Written By: Selena-Maria Foreman MS, RND, LD, CLT
What is Polycystic Ovarian Syndrome?
Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women. It affects women’s hormonal balance due to an overproduction of androgens (male sex hormones) which in turn can limit the amount of estrogen and progesterone women produce which are needed for ovulation. These imbalances in hormone levels can cause things like irregular menstrual cycles, acne, weight gain, excess hair growth (stomach, back, and chest), infertility, and ovarian cysts.
While there has not been one distinct cause identified in PCOS, research has pointed to a link with insulin resistance. Insulin resistance is present in 65-95% of all PCOS patients. You may be wondering “What is insulin resistance?”. To understand this we need to go over a little biochemistry. I know this sounds complicated but stay with me here. When our body breaks down carbohydrates it is turned into glucose (sugar) which then signals for insulin to be released to help get the sugar into our cells to be used as energy by our body. When our cells are insulin resistant, insulin has a hard time converting that sugar into energy for our body to use. This leads to a build up of sugar in our blood. When these levels stay elevated it leads to increased inflammation and can also cause the ovaries to produce more androgens a.k.a testosterone. This is what researchers have found can add to the hormonal imbalance in women with PCOS and is why it is believed that improving insulin sensitivity can improve overall symptoms related to PCOS. To improve insulin resistance from a nutrition standpoint I like to focus on the big three: protein, fiber, and fat.
Fiber:
One of the ways we can slow the spike of our blood sugar at meals is by adding more fiber. This is because the added fiber helps slow our digestion down which slows the absorption of the broken down carbohydrates in our meal. The recommended daily intake for fiber in women is at least 25 g fiber. A diet high in fruits, vegetables, whole grains, nuts/seeds, and legumes is the best way to increase fiber intake naturally. Did you know the average American woman only gets 10-15 grams of fiber a day?
Protein:
As you may have heard by now, protein plays an important role in our overall health. Not only is protein great for helping us build muscle but it is also needed for the function of our hormones, digestive system, metabolic pathways, and more. Making sure you are getting adequate protein at meals can even play an important role in weight management. When we’re looking at balancing our blood sugar the best meal to prioritize protein at is breakfast. This meal sets the tone for the day. By having a higher protein breakfast this can help you feel more full leading to less crashes in the day that may cause you to reach for those high sugar snacks and treats. In one study they gathered two groups of women with PCOS and gave group one a higher protein diet and group two a standard protein diet. The results found that the women in group one had more weight loss and improved glucose metabolism after the study in comparison to group two.
Fats:
We know fats may have a bad reputation at times and are often seen as a driver of weight gain and cardiovascular disease. I am here to talk about what good fats can do for our health. Fats are not only important for women’s hormonal health but are also crucial in maintaining the health of our cells as they make up our cell membranes. Healthy cells allow our body to carry out functions more efficiently. Fat is needed to build our sex hormones estrogen and progesterone. So when we think about the levels of these hormones potentially being disrupted it would make sense that we need to get adequate amounts of fats to help in supporting our hormones. Another great component about fats is that adding it to a balanced meal helps us feel more satiated after meals. Let’s take a look at the different types of fats. There are monounsaturated, saturated, and polyunsaturated. Monounsaturated fats are found in olives, nuts and seeds, and avocados. Saturated fats are mostly found in animal products such as meat and dairy products however it is also present in things like coconut and palm oil. Polyunsaturated fats are found in flax seeds, sunflower oil, fish, and walnuts. Based on studies around PCOS it has been found that diets higher in unsaturated fats and lower in saturated fats are recommended.
Many aspects of PCOS can be easily managed through dietary changes. If you would like to further explore how diet can personally help you to manage your PCOS, we would love to help. Please schedule an appointment with one of our registered dietitians today!
References:
Han Y, Wu H, Sun S, Zhao R, Deng Y, Zeng S, Chen J. Effect of High Fat Diet on Disease Development of Polycystic Ovary Syndrome and Lifestyle Intervention Strategies. Nutrients. 2023 May 8;15(9):2230. doi: 10.3390/nu15092230. PMID: 37432488; PMCID: PMC10180647.
Sørensen LB, Søe M, Halkier KH, Stigsby B, Astrup A. Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome. Am J Clin Nutr. 2012 Jan;95(1):39-48. doi: 10.3945/ajcn.111.020693. Epub 2011 Dec 7. PMID: 22158730.
Polycystic Ovary Syndrome (PCOS). (2019). John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos
Zhao, H., Zhang, J., Cheng, X. et al. Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. J Ovarian Res 16, 9 (2023). https://doi.org/10.1186/s13048-022-01091-0
Purwar A, Nagpure S. Insulin Resistance in Polycystic Ovarian Syndrome. Cureus. 2022 Oct 16;14(10):e30351. doi: 10.7759/cureus.30351. PMID: 36407241; PMCID: PMC9665922.
Rana A, Samtiya M, Dhewa T, Mishra V, Aluko RE. Health benefits of polyphenols: A concise review. J Food Biochem. 2022 Oct;46(10):e14264. doi: 10.1111/jfbc.14264. Epub 2022 Jun 13. PMID: 35694805.