What is PCOS? [1]

Polycystic ovarian Syndrome (PCOS) is a common hormonal condition which affects 1 in 10 women. It is diagnosed based on the individual having an irregular menstrual cycle, excess male hormone production e.g. testosterone (detected through a blood test) or if the individual has cysts on the ovaries detected via an ultrasound scan.

What is Insulin Resistance? [1]

Insulin is a hormone produced by the pancreas that allows cells to absorb and use glucose as energy. When there is excess glucose in the blood, it reduces the ability of insulin to easily absorb and use the blood sugar for energy, this is insulin resistance.

Insulin resistance increases the risk of developing type 2 diabetes as the body is less able to remove excess glucose from the blood, leading to high insulin levels and high blood glucose levels. Insulin resistance can cause higher blood pressure and weight gain. Managing PCOS is mainly associated with reducing insulin resistance and the effects of it.

What affects hormone imbalance with PCOS [1]

• Poor ratio of protein, fat and carbohydrates
• Stress
• Nutrient deficiencies
• Sleep
• Gut health
• Thyroid health
• Inflammation

Nutrition and PCOS

Healthy Diet [2]

• Consume an overall healthy diet incorporating the 5 key food groups namely, fruits, vegetables, lean meats or meat alternatives, dairy or dairy alternatives and whole-grains.
• Other general rules of a healthy diet also apply to nutrition for PCOS as well.

Managing your weight [2,3]

• Weight loss can be beneficial for PCOS if the individual is carrying excess weight above their ideal body weight.
• Weight loss has been shown to decrease insulin resistance for those with PCOS.
• You will have to be in a calorie deficit to lose weight and using the balanced plate method and incorporating ½ plate of vegetables, ¼ plate of whole-grains and a palm size portion of lean meats, can aid in weight loss.

Choosing low glycemic index (GI) carbohydrates and reducing carbohydrates [2]

• It is not necessary to cut out carbohydrates. However, choosing a low carbohydrate diet with whole-grains, unrefined carbohydrates and low GI food can work well.  
• Good quality carbohydrates can add fibre, micronutrients and also help maintain quality of life, since it is impossible to cut out carbs for life.
• All carbohydrates are broken down into glucose in the blood which requires insulin to be utilised to take the excess glucose out of the blood and this becomes difficult with insulin resistance. Therefore, avoid excess glucose and excess carbohydrates and stick to low GI, high fibre wholegrain carbohydrates.

Choosing healthy fats such as monounsaturated fats [2,3]

• Choose good fats such as monounsaturated fats found in olive oil, avocado, unsalted nuts such as almonds, cashews, peanuts, olives.
• Adding good fats into your diet can help reduce insulin resistance without adversely affecting cholesterol levels.

Eating a diet high in antioxidants [2,3]

Choose food containing antioxidants namely grapes, berries, apples, pears, guava, oranges, watermelon, papaya, tomato, dates, prunes, broccoli, spinach, carrots, cabbage, avocado, beetroot, sweet potato, pumpkin, kale, oatmeal, almonds, cashews etc.

Tips to improve insulin resistance with PCOS [2,3]

• Include fibre containing food with all meals and snacks
• Always pair carbs with protein and fats
• Eat breakfast
• Do not skip meals

How to lower testosterone levels [2]

• Drink spearmint or mint tea
• Pair carbs with protein and good fats to lower blood sugar levels.
• Choose Omega-3 fatty acid containing food (flax seeds, chia seeds, canola oil, salmon, sardines, tuna or a fish oil supplement)

Other tips to focus on in PCOS instead of weight loss [3,4]

• Paring carbohydrates with good fats, protein and fibre.
• Find an exercise/movements you enjoy.
• Eat consistently throughout the day to prevent binge eating.

Supplementation [5]

• Inositol has been shown to improve insulin sensitivity and lower testosterone levels and aid in improved fertility. (only take If prescribed by your doctor)
• Magnesium, Omega 3’s, Zinc, Vitamin D can be taken as a supplement only if prescribed by the doctor and will only be beneficial if you are deficient.
• Prioritise your overall nutrition as it will be more beneficial for your overall health instead of any individual supplement. However, supplements can provide some value depending on your doctors medical advice and if you’re deficient or at risk of deficiency.

Exercise and PCOS [5]

• Choose any movement/exercise of your choice
• Exercise helps to boost insulin sensitivity, decrease cholesterol, increase endorphins and balance hormones.

References

1. Witchel S, Oberfield S, Peña A. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. Journal of the Endocrine Society. 2019;3(8):1545-1573.
2. Faghfoori Z, Fazelian S, Shadnoush M, Goodarzi R. Nutritional management in women with polycystic ovary syndrome: A review study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017;11:S429-S432.
3. Szczuko M, Kikut J, Szczuko U, Szydłowska I, Nawrocka-Rutkowska J, Ziętek M et al. Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review. Nutrients. 2021;13(7):2452.
4. Moran L, Hutchison S, Norman R, Teede H. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews. 2011;.
5. Günalan E, Yaba A, Yılmaz B. The Effect of Nutrient Supplementation in Management of Polycystic Ovary Syndrome Associated Metabolic Dysfunctions: A Critical Review. Journal of the Turkish-German Gynecological Association. 2018;.