What is the recommended diet for Polycystic Ovary Syndrome (PCOS)?

Optimal Diet for Polycystic Ovary Syndrome (PCOS)

A balanced dietary approach with an energy deficit of 30% or 500-750 kcal/day (1,200-1,500 kcal/day), focusing on low glycemic index foods, adequate magnesium and zinc intake, and limiting fat to 25-30% of calories is recommended for women with PCOS. 1

Dietary Composition Recommendations

Macronutrient Distribution

• Carbohydrates (40% of total energy) 2

  • Focus on low glycemic index carbohydrates 1, 3
  • Limit sugar and refined carbohydrates 4
  • Divide food intake into small, frequent meals with higher caloric intake at breakfast 4

• Protein (30% of total energy) 2

  • Ensure adequate protein intake to prevent deficiencies (36.7% of women with PCOS are at risk of protein deficiency) 5

• Fat (30% of total energy) 2

  • Limit saturated fat to <7% of total calories 1
  • Avoid trans fats completely 1
  • Increase omega-3 fatty acids through fish consumption (4 times/week) or supplements 4

Micronutrient Focus

• Increase intake of:
  • Magnesium and zinc (commonly deficient in PCOS) 1, 5
  • Calcium (average intake in PCOS patients is only 634 mg) 5
  • Folic acid (70% of women with PCOS have insufficient intake) 5
  • Vitamin D (average consumption is only 3.4 μg) 5
  • Vitamin C (36.7% of PCOS patients have insufficient intake) 5
  • Vitamin B12 (26.7% of PCOS patients have insufficient intake) 5
  • Dietary fiber (aim for >25g daily; 83.3% of PCOS patients consume insufficient amounts) 5

Anti-Inflammatory Dietary Patterns

The most recent evidence supports focusing on anti-inflammatory dietary patterns 1, which may include:

• Mediterranean Diet approach 6

  • Rich in fruits, vegetables, whole grains, legumes
  • Moderate amounts of fish and seafood
  • Limited red meat
  • Olive oil as primary fat source

• DASH Diet (Dietary Approaches to Stop Hypertension) 7

  • Has shown benefits in PCOS management
  • Emphasizes fruits, vegetables, whole grains, lean proteins

Weight Management

• A modest weight reduction of 5-10% can significantly improve:

  • Insulin resistance
  • Hyperandrogenism
  • Menstrual function
  • Fertility outcomes 1, 4

• Weight management should be achieved through:

  • Caloric deficit of 500-750 kcal/day 1
  • Daily caloric intake of 1,200-1,500 kcal/day 1

Exercise Recommendations

Exercise should be combined with dietary modifications for optimal results:

• Frequency/Duration: At least 60 minutes of moderate to vigorous activity daily 1
• Type: Combination of aerobic and resistance exercises 1
  • Weight training recommended 3 times per week 1
• Benefits: Improves insulin sensitivity even without significant weight loss 1
• Duration of Program: Longer durations (24 weeks vs. 12 weeks) show greater metabolic benefits 1

Important Considerations

• Insulin Resistance: A key factor in PCOS pathogenesis that should be targeted through diet 3

• Avoid Common Pitfalls:

  • Excessive saturated fat intake (70.4% of PCOS patients consume too much) 5
  • High sugar consumption (50% of PCOS patients consume excessive amounts) 5
  • High cholesterol intake (40.74% of PCOS patients) 5
  • Insufficient fiber intake (83.3% of PCOS patients) 5

• No single "best" diet: The systematic review evidence indicates that no specific macronutrient composition has selective long-term advantages 7

  • Focus should be on overall healthy dietary composition to achieve energy deficit 7

Monitoring and Evaluation

• Regular assessment of:
  • Body mass index (BMI) and waist-hip ratio 1
  • Menstrual cycles (every 3-6 months) 1
  • Metabolic parameters (annually) 1

By implementing these dietary and lifestyle modifications, women with PCOS can effectively manage symptoms, improve metabolic parameters, and reduce long-term health risks associated with the condition.