Polycystic ovary syndrome (PCOS) affects approximately one in ten women in France. This endocrine disease is due to a hormonal imbalance of ovarian and/or central origin (at the brain level), specifies Inserm. Symptoms vary from one patient to another and can be very disabling. Indeed, this pathology causes a disruption of the menstrual cycle and excessive production of ovarian androgens, particularly testosterone. This can manifest itself by ovulation disorders, hyperpilosity, acne, alopecia, weight gain, mood disorders.
The treatment of PCOS is only symptomatic, and is essentially based on an adapted lifestyle. On the occasion of World PCOS Awareness Day, this 1is September, Sophie Janvier*, dietician nutritionist, gives her advice on food.
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ELLE. – What is the role of diet in the treatment of PCOS?
Sophie Janvier. – The hormonal imbalance that causes PCOS is accompanied in most cases by resistance to insulin (a hormone that allows glucose from food to enter our cells). In these patients, the pancreas produces much more insulin to compensate for this resistance. This hyperinsulinemia promotes the production of androgens (hyperandrogenism) and greater fat storage (weight gain). In addition, several scientific studies have shown that PCOS is accompanied by low-grade inflammation, i.e. silent, somewhat sneaky inflammation.
“An anti-inflammatory and low glycemic index diet can also help patients regain their ideal weight.”
All this context leads us to say that there is certainly something to be done in terms of diet, to prevent possible cardiovascular risks, and to limit chronic inflammation as much as possible. What we can hope is that this improves general well-being. If PCOS sometimes does not create any pain, it can cause chronic fatigue and discomfort related to weight gain. An anti-inflammatory and low glycemic index diet – the two go very well together – can also help patients get back to their ideal weight.
ELLE. – What foods should we favor?
S.J. – First of all, you should know that the latest international recommendations for PCOS do not mention a specific diet, to date – other than following the health recommendations for the general population, namely adopting a balanced diet.
On the other hand, I think we can go a step further. Several studies have shown that there is an interest in controlling hyperinsulinism by helping the body to secrete less insulin. It is then necessary to consume fewer foods with a high glycemic index. We can therefore adopt a Mediterranean-type diet, with a largely plant-based diet rich in fiber: fruits and vegetables, whole grains, wholemeal bread, fiber-rich cereals (quinoa, oats, buckwheat, brown rice), pulses, and of course protein foods (lean meat, fish, eggs) or good fats (olive oil, rapeseed, etc.), which do not contain carbohydrates. The latter, in particular plant-based Omega 3 (rapeseed, walnut, flax, hemp oils; walnuts, chia seeds, flax seeds) and marine Omega 3 (tuna, salmon, mackerel, sardines, herring) also have anti-inflammatory properties.
HER. – What foods should be avoided?
S.J. – To limit insulin secretion, it is necessary to limit products with added sugars (pastries, biscuits, chocolate, breakfast cereals) as well as white cereals (white bread, white pasta, white rice).
Furthermore, it is suspected, without yet having strong evidence, that endocrine disruptors are a factor that promotes the occurrence of PCOS. Once the disease is there, it is better to limit exposure to EDCs as much as possible, by taking a few precautions (do not reheat in plastic containers, do not reuse plastic bottles, do not put aluminum foil directly on hot food, etc.)
ELLE. – Are some food supplements also effective?
S.J. – Yes, there are some dietary supplements that can be interesting. The only one that has really been the subject of scientific studies to date is myo-inositol, which improves insulin sensitivity. It promotes the consumption of glucose by the muscles rather than storage. Then, we can think that chromium could lower blood sugar when necessary, and that zinc or magnesium could play an antioxidant role. But it’s a bit on a case-by-case basis.
HER. – Do you have any other tips related to eating habits?
S.J. – It is good to start your meal with a vegetable starter to avoid a possible spike in blood sugar. Do not start the day with a breakfast that is too sweet. If you want to eat a snack with a sweet product from time to time, it is better to accompany it with a protein – a fromage blanc for example – to cushion the blood sugar, or to accompany it with fiber. This is why for a snack, it is better to eat a whole apple rather than drink apple juice.
“The goal is not to aim for perfection either, because that is the best way to give up.”
ELLE. – It can be difficult, psychologically, to submit to a diet plan. What advice would you give to women with PCOS, to experience this change in diet more serenely?
S.J. – The idea is not to have too strict restrictions. As a dietitian nutritionist, you always have to start from the way the patient eats, without changing all her habits overnight. It is a dialogue, a therapeutic alliance that we create. We see what we can do step by step, depending on what the patient wants to experience, and what can work little by little. The goal is also not to aim for perfection, because that is the best way to give up.
I also advise avoiding overly extreme recommendations, such as drinking cider vinegar before meals or absolutely refusing any sugary products. When you have a chronic condition like PCOS, it’s already not easy to live with, so it has to remain acceptable, and eating has to remain enjoyable!
“The gentle method for eating better, 33 micro-changes to rebalance your diet without depriving yourself”, Sophie Janvier (Ed. Leduc)
BOOST anti-inflammatory program (adapted to PCOS).
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