PCOS: Simple Tips to Improve Insulin Resistance Through Diet
This blog is all about PCOS and insulin resistance and how you can start managing it through diet.
Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age. Its main defining feature is an imbalance of sex hormones and insulin. Currently, 8-13% of women are diagnosed with PCOS; however, many women don’t know they have the condition until they find themselves struggling to fall pregnant. Around 70% of women are currently going undiagnosed, likely due to complex diagnostic criteria.
Common PCOS Symptoms
Periods and fertility
- Irregular, infrequent or no periods
- Polycystic ovaries
- Difficulties falling pregnant
The body
- Excessive growth of dark or coarse hair on the face and chest, known as hirsutism
- Hair thinning or hair loss
- Acne
- Darkening of the skin
- Rapid weight gain
- Difficulty losing weight
Mental wellbeing
- Anxiety/depression
- Poor self-image
- Mood changes
One of the main features of PCOS is insulin-resistance (IR).
What is Insulin Resistance and Why Is It Important In PCOS
Insulin is the hormone that controls blood glucose (a type of sugar) levels. When you digest carbohydrate-containing foods such as starchy vegetables, grains, lentils, beans, sugary drinks and treats glucose is released into your bloodstream, increasing its levels in your blood. This increase signals the pancreas to release insulin. Insulin tells cells in your body to absorb glucose and use it for energy. For most women (65–70%) with PCOS, their cells can’t utilise insulin properly, this is known as IR. Because of this, the glucose level becomes too high. To compensate, even more insulin is released to lower glucose levels.
High insulin levels can result in ovaries producing androgens (male sex hormones), particularly testosterone. In addition to the ovaries producing more androgens, high insulin levels can lead to weight gain, irregular periods and fertility problems. The management of IR can help ease these symptoms and reduce the likelihood of developing Pre-Diabetes, Type 2 Diabetes, and Cardiovascular Disease.
What Foods Impact Insulin Resistance
Diets high in refined carbohydrates (also known as high glycemic carbohydrates), such as sugary treats, and highly processed grains – think white bread, pasta and white rice can exacerbate IR making it harder to control PCOS symptoms. These foods contain carbohydrates that are quickly and easily used by the body for energy, resulting in a fast rise in blood glucose levels. Consequently, women who eat a diet high in refined carbohydrates are likely to have frequently high glucose and insulin levels.
How Diet Helps Manage Insulin Resistance
The good news is healthy lifestyle changes are very effective at managing IR and PCOS symptoms. The goals when it comes to diet are to 1). Reduce the amount of glucose entering the bloodstream at a given time and 2). Keep glucose levels at a constant healthy level throughout the day.
There is no one dietary approach that is proven as best for managing IR in women. However, below are several possible eating patterns that have positive effects on IR in women with PCOS.
The DASH Diet (Dietary Approaches to Stop Hypertension)
The DASH diet is similar to the Mediterranean diet style which is a popular eating pattern to reduce inflammation and improve heart health.
A recent scientific review concluded that the DASH diet could be one of the best diets for women with PCOS, as it significantly improved IR. The DASH Diet was originally designed as life-long management for the treatment and prevention of high blood pressure. It’s a diet rich in fruits, vegetables, whole grains, nuts, legumes, low-fat dairy and low in saturated fat, cholesterol, red and processed meats, refined grains and sweets. It’s relatively easy to follow, making it an easy dietary regime to implement.
Change the types and amounts of carbohydrates
As previously mentioned, the types of carbohydrates eaten can have an impact on IR and PCOS symptoms. Diets containing low GI carbohydrates like brown rice, sweet potato and wholegrain bread have shown to improved insulin sensitivity and lower blood glucose. Low GI carbohydrates take a while to breakdown, resulting in glucose slowly being absorbed into the bloodstream. This slow absorption reduces the amount of glucose in the blood, reducing the amount of insulin released. Low GI foods also contain lots of fibre, helping you stay fuller for longer.
Making simple food swaps is a good start when it comes to improving your IR and PCOS symptoms.
Try swapping:
- White bread for wholegrain bread.
- Plain pasta for wholemeal pasta.
- Baked potato for sweet potato.
- Sweetened beverages for herbal tea.
- White or Jasmine rice for brown rice.
The number of carbohydrates eaten throughout the day also matters. There is no need to heavily restrict your carbohydrate intake or start eating a ketogenic diet. Evidence does suggest, however, that reducing the number of carbohydrates eaten does improve IR. It can be as simple as having one slice of toast for breakfast instead of two, eating a protein-rich open sandwich at lunchtime and making sure there is just one portion of carbohydrates on your plate at dinner time. Where possible have small amounts of carbohydrates throughout the day, this will reduce the likelihood of your blood glucose and insulin levels spiking too much.
There is evidence to suggest that how much you eat and when could also help. A study found that women who had PCOS who ate most of their calories at breakfast, compared to women who ate most of their calories at dinner saw a 56% decrease in IR and a 50% decrease in testosterone by the end of the study. Those who ate the majority of their calories at dinner time had higher IR and testosterone levels throughout.
Top tips to get you started
This is a lot of information to take in at once. So, here are a few simple tips to get you started in taking control over your IR and PCOS symptoms.
- Eat a balanced diet rich in fruit, vegetable and whole grains. Why not give the DASH or Mediterranean Diet a go?
- Try eating most of your calories at breakfast and reducing the number of calories you eat throughout the day. If this is too difficult, then try evenly spreading your meals out throughout the day instead.
- Where possible swap high GI carbohydrates for Low GI carbohydrates.
- Exercise for 30 minutes every day. A brisk walk around the block will get your heart rate up, helping to move glucose into your cells where it will be used for energy. Exercise also helps improve insulin sensitivity.
- Get a good night sleep. It’s amazing what a good night’s rest can do. It helps our bodies rest and recover, improves mental health, and increases insulin production for the next day.
Remember that this blog is for educational purpose only and these are general tips. This is not a substitute for individual medical or nutrition advice.
Written by Vitoria Ferguson for Women’s Health Dietitian