What is 'The Ultimate Diet' for PCOS?
Dr. Ayla Coussa
RD, MSc, PhD
Clinical Dietician, Fakih IVF Fertility Center, UAE
Dr. Ayla Coussa is a Clinical Dietician working in one of the leading Fertility Centers in the UAE. She practices as a Clinical Dietitian with a focus on fertility and pregnancy-related complications, and if that wasn’t enough, she is also pursuing her PhD with a focus on reproductive medicine.
As an ongoing advocate of public health and well-being, we asked Dr. Ayla Coussa what diet she advises for women with PCOS. Here is what she had to say.
Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Obesity has increased along with the increasing obesity-related abnormalities in the reproductive system, and which includes anovulation (irregular or absence of menstruation) and infertility. The rapid incidence of PCOS and infertility is a rising concern worldwide especially with the increased obesity rate among women. Both obesity and PCOS independently predispose women to adverse pregnancy outcomes: gestational diabetes, preeclampsia, preterm labor and higher risk of miscarriages. The prevalence rate of these medical conditions increases when both the obesity and PCOS factors coexist.
Studies have asserted the importance of preconception weight loss in obese women with PCOS on improving reproductive performance and pregnancy outcome. In this regard, different caloric restriction interventions have been tested, from specific macronutrients composition (e.g. high protein, low carbohydrate, high carbohydrate/ low fat, etc),vegetarian, ketogenic to a liquid diet. Diet interventions are also evaluated based on enhancing compliance rate and inducing an effective and sustainable weight loss. Irrespective of dietary composition, weight loss and PCOS markers are improved, but sustainability of the weight loss is not guaranteed in all diets. In my opinion, delaying fertility treatments to achieve some weight loss (if presenting with a BMI>30 kg/m2) is important as it allows for improvement in hormonal imbalance and fertility treatment success rate.
“A 5-10% reduction in body weight improves menstrual cyclicity and fertility, as well as insulin sensitivity in obese women with and without PCOS. ”
While the optimal PCOS diet is yet to be confirmed, a balanced and nutritious energy-restricted diet remains key to improve egg quality and hormonal imbalance as well as achieve sustainable weight loss.
Ayla’s Tip
“Due to the common sensation of hypoglycemia (fall in blood sugar) with PCOS, it is very important to avoid skipping or delaying your meals. This will also help to reduce your portion sizes and binge eating habits. In addition, limiting your simple sugar intake and consuming sugar-free foods in moderation, helps in reducing your cravings for carbohydrates, which is also frequent in PCOS. I believe that the best diet for you is the one customized to your nutritional needs, habits and food preferences, and which you can sustain if planning a pregnancy or eventually in pregnancy. ”
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