What is the best dietary approach for PCOS?

There are a range of dietary approaches that can be tried for weight management in PCOS. When considering changing your diet to manage or lose weight it is important that you research the diet first.  Ensure that the diet you are trying provides adequate amounts of nutrients, vitamins and minerals and is consistent with the Australian Dietary Guidelines.

Unfortunately there does not seem to be any one dietary approach that is ‘best' for women with PCOS. This means that if you have tried one in the past and did not find it useful for weight loss, there are other options available to try.  Seek the advice of an accredited dietitian if you are in any way confused or concerned about which dietary approach is best for you.

The Australian Dietary Guidelines

Enjoy a wide variety of nutritious foods

• Eat plenty of vegetables, legumes and fruits. 
• Eat plenty of cereals (including breads, rice, pasta and noodles), preferably wholegrain.
• Include lean meat, fish, poultry and/or alternatives.
• Include milks, yoghurts, cheeses and/or alternatives. Reduced-fat varieties should be chosen, where possible.
• Drink plenty of water.

and take care to

• Limit saturated fat and moderate total fat intake.
• Choose foods low in salt.
• Limit your alcohol intake if you choose to drink.
• Consume only moderate amounts of sugars and foods containing added sugars.

Following these guidelines will provide adequate levels of fibre, nutrients, vitamins and minerals. When you are trying to lose weight it is important that in addition to making sure you have an adequate nutritional intake, you need to watch portion sizes, limiting high fat and sugar intake. Be careful with high energy foods and added fats, and combine healthy eating with physical activity to maximise weight control.

Depending on how much exercise you do and how much you weigh, eating 5000-8000 kJ/day is suitable for weight loss. As a rough guide, to lose 0.5-1 kg per week, you need to be eating 2250-4500 kJ less than you are expending (using up) per day, but slower loss achieved through sustainable changes is usually easier to sustain.

Low Glycemic Index or Low Glycemic Load diets

Alternative options that are popular for women with PCOS include diets that lower the glycemic index (GI) or glycemic load (GL). This is a measure of the type of carbohydrate in the diet.

• A low glycemic index carbohydrate produces less of an increase in glucose levels and insulin levels in the blood after eating.
• The glycemic load refers to the overall impact of foods on blood glucose over the course of an entire day and refers to the GI of each individual food as well as the carbohydrate content of each food.

A lower GI or GL diet is commonly used for people with diabetes and can reduce risk factors for heart disease. There is some evidence that a low GI or GL diet can reduce hunger and help improve weight loss long-term. However, it is not clear if a low GI or GL diet specifically reduces insulin resistance.

There is currently no evidence specifically assessing the role of a lower GI or GL diet in women with PCOS. Whilst it is not proven to be better than general decrease in calories, a low GI diet is still a healthy approach consistent with the Australian Dietary Guidelines and can be a useful alternative, particularly when followed with other principles consistent with the guidelines such as increasing fruit, vegetable, legume, lean meat and low fat dairy and reducing fat, saturated fat, added salt and added sugar intake.

"The Low GI Guide to Managing PCOS. J Brand-Miller, N Farid, K Marsh" is a useful resource for women with PCOS wanting to trial a reduced GI diet.

Available from the Jean Hailes Foundation for Women's Health Shop.

Higher protein diets

Diets with an increased protein intake have recently been studied both in overweight people with increased risk for heart disease and type 2 diabetes, and in overweight women with PCOS.

In general, the Australian Dietary Guidelines recommend a moderate protein intake of approximately 15-20 per cent of your daily energy intake. An increased protein diet contains approximately 25-35 per cent of your daily energy intake.

In overweight people who are at risk for heart disease and type 2 diabetes, a high protein diet has been shown to lead to reductions in risk factors for these conditions. There is some evidence that weight loss can be improved due to the protein reducing hunger levels.

In overweight women with PCOS, high protein diets have been compared to high carbohydrate diets (similar to the Australian Dietary Guidelines) in two small studies. After two to four months, both diets showed similar weight loss and reductions in insulin levels.

In the first study, the higher protein diet led to greater reductions in glucose levels after eating, greater reductions in male hormones (androgens) and a better level of high density lipoprotein cholesterol (or "good" cholesterol). However this was not evident in the other study. A higher protein intake therefore might have some benefits for women with PCOS but is not necessarily the best or only approach to follow.

"The CSIRO Total Wellbeing Diet. M Noakes, P Clifton" is a useful resource for women with PCOS wanting to follow an increased protein diet.

Available from the Jean Hailes Foundation for Women's Health Shop.

Other diets

There has been a great deal of interest in recent years in very low carbohydrate diets such as the Atkins diet. These diets contain typically 20-30 grams carbohydrate per day in the initial weight loss phases compared to an average daily carbohydrate intake for women of 150-250 grams carbohydrate per day.

Fat intake is generally much higher on these diets and protein intake is moderately higher. Although there is some evidence that short-term weight loss can be better on these diets, over a longer period (2-3 years), weight loss is generally the same or even worse than other approaches. These diets do not seem to reduce insulin levels like some other diets do. There is also some concern about the effect of this approach on risk factors for heart disease. Long-term use of these diets is currently not advised.

Summary

Overall a better balance of intake and output (activity and exercise) is the only way to lose weight.  Fad, short-term diets should generally be avoided.

Further Resources

 Healthy Eating (94.81 KB)

Nutrition Australia - http://www.nutritionaustralia.org/

Content updated July 31, 2009