What is the Best Diet for PCOS?

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The word “diet” implies a temporary, restrictive eating plan based on lists of 'approved foods' and 'foods to avoid'. In this context, there is no such thing as a PCOS diet because PCOS is not temporary! It is a lifelong condition that will require a lifelong commitment to making healthy choices. Learning to adopt principles of healthy eating is essential, while a “diet” is only good for as long as you're sticking to it.

“Diet” can also refer to a regular eating pattern or the typical foods a person consumes. In this context, research shows that diet and lifestyle modification are a first line approach to managing PCOS (1). In most cases of PCOS, changing your way of eating is necessary.

The available evidence from diet studies in women with PCOS tells us that there is not one perfect diet. Instead, many different approaches can work to achieve the same goals: improved ovulation, weight loss, normalized hormone levels, improvement in insulin sensitivity, and reduced hair growth.

In one small research study, PCOS women who consumed a low dairy (1 oz of cheese per day) and grain-free diet over the course of eight weeks showed improvement in weight, body composition, insulin sensitivity, testosterone, and hair growth (2). However, other studies evaluating low carbohydrate (3), low fat, moderate carbohydrate with low glycemic index (4), plant-based (5), high protein (6), calorie restriction (7) and anti-inflammatory diets (8) have all shown positive improvements in measures of metabolic, clinical, reproductive, menstrual, or emotional well-being parameters in PCOS.

Improvements in these outcomes seem to occur with weight loss, regardless of macronutrient composition. Translation: you don’t have to overly restrict or cut out any food group.


Basic Guidelines

Since there is not one perfect diet for PCOS, and because diet change can feel very overwhelming, consider making tweaks instead. Keep it simple. To help you make small shifts in how you think about food, follow these basic guidelines.

  1. Break out of your diet mentality. Stop restricting calories. Instead, make value-based decisions about food. By eating more vegetable-based and high quality meals, you will naturally decrease calories. (Hint: this might mean eating out less and preparing meals from home.)

  2. Stop counting carbs. Diets ranging from 40% to 52% of carbohydrates are effective in managing PCOS. The quality of carbs and the quality of the diet matters more than total carbs.

  3. Focus on whole foods. Can you swap out boxed cereal for oatmeal or choose to make scrambled eggs with spinach and mushroom instead of picking up a breakfast sandwich from Starbucks? How about swapping the afternoon M&Ms for a handful of fruit and nuts?

  4. Aim for 3 colors at each meal. Follow the rainbow - ROYGBIV.

  5. Vegetables should be the star of the plate. Instead of having a plate of pasta and a meat as the entree with a bite of broccoli, try doing it the other way around. Make the majority of your plate veggies and complement it with a small side of your carb of choice and a “palmful” of protein. Don’t like veggies? Learn to bake ‘em, roast ‘em, saute ‘em, steam ‘em. Put them in soup, add them to your rice dishes. Season them. Add butter, oil, salt, pepper, and other herbs and spices.


Template for a Balanced Meal

To provide you with structure, here is a template to help you construct a meal with ease and confidence. The purpose of this template is to help guide you while also allowing you leeway to choose the foods you like. I often get asked which fruits and vegetables are “better” and which ones to stay away from. While the glycemic index of a food can be a way to measure how much a food will affect your blood sugars, and some research supports using the glycemic index to manage PCOS (4), I encourage you to simply eat more fruits and vegetables as a starting point. It comes down to balance and variety. Also, it’s important to eat foods you enjoy!

  1. Visualize your plate! Fill 1/2 of your plate (or more!) with veggies. Reference pictures above and below. Examples include leafy greens (spinach, romaine, green leaf, red leaf, watercress, microgreens) and cruciferous vegetables (cabbage, broccoli, cauliflower, Brussels sprouts, kale, bok choy, collard greens, arugula).

  2. Make 1/4 of your plate grains, root veggies, or fruit for quality carbohydrates. Examples of grains include whole oats, buckwheat, rice, and quinoa. Examples of root vegetables are sweet potatoes, white potatoes, onion, carrot, radish, turnip, beets, celery root, and rutabaga. Low glycemic fruit includes berries, peaches, oranges, and grapefruit.

  3. Make 1/4 of your plate quality protein. This includes wild-caught fish, chicken, eggs, lean pork, beef and lamb, lentils, and beans.

  4. Include quality fat at every meal for flavor, satiety and to enhance nutrient absorption. Contrary to popular belief, eating fat does not make you fat. The following are examples of foods that provide healthy fats.

    1. Oils: cold-pressed extra virgin olive oil, avocado oil and virgin coconut oil are good choices. Use to flavor veggies and grains.

    2. Seeds: examples include flax, hemp, chia, sunflower, pumpkin, sesame. Use to top oatmeal, salad, soup, or add to a smoothie.

    3. Nuts: examples include almonds, pine nuts, hazelnuts, Brazil nuts, cashews, pistachios, walnuts, nut butters. Use to make hummus, trail mix, top oatmeal and salad, or add to a smoothie.

    4. Other: avocado, grass-fed butter.

Numbers 1-4 above imply that you're making the majority of your meals from scratch, however, you can follow this template as a checklist when ordering out as well. For tips on eating out, check out my blog here.

What has worked for you? Leave comments below.

In Health,

Stephanie



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