Dietary changes in polycystic ovary/ovarian syndrome (PCOS) is intended to :
- Reduce body weight and decrease obesity
- Improve glucose tolerance and reduce blood glucose levels
- Prevent the development and limit the progression of hyperlipidemia (high LDL-cholesterol and/or triglyceride, low HDL-cholesterol levels)
Dietary management should be adopted in conjunction with medication and exercise for the maximum benefit.
Adhering to a diet plan that achieves these targets may :
- Increases ovulation rate and therefore fertility
- Stabilize menstrual irregularity
- Limit the complications associated with impaired glucose tolerance and hyperlipidemia and delay the onset of diabetes mellitus
An improvement in the other signs and symptoms of PCOS is also reported with dietary management.
There are three key areas that should be included in any PCOS diet plan :
- Calorie reduction and restriction
- Low glycemic index foods only/mainly
- Low saturated fat, trans fats and moderate unsaturated fats (mono- and poly-)
Ideally a patient with polycystic ovarian syndrome should consult with a dietitian who is working in conjunction with their gynecologist and endocrinologist.
Calorie Reduction and Restriction
The average adult female requires approximately 2,000 calories per day to maintain a normal body weight. This may vary depending on height and level of activity. A calorie-restricted diet may vary between 1,500 to 1,800 calories per day for an overweight or obese patient and rarely a diet of 1,200 calories per day is adopted. Any diet that is less than 1,000 to 1,200 calories may be detrimental to a person’s health, lead to nutrient deficiencies and further exacerbate anovulation and amenorrhea.
Calorie-reduction is often the better approach. By teaching a PCOS patient to remove anywhere between 500 to 1,000 calories per day, a patient can gradually adapt to the eating plan. This increases the chances of compliance and allows the patient to learn and practice proper dietary management.
The goal of any calorie-reduction or restriction is to reduce the body weight and ultimately improve glucose tolerance. Exercise is a key factor in any plan.
Low Glycemic Index (GI) Diet
Glycemic index or GI is the measure of the extent certain foods, mainly carbohydrates, raise the blood glucose levels. High GI foods contribute to weight gain and poor glucose control. The modern diet is laden with high GI foods primarily derived from refined carbohydrates and other starches.
Eating low GI foods essentially improves glucose tolerance by reducing the ‘spikes’ in post-prandial glucose levels (after eating) and controlling the secretion of insulin in response to elevated blood glucose levels. This is an essential component in the dietary management of impaired glucose tolerance and diabetes mellitus.
A basic guideline to glycemic index of foods :
- White, brown and wholewheat breads have a high glycemic index.
- Rye bread, whole grain and breads marked as low GI are preferable.
- Most pastas are high GI foods unless otherwise stated.
- Pasta made with durum wheat is preferable.
- Rice is a low GI food, especially variants like basmati rice. However, calorie content has to be carefully monitored as 1 cup of cooked rice could exceed 200 calories.
- Most fruits are acceptable.
- Pineapple, mango and dried fruits like raisins should be eaten in moderation. Watermelon should be avoided.
- Most vegetables are acceptable.
- Parsnips, pumpkins, potato and carrots should be eaten in moderation or avoided.
* Please note that there may be certain variations with the list above based on preparation methods, plant species, ingredients and combination with other low GI foods. Always consult with a registered dietitian.
Low Fat Diet
Ideally a PCOS eating plan should include moderate amounts of mono- and polyunsaturated fats. Saturated fats and trans fats should be excluded from the diet. Refined carbohydrates may contribute to elevated triglyceride levels and low HDL-C (HDL cholesterol or the “good cholesterol”).
A list of foods that contain saturated, trans and unsaturated fats are discussed under :