Should Women with PCOS Follow a Low Carbohydrate Diet?
Updated September 03, 2013.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
It has long been hypothesized that women with PCOS follow a low carbohydrate diet, due to the association with insulin resistance and diabetes. This was controversial for many years, and many physicians and researchers debated the usefulness of a low glycemic index in managing weight loss and diabetes risk in women with PCOS. A study published in the American Journal of Clinical Nutrition actually put this question to the test in 2010, and found evidence to support the use of this specialized diet.
The women who participated in the study were between the ages of 18 and 40, and were diagnosed with PCOS using the Rotterdam criteria by their gynecologist or endocrinologist. Women who were taking metformin were still eligible, though women who were taking anti-depressants, cholesterol-lowering medication or the birth control pill, and women who had diabetes or depression were excluded from the study. The women were assigned to different categories depending on their BMI and whether or not they were taking metformin and were instructed to follow either a low fat, low glycemic index (GI) carbohydrate diet, or a low fat, otherwise healthy diet with moderate to high glycemic index carbohydrates.
The women were followed for a period of a year, or until they lost 7% of their body weight. Follow up consisted of frequent visits with a registered dietician, during which the women were weighed and given dietary education. Blood samples were also taken at the beginning and end of the study to measure cholesterol, testosterone, sex hormone-binding globulin and other hormones.
Glucose tolerance testing was also performed. Finally, women were instructed to keep track of their menstrual cycles to see if they became regular, and to take a questionnaire designed to assess their perception of their quality of life.
Of the 96 women who started the study, 50 were assigned to the low GI diet group and 46 women were assigned to the moderate to high GI diet. While all participants reached their weight loss goal, 41% of the low GI dieters and 50% of the regular GI dieters failed to reach that goal within the specified one year goal. It was also found that women who followed the low GI diet had better insulin sensitivity, reported more regular menstrual cycles, and rated higher improvements in their quality of life. Women who took metformin in addition to following a low GI diet had significantly higher improvements in their glucose tolerance testing as well.
So what does this mean for a woman with PCOS? Well, while the results are promising, keep in mind that only a few women were studied and many more studies are needed to fully evaluate the relationship between diet and PCOS. If, however, you are struggling to lose weight, regulate your menstrual cycle or deal with hormonal abnormalities or insulin resistance, talk to your doctor about the possible benefits of following this type of diet. If you are given the okay to proceed, ask for a referral to a nutritionist or registered dietician to help you create healthy meal plans. You’ll want to make sure that you are getting sufficient levels of crucial vitamins and minerals, and seeing a specialist can help. It can also be useful to keep track of how you are feeling – keep an eye on your weight, period dates and even other hormone levels (if your doctor runs these tests). Make sure to give it a few months before deciding whether it’s working for you.
Source:
Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Am J Clin Nutr. 2010 Jul;92(1):83-92. Epub 2010 May 19.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
It has long been hypothesized that women with PCOS follow a low carbohydrate diet, due to the association with insulin resistance and diabetes. This was controversial for many years, and many physicians and researchers debated the usefulness of a low glycemic index in managing weight loss and diabetes risk in women with PCOS. A study published in the American Journal of Clinical Nutrition actually put this question to the test in 2010, and found evidence to support the use of this specialized diet.
The women who participated in the study were between the ages of 18 and 40, and were diagnosed with PCOS using the Rotterdam criteria by their gynecologist or endocrinologist. Women who were taking metformin were still eligible, though women who were taking anti-depressants, cholesterol-lowering medication or the birth control pill, and women who had diabetes or depression were excluded from the study. The women were assigned to different categories depending on their BMI and whether or not they were taking metformin and were instructed to follow either a low fat, low glycemic index (GI) carbohydrate diet, or a low fat, otherwise healthy diet with moderate to high glycemic index carbohydrates.
The women were followed for a period of a year, or until they lost 7% of their body weight. Follow up consisted of frequent visits with a registered dietician, during which the women were weighed and given dietary education. Blood samples were also taken at the beginning and end of the study to measure cholesterol, testosterone, sex hormone-binding globulin and other hormones.
Glucose tolerance testing was also performed. Finally, women were instructed to keep track of their menstrual cycles to see if they became regular, and to take a questionnaire designed to assess their perception of their quality of life.
Of the 96 women who started the study, 50 were assigned to the low GI diet group and 46 women were assigned to the moderate to high GI diet. While all participants reached their weight loss goal, 41% of the low GI dieters and 50% of the regular GI dieters failed to reach that goal within the specified one year goal. It was also found that women who followed the low GI diet had better insulin sensitivity, reported more regular menstrual cycles, and rated higher improvements in their quality of life. Women who took metformin in addition to following a low GI diet had significantly higher improvements in their glucose tolerance testing as well.
So what does this mean for a woman with PCOS? Well, while the results are promising, keep in mind that only a few women were studied and many more studies are needed to fully evaluate the relationship between diet and PCOS. If, however, you are struggling to lose weight, regulate your menstrual cycle or deal with hormonal abnormalities or insulin resistance, talk to your doctor about the possible benefits of following this type of diet. If you are given the okay to proceed, ask for a referral to a nutritionist or registered dietician to help you create healthy meal plans. You’ll want to make sure that you are getting sufficient levels of crucial vitamins and minerals, and seeing a specialist can help. It can also be useful to keep track of how you are feeling – keep an eye on your weight, period dates and even other hormone levels (if your doctor runs these tests). Make sure to give it a few months before deciding whether it’s working for you.
Source:
Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Am J Clin Nutr. 2010 Jul;92(1):83-92. Epub 2010 May 19.
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