Key Topics Covered
In this episode we discuss what PCOS is, how it is diagnosed and the diets shown to best manage it.
- PCOS – Polycystic Ovarian Syndrome
- PCOS affects 12-15% of women that are of reproductive age. However, up to 70% go undiagnosed.
- Polycystic means “many cysts”. Individuals won’t always present with cysts.
- To be diagnosed, individuals must present with at least 2 of the following:
- Lack of ovulation (irregular or no menstrual cycles)
- Excessive testosterone
- Cysts on ovaries
- Other symptoms include:
- Excessive hair growth – inc. facial
- Hair loss
- Skin changes – darkening or acne
- Weight gain
- Anxiety, depression, sleep apnea
- Difficulty conceiving
- Insulin resistance
- 85% Experience insulin resistance. On average women with PCOS are 35-40% less sensitive to insulin.
- Those with higher body fat typically have more issues with insulin resistance.
- Fortunately, the steps to manage PCOS involve the reduction of insulin resistance or its effects.
- Meeting core food group requirements – this is the foundation
- Weight management
- When people decrease body fat, it has been proven that this improves insulin sensitivity.
- In saying this, one study showed that people with PCOS had a BMR 14-40% lower than expected. Those with insulin resistance had the greatest drop in BMR.
- Anti-inflammatory diet
- Eg. Meditterainian diet or Plant-based
- Containing high amounts of fibre, omega-3, and antioxidants
- Not everyone with PCOS is insulin resistant.
- One small study showed that reducing carbohydrates assists in managing PCOS. However, it’s not the only option.
- Decreasing carbs will help to manage insulin resistance.
- Decreasing carbs will more often than not decrease calorie intake, thus helping weight management.
- Challenges associated – adherence, quality of life, and micronutrient intake.
Dairy & Gluten Free
- Typically based on the assumption that dairy & gluten cause “inflammation” to the body.
- However, there’s no strong evidence to show that eliminating dairy or gluten from ones diet will improve PCOS.
- There’s a small link between dairy and acne, so people could see benefits from that perspective.
- Inositol – Recommend 2-4g/day of Myo-inositol. Effective at 40:1 Myo to D-chiro inositol.
- Myo-inositol improves egg quality and fertility.
- D-chiro inositol increases insulin sensitivity.
- On average, individuals with PCOS have a deficiency of Myo inositol in their ovaries.
- Magnesium – Recommend 300mg/day before bed. Recommended to those interested or deficient.
- Magnesium can improve insulin sensitivity.
- Theoretically, this can improve sleep quality for those with insomnia.
- If consuming the RDI for magnesium, an additional supplement likely won’t add any further benefits.
- Omega-3 – Recommend 1000-3000mg of fish oil/day or microalgae supplement.
- Can help reduce testosterone and improve the regularity of the menstrual cycle.
- If an individual is already consuming a high amount (ie. consuming fatty fish 2-3x/week) this probably won’t benefit them.
- Zinc – Recommend 50mg/ day. This is well above the upper limit recommended for women.
- Helps with hair growth or hair loss.
- It can also help with insulin resistance.
- If consuming the RDI for zinc, an additional supplement likely won’t add any further benefits.
- However, consuming too much zinc can cause zinc toxity and copper deficiency.
- Chromium – Recommend 200micrograms chromium picolinate/ day.
- Can improve insulin sensitivity.
- Vitamin D –
- A larger percentage of people with PCOS are deficient in vitamin D.
- It helps with insulin resistance.
- It can help with mood and decrease depression.
Summary for management
- People with PCOS can benefit from weight loss if they’re overweight. This is not always an easy task as PCOS often decreases BMR up to 40%.
- Eat a Mediterranean-style diet, with high amounts of plant foods and omega-3.
- Focusing on low GI carbohydrates (ie. wholegrains) and moderating carbohydrate intake.
- Supplements recommended – Inositol and Omega-3.
Relevant Links/ Resources
- Basal Metabolic Rate decreases in those with PCOS
- Consuming as Few Carbohydrates as Sustainably Maintainable
- All Women with PCOS Should Be Treated with Insulin Resistance
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