Polycystic Ovary Syndrome (PCOS) is an endocrine and reproductive disorder that affects roughly 1 out of 10 women in the United States. PCOS is diagnosed by having two out of these three criteria: having high androgens (such as testosterone) in the body, irregular menstrual cycles, and/or cysts surrounding the ovary. Since PCOS is often associated with insulin resistance, it is now viewed mainly as an endocrine disorder. Appl
Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels by facilitating the uptake of glucose from the bloodstream into cells. Insulin resistance is a condition in which the body's cells become less responsive to the effects of insulin, leading to impaired glucose metabolism or high blood sugar. Consequently, many people with PCOS are advised by clinicians to follow a low-carbohydrate diet to manage their blood sugar levels and “just lose weight”. This blog post will review why this messaging is not only unnecessary, but harmful to some people.
The Downsides of a Low-Carbohydrate Diet for PCOS
Low-carbohydrate diets are popular among people with PCOS because they are believed to reduce insulin resistance, lower blood sugar levels, and promote weight loss. While this may temporarily reduce blood glucose and cause weight loss in some folks, the long-term effects can be detrimental to one’s health.
Firstly, low-carbohydrate diets may lead to nutrient deficiencies, particularly in fiber, vitamins, and minerals. Carbohydrates are the primary source of fiber in the diet, and fiber is essential for gut health, satiety, and glucose metabolism. A lack of fiber may also worsen constipation, a common symptom of PCOS. Moreover, low-carbohydrate diets may limit the intake of fruits, vegetables, and whole grains, which are rich in antioxidants, phytochemicals, and fiber. These nutrients are crucial for reducing inflammation, improving insulin sensitivity, and preventing chronic diseases.
Low-carbohydrate diets may also increase the risk of disordered eating, binge eating, and emotional eating. People with PCOS who have a history of dieting or eating disorders may be particularly vulnerable to these risks. Both research and our client’s lived experiences show that restriction is the main reason why people end up binge eating or feel out of control around food. If we told you that you could never enjoy bread again, what do you imagine you would think about all day? Bread. Moreover, low-carbohydrate diets may trigger cravings, mood swings, and fatigue, which may affect mental health and overall quality of life.
Lastly, low-carbohydrate diets may not be necessary or effective for everyone with PCOS. While insulin resistance is a hallmark of PCOS, not all people with PCOS have the same degree of insulin resistance or re
spond to low-carbohydrate diets in the same way. When we work with people who have PCOS, we focus on eating a balanced diet that includes carbohydrates, protein, fiber, and fat, and emphasize food quality, timing, and variety.
The Non-Diet Approach to PCOS and Carbohydrates
The non-diet approach is a paradigm shift from traditional dieting and focuses on self-care, body neutrality, and behavior change. This compassionate approach recognizes that health is not only about weight or food choices but also about social, emotional, and environmental factors that influence well-being. When working with clients, I promote flexibility, autonomy, and pleasure in eating, rather than rigid rules, guilt, and shame.
The non-diet approach can be particularly helpful for people with PCOS who have been chronic dieters and do not want to restrict food anymore. Instead of cutting out carbohydrates, the non-diet approach encourages balancing carbohydrates with protein, fat, and fiber while enjoying fun foods for pleasure and satisfaction. This approach helps to stabilize blood sugar levels, reduce inflammation, and promote satiety and satisfaction.
Here are some practical tips for using the non-diet approach to PCOS and carbohydrates:
Choose carbohydrates that are high in fiber, such as vegetables, fruits, whole grains, and legumes.
Pair carbohydrates with protein, fat, and fiber to slow down digestion and absorption, such as adding avocado or cheese to a salad, or having a fruit smoothie with Greek yogurt or chia seeds.
Include protein-rich foods in every meal and snack, such as eggs, chicken, fish, tofu, or beans.
Choose unsaturated fats, such as olive oil, nuts, seeds, and fatty fish, to provide energy and support hormone production.
Aim for a variety of colors, flavors, and textures in your meals, and try new recipes and cuisines to prevent boredom and increase enjoyment.
Stuck on snack ideas? Check out our handout on PCOS-friendly snacks which includes a recipe for a creamy, high protein dip.
Low-carbohydrate diets may have some drawbacks, such as nutrient deficiencies, disordered eating, and limited effectiveness. The non-diet approach to PCOS and carbohydrates offers a more balanced, flexible, and sustainable approach to blood sugar management and overall health. By pairing carbohydrates with protein, fat, and fiber, people with PCOS can enjoy a wide range of foods without compromising their well-being. If you have PCOS and want to adopt a non-diet approach to your eating habits, book a free discovery call with Katy Zanville Nutrition Therapy.