Best Diet and Exercise for PCOS

Looking for the Best Diet For PCOS Weight Loss? One of the cornerstones of PCOS weight loss treatment includes “lifestyle changes” such as “diet and exercise”

Polycystic ovary syndrome, or PCOS, is a hormonal disorder that affects 6% to 12% of females of reproductive age in the US – that is over 5 million people! Those with PCOS often experience irregular menstrual periods, acne, excessive body hair growth, and weight gain. One of the cornerstones of PCOS treatment includes “lifestyle changes” such as “diet and exercise”. However, there are endless diet and exercise programs out there, so what does “diet and exercise” mean for someone with PCOS? What is the best diet for a person with PCOS?

symptoms of pcos

                                                                                         Symptoms of PCOS

Why are diet and exercise important in PCOS?

Those with PCOS are at a higher risk for developing insulin resistance. Insulin resistance is when the body’s cells do not respond properly to the hormone insulin. Insulin is produced by the pancreas and helps regulate the levels of glucose (sugar) in the blood. A person with insulin resistance will have higher blood sugar levels, which will put them at higher risk for developing type 2 diabetes.

Insulin resistance

                                                   Insulin resistance

Exercise can help make the body more insulin sensitive, meaning the body’s cells are more effective at absorbing sugar, combating insulin resistance and helping prevent the development of type 2 diabetes. Diet also contributes to the prevention of type 2 diabetes by avoiding high blood sugar. This shows why diet and exercise is important in PCOS, but the question remains – what are the best diet and exercise regimens for someone with PCOS?

Best Diet for PCOS

A recent paper reviewed many studies investigating diet and nutrition management of PCOS. Their results showed that it is beneficial for those with PCOS to eat less than 37% of dietary fat as part of your total daily energy intake. Of this 37%, unsaturated fatty acids were shown to be more beneficial to insulin sensitivity as well. Dietary fats can be thought of in three groups: saturated fat, unsaturated fat (which is occasionally subdivided between monounsaturated and polyunsaturated), and trans fat. These fats differ in their molecular structure, but an easy way to distinguish them is that unsaturated fats are typically liquid at room temperature (think oil) and saturated fats are solid at room temperature (think butter). The best diet for a person with PCOS will focus more on incorporating unsaturated fats, and aim to have this make up less than 37% of their overall energy intake for the day.

Saturated and unsaturated fat

                                                                                                                        Saturated vs Unsaturated fats

In terms of carbohydrates in a best diet for PCOS, this paper compared foods based on their glycemic index, which is a value assigned to foods based on how those foods affect blood sugar levels. The higher the glycemic index, the greater the effect on your blood sugar. This reviewed how foods with a high glycemic index (white bread, white rice) can contribute to insulin resistance, and foods with low glycemic index (whole grains) can be protective against the development of diabetes.

Glycemic index foods

                                                                               Glycemic Index

In terms of balancing proteins and carbohydrates for the best diet for a person with PCOS, the paper discussed how a low-carb, high protein diet did not show significant differences in terms of fasting insulin levels, insulin sensitivity, or weight loss when compared to a high-carb, low protein diet. However, the low-carb, high-protein diet did show a difference in post-meal insulin response and showed an improvement in cholesterol.

What about exercise?

Unfortunately, there is surprisingly little research into what the best exercise regimen is for a person with PCOS. Generally, 30 minutes of exercise 5 days a week is recommended. Among other benefits, aerobic exercise will help improve cardiovascular fitness and assist with weight loss, stretching helps reduce the risk of injury, endurance exercise helps to gain fitness and increase energy expenditure, and resistance training helps increase muscle strength and muscle mass. All are part of a well-balanced exercise regimen. However, the best exercise for a person with PCOS needs to be investigated further.

So, what is best for a person with PCOS?

Based on a review of scientific literature, the best diet for a person with PCOS will consist of <37% of fats per day, most of these being unsaturated fats, a higher amount of protein compared to carbohydrates, and carbohydrates with a low glycemic index. For exercise, there needs to be greater investigation into the best exercise for a person with PCOS, but generally 30 minutes of exercise 5 days a week is recommended.

Eva Shelton, M.D.

Harvard Medical School, Brigham and Women's Hospital

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