What Is the Main Idea?

Polycystic ovary syndrome (PCOS) affects 5–20% of women of reproductive age worldwide. When left untreated, this can lead to issues from metabolic dysfunction to reproductive complications. Diet is found to help women control PCOS and improve their health. Based on the open-access review article “Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome” published in the journal Annals of Nutrition and Metabolism, different diets and their effect on PCOS are discussed here.

What Else Can You Learn?

Through this post, learn about PCOS, the symptoms, causes, and effects.

What Is Polycystic Ovary Syndrome (PCOS)?

PCOS is a hormone-related condition in menstruating women. The main symptoms are irregular periods or issues related to the excess male hormone, androgen. The irregular periods occur because the ovaries develop multiple follicles (little fluid-filled sacs that can mature into eggs) instead of one and an egg is not released on time. The excess androgen can further increase the difficulty for ovaries to release eggs. It also causes extra facial and body hair growth and severe acne.

What Are The Causes And Effects of PCOS?

The exact reason for PCOS is not known. However, it has been seen that obesity increases the chance of having it. Another major factor seen is excess insulin (a hormone that helps cells break down sugar). When cells become resistant to insulin action, the sugar level rises. In response, insulin levels also rise and that increases androgen production. Apart from these, low-grade inflammation and heredity could also be reasons for developing PCOS.

If left untreated, PCOS can lead to further issues like infertility, diabetes, metabolic issues (high blood pressure, abnormal cholesterol, etc.), abnormal bleeding, and even depression.

Treating PCOS

The most common medical treatments for PCOS include birth control pills, a medication that treats diabetes (to control insulin resistance), and other symptomatic relief. However, the main recommendation is lifestyle changes, specifically diet and activity. Obesity, excess insulin, low-grade inflammation, and excess androgen can be connected to both.

Unhealthy diets are found to be one of the underlying causes for most issues related to PCOS. Therefore, much study has gone into how different diets can potentially help with regulating PCOS. In a recent open-access review article, the authors analyzed the different dietary interventions and their effect on PCOS. Here is a summary of what they found regarding each diet.

  • Mediterranean diet (MedDiet): This diet consists of higher consumption of unsaturated fat and dietary fiber apart from a balanced intake of vegetables, fruits, and low glycemic index carbohydrates. Mediterranean diet consists primarily of plant polyphenols present in extra-virgin olive oil, grains, nuts, seeds, vegetables, and fruits. This has been considered as one of the healthiest diets and has been prescribed for insulin-resistance disorders including obesity, cardiovascular problems, and diabetes. Women with PCOS were found to have a lower intake of extra-virgin olive oil, legumes, fish, and nuts. Instead, they consumed more simple carbohydrates, saturated fats, and n-6 polyunsaturated fats (or Omega 6). Instead, when n-3 polyunsaturated fats (or Omega 3) were supplemented, insulin resistance was better controlled. The polyphenols like resveratrol found in grapes, berries, and wine reduce androgen production. Overall, adhering to the Mediterranean diet showed lowering of PCOS severity and improved ovarian health by controlling obesity, insulin resistance, and hyperandrogenism. With all these advantages, the Mediterranean diet is surely a diet to try for treating PCOS.
  • Ketogenic diet (Keto): This is predominantly a high-fat and low-carbohydrate diet. When a person stops the intake of carbohydrates and excess protein, the stored fat starts breaking down and helps in weight loss. Different studies show that in women with PCOS who are overweight or have obesity, the ketogenic diet helps in reducing weight and testosterone levels and in improving insulin resistance. The levels of hormones related to ovarian function are also normalized. While all these results are positive, due to the high-fat intake, the ketogenic diet can have negative effects on the metabolic state and fat storage in the body in the long term. Therefore, instead of the regular ketogenic diet, a very-low-calorie ketogenic diet is recommended. However, this requires more studies to understand its long-term effects.
  • Dietary Approaches to Stop Hypertension (DASH): This is a low-glycemic index and low energy-dense diet designed for lowering blood pressure. It focuses on the consumption of vegetables, fruits, low-fat dairy, whole grains and nuts, and legumes. It requires reducing sodium and saturated fat. The diet has higher antioxidants, magnesium, calcium, and folate. When on this diet, women with PCOS (and in some cases with obesity) showed a reduction in weight and resistance to insulin, improved ovarian function, and an increase in antioxidant capacity.
  • Low-Glycemic Index (GI) diets: Glycemic index refers to the rate at which carbohydrates are digested. In a low-glycemic index diet, the carbohydrates consumed digest slowly. Therefore, there is a slower increase in blood sugar and insulin secretion. This helps in lowering insulin resistance. In the case of PCOS, this diet has helped patients lower their weight, increase insulin sensitivity, and improve the ovulation cycle. While low-glycemic index food helps PCOS, with a lot of variability in the rest of the diet, it is hard to implement only this one approach and get similar results in all women. Combining it instead with other interventions as in the Mediterranean diet or DASH diet might be better.
  • Pulse-based diets: Pulses are high in protein and fiber as well as low in fat and glycemic index. They also have a lot of vitamins and minerals. In women with PCOS, this diet reduces cardiometabolic risk. Pulses have an anti-cancer effect. With chances of endometrial cancer increasing 3-fold with PCOS, this is a diet that must be studied further in the context of helping PCOS.

In Short

Lifestyle changes are required to reduce the effects of PCOS and for long-term health. Along with increased physical activity, diet is one of the important things that women can alter. With many different diet choices, women with PCOS should make an informed decision by discussing them with a doctor or dietician. Doctors and PCOS patients can even consider combining different diets to make it more specific for PCOS and the patient. Most importantly, it needs to be ensured that the diet is sustainable and adhered to in the long term.

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