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Should I stop eating carbs to treat PCOS?

Should I stop eating carbs to treat PCOS?

Kindara | December 22, 2020 | Women's Health
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Polycystic Ovary Syndrome (PCOS) is a condition that impacts 1 in 10 women in the United States (1). Symptoms of PCOS often include irregular periods, acne, excess facial and body hair, and enlarged ovaries with small, fluid-filled sacs. It's caused by a hormonal imbalance — people with PCOS tend to have higher levels of androgens, a group of hormones that are responsible for, among many things, the development of "male" secondary sex charcteristics, such as hair on the chest and face. Elevated levels of androgens may also impact your ability to ovulate predictably, if at all. In spite of this, PCOS is actually highly treatable and you and your doctor can work together to put together a plan for successful pregnancy. 

Excess androgens in PCOS have also been connected to insulin resistance, another symptom of PCOS, and it also plays a role in how the syndrome functions (2). Insulin is a hormone which controls the amount of sugar in the blood, so when you're insulin resistant, sugar just accumulates in the blood, eventually leading to Type 2 Diabetes if it's not caught and treated. Diabetes is a common health issue for folks with PCOS, and carbohydrates can play a major role in keeping blood sugar high (3). So if you have PCOS, should you avoid carbs altogether? Let's take a look at what science says. 

Simple carbs versus complex carbs 

When it comes to the question of whether or not to eliminate carbs, it's actually much more complicated than just "yes" or "no." 

There's more than one kind of carbohydrate, so how much you eat is just as important as the type. Carbs can be found in many different kinds of foods, but the healthy sources of carbs come from sources like unprocessed or minimally processed whole grains, vegetables, beans, and fruits. These carbs are called complex carbs, and they give you energy, control your weight via their fiber content, may also reduce your risk of cardiovascular disease and diabetes, and help you maintain digestive health (4). 

The not-so-healthy carbs are referred to as simple carbs, and those are found in processed foods like pastries and sodas (5). It's these carbs that can lead to weight gain, high blood pressure and diabetes, and can augment the symptoms of PCOS, such as irregular periods, facial hair growth, and acne (6). 

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Dos and don'ts: PCOS and carbs 

Not only do you need carbs for the reasons mentioned above, but any kind of diet that requires the absolute elimination of something is likely to fail. "PCOS is not a one-size-fits-all condition," says Danni Allen, winner of season 14 NBC's BIGGEST LOSER and who lives with PCOS and is an advocate for awareness. "You certainly have to be more mindful of a balanced diet. Omitting carbs completely is a very difficult task and one I do not recommend. I don’t believe in elimination diets as I feel that desire/craving will come out in other ways with potentially higher calorie foods." 

Tiffany Joy Yamut, RN, co-founder of Ketogenic Buddies, has struggled with PCOS for years. Her strategy: "I embraced the importance of lowering carbohydrate intake — not stopping it." She points out that our bodies change over time, and depending on how old you are, and your level of physical activity, you might need more or fewer carbs to sustain yourself. She opted for a very low-carb keto diet. 

The ketogenic diet is high-fat, moderate-proteins, and very low carb. If you eat 2000 kilocalories a day, 20-50 grams would be carbs. This diet can significantly reduce insulin secretion (7). A 2005 pilot study of women with obesity and PCOS indicated that a low-carb ketogenic diet did have a significant improvement on their weight, hormone levels, and insulin levels (8). Keto isn't right for everyone — the long term effects of it aren't known, and if you're already someone with diabetes, liver failure or pancreatitis, it's not recommended. For Tiffany, though, it's worked. "My acne is gone. I now have regular periods. Most of all, I'm the healthiest version of myself." 

An alternative to going very low carb is going selectively low carb, focusing on those which are nutrient dense and don't trigger a high glycemic response, or a rapid release of sugar that spikes your blood sugar levels (9). "The reason carbs get a bad rap is that they cause your blood sugar to rise, and this can be problematic for women with PCOS because about 70% of women with PCOS have insulin resistance (10)," says Kelly Keating, who runs the blog PCOS Living and lives with PCOS herself.  "It is important for women with PCOS to maintain stable blood sugar levels." 

Dr. Faaria Karim, a Naturopathic Doctor and Master of Acupuncture, initially starts PCOS patients on a higher protein/lower carb diet accompanied by herbs and nutrients for a month or two. "This is aimed to bring down insulin and blood sugars back to normal levels and increased activity/exercise. This gives a kickstart in the right direction and helps with improving PCOS symptoms. Then we transition to a more whole foods based diet that allows for whole grains." 

We know that even a small reduction in weight (5%) can improve the symptoms of PCOS, including those high levels of androgens, insulin resistance, and absent or inconsistent ovulation (11). A low carb diet can facilitate weight loss, among other specific goals, says Dr. Rashmi Byakodi, health and wellness writer and the editor of Best for Nutrition. "It limits the intake of simple sugars and refined carbohydrates and facilitates the consumption of foods with a low glycemic index. By addressing some root causes like obesity and insulin resistance, a low carb diet brings positive changes in PCOS." 

Let's sum it up: quitting carbs altogether if you live with PCOS isn't the answer, but making sure you're consuming the right kind and amount of them can make an important impact on your symptoms and your health. 

As always, be sure to check in with your doctor or healthcare provider to figure out what the best diet for your body.

About the author

Chanel Dubofsky's writing on gender, reproductive health, popular culture, and religion, can be found in New York Magazine, Lilith, Rewire, Modern Fertility, Cosmopolitan, and others. She lives in Brooklyn, New York. Follow her on Instagram at cdubofsky.

References +
1

Polycystic ovary syndrome. (2019, April 1). Retrieved November 30, 2020, from https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

2 Diamanti-Kandarakis E, Papalou O, Kandaraki E.A. (2019). The Role of Androgen Excess on Insulin Sensitivity in Women. In R. Pasquali and D Pignatelli (Eds.), Hyperandrogenism in Women. Beyond Polycystic Ovary Syndrome (pp 50–64). Karger Publishers.
3

PCOS (Polycystic Ovary Syndrome) and Diabetes. (2020, March 24). Retrieved November 30, 2020, from https://www.cdc.gov/diabetes/basics/pcos.html

4

Carbohydrates: How carbs fit into a healthy diet. (202, April 17). Retrieved November 30, 2020, from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/carbohydrates/art-20045705

5

Carbohydrates: quality matters. (n.d.). Retrieved November 30, 2020, from https://www.hsph.harvard.edu/nutritionsource/carbohydrates/

6

Polycystic Ovary Syndrome (PCOS). (n.d.) Retrieved November 30, 2020, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos

9

Glycemic index for 60+ foods. (2015, February).  Retrieved November 30, 2020, from https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods

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