PCOS and Vegan Diet
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PCOS is linked to insulin resistance, and it can put people who have it at increased risk for infertility, diabetes, endometrial cancer, and

other conditions.

A PCOS diagnosis is usually made in people who have two of these three symptoms: irregular or no periods, elevated levels of

testosterone, and “cysts” in the ovaries, which are not really cysts but follicles that have built up around the ovary because they failed to be matured into an egg

PCOS affects people of all body types (lean, overweight and obese)

PCOS research has shown that lots of women in lean bodies have it, but it remains under diagnosed, in part because most health professionals imagine it as something only the problem of big women (common belief)

Bottomline 1 –

Nobody really understands the root cause of PCOS

Bottomline 2 –

There is no one best diet, and eating vegetarian or vegan can be a great way to manage PCOS

Vegetarian and vegan diets make a lot of sense,”. Because PCOS is not one thing but a range of conditions, different people will feel better eating different things ( Minus animal fat and protein)

There are a million different ways to eat as a vegan

There are many underlying causes of PCOS but by far the most common is insulin resistance, accounting for an estimated 70% of all PCOS cases.

Insulin resistance is sometimes called pre-diabetes,

Insulin is a hormone secreted by the pancreas that is responsible for moving glucose from the blood and into the cells so that the cells can use the glucose for energy.

The insulin resistance analogy being, it is a kind of like a boat that has to knock on the door (cell receptors of the cells) so that it can dump its cargo ( the sugar into the cell). Extending the imagination further, the doors are stiff and now more power ( more insulin) is needed to open the same doors. This is what happens in insulin resistance in PCOS. To move the same amount of sugar into the cell from the circulating blood, more insulin is needed. This causes high insulin levels in the blood (hyperinsulinemia)

Insulin resistance means that the cells are no longer opening their gates to the insulin or are not responding as well to the insulin which can eventually lead to elevated sugar in the blood.

It’s a good idea to focus on foods that are low on the glycaemic index meaning that they are digested slowly and are less likely to cause rapid spikes in insulin.

Most whole, plant-based foods like vegetables, beans, legumes, and fruits are low on this scale, while more processed foods like added sugar and white flours are higher.

Because carbs are the primary driver of insulin (though protein and fat also raise insulin to a lesser extent), low-carb advocates say that cutting carbs will minimize insulin spikes. Since most plant sources of fat and protein come packaged with some carbs, skipping carbs as a vegan is harder, but by no means impossible

More importantly, there’s just no reason to think that slashing carb intake altogether is a good idea for PCOS

Many carb-rich, slow-digesting vegan foods like beans and chickpeas are full of things that are amazingly rich in fibre which has been shown to improve insulin resistance and reduce the risks of metabolic conditions associated with PCOS

By contrast, certain non-carb foods like saturated fats, which are widespread in many non-vegan keto diets, also play a role in PCOS symptoms and in fact may worsen PCOS

“If one is substituting saturated fat for low-glycemic-index carbs, then, probably this will increase inflammatory markers and insulin resistance and then increasing androgen secretion such as testosterone.

Polyunsaturated fats found in many nuts and vegetable oils, can be particularly good for insulin resistance

Saturated fat (Animal protein) can increase inflammatory markers in the blood among women with PCOS. Inflammation in turn contributes to insulin resistance. Inflammation underpins both insulin resistance and lack of ovulation in PCOS

Bottomline 3 –

PCOS should not be managed with a restrictive, carb-cutting diet.

In PCOS it is important to have insulin levels checked (not just blood sugar) as women can be insulin resistant for many years without it affecting blood sugar levels.

For women, insulin resistance leads to an increase in testosterone production which in turn leads to insulin resistant PCOS.

The most effective treatment of insulin resistant PCOS is to improve insulin function and reverse insulin resistance, by doing this testosterone levels drop and many other bodily functions improve which means it is much easier for the body to re-establish normal ovulation, normal periods and normal hormone levels.

Is low carb/high fat diet (Keto diet) any good for women with PCOS ?

And the recent resurgence of low-carb/high-fat diet trends like keto diet have created an environment where PCOS-havers are encouraged to slash their carb intake — even to rely on animal products to manage their condition.

One famous PCOS blogger writes, (verbatim)

“The best diet for PCOS includes eating animal protein,” —- Really?

“Vegan diets concentrate on the intake of grains, vegetables and fruits, which all help to ward off PCOS and its comorbidities and it can be a nice type of diet to stick to.”

Yet the more I read and watched online PCOS content, the more I realised the information on offer was so low-quality, and that it intersected with the most persistent myths about veganism, like the idea that it’s hard to get enough plant-based protein (despite being widely discredited notion, that one will never die).

Excess testosterone can cause hair growth in unwanted places (like on the face), hair loss, and acne, but not everyone will have all, or any, of these symptoms.

And most people with PCOS have some degree of insulin resistance, meaning that they don’t respond normally to insulin, the hormone that allows the body’s cells to absorb energy from food. So the body produces ever-increasing levels of insulin.

According to the traditional thought, overproduction of insulin causes the ovaries to secrete too much testosterone, which results in the lack of ovulation and other symptoms associated with PCOS

According to the modern concepts, in PCOS women, there is a central defect, meaning something is faulty with the signalling system in the hypothalamus that controls reproductive hormones.

This prevents ovulation and causes the ovaries to secrete too much testosterone. Excess insulin also signals the ovaries to produce more testosterone, so insulin spikes can worsen symptoms, or even make PCOS manifest in patients who wouldn’t otherwise show any symptoms.

Bottomline 4 –

To avoid insulin spikes that can intensify symptoms, people with PCOS are encouraged to eat a healthy, balanced diet

a low-fat, low-GI vegan diet produced significantly greater weight losses at 3 months and greater improvements in dietary intake at 6 months as compared with a standard low-calorie dietary approach.

