The PCOS Diet

*NEW AND UPDATED 2022*

PCOS is the most common condition impacting women’s menstrual cycles, and the symptoms of PCOS can be incredibly disruptive to a woman’s life.  From irregular or absent periods, trouble getting pregnant, depression, to acne, hair loss, and facial hair growth, the symptoms are as varied and diverse as the women who develop PCOS.

While PCOS is mostly driven by your genetics, your diet is one of the most powerful ways you can influence your symptoms and help to keep your PCOS in check.

The PCOS Diet – What to Avoid

Honestly, if you are eating a healthy, whole foods based diet, you can eat just about anything in moderation.  One of the most important treatment targets for PCOS is weight loss – losing just 3-5% of your body weight can normalize menstruation for most women.  So don’t go all frat-boy and eat all the refined grains and refined sugars, but indulging once in a while is not going to derail all your progress in treating your PCOS.

I do recommend women with PCOS try to avoid alcohol, or limit it to no more than three drinks per week.  The reason for this is the fact that women with PCOS have an increased risk of non-alcoholic fatty liver disease (NAFLD) and alcohol can further increase this risk.  Alcohol also impacts our ability to detoxify and eliminate hormones through our liver, which can worsen symptoms associated with high androgens (acne, hair loss, facial hair growth.)

If you are suffering with acne, limiting dairy intake is also a good idea.  Research has shown that dairy can worsen acne symptoms.  Additionally, dairy increases the production of insulin-like growth factor (IGF) which is known to negatively impact ovulation in PCOS.

THE PCOS DIET – What To Enjoy

I want to first talk about the Big Three Recommendations when it comes to the PCOS diet – calories, macronutrients, and food quality.

Calories

For most women with PCOS, weight loss will help to restore ovulation and reduce the symptoms associated with the hormonal imbalances of PCOS.  And it doesn’t have to be fast or dramatic weight loss – 3-5% loss of your total body weight is what is shown in studies to be most impactful.  This can be accomplished with a caloric reduction of 300-500 calories per day.

Macronutrients

Your four main macronutirents – protein, carbohydrates, fat, and water, make up your diet and provide you with the micronutrients (vitamins and minerals) that you need to thrive.  And finding a healthy balance of these macros can help you to feel great, lose weight, and treat symptoms of your PCOS.

Protein

A higher intake of protein is naturally lower in calories, slower to digest, and keeps you feeling full longer.  Aim to get about 30% of your daily calories from protein.  For most of us, that’s around 1.2-1.5g per kg of our body weight, or 25-35g of protein per meal.  Excellent protein choices include lentils, soy and tofu, chickpeas, black beans, protein powders, eggs, fish, and poultry.  There is research suggesting that including soy protein 2-4 times per week also helps to treat PCOS, so I recommend it highly for its hormone balancing benefits and high protein.  Look for tofu, tempeh, edamame, and soy milk for these proteins.

Carbohydrates

The most abundant of our macronutrients, we want about 40% of our calories to come from carbohydrates.  But not just any carbohydrates – we want to focus on vegetables, some fruit (1-2 per day) and whole grains (1-2 per day).  You can eat unlimited non-starchy vegetables like broccoli, cauliflower, zucchini, peppers, carrots, leafy greens, tomatoes, mushrooms, asparagus, and green peas.  You can also have beans and lentils as often as you want.  For grains stick to oats (not quick cook), barley, quinoa, brown rice, and other whole grains.  Try to limit pasta, breads, bagels, quick oats, and other refined grains as they are low in nutrients and quickly can overwhelm our daily caloric intake.

Fats

The remaining 30% of our diet should be made up of healthy fats, including nuts, seeds, avocado, olives, and healthy oils – like walnut oil, flax oil, and olive oil.  Fat is the most calorie dense nutrient so it doesn’t take a lot to reach 30% of our daily calories for fat!  Add a healthy source to each meal and you should be right on track.

