Polycystic Ovarian Syndrome, also known as PCOS, affects approximately 5 million reproductive women in the United States alone. It is also one of the most common reasons for female infertility. And although most women are diagnosed within the reproductive age group, the disease can continue to manifest far beyond the child bearing years.
Weight gain and difficulty in losing weight is one of the main factors in both diagnosing and treating a woman living with PCOS. Losing weight for someone with PCOS may seem difficult but it is doable. Eating the right kinds of food and living a healthier lifestyle make it completely possible.
And do not be fooled by what the diet industry may be telling you. They gain when you gain…weight. The more weight we put on as a society fuels their revenue and increases their profit. Today is the day to lose weight beginning with simple changes in your diet.
Continue reading to learn the best PCOS diet to help with weight loss or maintenance.
What is Polycystic Ovarian Syndrome?
Polycystic ovarian syndrome (PCOS) is a endo-hormonal condition characterized by high levels of androgens within the ovaries. Normally, androgens are present in only very small amounts. And although they promote growth and reproduction in both females and males, androgens are actually thought of as male hormones. Which can help explain why having a large amount of them as a female is troublesome.
As for the name itself, polycystic ovary refers to many, small fluid filled sacs called cysts found inside the ovaries. Alot of women with PCOS have these cysts. But not all women with PCOS do.
PCOS is considered a syndrome because the same signs and symptoms are always seen together.
Typically those signs and symptoms consist of:
- Irregular or absent periods
- Excessive facial and body hair and/or acne
- Weight gain and/or difficulty in losing weight
- Increased risk of developing type 2 diabetes, heart disease and certain cancers
Causes of PCOS
As with a number of female hormonal diseases, the exact cause is not known.
Despite knowing that androgen and insulin levels are high, no exact cause has been determined as of yet.
There are a number of contributing factors that are listed below:
- Family History
- Overweight and/or Obesity
- Insulin Resistance
Family History of PCOS
Family history is likely the most important risk factor in the development of polycystic ovarian syndrome.
Twin studies have exhibited a 79% heritability risk for PCOS. It’s also been reported that multiple women in the same family also have a greater chance of having PCOS as well.
The exact mode of inheritance has not been found therefore PCOS is thought to be a more complex genetic disorder with several gene involvement.
Overweight and/or Obesity
PCOS is actually considered an obesity related comorbidity. Meaning PCOS can be an outcome from being obese.
However, the relationship between obesity and polycystic ovarian syndrome is more complex. Genetically predisposed obese women are more likely to actually get PCOS as a result (compounded with environmental factors) of being obese and/or overweight.
Note that although not all women diagnosed with PCOS will be obese, they have a greater propensity to gain weight. And/or they may have a more difficult time losing weight than those in the general population would.
Insulin Resistance
Insulin resistance generally goes undetected until an overt type 2 diabetes diagnosis is made.
However, more than 50% of women living with PCOS are insulin resistant at the time of diagnosis independent of obesity.
So regardless of a woman’s weight, she has a chance of already being insulin resistant if and when diagnosed with PCOS.
Insulin resistance also causes compensatory hyperinsulinemia (high insulin levels in the blood). These high insulin levels then help maintain hyperandrogenemia (high androgen levels in the blood) which perpetuates PCOS symptoms and treatment.
Polycystic Ovarian Syndrome and Obesity
There is a strong link between PCOS and obesity/overweight women. Anywhere between 40% to 80% of PCOS women report being overweight or obese.
As obesity levels have risen around the world so has the diagnosis of PCOS.
However this does not imply that ONLY overweight and/or obese women develop PCOS. On the contrary, women with a normal BMI may also develop PCOS. And in most instances, are not diagnosed as quickly because they look healthy.
For obese individuals, weight loss then can be beneficial to curbing the effects of PCOS.
Even modest weight loss of 5-10% of your total body weight can decrease symptoms of PCOS, such as insulin resistance and irregular menstruation. Insulin resistance may make it difficult to lose weight but sticking to a diet low in unhealthier carbs and whole foods and spacing out your meals can help tremendously.