  • Eliminate all refined sugars and refined carbohydrates:

    Refined sugars and carbohydrates are sugars and starches that have been processed into a form that no longer resembles the form found in nature. Refined sugars are the number one driver behind insulin resistant PCOS and diabetes. Refined carbohydrates also include white wheat flour found in bread, cakes, pastries, etc as well as white pasta and white rice. Same applies to soft drinks and highly processed fruit juice. Refined carbohydrates should be replaced with their whole form by eating whole grains, legumes and fruits and vegetables. It may be useful to cut all sweeteners out for a period of time until insulin levels regulate. Many women can reverse their PCOS just by following this first step! Cutting out sugars and refined carbohydrates is the biggest hurdle

  • Eat more fibre:

    Fibre helps drop the glycaemic index of our foods and it helps to flush out excess oestrogen and other hormones from the body which is important for most hormonal imbalances. Many studies have also shown high fibre diets to promote weight loss in PCOS and diabetes. All plant-based foods contain some fibre, but some are higher in fibre than others. For hormone support, cruciferous vegetables like cabbage, broccoli, cauliflower, and kale are very important to help flush out excess estrogen and other hormones from the gut. Whole grains and legumes have high fibre and should be eaten regularly for PCOS.

  • Don’t eat in between meals:

    Constant snacking and grazing is enough to deregulate insulin even with healthy eating. Every time we eat we stimulate our pancreas to release insulin. Snacking in between meals keeps our insulin high constantly. Over time constantly stimulating the pancreas to release insulin can overtax the system and lead to PCOS and diabetes. For optimal insulin levels and digestion, most people do well on 2 large balanced meals a day with no snacks or drinks between meals except water.

  • Cut out all the animal fats and trans fats:

    Women with PCOS are known to be more sensitive to AGE (advanced glycated endproducts) containing foods. AGE are molecules that cause inflammation and insulin resistance. Foods containing the highest amounts of AGEs especially when exposed to high heat (think of weekend barbeque or Turkish kebabs) that include pork, beef, chicken, butter, cheese, and processed snacks. Foods lowest in AGEs are whole grains, legumes, fruits, and vegetables. Animal Fats and trans fats are known to clog insulin receptors on the cell membranes which means insulin and blood glucose levels rise. This is why some studies suggest you can improve diabetes with a low saturated fat diet; however, these types of diets can lead to an increase in sugary food intake. The best and most sustainable results occur when cutting out refined carbohydrates as well as cutting out animal and trans fats. These groups should be replaced with whole food carbohydrates and good quality plant-based fats. If you are already into plant-based diet and consume minimal animal products, you should look at reducing trans fats that can be found in processed foods and baked goods as well as unhealthy vegetable oils and margarine, etc

  • Try intermittent fasting

    There is a strong evidence suggesting intermittent fasting is powerful in reversing insulin resistance. Intermittent fasting means that you eat within an eating window. In general, fasting up to 16 hours should be fine. Most forms of intermittent fasting suggest skipping breakfast. The most effective method is actually to skip dinner or have a lighter dinner. This ensures you have adequate digestion overnight and has better health effects long term. Intermittent fasting a few times a week can be very helpful and is a practice that can be carried out long term. Studies have shown that animal protein to be inflammatory for women with PCOS and have been shown to increase insulin resistance in PCOS. Experiment with wheat. Although wheat is a whole grain it has become highly processed and refined. It is difficult to find good wholesome wheat products that have been properly prepared Try sticking to 100% wholemeal varieties always (white varieties are refined carbohydrates) Add Resistant Starch into your diet. Resistant starch is great at lowering blood sugar levels. It is so powerful that it had a second meal effect. So you can have resistant starch for breakfast and it will also lower your blood sugar for lunch as well. Resistant starch is currently being researched as an alternative to blood sugar medication because it is so powerful. Foods containing resistant starch include undercooked or raw potatoes and other starchy vegetables (Yam) and is present in small amounts in most grains and legumes Don’t fear your food and eating. Stress is behind almost every single hormone imbalance and PCOS is no different. It can be overwhelming to be faced with the number of dietary changes that are needed in order to combat PCOS but food should be a pleasant experience. Fear around food and eating only leads to more problems long-term. Don’t stress the occasional sugary dessert or pastry or snack etc. Relax and trust your body.

  • Low GI foods: Low GI Rolled Oats - 51 Special K (UK/Aus) - 54 Natural Muesli - 40 Porridge - 58 New Potatoes - 54 Brown Rice - 50 Buckwheat - 51 White long grain rice - 50 Pearled Barley - 22 Yam 35 Sweet Potatoes 48 Instant Noodles 47 Wheat tortilla 30 Yam - 35 Sweet Potato - 48 Brown Rice 50 Buckwheat 51 Soya and Linseed bread - 36
  • Medium GI: Basmati Rice - 58 Couscous - 61 Cornmeal - 68 Canned Potatoes - 61 Chinese (Rice) Vermicelli – 58 Baked Potatoes - 60 Wild Rice - 57 Further details about above are at http://www.the-gi-diet.org/lowgifoods BBC Good food and Low GI foods Spotlight on… low-GI https://www.bbcgoodfood.com/howto/guide/spotlight-low-gi
Vivek Nama
Vivek Nama

I'm a Consultant Gynaecologist and Lead Gyn Oncologist at Croydon University Hospital. I pride myself on delivering compassionate and cost-effective care to all my patients. Patient satisfaction and experience are quintessential pillars of all my predominant decisions. With over 18 years of experience in gynaecology and gynaecological oncology, I strive to offer an evidence-based approach to my practice. It has been made effortless through my research activities and the many national and international presentations. If you are concerned about your gynaecological condition, I will be able to help you.