I discuss the research on the PCOS diet and what to eat if you want to better manage your polycystic ovary syndrome symptoms without dieting.
Thanks for joining us back for part 2 of this PCOD Diet tell all. In part 1, we covered what PCOS is, the medications for it, and the persistent notion that losing weight is the only management strategy. In this part, we will critique that perception and look at the types of foods to focus on without dieting instead.
Can Dieting Worsen PCOS?
Julie Dillon, a pretty rad RD that specializes in PCOS, makes a strong case that the more dieting attempts we do, the further away we get from managing our PCOS symptoms.
First, a little background on dieting for weight loss in general. It doesn’t work. Evidence, you ask? Along many (including the Biggest Loser studies I spoke about here), there’s a classic Finnish study that was conducted on twins that concluded that dieters were more likely to gain weight compared to non-dieters (dieting was defined as the number of times an individual intentionally lost 5kg in their lifetime). Here are a few explanations for this result:
1. Restriction = Overeating
The minute we restrict something in our diet, we become preoccupied with it and are more likely to binge on it. This theory was originally discovered in a famous 1940s study known as the Minnesota Starvation Experiment. Subjects were basically starved, then given a restricted diet and then an unrestricted diet. During the restricted diet phase, subjects became obsessed with food and during the unrestricted phase, subjects would binge which resulted in some subjects re-gaining more weight compared to their pre-study weight. You don’t need a classic study to prove that- we all do it, every time we go on a new trendy cleanse. We get hangry and we binge.
2. Slows Metabolism
As soon as we restrict calories, our body goes into starvation mode, and our metabolism slows down, so instead of burning calories, our body tries to conserve as many calories as possible. The result? We gain weight. Not just some weight, but usually all of it right back again.
3. Set Point Theory
Our bodies have a happy place where they feel most comfortable- we call it homeostasis. This is called the set point theory which states that our body has a specific weight range, and no matter what we do, our body will fight to stay in that range. When we diet (to lower our body weight), our body produces hormones to make us go ga-ga over food and increase our hunger. It fights like hell to get us back to homeostasis. Sadly, we tend to gain MORE weight than we lose so set point only ever goes up.
Dillon purports that continually restricting calories promotes a state of inflammation, which spikes our insulin response. With more insulin in our body, two main things happen: a) it perpetuates the PCOS symptoms by interfering with our menstrual cycle (again), and b) we crave carbs, binge, and gain weight (aka. exactly what we were trying so hard to avoid!)
Non-Weight Loss Driven Diet Recommendations for the PCOS Diet
So knowing that long term weight loss is not a FEASIBLE response to any problem (and in fact, may WORSEN the condition), I wanted to look at some lifestyle to managing your PCOS symptoms.
PCOS and Vitamin D
It has been estimated that the prevalence of vitamin D deficiency in women with PCOS is close to 60-80%. Due to this statistic, there have been a handful of studies that have looked at the association between PCOS and vitamin D. Some studies have attempted to make the association that vitamin D deficiencies may cause increased insulin resistance and menstrual cycle irregularities. In a small sample size of eleven women with PCOS, a short duration of vitamin D supplementation improved insulin resistance. In another small trial study, 13 women who were deficient in vitamin D had their menstrual cycles resume when given vitamin D supplementation, and some were even able to get pregnant. However, in another study, women were given vitamin D for 6 months and there were no significant results. More research is needed to make the case for vitamin D supplementation to improve PCOS symptoms. Regardless of whether or not it has a significant impact on PCOS, according to a 2013 report by Statistics Canada, one third of Canadians are deficient in vitamin D. Some foods that are rich in vitamin D that may be great additions to your diet include salmon, cod liver oil, tuna, and fortified cheese, eggs and milk and you can also speak to your doctor about taking a supplement.
PCOS and Inositol Supplements
Inositol is a member of the B vitamins – it is naturally found in fruits, beans, grains and nuts and is also made by the body. Inositol acts by improving glucose metabolism, thereby requiring less insulin secretion. An RCT that involved 281 women found that those who took the inositol supplement experienced increased ovulation frequency (23%) compared to those on a placebo (13%). Individuals taking inositol also saw an increase in circulating HDL (good cholesterol) in the blood compared to the placebo group. Finally, individuals taking inositol experienced significant weight loss compared to the placebo group. Weight loss aside, the supplement does show some promise at improving ovarian function for women with PCOS so it may be worth speaking to your doctor about an appropriate dose.
