What is pcos?
Polycystic ovary syndrome (PCOS) is estimated to affect around 1 in 10 women in the UK (NHS 2022).Despite the name, PCOS does not involve the development of cysts.
The three main symptoms of PCOS are:
- irregular periods (due to eggs not been regularly released by the ovaries),
- higher or more active levels of androgen (a group of hormones known as “male type hormones” e.g. testosterone) which can cause physical signs such as excess facial or body hair,
- enlarged ovaries which may contain several fluid-filled sacs (follicles) which surround the eggs (NHS 2022).
Other symptoms of PCOS may include thinning of scalp hair, acne, food cravings (particulalry for carbohydrates or sugary foods), difficulty losing weight, depression and anxiety, body image concerns, and sleep disturbances/ sleep apnoea (BDA nd). Many of these symptoms relate to high levels of androgens and insulin. Additionally, research has found that 80% of individuals with PCOS are insulin resistant (cannot effectively use insulin in the body) and thus have higher levels of insulin in the blood to compensate (BDA nd).
As with many conditions you may see a large amount of diets promoted and promising to “cure” and “treat” PCOS, however many of these come from unreliable sources with minimal to no research. In this blog post I will explore the topic of nutrition and PCOS management, using evidence based research to support the points that I make.
how to manage pcos with diet…
At present, there is no cure for PCOS, however the symptoms (collectively or individually) can be managed. Management, as with all conditions, depends largely upon the symptoms an individual is experiencing, it should also be considered that we are all unique entities thus things that work for one person may not work for another.
One management method for PCOS is eating regularly. Eating smaller, more frequent meals, opposed to the traditional 3 meals, helps stabilise the blood sugar levels in the body, reducing insulin resistance which can help prevent things like type 2 diabetes (BDA nd). This is supported by a number of research studies including a 24 weeks randomised study with 40 women living with PCOS which found a significant decrease in fasting insulin and post-OGTT insulin sensitivity in participants who had 6 meals per day vs those which had 3 meals per day (Papakonstantinou et al 2016).
Another management method for PCOS is opting for lower gylcaemic index (Gi) carbohydrates and whole grains where possible. Before I begin this section I would like to clarify that this does not need to be applied to all meals at all times, nor do we need to demonise foods and cut foods out which are now low GI carbohydrates and wholegrains. A healthy balanced and a positive relationship with food is key. Firstly let’s explore what GI carbohydrates are. The glycaemic index (GI) is a ranking system, which shows how quickly your blood sugar rises after eating different carbohydrates (BDA nd). Therefore foods labelled as “low GI” cause your blood sugar levels to rise slowly, which can be helpful to reduce the symptoms of PCOS as they can improve insulin levels and reduce insulin resistance (BDA nd) (Bar et al 2013). Therefore you may find swapping some high GI foods for low GI foods helpful for improving your bodies ability to respond to insulin, eating low GI foods is also linked with having more regular periods (Bar et al 2013) (BDA nd). Many wholegrains are classified as low GI (BDA nd). You can find out more about the GI index here: https://www.healthline.com/nutrition/glycemic-index
The next nutritional management which may help manage PCOS symptoms is having balanced meals and snacks, where possible. Again I would like to again confirm that not all snacks or meals have to be balanced all the time, however having balanced meals the majority of the time can be beneficial. By balanced meals and snacks I mean ensuring all macronutrients are represented- protein, fat and carbohydrates (low GI where possible). This has been shown to improve insulin levels by reducing the impact of the whole meal on blood sugar levels (BDA nd).
Omega 3 (found in oily fish) has been found to help lower inflammation commonly seen in PCOS (). Where possible aim for one to two portions a week of oily fish- e.g. salmon, mackerel, sardines, sprats, and herring. It might be worth considering that often frozen fish products or those that are tinned are generally cheaper in price, and still contain omega 3. There are also plant-based sources of omega 3 in chia seeds, walnuts, flax seeds, and soya beans.
SUMMARY
In conclusion, there are a number of dietary approaches which may prove beneficial in managing PCOS symptoms. However, it should be considered (as with all conditions) that we are all unique and thus a “one shoe fits all” approach is not effective. It should also be noted the need to ensure all nutrients are represented in the diet. There are also other management techniques to consider which are non-nutrition related such as movement and medication.
For more information or support please seek support from a clinical practitioner (either a GP, Dietician, or AFN registered Nutritionist).
References
- NHS (2022) https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/
- BDA (Nd) https://www.bda.uk.com/resource/polycystic-ovary-syndrome-pcos-diet.html
- Papakonstantinou et al (2016)https://pubmed.ncbi.nlm.nih.gov/26862008/
- Bar et al (2013) https://pubmed.ncbi.nlm.nih.gov/23999280/
- Yang K et al (2018) https://pubmed.ncbi.nlm.nih.gov/29580250/
Contribution by Associate Nutritionist, Georgia Spence BSc ANutr
