We are now at the end of the PCOS series, discussing a crucial aspect of managing a PCOS life: Diet. It has been repeatedly said by a gynecologist, the internet, and even by me: PCOS cannot be cured but can be managed by lifestyle modifications. And when it comes to managing a healthy lifestyle, it involves maintaining an active life by exercising and doing stuff that involves physical work, getting proper sleep, taking care of mental health (extremely important), and having a proper dietary intervention. 

Even though limited studies are prevalent regarding a diet suitable for PCOS, several studies have shown the positive effects of maintaining a proper diet containing essential elements in coping with insulin resistance. This is a very common aspect of this disorder and relates to obesity (another very common condition in PCOS women), elevated glucose, and androgen levels. Most of the data revolving around a diet plan on PCOS revolves around the strategies to enhance insulin sensitivity and help in ideal weight management.

It has been observed and suggested that a low Glycemic index (GI) diet, low Carbohydrate diet, Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet, to name a few, can help control insulin resistance, obesity, and managing weight. Okay, let me explain the nitty-gritty of every form of diet plan mentioned here.

Glycemic Index is not a term for a diet plan but a system of assigning certain numbers to carbohydrate-rich food items. A high glycemic index implies the food item can elevate blood sugar levels rapidly, especially in diabetic patients (which can be a complication associated with PCOS). A low glycemic index diet includes food items having low GI, or simply those that tend to gradually elevate glucose levels in the blood as they are digested slowly. Some examples of low GI foods include wholegrain bread, brown bread, brown rice, carrots, broccoli, chickpeas, lentils, apples, strawberries, to name a few.

A low carbohydrate diet is different from a low GI diet and can sound synonymous. Here is the difference: a low GI diet consists of food products having a low glycemic index, while a low carbohydrate diet involves a diet with a lesser quantity of carbs. So, if I simply put it up, a low GI diet refers to the quality of carbs, whereas a low carbohydrate diet indicates the quantity of the same.

When incorporated into the diet regime, food items with a low GI helps enhance insulin sensitivity, reducing glucose levels and free fatty acid content in the body, thereby reducing the risk of cardiovascular diseases. A low carbohydrate diet has been shown to reduce fasting glucose and insulin levels, reduce insulin sensitivity, and eventually reduce the levels of androgens in the body.

The DASH diet incorporates food items rich in fiber, protein and low in fat, such as cereals, milk, yoghurt, fish, etc. Food items rich in high amounts of fat, such as red meats (beef, pork, and lamb), and high-fat dairy products, such as butter, full-fat cheese, etc., are not included in this type of diet plan. The DASH diet provides a rich source of micronutrients and fiber and is beneficial in managing glucose levels in the body. The DASH diet is easy to stick to regularly because of its lack of calorie restriction, the richness of nutrients, and strong satiety.

The Mediterranean diet is based on the dietary pattern followed by people living near the Mediterranean Sea, which includes the countries of France, Spain, Italy, and Greece. It does not involve a steadfast rule on what kind of and how much of a food item needs to be consumed, but it promotes the consumption of fruits, vegetables, legumes, seeds, nuts, low-fat meat, etc. The diet has been shown to maintain adequate glucose levels, reduce inflammation, and lower insulin resistance by incorporating whole grains and healthy fats such as those present in avocados, nuts, seeds (pumpkin, hemp, chia seeds, to name some), and olive oil.  

However, there is still a lot to consider regarding the relationship between PCOS and dietary habits. For one thing, PCOS is a multi-factorial disorder and displays several phenotypes. For instance, it is not necessary to be obese when having PCOS; it can be a lean disorder. So, the dietary pattern may focus on maintaining a healthy weight rather than losing it. Studies focusing on a specific phenotype are not yet conducted, so it might be difficult to provide specificities related to a particular phenotype. The duration of most of the trials conducted lasted for about 3 months, so studies involving a longer period should be conducted. It has been found out in the analysis that the longer is the duration, the more effective is the outcome. More studies need to be conducted with a larger sample size to yield more significant outcomes.

I believe that living with PCOS can be daunting and stressful. As it cannot be cured, the only way to live comfortably is to devote yourself to lifestyle changes. Exercising regularly can do wonders. It can be difficult to keep consistency initially, but with time, one gets the proper pace. Exercising can also help elevate mood and improve mental health. Mediation, getting the proper amount of sleep, and consulting a therapist if needed, are necessary to manage mental well-being. And when it comes to diet, it can be very hard for some to avoid relishing their favorites. It will undoubtedly take time to adjust to a new lifestyle for women with PCOS, especially obese ones. Weight loss is a tough journey for them. However, maintaining consistency is the key. Getting a nutritionist on board may help one sort out dietary intake and help to consume necessary nutrients in adequate amounts. As PCOS is something that will always be by your side, be clingy, and irritating, you have got to manage it by taking the road to a healthy mind and body!

 

References:

1. Barrea, Luigi, et al. “Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS).” Nutrients, vol. 11, no. 10, 2019, p. 2278.  Crossref, https://doi.org/10.3390/nu11102278.
2. Goss, Amy M., et al. “Effects of a Eucaloric Reduced-Carbohydrate Diet on Body Composition and Fat Distribution in Women with PCOS.” Metabolism, vol. 63, no. 10, 2014, pp. 1257–64.  Crossref, https://doi.org/10.1016/j.metabol.2014.07.007.
3. MediaChair. “5 Ways the Mediterranean Diet Improves PCOS.” Eatrightseattle.Org, 25 Feb. 2021, www.eatrightseattle.org/7857/nutrition/5-ways-the-mediterranean-diet-improves-pcos.
4. Radulian, Gabriela, et al. “Metabolic Effects of Low Glycaemic Index Diets.” Nutrition Journal, vol. 8, no. 1, 2009.  Crossref, https://doi.org/10.1186/1475-2891-8-5.
5. Shang, Yujie, et al. “Effect of Diet on Insulin Resistance in Polycystic Ovary Syndrome.” The Journal of Clinical Endocrinology & Metabolism, vol. 105, no. 10, 2020, pp. 3346–60.  Crossref, https://doi.org/10.1210/clinem/dgaa425.

 

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Writer

Sreelakshmi S Kumar

Sreelakshmi is pursuing her master’s in Biotechnology from Pondicherry University, Pondicherry. The field of Immunology and Virology interests her the most. She harbors her love for science and teaching inside her, and she wishes to teach in the future. Dancing, reading and calligraphy are some of her leisure activities and she is a big foodie too!

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