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Nutrition is one of the cornerstones for helping women with PCOS restore menstrual cycle regularity, rev up their metabolism, and reduce symptoms of androgen excess. Many of the women I see with PCOS have tried gluten and dairy-free diets, which can be quite restrictive and difficult to maintain long-term. In this month’s blog I will review the research on gluten and dairy free diets for PCOS, and offer suggestions on how to build your best diet for PCOS.

Gluten & PCOS

Many of the patients I see with PCOS have already tried eliminating gluten from their diet. Some report improvements, while others don’t notice any changes in how they feel. There are actually no research trials on gluten-free diets as a treatment strategy for women with PCOS, so it is not a blanket recommendation that I often make. If I suspect that a women has an underlying gluten sensitivity, which is independent of having PCOS, then I may recommend either reducing her gluten load or removing it for a trial period of time. Part of the benefit women notice when removing gluten is that they have lowered their overall carbohydrate load. Reducing carbohydrates to about 40% of a woman’s diet has been shown to have positive effects in managing PCOS. I generally recommend women swap refined carbohydrates such as white bread/rice/pasta, etc. for complex carbohydrates. Examples of complex carbs include steel cut oats and quinoa, starchy vegetables such as sweet potatoes, squash and beets, and low sugar fruit such as blueberries, raspberries, blackberries, strawberries, rhubarb and grapefruit.

Dairy & PCOS

There have been a small number of studies that have looked at the effect of dairy on weight loss and androgen production in women with PCOS.  Results of these studies show that a low-dairy diet helps with weight loss, improves body composition, and reduces testosterone levels. The effect is thought to be by reducing insulin secretion. However, yogurt and cottage cheese are good sources of protein, which many women do not get enough of in their diet. If a woman digests dairy well, I generally recommend including small amounts as needed to help her achieve her daily protein requirement. If she takes dairy out all together, then it is important to ensure she is getting enough calcium in her diet from non-dairy sources.

So what is the best diet to manage PCOS symptoms? It depends on each individual’s taste preferences and whether there are any additional underlying health concerns. When working with women to help them build their best nutrition plan, I start by focusing on the following foundational elements:

  • Shift away from processed & packaged foods.
  • Eat more veggies (aim for 2 cups with lunch AND dinner, or about half your plate).
  • Make sure to include enough protein with each meal (women need approximately 20-25g with each meal, or about the size of your fist).
  • Reduce (rather than eliminate), starch and dairy products. Aim for your serving of starch to be about the same size or smaller than your serving of protein.

I further tailor her nutrition plan after we’ve screened for insulin resistance, a condition affecting 65-70% of women with PCOS, and a common barrier to weight loss success. Our overall goal is to create a nutrition plan that makes a woman feel good, increases her energy, reduces sugar cravings, satisfies her taste preferences, and is one that she can follow for the long-term.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516387/

https://pubmed.ncbi.nlm.nih.gov/27925712/

https://pubmed.ncbi.nlm.nih.gov/22158730/