Fighting Cravings with Protein, Fibre & Fat
Adding lean protein, high fibre carbs and healthy fats in every meal helps keep us satiated for longer which may help you curb your cravings for refined carbs caused by soaring insulin. For example, pair that piece of bread with peanut butter or an egg to boost the protein and healthy fats.
Eat Regularly and Don’t Diet
When we let ourselves get too hungry, our blood sugars get too low, and then spike up when we finally do let ourselves eat. Restricting also sends us into a binge and restrict cycle which results in weight gain and metabolic disorders.
Get in your daily exercise
Exercise can moderate insulin levels and help us better acknowledge our hunger cues. Aim to get in at least a half hour of movement each day, and choose something you love!
Quit Smoking
One study looked at the association between smoking, testosterone and insulin levels in women with PCOS. They found that women with PCOS that smoked had higher androgen levels and insulin resistance compared to non-smokers so put the smoke out!
Stress Less
Research has shown that stress can have a serious impact on our reproductive system, causing menstrual irregularities which compromises fertility. When we get stressed, one of the many hormones we release include adrenal androgens, and as we know, some women with PCOS have an increased level of androgens in our body which contributes to those unfavorable symptoms. As mentioned earlier, women with PCOS experience higher levels of anxiety and depression, so stress management can be a key tool to manage symptoms. So find something that gives you peace in the day. Maybe it’s meditating for twenty minutes or going for a walk to clear your head.
Avoid the Dirty Dozen
While the research in this area is certainly controvercial, and my honest opinion is if it comes down to conventional produce or less produce in your diet, I would say conventional all the way, cutting back on pesticide and hormone exposure may be helpful. Some research suggests that excessive pesticide consumption may be linked to fertility and ovulation dysregulation, so if you’re trying to conceive, you may want to focus on at least buying the “dirty dozen” organic. That means apples, peaches, nectarines, strawberries, grapes, celery, spinach, bell peppers, cucumbers, cherry tomatoes, snap peas and potatoes.
Where I’m at with my PCOS
As mentioned, I was diagnosed after coming off the pill and waiting months for my period to come back with no avail. After a bunch of tests, a fertility specialist told me I had PCOS and I assumed they made a mistake. I’m not overweight, I don’t have a hairy face, my blood sugars are perfect. I’m healthy! I had so many questions and a world of misinformation online. But alas, many weeks and meds later, and I’m still struggling to ovulate and get a period. I’m on a wack load of supplements – prenatals, inositol, vitamin D, omega 3, co Q 10, and also lots of meds.
I tried metformin. Lots of morning sickness and blood sugar lows but no period.
I tried metformin + a low dose of letrozole. Almost (I got SO excited), but nope (I cried. A lot).
Metformin + double the first dose of letrozole. Nothing except even worse GI issues.
Now I am on metformin + triple the original letrozole + dexamethasone. I’ve almost vommed more than once but I’m riding it out.
The bottom line is, PCOS is frustrating. It doesn’t make sense and it’s no ones fault. You and I haven’t done anything wrong. Nutrition is just a very small piece of the puzzle (and the PCOS diet shouldn’t be stressful), along with basic stress management and medicine. I hope you now feel like you’ve got a bit more information to help you manage your PCOS symptoms and know that weight loss isn’t the only solution. Remember that this post is in no way a replacement for treatment by a healthcare practitioner. To get tailored dietary advice that is individualized for you, speak with a registered dietitian that specializes in the management of the PCOS diet. And don’t forget to head over to Part 1 for the background scoop.
IN THE MEANTIME, I WANT TO KNOW:
HAVE YOU STRUGGLED WITH PCOS OR INFERTILITY?
WHAT ARE YOUR THOUGHTS ON LOSING WEIGHT FOR PCOS?
LEAVE ME A COMMENT BELOW WITH YOUR THOUGHTS!
Photo Credit: https://www.freshnlean.com/vegan-b12-sources/
In collaboration with Sofia Tsalamlal, RD
Updated on July 29th, 2020
Abbey Sharp is a Registered Dietitian (RD), regulated by the Ontario College of Dietitians. She is a mom, YouTuber, Blogger, award winning cookbook author, media coach specializing in food and nutrition influencers, and a frequent contributor to national publications like Healthline and on national broadcast TV shows.
