Low Carb and Ketogenic Diets for PCOS
Low-carb and ketogenic diets are ideal for women with PCOS, especially those with insulin resistance. Carb restriction has been linked to weight loss and visceral fat, reductions in insulin and blood sugar levels, and improvements in other cardiac disease risk factors in those with metabolic syndrome.
Although ketogenic diet shows a lot of promise for PCOS, a more liberal low-carb diet may also be effective for weight loss and improve symptoms. This blog aims to highlight what foods are good for us with PCOS and what foods to avoid.
In addition to reducing insulin levels, ketogenic and low-carb diets also help control appetite, which results in a reduction of calorie intake that can lead to weight loss without hunger.
With the limited formal research on low-carb and ketogenic diets in women with PCOS, its proven that eating a low carb diet decreases insulin resistance and hyperinsulinemia which is effective for managing the disorder.
Keto-friendly foods that may be especially beneficial for women with PCOS
Foods high in lignans, such as flaxseed
Lignans are a type of plant compound known as polyphenols. Lignans are a type of fibre known to increase Sex hormone-binding globulin and reduce androgen and insulin levels. A PCOS case study found that consuming about 1 ounce (30 grams) of flaxseed per day dramatically lowered free testosterone levels. Additionally, a randomised controlled trial in obese older women showed increased insulin sensitivity and lower insulin levels in the group that took flaxseed compared with those who received a probiotic or placebo.
When you consume lignan precursors, bacteria in your gut convert the “plant” lignans into “human” lignans, including enterodiol and enterolactone, which have weak estrogenic activity.
This can be beneficial for women’s health, because if you have naturally high estrogen levels, the weak “estrogens” from lignans may bind to some of your estrogen receptor sites, thereby actually reducing total estrogen activity.
Aside from cancer, there is evidence that eating a diet rich in plant lignans may be linked to a lower risk of heart disease.
Other low-carb foods rich in lignans include sesame seeds, berries, pumpkin, broccoli and curly kale.
Generally speaking, all types of fish are good for you. Fatty fish like sardines, salmon, herring and mackerel: The omega-3 fats found in fish oil may help reduce insulin levels and improve insulin sensitivity in those with PCOS.
Some fish are better than others, and the fatty types of fish are considered the healthiest. That’s because fatty fish (like salmon, trout, sardines, tuna and mackerel) are higher in fat-based nutrients. This includes the fat-soluble vitamin D, a nutrient that most people are deficient in. It functions like a steroid hormone in the body.
Fatty fish are also much higher in omega-3 fatty acids. These fatty acids are crucial for your body and brain to function optimally and are strongly linked to reduced risk of many diseases. To meet your omega-3 requirements, eating fatty fish at least once or twice a week is recommended. Fish is also generally considered to be among the best foods you can eat for a healthy heart.
Nuts are nature’s way of showing us that good things come in small packages. These bite-size nutritional powerhouses are packed with heart-healthy fats, protein, vitamins, and minerals.
Both walnuts and almonds have been shown to reduce androgen levels and improve heart disease risk factors in women with PCOS. Other nuts haven’t been studied for their effects on PCOS, but it’s likely that they provide similar benefits.
People consuming at least 20 grams of nuts daily were less likely to develop potentially fatal conditions such as heart disease and cancer, a study found.
Nuts and peanuts are high in fibre, magnesium, and polyunsaturated fats – nutrients that are beneficial for cutting cardiovascular disease risk and which can reduce cholesterol levels. Some nuts, particularly walnuts and pecan nuts, are also high in antioxidants, which can fight oxidative stress and possibly reduce cancer risk.
Cinnamon is a powerful spice that has been used medicinally around the world for thousands of years. It is still used daily in many cultures because of its widespread health benefits, not to mention its distinctly sweet, warming taste and ease of use in recipes.
According to researchers, out of twenty-six of the most popular herbs and medicinal spices in the world, cinnamon actually ranks #1 in terms of its protective antioxidant levels!
Some studies suggest that this spice may improve insulin resistance and help restore ovarian function in women with PCOS.
A little bit of cinnamon goes a long way, and its antioxidant abilities are what makes it especially beneficial to include in your diet. As little as ½ teaspoon of cinnamon daily can have positive effects on blood sugar levels, digestion, immunity and more; however, stronger doses are also extremely beneficial for improving heart disease risk and cutting the risk of diabetes, cancer and neurodegenerative diseases.
Recommended dosage: ½ to 1 teaspoon per day.
Apple cider vinegar
Vinegar has been used for more than 2,000 years to season and preserve foods, heal wounds, treat infections, prevent cardiovascular disease, and suppress tumour formation.
