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PCOS and healthy eating

In my private practice, I noticed that I get quite a few questions about or ladies coming in to see me for Polycystic Ovarian Syndrome or you may know it as PCOS. It affects between 15-20% of women who are still within their reproductive years. This condition basically affects how a woman’s ovaries work but healthier food choices and regular exercise can help improve the symptoms.

Some of the symptoms experienced are:

  • Irregular or absent periods
  • Excessive hair on the face, chest or stomach
  • Acne
  • Thinning of hair
  • Difficulty maintaining a healthy body weight
  • Abnormal insulin metabolism
  • Fertility problems

And if not treated, later in life can lead to type 2 diabetes and cholesterol.

I think the main concern when it comes to diet and PCOS, is that a lot of women are carb phobic and often avoid carbs. By doing this, you end up eating more protein and fats, and not enough healthy plant-based foods. Eating large amounts of protein can also increase insulin levels, just like certain carbohydrates do. With PCOS, I wouldn’t say that you need to avoid all carbohydrates. You should definitely avoid refined carbs and processed sugars as these digests quickly and cause spikes in your sugars and insulin e.g. sweets, biscuits, cakes, ice creams, desserts, fruit juices, cold drinks, sugar added to tea, coffee or cereals, syrups, honey or jam.

You should eat moderate portions of healthier and most importantly lower glycaemic index carbohydrates for e.g. whole wheat low GI bread, brown rice, basmati rice, oats, whole wheat pasta. These digests slower causing a gradual rise in your blood sugar levels giving you sustained energy. Together with this include lean proteins and healthy fats and you will be sure to prevent sugar spikes and raised insulin levels. With regards to portion sizes, it would be calculated specifically to your age, height, weight and physical activity levels. But generally, you shouldn’t include more than a fist size of starch per meal. It is important to remember that just because a starch is a low GI, it doesn’t mean that you can eat more. The calories are still the same, it’s just that the low GI one will keep you fuller for longer.

Inflammation is another concern with PCOS. Other than high insulin levels, there are also high levels of inflammatory markers. Foods that promote inflammation are high intakes of red meat, processed meats, sugar and foods with high levels of saturated and trans fats. So, you can see that if you cut out carbs and fill up on protein, you can potentially increase your levels of inflammation. Anti-inflammatory foods include whole grains, legumes, fruit and vegetables as well as fatty fish like salmon and sardines, and healthy plant fats like olive oil and certain nuts and seeds.

Unnecessarily restricting carbs can also lead to having anxiety or depression. This is because serotonin levels become low. It could also increase the risk of developing eating disorders because you become so focused on excluding foods that most people would consume but also the high insulin levels cause cravings and binge eating behavior.

Over-restriction of carbs can also lead to low energy levels and then chances of you working out become slim. Exercise forms a very important part of the treatment of PCOS and especially improving insulin sensitivity.

Excluding whole grain carbohydrates can also have a negative impact on your gut microbiome and decrease levels of good bacteria in your digestive tract that can lead to constipation, bloating or even IBS.


Research on supplements to aid PCOS symptoms is growing. I just picked out a few common ones.

Inositol: believed that women with PCOS are unable to use inositol properly. This is a ‘secondary messenger’ that regulates activities of hormones, so this could explain the high insulin levels experienced. Taking myoinositol can help improve insulin sensitivity – inofolic, metsynx

Fish oil: omega 3 needed to reduce inflammation but also shown to reduce testosterone and regulate menstrual cycles – solgar, omegagenics

Top 10 tips to improve PCOS symptoms

  1. Get enough good quality sleep
  2. Eat regularly and don’t skip meals to avoid blood sugar drops and over-eating or bingeing
  3. Balance is key – include suitable portions of wholegrains and low GI carbs, and enough lean protein and healthy fats based on your personal requirements
  4. Maintain weight, visceral fat and body fat at healthy levels.
  5. Avoid refined sugars and processed carbs
  6. Include fruit and veg: 1-2 fruit and 3-4 veg to get in “5 a day”. Remember starchy vegetables.
  7. Limit saturated and trans fats
  8. Don’t smoke
  9. Exercise regularly
  10. Manage stress levels
Sumaiya Essa

Sumaiya Essa RD (SA), completed her Bachelor of Science degree in Dietetics at the University of Kwazulu Natal in Pietermaritzburg. Having always believed that “you are what you eat” and chose this career in nutrition and dietetics to educate, inspire and encourage people to make the right food choices. As the great Hippocrates once said, “Let food be thy medicine and let medicine be thy food”. Disclaimer: The views and opinions expressed on this blog are entirely my own. This website is for informational purposes and please be aware that any information contained within this website should not be considered as medical diagnosis or treatment and should not replace physical treatment with a medical professional.