Estefania says
I was diagnosed with PCOS a little while ago… so I’ve taking metformin + contraceptive pills because that’s what my gynecologist recommended… but now I’m getting more and more afraid of struggling with infertility when hubby and I decide to get pregnant and we go off the pill… but I’m afraid of leaving the pill as well because IDK what that’ll do to my hormones…
Megan says
I was a teenager when I was diagnosed and my doctor at the time never really taught me about the condition or treatment options. I have had other health issues that always took precedent over my PCOS, but now that I am thinking about trying to get pregnant in the next few years I am realizing that I want to be more proactive than I am currently being. I have a very hard time finding and trusting the information on the internet. I am a dietetics student which I think makes me a little more critical of all the information out there. I need everyone to cite like three sources before I trust the information. I appreciate how you used evidence based science, but are also open about the lack and gaps in the research. I’m still trying to figure out how I want to approach treatment, but your information has been a very helpful first step.
Abbey Sharp says
Im so glad 🙂 Thanks for your comment Megan.
Leslie says
You probably don’t even realize how many women you just helped by writing this post! Thank you!
Abbey Sharp says
aw I hope so! Thanks Leslie
Diana says
The worst was the Shame that was following me from doctor to doctor. And I do not like to talk that I have Pcos because people and do talk does not take me seriously
Abbey Sharp says
That’s so awful and needs to change.
Kalee says
Wow, Abbey! This is such a great post! Thank you for sharing your honest experience, and providing what you’ve learned that has helped you!!
Abbey Sharp says
Thanks Kalee
Salvy Tikkas says
Is it good to have a warm water and organic honey empty stomach before exercise , does it have any adverse effects on PCOS?
Abbey Sharp says
Before exercise, I would recommend water for hydration.
Hailie says
I literally cried while reading this. When I was about 15 years old I was put on Yasmin, which was a birth control used to treat what was called Pre-Menstrual Distort Disorder, which I am now convinced isn’t even a real thing. Even while on birth control I always struggled with my weight but that was my only symptom. My current OBGYN said that Yasmin was very good at managing PCOS symptoms, but I developed heart palpitations while taking it and they eventually took it off the market all together. After stopped taking it I gained almost 75 pounds, had horrible crippling periods, and I never had a regular ovulation cycle. Every time I went to the doctor about it they would just try to put me on a new birth control and it would make me sick. They never recommended me to a OBGYN and constantly told me it was just stress and that I needed to watch my weight. I never got answers. It wasn’t until I had an abnormal pap that they suggested that I see an OBGYN and then it took them so long to refer me to one that I sought one out myself and I am so thankful that I found one who actually listened to me. The only PCOS symptoms that I have are insulin resistance and high estrogen. She put me on Progesterone and Inositol, as well as other supplements that have significantly helped. She has also helped me with my relationship with food and encouraged me to keep a food journal which I have found has helped me develop a healthier relationship with my eating habits. Sorry that this got long, but cannot stress enough how important it is to have a good health care provider that listens and actually wants to help you get healthy. Thank you Abbey for the awesome information, encouraging words and for sharing your story!
Abbey Sharp says
Hey Hailie, so sorry you had to go through all of that, but I’m glad someone finally listened! And I agree, having a doctor that actually listens makes all the difference. Thanks so much for sharing your journey with us 🙂
Tracy says
Excessive weight does not cause PCOS but rather PCOS causes weight gain. I was diagnosed with PCOS nearly 20 years ago when I was very slim weighing 9 stone (I’m nearly 6 foot tall). I had all the symptoms especially excessive facial and body hair. I was given medication and told I must be eating the wrong things. As I’ve gained weight and am now classed as overweight my doctors say its the weight causing your symptoms so you need to loose weight and change to a healthy diet !!! I’ve been vegetarian all my adult life and have a balance diet with no processed foods at all. I also take Vitamin B & D suppliments. My experience is that weight makes no difference to the symptoms, the medication adds to the weight gain and only treats the symptoms and not the cause. The doctors are focusing on weight only because its easy for them to say go away and loose weight and you will be better. It then becomes your fault because you don’t loose the weight, which is extemely difficult with this condition.
Abbey Sharp says
definitely agree that weight always tends to be the main focus. Thanks for sharing Tracy
Laura Reed says
I was diagnosed when I was around 25. Before then I just was the heavy girl/woman who could never lose weight and would gain it without any real reason. I went through metformin clomid nothing then went and had fertility treatments with insemination. And had a son. I’m 42 now and for the last 5 years I’ve had a regular period have lost a little weight. I am now on something called Berberine for the last month. I take it 2 pills in the morning and 2 pills at night after dinner. Seems to help with my cravings for carbs and my appetite. I’ve lost 10 pounds without much effort. Plus I haven’t had any side effects like on metformin. I am also on a vitamin b complex.
