PCOS or Polycystic Ovary Syndrome is the most common hormone related problem in women worldwide.
PCOS is the number one most common cause of infertility due to ovulation problems but
is also the cause of many other health problems in women.
Being overweight or obese does not cause PCOS.
In fact, PCOS is only slightly more common in obese women than in normal weight or underweight
women.
However, being overweight can make the problems associated with PCOS worse and harder to get
rid of.
It is generally well accepted that weight loss can improve some, but not all, of the
problems that are due to PCOS.
In fact, some studies have found that only a 5% loss in your weight can result in improvements
in the symptoms of PCOS.
There is little agreement, however, on the best diet for PCOS.
There are many problems with diet studies for PCOS.
These tend to be the same types of problems we encounter in any weight loss study.
One of the biggest problems is patient dropout.
It is not unusual to have more than half of the patients in these studies leave the study
before the end.
This means that the results are based on only a fraction of the women studied.
This is really important because in a weight loss study, drop out may be due to the fact
the diet was difficult to maintain and therefore would be less likely to work in the real world.
Problem number two is that many of these studies are very short, usually around two to three
months.
A particular diet may look great for 8 weeks but not be nearly as effective after say 5
years.
Diet studies can also be difficult to compare because they dont always measure improvement
in the same problems in the same way.
For example, some diet studies in PCOS may have weight loss as an endpoint, others may
measure improvement in certain blood tests and still other may measure ovulation.
This is an important point because a certain diet may be good for improving one type of
problem but have no effect on another type of problem.
A final problem with these studies is that they don’t always use the same criteria
for diagnosing PCOS.
Remember PCOS is a syndrome which means there are lots of different signs and symptoms.
Not all women with PCOS have the same symptoms or problems
Lets talk about some specific diet regimens.
Since there are so many of these diets and so many recommendations form websites and
channels, I am going to focus only on the diets that have the best quality scientific
evidence to back them up.
I do not list these in any sort of order
This diet was originally created as a means to help people with high blood pressure.
DASH stands for Dietary Approach to Stop Hypertension.
The DASH diet is rich in vegetables, fruits, whole grains and low-fat dairy products, as
well as low in saturated fats, cholesterol, refined grains and sweets.
This study compared the DASH diet with another low calorie diet in women with PCOS and found
that women on the DASH diet achieved greater weight loss and had lower levels of one type
of androgen hormone and higher levels of antioxidants.
This website has detailed information about getting started on a DASH diet
The soy diet involves eating foods that are derived from soybeans.
Soy foods are a good source of plant based proteins, have no cholesterol, are high in
fiber and low in saturated fats.
Soy foods also contain high levels of a chemical called isoflavones.
This study compared a soy diet to a similar diet but with a higher percentage of protein
from animal sources instead of soy.
Those on the soy diet showed greater improvements in weight, some androgen levels, measures
of insulin resistance and antioxidants.
This review of several studies found specifically that soy isoflavones reduced levels of testosterone
in PCOS.
Info about a soy diet can be found here
Pulses are dried edible seeds of the legume family that include split-peas, dry beans,
lentils, and chickpeas.
Pulses are high in fiber, complex carbohydrates and plant based protein and are low in fat.
Pulses have a low glycemic index which means that it doesn’t increase your blood sugar
as much after eating them.
This study compared a pulse diet to the TLC diet.
The TLC diet was created to help people reduce their cholesterol and contains veggies, fruits,
breads, cereals and pasta and lean meats.
One unique aspect of this study is that the women were not required to cut their calories.
Women in both groups were encouraged to exercise and had monthly lifestyle counseling.
The Pulse diet was better at reducing blood pressure and triglycerides and improving cholesterol.
When women were re-evaluated after 6 to 12 months, however, some of those improvements
went away.
Women in both groups achieved similar amounts of weight loss - about 5% but both groups
experienced some weight gain again by 6 to 12 months
This website has information about the Pulse diet
Other types of diets I looked at did not have enough high quality scientific evidence for
me to recommend.
This includes popular diets like low carb diets.
In fact, a review of fifteen low carb diets did not find any benefit in hormones, metabolic
measurements or weight loss
None of the previous diet studies looked at ovulation or fertility specifically.
In fact, there is surprisingly little data looking at the benefit of diet or weight loss
directly in PCOS.
In one study, subjects followed a low calorie diet whereby two meals daily were replaced
with commercially available meal replacements.
They compared overweight women with PCOS and those without PCOS.
Both groups lost the same amount of weight.
This is important.
It points out that there is no evidence that women with PCOS have more difficulty with
weight loss.
Even though both groups lost the same amount of weight.
The women with PCOS ovulated only half as often.
Weight loss, at least by calorie restriction, is less effective for fertility in women with
PCOS.
Data from a large PCOS study looked at whether weight loss by diet, exercise and medications
before starting the fertility medication clomid, could improve the success of the clomid treatment.
They found that the ovulation rate on clomid was better.
Women who delayed treatment with clomid to achieve weight loss first not only ovulated
more often but actually had more live births
What have we learned.
If you are a woman with PCOS, there are a number of diets that can help you to lose
weight and improve some of the metabolic problems associated with PCOS.
If you are attempting to conceive, it seems that diets and weight loss will be less successful
than for other overweight women but gives a definite advantage prior to treatment with
clomid
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