PCOS and Fibre #14
Is fibre good for PCOS?
Hello Curious Minds,
This is Francesca from The PCOS Newsletter.
I want to wish a Happy Easter to those celebrating this weekend. I am currently in the beautiful Scottish Highlands, enjoying a weekend of fresh air and nature.
In today’s newsletter, I would love to share more about Fibre. This nutrient doesn’t get the love that it deserves. Whilst practising in the clinic, I saw countless women missing this nutrient from their diets.
This week’s question
Is fibre good for PCOS?
In this newsletter, you will learn about the following:
How a diet low in fibre can affect PCOS
Why fibre affects our health
The benefits of the miracle molecule SCFA (Short-Chain Fatty Acids)
A high-in-fibre day menu and list of foods
How to increase fibre without getting bloated
The answer
To keep it short, fibre is so essential for our health that I believe it should be considered a treatment. Let’s see why.
What is fibre?
Fibre is technically a non-digestible carbohydrate. There are two fibre types, depending on how soluble they are in water. Soluble fibre dissolves in water and creates a gel-like substance, whereas insoluble fibre doesn’t dissolve in water and helps bulk up our stool and have a good time whilst 💩. Most naturally available high-fibre foods contain variable amounts of soluble and insoluble fibre.
Why is fibre important for PCOS?
A few studies looked directly at the impact of fibre on PCOS. They found that women with PCOS who consumed a low-fibre diet had higher LH: FSH ratio, insulin resistance, testosterone and lower HDL cholesterol. These are the most significant markers of PCOS we want to have in check. Researchers went as far as identifying specific gut microbiome species: Parabacteroides distasonis, Bacteroides fragilis and Escherichia coli who prevail in the lack of fibre metabolites (SCFA). These bacteria have been associated with an inflammatory state, raising the markers discussed above.
These studies are relatively small, and the role of the microbiome in PCOS is an emerging research field. However, dietary fibre is a sample of the Med diet, which has been extensively proven to improve PCOS symptoms.
What can Fibre do?
The effect of dietary fibre on our health has been extensively studied. There is considerable epidemiological evidence that higher dietary fibre intakes reduce the risk of disease, including cardiovascular disease (CVD), type 2 diabetes and cancer.
These are the most relevant benefits:
One of fibre's most crucial jobs is producing SFCA (short-chain fatty acids). Specific bacteria in the gut can ferment dietary fibre and create these miracle molecules. Why are they miraculous?
They can increase the production of satiety and insulin sensitivity hormones (GLP-1, PYY, adiponectin, etc.), signalling to your brain that you are full and keeping you satisfied for longer. In time, this reduces food intake, helps regulate blood sugar levels and protects against diseases such as type 2 diabetes. This is particularly important for us as we know that excess insulin can further drive the production of androgens.
They maintain the intestinal tract's pH, making minerals such as calcium and magnesium more soluble and, as a result, more absorbable.
They have been shown to lower inflammation in the body and support the proper functioning of the immune system. Due to SFCAs’ effect on the immune system, they have been shown to be protective against certain cancers, including colon cancer.
SFCA acts as the primary source of energy for our gut microbiome and, as a result, has the ability to contribute to the increase in the number of good bacteria in the gut.
Fibre further helps with blood sugar levels by slowing down the digestive process.
Due to fibre not being quite digestible, it slows down the release of glucose. A fibre-rich meal gets digested slower because enzymes take longer to get to the food. This leads to a more sustained release of glucose and insulin in the bloodstream, keeping you fuller for longer and avoiding sugar spikes.
It lowers cholesterol levels.
Fibre can reduce cholesterol absorption in your intestines by binding with bile (which contains cholesterol) so that the body excretes it. We know that women with PCOS tend to have higher cholesterol levels. We will look at cholesterol closely in a future newsletter.
It helps with the regularity of 💩
Very simply, when you eat food, you must expel waste and toxins from your body. After our digestive system has absorbed all the nutrients from food, anything remaining must be eliminated. Dietary fibre increases the weight and size of your stool and softens it. A bulky stool is easier to pass, decreasing your chance of constipation.
How much fibre is enough?
For women, the recommended guideline is 25–32g of fibre per day. However, populations that consume 50-100g of fibre per day have been shown to have a lower incidence of chronic disease. In addition, some studies show that an added 10g of fibre per day to the recommended 32g can further reduce the risk of disease.
A comprehensive dietary review in European countries, including data from nearly 140,000 individuals, showed that women's fibre intake was only 18-24g. This low amount of fibre is one of my main concerns with low-carbohydrate or keto diets. Given fibre is found primarily in carbohydrate foods, reducing them considerably will deprive you of this important nutrient.
How can I get that much fibre in my diet?
It is relatively easy to achieve that amount of fibre. Here is a sample menu for a day where you can achieve the desired fibre levels.
For the recipes, visit: https://www.pickuplimes.com/
Some ideas of foods that are delicious and high in fibre:
But, I get bloated from too much fibre…
I hear you. It is totally normal to do so. If your diet is currently not high in fibre and you introduce 50g of lentils overnight, your digestive system will react. The gas is a byproduct of the bacteria digesting the fibres. As you increase your fibre intake, your gut will get used to it, and the gas will reduce over time.
These are my recommendations for increasing fibre:
Increase fibre intake gradually, 2-3g per day (which equals ¼ cup of lentils)
Soak dry legumes for at least 16h, and make sure you cook them fully
Make sure you chew well and eat slowly
Drink plenty of water
If you have IBS or other gastrointestinal issues, those must be addressed, as fibre might bother you.
Is fibre good for PCOS?
Fibre is not just good; it is essential for PCOS. This is one of the main pillars of a healthy diet, and I would strongly recommend to asses whether your diet has enough of it and try adding some of the foods above.
I hope you enjoyed this Nutrition Series Newsletter. See you next Sunday.
Francesca
1 Sources
Barber, T. M., Kabisch, S., Pfeiffer, A. F. H., & Weickert, M. O. (2020). The health benefits of dietary fibre. Nutrients, 12(10), 3209. https://doi.org/10.3390/nu12103209
Cutler, D. A., Pride, S. M., & Cheung, A. P. (2019). Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Science & Nutrition, 7(4), 1426–1437. https://doi.org/10.1002/fsn3.977
Jian Tan, Craig McKenzie, Maria Potamitis, Alison N. Thorburn, Charles R. Mackay, Laurence Macia. (2014). Chapter Three - The Role of Short-Chain Fatty Acids in Health and Disease. In Advances in Immunology (p. Volume 121, Pages 91-119).
Liang, Z., Di, N., Li, L., & Yang, D. (2021). Gut microbiota alterations reveal potential gut-brain axis changes in polycystic ovary syndrome. Journal of Endocrinological Investigation, 44(8), 1727–1737. https://doi.org/10.1007/s40618-020-01481-5
Disclaimer: We are all unique in our own ways, so this information is for educational purposes only. Please further consult your healthcare provider about your health needs.