September is Polycystic Ovarian Syndrome Month, and while this is a condition that is hard to treat, as hormones go into overdrive and create symptoms throughout the body, there are dietary ways to alleviate some of the worst symptoms, and most of the foods doctors recommend are plant-based.

What is PCOS?

PolyCystic Ovarian Syndrome, also known as PCOS, is one of the most common endocrine disorders among women of childbearing age. In the United States, 1 in 10 reproductive-age women will experience PCOS in their lifetime.

The syndrome is thought to be caused by hormonal imbalance, which is linked to metabolism problems that may affect a woman's overall health, reproductive health, and appearance. Specifically, PCOS patients are likely to have high levels of androgens, or testosterone, which in turn can lead to symptoms such as excess body hair or Hirsutism, and cystic acne, irregular or painful menstrual cycles, or small cysts on the ovaries, that only show up on an ultrasound. Moreover, 80 percent of PCOS patients tend to be overweight or have excess fat around the belly, which leads to difficulty processing the hormone, insulin. Because of the excess weight associated with the condition, PCOS patients can often have higher rates of sleep apnea, joint pain, and trouble with conceiving.

Some foods have been shown to help manage PCOS

While there are medical and pharmaceutical treatment options to manage symptoms, lifestyle changes are key to long-term success when treating PCOS, and dietary changes are often recommended as the first intervention. Dr. Shebani Sethi Dalai, MD, MS, the Founding Director of Stanford’s Metabolic Psychiatry Clinic, and Silicon Valley Metabolic Psychiatry advises that patients need to focus on the connection between metabolic function and mental health as well, to help come up with a strategy for dealing with PCOS by reducing inflammation and insulin resistance through food choices.

“Research shows that healthy eating and physical activity can help manage symptoms of PCOS,” says Dr. Sethi Dalai. “This includes blood sugar and insulin resistance, which we often see in PCOS and is a cause for infertility in young reproductive-age women.”

Food choices matter when dealing with PCOS, according to a study published in the International Journal of Reproductive Medicine, which examined the relationship between a Healthy Eating Index (HEI) and PCOS. Researchers found that the consumption of whole grains, plant proteins, and fewer refined grains was associated with a lower risk of PCOS in women ages 20-40. Here are the six best foods to eat if you are dealing with PCOS.

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1. Cruciferous vegetables to lower insulin resistance

Green leafy veggies like broccoli, brussels sprouts, and cabbage are filled with tons of magnesium, which are incredibly helpful in tackling insulin resistance, seen in many individuals with PCOS. One study published 2019 in Food Science & Nutrition found that increasing dietary fiber and magnesium may assist in reducing insulin resistance and hyperandrogenemia (the increased production of androgens, common in women with PCOS). Leafy greens, such as spinach, collard greens, and mustard greens contain high amounts compared to other vegetables. One cup of cooked spinach has 157mg of magnesium (37% DV). Leafy greens are also filled with nutritious vitamins and minerals, such as iron, manganese, and Vitamins A, C, and K.

“Fibrous, non-starchy green vegetables can be consumed with each meal. They are helpful in reducing blood sugar and they add to the magnesium daily value needed,” adds Dr. Sethi Dalai.

2. Legumes for fiber, protein and lowering insulin resistance

This family of nutrient-dense plants of chickpeas, beans, lentils, peas, and soybeans are loaded with rich fiber, protein, and zero cholesterol. A 2018 study published in Nutrients examined the association between certain beans and pulses in effectively reducing insulin resistance. Findings supported how legumes such as soybeans and pulses are known to be beneficial for diabetes management as a result of their low glycemic index, which leads to a low rise in blood sugar after consumption. Research shows that women who have PCOS have a higher risk of developing type 2 diabetes, due to high glucose levels and insulin resistance. Lentils and chickpeas can be an easy protein boost to your plant-based tacos, salads, and soup!

3. Healthy fats to keep insulin in check and get essential Omega-3s

Unsaturated fats have been proven to balance hormones and optimize insulin levels in women with PCOS. Healthy fats such as certain nuts and seeds are filled with Omega-3 fatty acids, which has abundant health benefits for the body and the brain. A study published in 2017 in Experimental and Clinical Endocrinology & Diabetes found that supplementing with omega-3 fatty acids for 12 weeks drove a reduction in testosterone levels and improved insulin resistance in women with PCOS, through a randomized double-blind placebo-controlled trial.

“Use healthier, less processed oils such as olive or avocado oil with higher heat cooking. Try eating avocado in your salad or with your breakfast. Your breakfast should have adequate fat and protein, such as egg (or substitute a plant-based protein if you are vegan) and avocado,” says Dr. Sethi Dalai.

4. Colorful berries for antioxidants to fight inflammation

Findings from a 2018 study published in The Journal of Metabolic Diseases supported evidence that oxidative stress and decreased antioxidant status are often linked with PCOS. Colorful berries are extremely beneficial for patients with PCOS as they are filled with antioxidants that may help reduce oxidative stress. They also help control free radicals, unstable molecules that can cause damage to your body when in high amounts. Berries contain polyphenols, which have been shown to help in the management of weight, diabetes, and indigestion. Highbush blueberries (560mg), blackberries (260mg), and strawberries (235mg) are some of the colorful berries highest in polyphenols.

“Berries are a good fruit choice because they are high in fiber and low in sugar compared to other fruits like mango, watermelon, or banana,” says Dr. Sethi Dalai. They can also serve as a healthy dessert option.”

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5. Probiotics that are healthy fiber-filled foods to boost gut health

The gut microbiota is the largest population of microorganisms in the human body, which reside in the intestine. Research has shown that gut microbiota can cause insulin resistance and may contribute to the development of PCOS by impacting energy absorption, the brain-gut axis, and much more. A 2020 study explored the consumption of probiotics to treat PCOS. Findings from the research suggested that probiotics can be used to regulate gut microbiota and treat metabolic diseases, which also points to a new therapeutic direction for the treatment of the metabolic abnormalities associated with PCOS. While many dairy products are filled with probiotics, there are a multitude of fermented vegan options such as sauerkraut, pickles, kimchi, and kombucha.

6. Whole grains instead of simple carbohydrates to regulate blood sugar

A study published in 2018 in the European Journal of Endocrinology supported evidence that women with PCOS are at high risk of contracting type 2 diabetes than their counterparts. Whole grains high in fiber, such as rolled oats, bulgur, quinoa, and buckwheat, are slow-release carbohydrates. This means that they have a “low glycemic index”, releasing sugar into the blood at a slower, more regular pace. Therefore, they are less likely to cause spikes in blood sugar levels. They will also give you a boost of energy and keep you satiated for long periods of time.

“If you are choosing between simple versus complex carbohydrates, always choose complex since the glycemic index is lower,” adds Dr. Sethi Dalai. “While whole grains are higher in fiber, I would not recommend excessive consumption for someone with insulin resistance.”