammation and omega 3 fatty acids.
This goes in hand in hand with my next point about low carbs. If you are eating low carbs, you must replace some of your energy with protein (and healthy fats) so lean protein is essential. It is also great for keeping you full and regulating insulin. This study shows the benefits of supplementing with a whey protein (I would probably recommend a non-whey protein isolate like pea protein.)
However, I did find research that a high protein diet can worsen insulin resistance in overweight individuals. The high protein group was also only consuming 13g of fibre a day which I think does not help at all though. Protein does not have to all come from meat sources; legumes, pulses, eggs, nuts and even your vegetables (leafy greens especially) all have protein in them.
Some further interesting reading on protein here looks at the “high correlation between glycemic index and insulin index measurements, they stumbled upon an intriguing exception. High protein, virtually no-carb foods like meat and eggs, while low on the glycemic index, measured high on the insulin index. In other words, while the meat and eggs didn’t cause a spike in blood sugar the way most carbohydrates do, they did result in an unexpectedly significant rise in insulin.”
Don’t get scared now and think that insulin is a bad thing in the body. It’s not, in fact it helps drive amino acids into the muscle cells where they’re needed. When we have an insulin increase from eating protein, our body is clever and produces a “another chemical is released by the body that actually has a contrary effect to insulin. Protein-rich foods also result in a release of glucagon. (Carb-rich food does not.) Glucagon raises blood sugar levels in part to allow for absorption of amino acids in the liver and their subsequent transformation there to glucose.”
Which again leads me to the next area, that most people can keep our carbohydrates low and still have energy.
This is a very common recommendation across all the reading I have been doing. Because of the associated insulin resistance, carbohydrates are simply not metabolised well by women with PCOS. One major reason is that eating low carb helps to lower circulating insulin. When your body is insulin resistant, the muscle cells tend to not accept insulin and glucose, leaving you with elevated levels of both. Eventually even the fat cells can become resistant. But the cells of the ovaries tend to remain insulin-sensitive which means you are pretty much giving them an insulin overload. There is a few studies around about low carb nutrition, see this pilot study and here for a study on the effect of low carb on insulin and blood glucose levels.
Another thing to consider is that low carb is not no carb, so we need to be wise about where are carb sources are coming from. I like this post at by Mark.
A 1994 study focused on a diet of low glycemic index (GI) carbohydrates. The diet reduced insulin levels and weight in obese hyperinsulinaemic women significantly more than a conventional diet with the same energy.
So if eating carbs, most experts are recommending a low GI ones. Low GI foods prevent blood glucose levels from spiking suddenly, thus reducing the pancreas’s insulin response. They also indirectly reduce blood-insulin levels by controlling blood-glucose levels, reducing excessive hormone release from the ovaries and allowing the body to burn more fat.
It is a good idea to select low GI foods that carry a low GL index as well. This means low Glycemic Load, which is a combination of the foods GI and its carbohydrate content. Check here for a list of low GI and GL foods. For a very comprehensive list of 750 low GI foods see here.
Legumes & Pulses.
Which brings me to the legumes and pulses area. Most of these fit within the low GI group, so can be a good carb choice. They also often have a good protein content, especially ones like lentils, chickpeas and yellow peas. I’m not a huge fan of beans, mostly because they still make me a bit bloated but these do fit in this category as well. Legumes are also a good source of D-Chiro-Inositol which research shows increases the action of insulin in women with PCOS; thereby improving ovulatory function and decreasing serum androgen concentrations, blood pressure, and plasma triglyceride concentrations. Brown rice is also a good source of D-Chiro-Inositol. Whilst some legumes are still going to have a considerable carbohydrate content, they are balanced with protein and high in fibre which slows down the blood glucose response.
Legumes and pulses are also a source of phytoestrogens which is similar to the human hormone estradiol. Low estrogen is what causes hot flashes, low libido and mood swings. Phytoestrogens and fibre are two outstanding features of legumes that will benefit you. Olwen Anderson (Nutritionist-Naturopath) says –
“Phytoestrogens are naturally occurring plant chemicals that have a molecular shape similar to estrogen. When digested, they ‘latch on’ to the estrogen receptors of cell membranes, and effectively block real estrogen molecules from connecting with the cell. This means that when you have plenty of the right fibre in your diet, you’re automatically reducing the effects of excess circulating estrogen.”
This is another very good source of D-Chiro-Inositol and has been mentioned a lot in forums and articles online. Buckwheat flour is my favourite gluten free flour and I love the whole groats as well, so this is perfect for me. It is another low GI and good carb to include. There was research done that also looks at Myo-Inositol which is more effective apparently for fertility, whilst D-Chiro-Inositol is better for insulin management and weight loss.
