The question I hear most often from women is, “What is the best diet for my PCOS?” It’s usually followed by a run through of all the popular diets, “Is Paleo the best diet for PCOS? How about Low Carb? Keto? Vegan? Weight Watchers? Raw?”
The good news is that, by the time you’re searching for the best diet for PCOS, you’ve probably already come to realize that it’s an issue that can’t be solved by medication. Pharmaceuticals like metformin and the Pill can’t address root causes, but what you eat (and don’t eat) can. Eating the right types of food at the right times each month helps rebalance your reproductive hormones, stabilize insulin and blood sugar, and support your unique female biochemistry during each phase of your 28-day menstrual cycle.
If you have PCOS, you’re probably hyper-aware of all of the diets out there that are promoted for weight loss, but most diets that you hear about are built on research that was done on men and/or male rats. They are not designed for women’s bodies. They do not take into account women’s biology, menstrual cycles, or our changing hormone patterns — and that is why they fail us so often.
Why Popular Diets Fail When It Comes to PCOS
Eating too much animal protein (I’m looking at you Paleo, Atkins!) can interfere with ovulation. Research suggests that women who eat more animal protein than plant protein ovulate less frequently. PCOS is characterized problems with ovulation, so anything that interferes with regular ovulation is inadvisable for women with PCOS.
Most women with PCOS struggle on a low carb diet (hi, Atkins, Paleo, South Beach, etc!). While it’s important to recognize that there are simple carbs (white bread, pasta, potatoes) and complex carbs (whole grains, sweet potatoes), and while it’s important to avoid gluten on the whole, cutting back carbs can make a PCOS sufferer feel even worse, because it can destabilize blood sugar.
I suggest incorporating brown rice, quinoa, or buckwheat on a daily basis in combination with healthy fats and plant-based protein, and when you get to your premenstrual phase you’ll be thankful for the option of sweet potatoes. It can feel easier to stop eating carbs in the first half of your hormone cycle (the follicular phase), but the hormone shift that happens in the second half makes low carb diets unnecessarily punishing. Keep your grain consumption to one half-cup serving at one time.
A diet that is too reliant on grains for protein and for feeling full and satisfied – like a vegan or macrobiotic diet – can fuel gut dysbiosis and decrease the absorption of the key nutrients that help with hormonal balance, especially if the grains you’re eating are not processed properly – i.e. soaked. If you have PCOS, this will make your symptoms worse.
Any diet that encourages calorie-restriction (Weight Watchers, raw, etc.) can cause problems with ovulation. Simply put, you enough healthy, nourishing calories to ovulate. Not enough calories can translate into no ovulation.
Processed foods contribute to inflammation and often contain unhealthy ingredients like dairy, gluten, non-organic and/or GMO ingredients, and processed soy. Many fresh juices contain as much sugar as a glass of soda and are treated by your body exactly the same way. Whole foods are a much better choice for women with PCOS and any woman who is hormonally-sensitive.
Even if calorie-restricted diets were healthy (they’re not) these diets can only be followed short-term, and when you come off the diet, you are primed to over-eat, even binge, when you have the chance. Studies have shown calorie-restriction diets simply do not work long-term.
Some “Healthy” Foods May Make Your PCOS worse
Before I made it my mission to fix my hormones and help other women do the same, I had no idea that some of the foods I believed to be “healthy” were actually making my problems worse. Now, I see how shocked my clients are when I tell them that some of the hyped-up health foods in their grocery carts might be hindering their progress in reversing symptoms.
For women with PCOS, it’s important to know which “healthy” foods to avoid. If you’re hormonally-sensitive like I am, these foods—foods that can be healthy for others—have a stronger effect on you can make the symptoms you desperately want to be rid of even worse.
The 4 “Healthy” Foods That Make PCOS Worse
Some foods that are touted as healthy can actually make PCOS worse. Here they are
1) Artificial sweeteners.
The quest to give up sugar—and get off the blood-sugar roller coaster— is so important. In all the years I’ve worked with clients, I’ve rarely met a woman who is struggling with hormone issues who isn’t also struggling with blood sugar issues. But in the quest to ditch the sweet stuff, we often turn to sugar substitutes, which come with their own problems.
One cause for concern is the intensely sweet flavor of these synthetic substitutes. When we rely on them heavily, they can hijack of our taste buds and make more complex flavors, like those found in vegetables and low-glycemic fruits like berries, less appealing—and the fewer whole, real vegetables and low-glycemic fruits we eat, the more we deprive the liver of the phytonutrients it needs to function optimally. The liver processes and eliminates used hormones from the body; when it doesn’t get the phytonutrient support it needs, it struggles to eliminate estrogen and other hormones from the body, contributing to hormonal imbalance.
For some women, I include stevia in this category. It’s not created in a laboratory like aspartame, for example, but, in some traditional societies, folk wisdom holds that regular intake of stevia is a form of birth control. Small amounts of stevia probably won’t have a profound effect on a woman’s fertility or cycles, but it’s best to err on the side of caution and choose a different sweetener, especially if you’re currently heaping spoonfuls into your herbal teas throughout the day.
2) Red meat.
