What type of diets can worsen PCOS? #70
What diets you may want to avoid if you have PCOS.
Hello everyone,
How is your May going? I absolutely love the long days. It makes me feel alive!
Today, we are discussing an important topic.
What type of diets can worsen PCOS?
The truth is the nutrition space is a bit of a mess. The diet industry is worth billions, making it challenging to sift through the noise and find what's right for someone with PCOS.
I have a very simple rule for identifying the diets we should avoid: Does it prioritise nutrients or energy?
What does that mean? Many available diets (that you should RUN from) are based on the simple equation of “energy in = energy out”. Calories counting, shakes, counting sync or restricting carbs look at our diet from a simplistic point of view: does it reduce energy intake?
Whilst this can seem logical because less energy intake might mean weight loss, less insulin, and less food processing needed by the body, it doesn’t help our system to function optimally. If you’ve been reading this newsletter for a while, you know how nutrients impact our body. Vitamin D helps the expression of 229 genes, Zinc is part of 3000 human proteins and Omega 3 literally holds our cells membrane together.
So, there is a simple question to ask: Does the food I am advised to eat offer my body the right level of nutrients it needs to function well?
If not, please know it will worsen PCOS symptoms. What should I stay away from:
Calorie Restriction
We often see diets pushing the limit to go on an 800-calorie-a-day diet. However, we know that our bodies don’t like hunger. Going on such a restrictive diet impacts the level of nutrients in two ways:
800 calories a day, even if you chose the most nutritious meals, won’t be able to offer you the nutrients your body needs, which in turn will lead to nutrient deficiency, which we know can impact our symptoms greatly
Your body will rebel very soon, and when it does, the hunger it creates leads to eating the quickest form of energy: simple, refined carbs with no nutritious value. Why? Your body will prioritise the quickest way to get energy. This is often from foods stripped of any fibre and can be digested quickly so glucose can be released. Pay attention the next time you are hungry—what foods do you gravitate towards?
However, caloric restriction has its advantages, and I advocate for it to manage weight and insulin levels. My recommendations. It would be to cut 150-250 calories per day if you are looking to lose weight and focus on nutrient-dense meals (I will discuss how to build nutritious meals in the next newsletter). This might mean that your weight loss will be slower, but it will ensure 1) you are offering your body what it needs and 2) you won’t run the risk of eating a whole packet of biscuits to satisfy your hunger.
Shakes/Meal Replacement/Protein bars
Whilst these are very appealing from a convenience standpoint, they don’t offer the variety of nutrients we need in our diets. Without various nutrients from different foods, we won’t get all the vitamins and minerals we need to manage symptoms effectively. This can worsen symptoms like insulin resistance and hormonal imbalances.
One thing that worries me the most about shakes is the lack of fibre. Fibre has been proven repeatedly to be a key component of our diet.
Cutting out food groups
Currently, there isn’t a consensus on the macronutrient composition of a diet to help manage PCOS. For example, a low-carb diet is not superior to the Mediterranean diet. Diets that promote cutting whole food groups are hazardous. For example, many carbohydrate foods, such as oats, contain quite a lot of fibre. Fibre helps us balance insulin resistance, inflammation and nutrient absorption (in-depth article here). The low-fat trend we saw in the 2000s led to yoghurts filled with sugar to make up for the consistency and taste.
Food in nature is not formed by one nutrient category. Take beans, for example—21% carbohydrates (mainly fibre) and about 42% protein. Very few foods in their natural state are only one food group. So when we try to cut food groups out, we end up having to resort to processed, manufactured foods to fit into this unnatural way of eating.
The higher a food has gone through processing, the higher the chance it won’t have the nutrients we need, and our body will find ways to break it down, which will impact our PCOS symptoms negatively.
Overall, these diet approaches for PCOS can worsen symptoms like insulin resistance, mood swings, and stress levels. In the long term, they may lead to metabolic slowdown, nutrient deficiencies, disordered eating behaviours, and an unhealthy relationship with food.
In addition, despite their differences, they share a common flaw: they fail to acknowledge the enjoyment and the social and cultural significance of food. They impose restrictions that can make us feel miserable and that’s not a nice place to be in. We need a more balanced and individualised approach to nutrition, focusing on celebrating food and nourishing the body rather than strict restrictions.
How do you judge a diet approach?
When doing research into what kind of approach to take to help lose weight and manage PCOS, ask yourselves the following questions:
Is this approach telling me to restrict a particular food group without taking into consideration my PCOS and without providing evidence behind it?
Does this approach focus on over-restriction, meaning that I can’t socialise?
Does this approach provide me with some education about my condition?
Does this approach help me understand my habits and provide me with tools to help me make changes?
Does this approach help me understand the underlying reasons for overeating (if this is an issue for me?)
Does this approach take into consideration my cultural background and food preferences?
Does this approach understand my environment and can fit within my lifestyle?
If the answer is no to most of these, you might want to rethink your options!
I have also reviewed all of the research on what diet type is best for PCOS in the article below 👇🏼:
If you are in a position where you can invest in a healthcare professional to help you with a tailored approach to your life, I would highly recommend working with a nutritionist to help. It has been life-changing and pushed me to become a nutritionist.
In our next newsletter, we will learn how to build nutrient-rich meals to help you follow this clear guideline.
My Calendar is open to anyone who would like to chat about their diagnosis, their condition and all of the beauty that comes with it → https://calendly.com/francesca-the-pcos-clinic/pcos-research-call
See you next Sunday,
Francesca
www.pcos-clinic.com
1 Sources
Che, X., Chen, Z., Liu, M, and Mo, Z (2021) Dietary Interventions: A Promising Treatment for Polycystic Ovary Syndrome. Ann Nutr Metab, 77(6), 313-323.
Di Lorenzo, M., Cacciapuoti, N., Lonardo, MS., Nasti, G., Gautiero, C., Belfiore, A., Guida, B. and Chiurazzi, M. (2023). Pathophysiology and Nutritional Approaches in Polycystic Ovary Syndrome (PCOS): A Comprehensive Review. Curr Nutr Rep, 12(3).
Juhász, A.E., Stubnya, M.P., Teutsch, B., Gede, N., Hegyi, P., Nyirády, P., Bánhidy, F., Ács, N. and Juhász, R (2024) Ranking the dietary interventions by their effectiveness in the management of polycystic ovary syndrome: a systematic review and network meta-analysis. Reprod Health, 21(1), 28.
Teede, H.J, Tay, C.T., Laven. J.J.E., Dokras, A., Moran, L.J., Piltonen, T.T., Costello, M.F., Boivin, J., Redman, L.M., Boyle, J.A., Norman, R.J., Mousa, A. and Joham, A.E. (2023) International PCOS Network. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Eur J Endocrinol, 189(2), G43-G64.