It is difficult to say which one causes either, obesity leads to PCOS or PCOS leads to more weight gain. However the most important takeaway from the literature is that obesity is a strong predictor of PCOS. Obesity exacerbates the symptoms of PCOS leading to further metabolic and reproductive abnormalities.
Polycystic Ovarian Syndrome and Type 2 Diabetes
Polycystic Ovarian Syndrome puts a woman at a higher risk for developing type 2 diabetes (T2D). The reason behind this is because women with PCOS are generally insulin resistant and this is one of the main risk factors for type 2 diabetes.
In 2017 researchers found that women with PCOS were 4 times more likely to develop diabetes and diagnosis would be made 4 years earlier when compared to controls. The average diagnosis for T2D was 31 years old, with most women being diagnosed before the age of 40. And it because of this that screening for diabetes may be neccessary for those obese women with PCOS, even at a young age.
Another study examined obese women living with PCOS and how they went on to develop type 2 diabetes upto 24 years later.
It was found that BMI and fasting blood glucose levels were the best predictors for type 2 diabetes in women with PCOS.
Therefore regular testing of fasting glucose levels and BMI is important in women living with PCOS in order to prevent the development of type 2 diabetes in the future.
PCOS and Cardiovascular Disease
Polycystic Ovarian Syndrome puts a woman at a higher risk for developing cardiovascular disease.
Several studies have shown a much greater risk of developing cardiovascular disease, and accelerated subclinical signs of atherosclerosis (hardening of the large arteries in the body).
One study outlined how PCOS women were at an increased risk for both cardiovascular (i.e. myocardial infarction and ischemic heart disease) and cerebrovascular disease (i.e. stroke). Especially when compared to non PCOS women. The caveat from this study was that mortality from cardiovascular disease was almost the same between the two groups. Meaning death from heart disease did not seem to increase even if a woman had PCOS.
And unlike obesity and type 2 diabetes that tend to develop earlier in PCOS women, cardiovascular disease does not seem to lower the age of clinical presentation in premenopausal women.
Now the issue with this finding is that it is based only on one study with a small sample size. Researchers stat that in the future, more extensive studies need to be done. But as is true with most studies in women’s health, such studies are still pending.
The PCOS Diet
In 2013, researchers found that eating a diet low in unhealthier carbohydrates helped reduce fasting and post challenge insulin levels in healthy PCOS women. In return this lead to an improved endocrine profile and insulin sensitivity within just 16 days! This is an important finding – The type of diet an individual eats can influence symptoms and disease outcome.
Below is a list of food to eat if you have PCOS.
Foods to Eat with PCOS
Tips: Try and maintain a carbohydrate intake of less than 50% per day.
- Plant based whole foods
- Non starchy vegetables and low glycemic fruits
- Legumes and lentils
- High fiber foods
- Nuts and seeds
- Healthy fats in the form of avocados, extra virgin olive oil, and coconuts.
- Herbs and spices
- Fermented foods
- Fatty fish
- Dark chocolate in moderation
And below is a list of food to avoid if you have PCOS.
Foods to Avoid with PCOS
Tips: Avoiding foods altogether can be difficult. If avoidance is difficult, try to focus on limiting consumption of the following items instead.
- Refined and/or processed carbohydrates
- Processed meat
- Fried foods
- Solid fats
- Sugar laden beverages
- Overconsumption of meat, particularly red meat
And for anyone wondering about what effects PCOS may have on fertility, please read about the fertility diet here.
Eating to Beat PCOS
Eating to beat PCOS means an individual has the ability to influence their PCOS outcome.
As discussed above, certain foods should be consumed while others should be limited or if possible, avoided altogether.
Perhaps symptoms may be less severe, blood levels of certain hormones (i.e. insulin, progesterone or DHEAs) may be lower, or the disease itself may be curable depending upon your choice of food intake.
And although there is no obvious treatment right now for PCOS, simply preventing or managing complications such as diabetes and heart disease, should not be the only solution.
Eating high density, nutritious whole foods on a regular basis gives the individual more power over their PCOS condition. Managing it with changes in lifestyle, i.e. diet and activity, can improve disease outcome much more than prescription medication alone.