Paleo diets have become as trendy as intense boot camp classes in recent years. And all too often, women with PCOS are advised to eat like cavemen, subsisting mostly on lots and lots of protein-packed meat to lose weight and counteract the damaging effects of sugar. But here’s the deal: In my experience, if you have PCOS, following a Paleo diet will not bring about weight loss and it certainly won’t bring back your period. A high-protein diet causes a decrease in the production of sex hormone binding globulin (SHBG), which is vital to reducing testosterone levels — something that’s critical in PCOS recovery.
Plus, many women with PCOS have a specific genetic problem known as the methyl-tetrahydrofolate reductase (MTHFR) gene mutation. Eating Paleo when you have the MTHFR gene mutation can create too much of an amino acid called homocysteine, which can cause an increase in PCOS symptoms.
What’s more, eating a lot of meat often goes hand-in-hand with decreasing carbohydrates and this is a real issue for PCOS sufferers. Recent research suggests that PCOS may be connected to autoimmune thyroid disease (poor thyroid function) and your thyroid needs some complex carbohydrates (like quinoa, brown rice, and buckwheat) to function optimally.
Soy isn’t your ally if you have PCOS because it contains “phyto” or plant estrogen that acts like estrogen in the body—and eating too much of it confuses your body into thinking it has enough of the real deal on hand. This sends a signal your endocrine system to slow down estrogen production, subsequently slowing the production of luteinizing hormone (LH), and effectively shutting down ovulation.
4) Cooking oils like canola, sunflower, and vegetable oils (and synthetic spreads like margarine)
Unhealthy fats are bad news for hormonal harmony. For one, eating too many unhealthy fats crowds out our consumption of healthy fats, which are important for maintaining healthy levels of HDL (“good”) cholesterol. Cholesterol is a precursor to all the body’s steroid hormones, including estrogen, progesterone, and FSH. Simply put, and contrary to media reports about cholesterol in recent decades, we need cholesterol to make some of our most important hormones.
Vegetable oils and other cooking oils, like sunflower oil, are high in omega-6 fatty acids and low in omega-3 fatty acids. We need to consume both omega-6 and omega-3 fatty acids through diet (the body can’t produce them and we need them to live), but the problem is that the Western diet is flooded with omega-6 fatty acids—and tragically short in omega-3 fatty acids. When omega-6s are disproportionately high in the body relative to omega-3s, its a recipe for inflammation, which is the archenemy of hormonal health and overall health.
Canola oil presents its own set of problems. It’s higher in omega-6s than omega-3s, like other vegetable oils (though not by as high a margin), but the real causes for concern with canola are GMOs and toxic processing. The vast majority of the plants from which canola oil is harvested are genetically modified—and the oil is extracted by heating and crushing the plant seeds and then mixing them with hexane. In addition to being classified as a neurotoxin by the CDC, hexane and other organic solvents like it drive up inflammation and interfere with endocrine health.
The Best Diet for PCOS
PCOS is a complex imbalance and can be one of a few different types. However in the 20 years of helping women with PCOS, I’ve learned that the FLO Protocol is beneficial in helping all women with PCOS, no matter what type they have.
The first step in the FLO Protocol is to address blood sugar imbalances by emphasizing healthy fats, high-quality proteins, and complex carbohydrates in your diet — and avoiding simple carbs and processed sugars as much as possible. It’s also important to eat a good breakfast within 90 minutes of waking up everday. It’s an excellent way to safeguard your blood sugar for the day.
Make lunch your biggest meal of the day and include complex carbs (like black beans) and good fats (like avocado). If you do have a sugar craving in the afternoon, reach for the kind of sweeteners that don’t cause as much blood sugar disruption. I find honey and coconut nectar are good substitutes.
Watch out for hidden sugars in everything from pasta sauces to bread when you are grocery shopping. Remember that fruit-based juices and smoothies that don’t contain much fiber can have as negative an impact on your health as a can of soda.
The second step is to address cortisol dysregulation. Lifestyle strategies go a long way in helping support and soothe the adrenal glands (which produce the stress hormone cortisol) — strategies like prioritizing sleep, engaging in restorative movement, doing restful activities, and taking supportive adaptogenic herbs. That said, getting and keeping blood sugar stable (see the first step!) is absolutely critical. Dysregulated blood sugar is a huge stressor on the adrenal glands and will sabotage any other attempts you make to heal your adrenal glands.
The third step is to boost estrogen elimination. To help your body process and eliminate estrogen, you will want to focus on two key elements: improving the health of your gut microbiome and supporting your liver in its detox efforts. (Both the gut and the liver help break down and eliminate excess hormones from the body.) To support your microbiome, I recommend incorporating fermented and high-fiber foods and taking a high-quality probiotic. To help the liver flush estrogen from the body, incorporate cruciferous vegetables — like broccoli, broccoli sprouts, cauliflower and Brussels sprouts — into your diet and take a liver detoxifying supplement.
Once you’re cycle is restored, you can move to The Cycle Syncing Method™ to protect your hard earned hormonal balance.
Always remember that once you have the right information about how your body really works, you can start making health choices that finally start to work for you. You can do this – the science of your body is on your side!