Very interesting information on this one, I often drink a combination peppermint and spearmint tea, so need to go get a pure spearmint one I think. There is research that shows reductions in total and free testosterone as well as increases in LH (luteinizing hormone) and FSH (follicle stimulating hormone) concentrations. These can both improve PCOS symptoms and hormonal balance. Peppermint tea is also fantastic for your digestive health, reducing bloating and gas – all of which are very common for women with PCOS. Try drinking it about 30 minutes before a meal to help your digestive system process everything (a hot drink before eating is also good for your digestion).
There was a very small pilot study in 2007 on cinnamon and women with PCOS. Fifteen women with polycystic ovary syndrome were randomized to daily oral cinnamon and placebo for 8 weeks. The results indicated a reduction in insulin resistance in the cinnamon group but not in the placebo group. (Because the number of women studied was so small, a larger trial is needed to confirm the findings of this pilot study.)
There is plenty of other evidence that suggests cinnamon is good for regulating blood sugar levels though, for instance, this article on 1/2 tsp of cinnamon a day producing healthier blood and this study improved blood glucose and lipid factors. I think it’s also important to note that cinnamon can lower LDL and triglyceride levels –
“Other research shows that cinnamon not only lowers fasting glucose levels but cholesterol levels too. Sixty people with type 2 diabetes were divided randomly into six groups. The first 3 groups consumed 1, 3, or 6 g of cinnamon daily, while the remaining groups were given placebo capsules that corresponded to the number of capsules consumed for the three levels of cinnamon. After 40 days, all three levels of cinnamon reduced the mean fasting serum glucose (18-29%), triglyceride (23-30%), LDL cholesterol (7-27%), and total cholesterol (12-26%) levels.”
Bonus factor is that cinnamon tastes delicious and is basically calorie free!
WHAT NOT TO EAT:
Ok I’ll keep this one simple because I started avoiding wheat a few years ago now and in the past few months and focused on being gluten free entirely for digestion and inflammation reasons. This post from the PCOS Diva goes into great detail about the relation between gluten and PCOS, so I will just say go read that!
Aside from lactose intolerance and other gastrointestinal upset, dairy is pretty much no good for PCOS. Pregnant cows produce a protein that inhibits testosterone blocking within our own systems, making dairy a fairly high androgenic food out there i.e. it raises testosterone. Hence why bodybuilders used to (and some still do I guess) drink litres of milk to gain muscle.
Dairy also has a significant insulin response, which can irritate acne and obviously is not good for insulin sensitive people. In moderation, the dairy I would be choosing would be organic, preferably raw or A2 strain or from goats/sheep. (Whilst my stomach can tolerate A2 full fat milk, I choose almond milk instead and have been occasionally having full fat organic natural/greek yoghurt, goats yoghurt/cheese, organic butter and haloumi.) I am now considering cutting dairy all together though….
Ahhh how this saddens me. Not because of the caffeine but because my favourite ‘vice’ a hot, long black coffee contains caffeine. (Don’t get me started on decaf coffee, even the water filtered stuff tastes like crap in my opinion!) I also really enjoy green tea, although honestly I’m still drinking that right now…
Some research on coffee and how it hampers blood glucose regulation is interesting. It also elevates cortisol which is not a great thing for someone with PCOS as both contribute to central weight gain.
This blog here sums it up pretty concisely –
- Coffee and other stimulants increase insulin levels, a definite negative for those struggling to control insulin and blood sugar levels
- In general, caffeine intake has been linked to lowered fertility rates (this is somewhat debated- there are stats on both sides of the debate)
- Caffeine contributes to acidity in the body (rather than neutral or slightly on the alkaline side as they should be). This acidity can impact hormonal balance.
- At the very least, caffeine minimizes absorption of important minerals and other nutrients, and can even cause our body to excrete (get rid of) excess nutrients through our urine. When trying to build a healthy body with a healthy hormonal balance, we want to keep every nutrient we take in!
And so sadly, I quit coffee (again) last week. I’m still having green tea a little and raw cacao which also has some caffeine…but lots of magnesium so I’m keeping it based on that (and because I need love it.) I am researching still into coffee pre-workout because I know the body uses the caffeine but I need to find out further information of whether this reduces the negative effects on cortisol and insulin.
Ok so I don’t drink alcohol as of about 3 years ago. I’ve had maybe 3 glasses of wine on special occasions but honestly don’t even enjoy it now. I’d rather eat dark chocolate.