Water

The unsung macronutrient, our bodies need water to survive and thrive.  For women with PCOS I suggest 3-3.5 litres of water per day to support hormone balance, detoxification, skin health, and weight loss.  Herbal teas count towards your daily water intake and can be a great way to meet your targets.  Spearmint tea has been found in small studies to improve signs of abnormal facial hair growth in women with PCOS so that might be a good place to start.

Nutrient Quality

For women with PCOS weight loss may be one of our primary goals, but the quality of foods we choose matter as well.  Women with PCOS are more vulnerable to compounds called AGES – advanced glycation end products.  AGES are created by our bodies when fats or proteins are exposed to sugars, but more troublesome is how many of them we EAT in highly processed foods.  AGES have been found to be associated with accelerated aging, persistent inflammation, and insulin resistance in women with PCOS.  Yikes.  Researchers have also found that women who consume the most AGES in their diets tend to have higher androgen levels, irregular periods, higher AMH are are more likely to have irregular periods or difficulty getting pregnant.

So it’s not just what foods you eat, it’s the quality of those foods too.  Highly processed foods are by far the highest source of AGES – so even if you’re only eating a few cookies or crackers, they may be causing more damage than just being refined carbohydrates.

Foods that are most likely to contain AGES: fast food, crackers, cookies, chips, processed animal proteins, and vegetable oils.  So skip the processed and convenience foods and opt instead for whole foods or home cooked meals whenever possible.

The PCOS Diet – What to Enjoy

1. Vegetables and fruits

The foundation of the PCOS diet are plants.  Vegetables, fruits, beans and legumes, nuts and seeds are provide the body with essential nutrients and fiber.  Soluble fiber such as that found in apples, carrots, cabbage, whole grains such as oatmeal, and beans and legumes, can lower insulin production and support hormone balance in PCOS.

2. Proteins

Healthy proteins are an absolute necessity for women with PCOS.  Avoid the processed proteins like chicken nuggets and mass-produced burgers and instead choose plant based proteins like soy, nuts, seeds, beans, lentils and legumes.  Other healthy proteins like turkey, chicken breast, eggs and fish should also be emphasized.  For most women with PCOS, a daily intake of 60-80g of protein per day is recommended.

3. Slow carbs

You do NOT need to cut all carbs to address PCOS.  Nor do you need to go keto or do another dramatic diet.  Be suspicious of anyone who tells you this!  Carbs are essential for healthy brain activity and without them you will likely be a miserable raging bitch, and no one wants that for you.

Instead, choose high quality, unrefined carbohydrates – vegetables, fruits (two per day is a-ok), and healthy whole grains like oats, barley, quinoa, and brown rice.  Cut out the pasta, pastries, cookies, white rice, and popcorn.

4. Cinnamon

Spices are an amazing way to increase antioxidants in your diet, and cinnamon is especially useful for women with PCOS because it can help to regulate blood sugar. Sprinkle it on apples, oats or quinoa in the morning, add it to teas and use it in flavourful stews or curries.

5. Healthy Fats

   Not all fats are created equal, but we still need 30% of our daily calories to come from fat.  Choose healthy fats from plants whenever possible – avocado, nuts, seeds, olives, flax, and their oils – walnut oil, flax oil, olive oil.

   Try to keep dairy to a minimum, especially if you have acne.  And limit the high saturated fats found in animal fat and coconut oil.  Have a handful of almonds, walnuts, or olives for a snack.  Throw seeds on your salads.  Incorporating fats can be fun and add great flavour and texture to your meals.

The research on nutrition and diet has come a LONG way since I first published this article in 2016.  Now in 2022 the recommendations haven’t changed dramatically – eat whole foods with an emphasis on healthy proteins, lots of plants, and healthy fats.  As always, I hope you will embrace the PCOS diet – your diet is the most POWERFUL influence you have over your health. If you need more support or guidance, reach out.  Let’s talk.  I’m here for you.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

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