There have been a few reports in the medical literature suggesting that intake of vinegar helps to keep your blood sugar from getting too high after eating a meal containing carbohydrates.
Is it possible that vinegar can have an effect similar to metformin and thus reduce insulin resistance in PCOS? Researchers at Shiga University of Medical Science in Japan looked into this question. In a small pilot study, they evaluated seven women with PCOS who drank a beverage containing 15 grams (1 Tablespoon) of apple cider vinegar for 90-110 days. Four of the seven women experienced a menstrual cycle within 40 days. Most women had an improvement in their hormone balance, plus reduced insulin resistance.
Recommended dosage: 1-2 Tablespoons (15-30 ml) per day. It’s best to start with 1 teaspoon and work up to the recommended dosage gradually in order to avoid nausea and other digestive symptoms.
Women with PCOS tend to have low levels of chronic inflammation. This makes us more resistant to insulin, chronically fatigued and prone to gaining weight.
While managing those insulin levels will help with inflammation, making sure that your PCOS diet is rich in anti-inflammatory foods will help too.
Examples of anti-inflammatory foods
Here are some examples of anti-inflammatory foods to incorporate into your PCOS diet:
- avocado and coconut
- beans and lentils
- blueberries, blackberries, and cherries
- cold water fish, including salmon and sardines
- dark leafy greens, including kale and spinach
- dark red grapes
- extra virgin olive oil
- green tea
- nutrition-dense vegetables, such as broccoli and cauliflower
- turmeric and cinnamon
- spices and herbs
- walnuts, pistachios, pine nuts, and almonds
In a study published in the North American Journal of Medical Sciences, women with PCOS followed a Mediterranean style anti-inflammatory diet for 3 months. This diet was designed to be low calorie, low-fat, low-saturated fat, low glycemic index and moderate-to-high fiber.
The diet composition was 50% carbohydrates 25% proteins and 25% fat. Anti-inflammatory foods that were emphasized include fatty fish (2x/week), legumes, nuts, olive oil, herbs, spices, and green tea. Processed meat and poultry, as well as added sugars, were limited.
The results of this anti-inflammatory diet were very encouraging! Women with PCOS lost 7% of their body weight, 6.6% loss in waist circumference, and 9.2% loss of body fat and a 21.7% reduction in visceral fat.
Significant improvements in their cholesterol and inflammatory markers were found. Total Cholesterol decreased by 9%, TG decreased 18%, and LDL 10.6%. CRP levels decreased by 35%.
A big surprise: Sixty-three percent of women regained menstrual regularity and 12% conceived following this type of anti-inflammatory diet.
What foods should I avoid as part of my PCOS Diet?
Now I know that this is a tough one for many including myself but dairy is not good for PCOS for many reasons. One of the main issues with dairy is that it contains something called IGF-1 or insulin-growth-factor 1. IGF-1’s main role is to promote growth in newborn babies.
The problem is that it also mimics insulin in the body. Meaning, the more insulin we have, the more testosterone we also have, Causing PCOS symptoms worsen.
The only exception to the dairy rule is butter as it is high in good fats and vitamins that we may struggle to get elsewhere. Butter also has a fairly low dairy content.
Examples of dairy alternatives
Rice milk, almond milk, cashew milk, oat milk, coconut milk, hemp milk.
I personally love and recommend Hemp milk and cashew milk.
Soy products have been shown to delay ovulation in some women. And as we already struggle with ovulation already, I don’t recommend soy products for women with PCOS as it just exacerbates the problem.
Okay, so having looked at all of that, you may be wondering what on earth you’re actually going to be able to eat. I am going to research and look up more on this matter so I may add another blog at some point. For now, I am still going to use cheese in my diet as it’s one of the main forms of fat apart from meat I need to research and look into the factors of how much is acceptable and also the levels of testosterone I am thinking of doing a whole blog on this.
Gluten tends to create general inflammation in the body. Remember, the more inflammation we have, the more resistant we are to insulin and therefore the more testosterone we have floating around our bodies.
Now, before you rush off to the gluten-free aisle, just a word of caution. Gluten-free products tend to be highly refined and will have a high glycemic load, causing an insulin spike. So, I wouldn’t recommend gluten-free pasta, bread, treats, etc.
Amany Alsayed Salama, Ezzat Khamis Amine, Hesham Abd Elfattah Salem, and Nesrin Kamal Abd El Fattah. Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome. N Am J Med Sci. 2015 Jul; 7: 310–316.
GonzÃ¡lez F. Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10; 77:300-5.