Anyway, apparently a lot of people do enjoy a glass of wine or other alcoholic beverage and this may be your ‘vice’ like coffee is mine. So sorry, but it’s another no-no really for PCOS women. It’s not great for fertility and personally I think the effect it has on hormone balance outweighs the positives like antioxidants in wine. BUT I suppose one could include this sparingly, it just depends upon your goals.It is also a highly refined form of sugar and means your liver is busy detoxifying the alcohol metabolites when it could be getting rid of excess hormones which cause some of the most distressing symptoms of PCOS. Excessive consumption of alcohol can also damage the lining of the intestines and reduce the ability to absorb nutrients from food. (I personally think I damaged my gut flora and intestines from a few years of stupid drinking as a young teenager.)
In the ideal world, eating everything organic would be the way to go. But cost and availability can restrict people’s choice here, so I would say one of the key areas to go organic is meat and eggs. Basically if you are eating meat and eggs (and other animal products like dairy) then you are also eating the added growth hormones, chemical and antibiotic drugs given to them. It’s pretty basic to see why this is not a good thing for anyone, let along those with hormone imbalances.
Especially from animals, and especially from non-organic ones! So opt for leaner cuts of meat. Unhealthy fats include trans-fats (contained in almost all processed foods), too much saturated fat, polyunsaturated oils such as canola, corn, sunflower, vegetable, soybean oils, hydrogenated and partially hydrogenated oils. “Saturated fat contributes to insulin resistance and elevates cholesterol and triglycerides. Saturated fats, typically solid at room temperature, are found in animal products such as butter, cheese, luncheon meats, red meat, sour cream and mayonnaise.”
Trans fats are probably even worse.
“Trans fats are essentially the result of changing the chemical structure of a liquid fat into a solid fat. Trans fats raise LDL (the bad) cholesterol and lower protective HDL (the good) cholesterol.”
I do not include coconut in this saturated fat category as it is a medium-chain fatty acid so our bodies absorb it very differently, as I’ve discussed before.
Sugars & Refined Carbs.
I’ve lumped sugar and refined carbohydrates because there end up essentially the same in your body. I mean all sugars (natural included, although something like honey is a ‘better choice’ at least,) and flour, processed grains, pastas, white rice etc… I would also probably include potatoes and corn here. Fruit is something that should probably be limited as well, with moderate amounts of berries being the best choice. (I’ll touch on a whole food supplement in part 2.)
I’ll refer to Mark again here –
“…every type of carbohydrate you eat is eventually converted to a simple form of sugar known as glucose, either directly in the gut or after a brief visit to the liver. The truth is, all the bread, pasta, cereal, potatoes, rice (stop me when you’ve had enough), fruit, dessert, candy, and sodas you eat and drink eventually wind up as glucose. While glucose is a fuel, it is actually quite toxic in excess amounts unless it is being burned inside your cells, so the body has evolved an elegant way of getting it out of the bloodstream quickly and storing it in those cells.
It does this by having the liver and the muscles store some of the excess glucose as glycogen. That’s the muscle fuel that hard anaerobic exercise requires…But here’s the catch: once those cells are full, as they are almost all the time with inactive people, the rest of the glucose is converted to fat. Saturated fat.”
Which ultimately leads to insulin resistance, diabetes and thyroid problems (see the link for this information.)
Basically, sugar and refined carbohydrates are not going to help with PCOS and insulin resistance, even for lean PCOS women like myself. Sugar contributes to high blood pressure, high levels of triglycerides, and high levels of C-reactive protein, all of which has been linked to oxidative stress and inflammation. (My recent C-reactive protein levels can back very low…I eat very low sugar…connection?!)
Legumes & Pulses.
Yes that was on the first list of things to eat as well, but I thought I should list it here because I have found information that is from both sides. For example, this reference provides conflicting information regarding the consumption of phytoestrogens and PCOS, however it still doesn’t say not to eat legumes at all but to simply remember they are a “limited portion” and to focus on leafy vegetables. I totally agree with that view as does Mark.
The book ‘The PCOS Diet‘ has a similar perspective that legumes are going to work for some and not for others. The “recommended level” is for women who need to lose weight and whose symptoms are full-blown. The “maintenance level” is for women who are not overweight and have mild PCOS symptoms. This level allows selected starchy vegetables, whole legumes and whole grains.
Again, this comes under the phytoestrogens umbrella, so some say that soy should be included in a PCOS diet. I however, will not list in the foods to eat category because I do not like the highly processed, GMO soy products that we have available to us in Australia (and many other countries.) I don’t have an issue with non-GMO / organic soy products but only in moderation and not as staple nutrition source. Some take the easier to accept stance that limited servings are ok, but best to avoid consuming massive amounts of poor quality soy all the time.
Here is part 2 of this – I go through the other side of a natural approach to PCOS which looks at supplements and lifestyle…
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