Diet and PCOS
Last Wednesday morning if you happened to be peeking through the window of my she shed, you would have found me doing happy dances as I learned about the updates on nutrition and PCOS as well as BMI.
Why? Because emerging research is showing that diet quality is an important part of the conversation and guess who is getting the spotlight? The Mediterranean Diet, of course.
A quick recap: polycystic ovarian syndrome is one of the most common hormonal disorders affecting women and is associated with increased risk of diabetes, cardiovascular disease and endometrial cancer. To our estimate, it accounts for about 80% anovulatory infertility (Group, 2008). And in addition, as we’ve discussed previously, it also has a deep impact on mood.
Because PCOS has clear metabolic implications, including insulin resistance, diet has been a point of inquiry in the research. Back in 2019, researchers looked at the role of the Mediterranean diet in PCOS severity. They tracked a few things:
BMI
Body composition
Inflammatory marker (hs-CRP)
Insulin resistance (HOMA-IR)
Male pattern hair growth
All while comparing those who had a high adherence to the Med diet vs those who did not. And here is what they found:
A higher adherence to the Mediterranean diet was associated with (Barrea et al., 2019):
Lower inflammation
Improved insulin sensitivity
Lower testosterone
Decrease in male pattern hair growth
The authors went on to conclude that:
“On this basis, it was conceivable that MD might be considered to be one of the best nutritional strategies also for the management of PCOS women.”
The next question that researchers tried to answer (and this is where things get super exciting) is: in the presence of extra weight, can diet tip the scales between being metabolically healthy vs being metabolically unhealthy?
The research group took a cohort of 94 participants and looked at the Med diet score against metabolic markers. They found that at the same caloric intake, those who had a lower Med diet score were more highly correlated with metabolically unhealthy obesity (Barrea et al., 2021). In other words, the calories weren’t the game changer, but the composition of those calories tipped the scales towards increased metabolic health even at a higher weight.
Finally, to drive this point home, I want to share a review that was done on dietary interventions and miscarriage, pregnancy rate, cycle regularity and ovulation. On all 4 fronts, the results favored the dietary intervention with the Med diet shining in pregnancy and cycle regularity. A low carbohydrate diet also showed benefit for pregnancy and menstrual regularity (Shang, Zhou, He, & Lu, 2021).
Now, you can see why I was doing happy dances for the Mediterranean diet! It’s worth noting, that most improvements took a span of 3-6 months— a reminder that nutrition is a long game vs a flash in the pan solution.
And in case you’re wondering how to increase your own Med diet score, you’ll want to focus in on the following:
whole-grain products
fruits
In good health,
Dr. Antonella
References:
Barrea, L., Arnone, A., Annunziata, G., Muscogiuri, G., Laudisio, D., Salzano, C., … Savastano, S. (2019). Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients, 11(10), 2278. https://doi.org/10.3390/nu11102278
Barrea, L., Muscogiuri, G., Pugliese, G., Alteriis, G. de, Colao, A., & Savastano, S. (2021). Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition. Nutrients, 13(11), 3925. https://doi.org/10.3390/nu13113925
Group, T. T. E.-S. P. C. W. (2008). Consensus on infertility treatment related to polycystic ovary syndrome. Human Reproduction, 23(3), 462–477. https://doi.org/10.1093/humrep/dem426
Shang, Y., Zhou, H., He, R., & Lu, W. (2021). Dietary Modification for Reproductive Health in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Frontiers in Endocrinology, 12, 735954. https://doi.org/10.3389/fendo.2021.735954
