Best PCOS Diet

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Updated: 21-August-2024

There is literally an infinite number of diets to choose from, and a new one popping up every month, so which one is the right one for women with PCOS in 2024?

Let’s have a look at the evidence.

To date, several diets have been trialled in women with PCOS. These include:

⦁ Low carb diet
⦁ Low fat diet
⦁ Mediterranean diet
⦁ Ketogenic diet
⦁ Low inflammatory diet

Low carb diet

As explained by Barrea et al., high carbohydrate intake and low-grade inflammation cooperate with insulin resistance and hyperandrogenism to exacerbate the severity of PCOS.¹ With 65-80% of women with PCOS being resistant to insulin, this makes a low carb diet (< 26% carbohydrates) particularly important.²

A meta-analysis of low carb diet studies involving women with PCOS reported significantly reduced BMI, androgen and insulin resistance levels along with improved lipid (fat) metabolism after just 2 months without necessarily reducing calorie intake.³

References

1. Barrea L, et al. (2018). Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. https://doi.org/10.1017/s0954422418000136 ↩︎
2. Oh R, et al. (2022). Low Carbohydrate Diet. https://pubmed.ncbi.nlm.nih.gov/30725769/ ↩︎
3. Zhang X, et al. (2019). The Effect of Low Carbohydrate Diet on Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials. https://doi.org/10.1155/2019/4386401 ↩︎
4. Gonzalez F, et al. (2020). Inflammation Triggered by Saturated Fat Ingestion Is Linked to Insulin Resistance and Hyperandrogenism in Polycystic Ovary Syndrome. https://doi.org/10.1210/clinem/dgaa108 ↩︎
5. Cincione R I, et al. (2021). Effects of Mixed of a Ketogenic Diet in Overweight and Obese Women with Polycystic Ovary Syndrome. https://doi.org/10.3390/ijerph182312490 ↩︎
6. Paoli A, et al. (2020). Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. https://doi.org/10.1186/s12967-020-02277-0 ↩︎
7. Wong J, et al. (2016). A randomized pilot study of dietary treatments for polycystic ovary syndrome in adolescents. https://doi.org/10.1111/ijpo.12047 ↩︎
8. Barrea L, et al. (2019). Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). https://doi.org/10.3390/nu11102278 ↩︎
9. Mei S, et al. (2022). Mediterranean Diet Combined With a Low-Carbohydrate Dietary Pattern in the Treatment of Overweight Polycystic Ovary Syndrome Patients. https://doi.org/10.3389/fnut.2022.876620 ↩︎
10. Pandurevic S, et al. (2023). Efficacy of very low-calorie ketogenic diet with the Pronokal® method in obese women with polycystic ovary syndrome: a 16-week randomized controlled trial. https://doi.org/10.1530/ec-22-0536 ↩︎
11. Shivappa N, et al. (2014). Designing and developing a literature-derived, population-based dietary inflammatory index. https://doi.org/10.1017/s1368980013002115 ↩︎
12. Wang Q, et al. (2022). Higher dietary inflammation potential and certain dietary patterns are associated with polycystic ovary syndrome risk in China: A case-control study. https://doi.org/10.1016/j.nutres.2021.12.006 ↩︎
13. Sharkesh E, et al. (2021). The dietary inflammatory index is directly associated with polycystic ovary syndrome: A case-control study. https://doi.org/10.1111/cen.14672 ↩︎
14. Deshmukh H, et al. (2023). The Effect of a Very-Low-Calorie Diet (VLCD) vs. a Moderate Energy Deficit Diet in Obese Women with Polycystic Ovary Syndrome (PCOS)—A Randomised Controlled Trial. https://doi.org/10.3390/nu15183872 ↩︎
15. Nikokavoura E A, et al. (2015). Weight loss for women with and without polycystic ovary syndrome following a very low-calorie diet in a community-based setting with trained facilitators for 12 weeks. https://doi.org/10.2147/dmso.s85134 ↩︎
16. Kazemi M, et al. (2018). A Comparison of a Pulse-Based Diet and the Therapeutic Lifestyle Changes Diet in Combination with Exercise and Health Counselling on the Cardio-Metabolic Risk Profile in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial. https://doi.org/10.3390/nu10101387 ↩︎
17. Mizgier M, et al. (2021). Relation between Inflammation, Oxidative Stress, and Macronutrient Intakes in Normal and Excessive Body Weight Adolescent Girls with Clinical Features of Polycystic Ovary Syndrome. https://doi.org/10.3390/nu13030896 ↩︎
18. Mizgier M, et al. (2020). Risk Factors of Overweight and Obesity Related to Diet and Disordered Eating Attitudes in Adolescent Girls with Clinical Features of Polycystic Ovary Syndrome. https://doi.org/10.3390/jcm9093041 ↩︎
19. Toscani M K, et al. (2011). Effect of high-protein or normal-protein diet on weight loss, body composition, hormone, and metabolic profile in southern Brazilian women with polycystic ovary syndrome: a randomized study. https://doi.org/10.3109/09513590.2011.564686 ↩︎
20. Wang F, et al. (2024). Effects of high-protein diets on the cardiometabolic factors and reproductive hormones of women with polycystic ovary syndrome: a systematic review and meta-analysis. https://doi.org/10.1038/s41387-024-00263-9 ↩︎
21. Zumbro E L, et al. (2021). Whey Protein Supplementation Improves the Glycemic Response and May Reduce Non-Alcoholic Fatty Liver Disease Related Biomarkers in Women with Polycystic Ovary Syndrome (PCOS). https://doi.org/10.3390/nu13072451 ↩︎
22. Li C, et al. (2021). Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome. https://doi.org/10.1186/s12967-021-02817-2 ↩︎
23. Talebi S, et al. (2024). The effects of time-restricted eating alone or in combination with probiotic supplementation in comparison with a calorie-restricted diet on endocrine and metabolic profiles in women with polycystic ovary syndrome: A randomized clinical trial. https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.15801 ↩︎
24. Łagowska K and Pieczyńska J M, (2022). Not only diet quality and physical activity but also snacking and skipping meals could be related with menstrual disorders in PCOS. https://doi.org/10.1080/03630242.2022.2106529 ↩︎
25. Oyelowo O, et al. (2022). Skipping the first active meal appears to adversely alter reproductive function in female than male rats. https://doi.org/10.1016/j.crphys.2022.10.001 ↩︎
26. Fujiwara T, et al. (2009). Skipping breakfast adversely affects menstrual disorders in young college students. https://doi.org/10.1080/09637480802260998 ↩︎
27. Jakubowicz D, et al. (2013). Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome. https://doi.org/10.1042/CS20130071 ↩︎
28. Papakonstantinou E, et al. (2016). Effect of meal frequency on glucose and insulin levels in women with polycystic ovary syndrome: a randomised trial. https://doi.org/10.1038/ejcn.2015.225 ↩︎
29. Bozbulut R, et al. (2023). Beneficial effects of RESMENA diet on anthropometric, metabolic and reproductive profile in adolescents with obesity and polycystic ovary syndrome: a randomized controlled intervention study. https://doi.org/10.1159/000535053 ↩︎
30. Katcher H I, et al. (2008). Comparison of hormonal and metabolic markers after a high-fat, Western meal versus a low-fat, high-fiber meal in women with polycystic ovary syndrome. https://doi.org/10.1016/j.fertnstert.2008.01.035 ↩︎