Polycycstic ovarian syndrome, or PCOS, is a hormonal condition that affects an estimated six to 12 percent of people with female sex organs (as many as five million), according to the CDC. Symptoms of PCOS include ovarian cysts, irregular periods, high levels of androgen (male hormones), excess hair growth, acne, and weight gain. Although these symptoms can be controlled with medication including birth control to regulate hormones and Metformin to regulate blood sugar, the biggest way to get PCOS under control is through lifestyle changes: sleep, stress management, exercise, and — most notably — diet.
Since many women with PCOS also have insulin resistance, treating the condition requires a tricky balance of eating the right foods at the right times. Unfortunately, PCOS is a complex condition that doesn't adhere to a one-size-fits-all approach.
"Lifestyle management is recommended as a first-line treatment of PCOS; however, studies have not proven which type of diet is best," said PCOS expert Martha McKittrick, RD, CDE, and certified health coach. "This is probably because each woman is an individual and has different genes, metabolisms, medical issues, and phenotypes of PCOS."
Even if there's not one type of diet that's best for everyone with PCOS, there are some general diet tips that everyone with PCOS can benefit from. Here are the main guidelines McKittrick recommends:
Balance Carbs With Protein and Fat
McKittrick says balanced meals that contain protein and fat along with your carbs control blood sugar, prevent insulin spikes, and ward off carb cravings. For example, a slice of whole grain toast with natural peanut butter is more satiating than a bowl of cereal with fat-free milk since the peanut butter is higher in fat and protein to balance out the carbs from the toast. However, she emphasizes that it's a general guideline and not a rule you need to stick to 100 percent of the time; sometimes you may just want an apple by itself or a steak with salad and no carbs.
Eat Low-Glycemic Foods
She recommends is eating foods that are lower on the glycemic index and have a lower glycemic load, such as whole grains, fruit, and vegetables, instead of higher glycemic foods such as potatoes, white bread, rice, and refined sugar. Eating fiber-rich foods will also prevent blood sugar spikes and keep you feeling fuller longer.
Stick to Healthy Fats
Healthy fats such as nuts, nut butters, avocados, and olive oil will keep you feeling satiated and can help you lose weight. Omega-3 fats, like the ones found in fatty fish, walnuts, and canola oil, may decrease the risk of heart disease, improve insulin resistance, and decrease inflammation.
Limit Processed and Inflammatory Foods
Processed foods are usually loaded with refined sugars and carbs and empty calories that can spike your blood sugar. "Your best bet is to stick to food as close as possible to its natural state," she says.
PCOS is also associated with inflammation, so she recommends limiting inflammatory foods such as added sugars, trans fats, and refined carbs. Processed foods also tend to be inflammatory. Instead, she says to load up on anti-inflammatory foods such as fatty fish, dark leafy greens, berries, ginger, garlic, and turmeric.
Increase Veggies and Gut-Healthy Foods
Vegetables are not only anti-inflammatory; they can help you lose weight, too. They're low in calories but high in fiber, so loading your plate with vegetables will make you full without all the added calories of other calorie-dense foods. Veggies are also packed with micronutrients, vitamins, and antioxidants — all great news for those living with PCOS.
Poor gut health has been linked to obesity, according to a 2016 study, and McKittrick says gut health could also be tied to PCOS — after all, a healthy gut can help improve digestion, balance hormones, and boost immunity. Load up on probiotic-rich foods to feed your gut such as kombucha, unsweetened Greek yogurt, and fermented foods.
Choose Hormone-Free Meat and Dairy
Since your hormones are all out of whack with PCOS, it's best to stay away from any other external sources of hormones such as meat and dairy. When it comes to buying your animal products, try to buy organic if you can, which means they haven't been given antibiotics or growth hormones, according to the USDA guidelines. However, organic meat is more expensive than nonorganic, so it's best to buy what's in your grocery budget.
Meal Prep and Plan Ahead
One of the best ways to stay on track with your healthy eating regimen is to meal prep. Plus, it will save you time during the week and money in the long run because you'll be less likely to order takeout or pick up something processed. Set aside some time on the weekends to prep all your meals and snacks for the week. It doesn't even need to be complicated — you can make a variety of foods in just 30 minutes!
Enjoy What You Eat
At the end of the day, if you don't enjoy any of the food you are making or eating, you won't stick to your healthy eating plan.
"Eating is one of life's pleasures," McKittrick said. "If you feel deprived most of the time, it's likely that you'll end up bingeing on the foods you miss the most or will just feel totally miserable."
Find foods that you like and can eat frequently. If you miss your favorite comfort foods, try substitutes such as spiralized zucchini noodles instead of traditional pasta and cauliflower rice instead of white rice. It's all about balance, and as long as you are eating on your diet plan most of the time, there is still room for your favorite treats — just enjoy in moderation.