Abbey Sharp says
Hey Laura, glad you found something that works for you. Thanks for sharing Laura
Jerica says
Hello Abbey,
Thanks for sharing your part of the story. I had my PCOS diagnosed about a year ago, when I had frequent lower abdomen pain only to be confirmed by my Gynae it’s PCOS. I’ve gained so much weight over the last 5 years, and was never able to shake it off me. I’ve tried various dieting supplements, and exercised almost daily, but still, I’m not losing any weight. I’m getting frustrated, and work stress is not helping as well.
Abbey Sharp says
Hi love, it is definitely not easy. Thank you for sharing your journey with us
Nomcebo says
Thank you so much, I read both articles. I too suffer from PCOS and kidney stones. I am currently on metformin but still overweight especially the abdominal area. I have found that metformin does maintain my weight but it doesn’t reduce it. My weakness is sugar, even though I don’t eat cakes I love sweet black coffee in the mornings and fruit juice. I do however try to drink lots of water. As for my kidney stones I was told to stop taking milk because I have a lot of calcium. I truly wish these two can go away forever.
Abbey Sharp says
I hope so too love. Thanks so much for reading
Lexi says
Hi
Thanx for your very informative articles, I also have Pcos, and the only thing that ever helped was n acetyl cysteine from solal, it regulated my periods to a perfect circle, every 28 days. But solal stopped making it and other brands are not as good for me, so I started gaining weight again and hair on my stomach. This month I got a new brand of n acetyl cysteine and I heard maca and sweet potato extract helps. So that’s what I am trying now.
Abbey Sharp says
Hey Lexi, I’m glad you’ve found what helps. Thanks for sharing 🙂
Michelle McDaniel says
Thanks so much for the info. I have battled with PCOS for more than 15 years and infertility for at least 10 of those years. I also suffer with psoriasis. I have been on all the common meds metformin, clomin, birth control only for my body to reject the meds which cause major adverse reactions to where I had to come off all meds. I have also been on so many diets I can’t even count the number. My experience has been doctors just follow the book on treating PCOS rather than digging deeper to treat the patient. For the last few years I have takens a more holistic approach using chiropractic and supplements. I lost around 60lbs using a program called ideal protein two years ago but my cycles still did not regulate. I could not continue due to the huge expense. I have since gained all but about 10lbs back.
I did learn that my body does respond better to high protein, low carb, low sugar diet, but it’s so hard to stick to that. Your information will definitely help guide my next doctors visit. If you have any suggestions I definitely welcome them. Thanks for your dedication in helping others.
Abbey Sharp says
Hey Michelle, thanks so much for your comment. All I can recommend, is to keep searching for answers, that’s what I’ve been trying to do! Thanks for reading and sharing your experience with us 🙂
Heidi says
Your two posts have educated me more then my GP who told me I did not have PCOS after one round of blood work! I did see my naturopath and she confirmed I did have PCOS and has since put me on supplements to help and re adjusted my macros which I was doing to get some weight off! I’m very active but the weight will not come off! Thanks for all your wonderful info!
Abbey Sharp says
So glad you were able to finally get the right information! Thanks so much Heidi!
Amy says
Thank you for sharing this information. I found out about my PCOS when I was 20, so 12 years ago. The doctor is not massively helpful. I’ve been referred to the hospital and had tests and one lot of treatment for trying to increase my follicles so I can conceive, but this did not work and to get the next lot of treatment I have to have a BMI of 29, which means loosing 3 stone, which as you know is not the easiest with PCOS. All we get told is we need to loose weight to have a baby. I’m not on any medication and had to ask my GP for some tablets to make me have a cycle occasionally. Im now going to speak to them about vitimin D and other supplements to see if this help. Thank you again, I’ve learnt more reading your post then anything else I’ve been told or read over the last few years.
Abbey Sharp says
Hey Amy, thanks so much for sharing and for reading! I agree with you, there is so much of a focus on weight and that’s that. So simplistic, and doesn’t take into account the dangers with that. Good luck Amy :). We’re in this together!
Tiffany says
Visit the pcos diva site. She has a lot of info about supplements, getting pregnant, weight loss etc. A great site. My 19 year old daughter has suffered for 5 years with it…weight, no energy, unwanted hair, acne etc…everything as a woman you don’t want. It’s heartbreaking to watch.
Ashwini says
Hi I m suffering with pcod for last 5 years the effects of it being alopecia inability to loose weight and stress as well…I have been able.to.manage my irregular periods to a large extent with the practice of yoga…Yet unable to shred even an ounce of weight
Abbey Sharp says
Hey Ashwini, it’s a real struggle. I’m glad the yoga has helped. Thanks for sharing