PCOS and a Vegetarian Diet: What are the benefits?
Have you heard that a plant-based diet may help your polycystic ovary syndrome (PCOS) symptoms but you are not sure how or why? If you are looking for ways to adapt your current diet with meal plan ideas, practical tips and evidence based information on the benefits of eating plants with PCOS then you have come to the right place. Whether you have been a vegetarian for five years or just recently looking to increase your intake of plants into your current diet then this blog post is for you.
We will explain the different types of plant-based diets, the research behind how plants can help your PCOS symptoms, specific nutrients to look out for when eating plants to ensure you are getting everything you need in a healthy and well balanced diet with PCOS, and a meal plan to start you off! So, let’s get into it.
Plant-based diets, vegetarian diets, and vegan diets
Let’s start with clearing up our understanding between these three different diets:
A plant-based diet: focusing on eating primarily from plant-based sources. This involves fruits, vegetables, whole grains, legumes, beans, oils, and nuts and seeds. This does not mean that you are strictly vegetarian or vegan. Plant-based diets can include some animal products like meat or dairy, just as a small portion of your overall food intake with the large majority of food coming from plants. Some people like to call this a flexitarian diet.
A vegetarian diet: involves removing all meat, fish and poultry from your diet. Some people choose to go pescatarian which means that they restrict all animal meat other than seafood. A strict vegetarian diet does however mean no animal meat but allows animal products where no killing of animals is required such as milk, honey, cheese, and eggs.
A vegan diet: restricts all foods produced from or by animals including chicken, meat, dairy, seafood, eggs, and even foods like honey which don’t require the killing of animals but still involves animals.
These three diets can support healthy living at every life stage and age with appropriate planning to meet your nutritional needs (1).
Plant-Based Diets and PCOS: What does the evidence say?
We understand how confusing it can be trying to filter through all the information available on what you can and can’t eat with PCOS but the good news is whilst there is no one type of diet for PCOS, there have been proven benefits to eating more plants (2). The high fibre and low GI nature of a plant-based diet as well as the plant proteins from a plant-based diet contribute to numerous benefits including improving insulin resistance, microbial diversity, inflammation, weight control, fertility, and reducing the risk of developing chronic health conditions (2). Keep reading to find out more!
Insulin Resistance
Insulin is a hormone produced by the pancreas that helps to move glucose from the blood into cells to be broken down and produce energy (3). Up to 80% of people with PCOS are resistant to the effects of insulin which means their body has to produce more insulin to compensate for this which can lead to some of the common presenting symptoms such as hormonal imbalance, irregular periods, acne and excess hair (4).
The Glycaemic Index (GI) is a ranking system used for how quickly your blood glucose rises after eating certain types of carbohydrates (4). Eating low to moderate GI carbohydrates leads to a slower rise in blood sugars which helps to reduce insulin levels and insulin resistance (4). Plant foods like oats, muesli, brown rice, quinoa, and whole grain bread are low GI carbohydrates which can help reduce PCOS symptoms caused from insulin sensitivity and have even been linked with having more regular periods (4). These whole grains also contain nutrients like folic acid, b vitamins, and more which can help with your overall health (5).Inflammation & microbial diversity
Inflammation can cause pain which is what we see in people with PCOS, heavy periods, and endometriosis. Increasing your microbial diversity has been found to strengthen the body’s immune response to inflammation (6). Increasing your fibre intake by including more plant based foods can increase microbial diversity and strengthen your anti-inflammatory response and as a result help alleviate your pain symptoms (6).
Weight Control
It is important to note that PCOS can affect people with different sizes and shapes. Insulin resistance does have the potential to lead to weight gain which can make PCOS symptoms worse as excess fat causes more insulin to be produced (5). Additionally, binge eating and cravings can make it very difficult to lose weight in someone with PCOS (6).
Eating plants has been found to help with weight control (7) which could be an added benefit to helping you with your PCOS symptoms (2). A study following over 200,000 male and females in the US for more than 20 years found that the high fibre content and low calorie nature of a plant-based diet helped with weight loss which in turn helped reduce the risk of type 2 diabetes (7).
However, it has been recognised that a general healthy lifestyle benefits PCOS symptoms independent of weight loss and therefore focus on eating well and lifestyle management is where we should put our energy towards (2).
Fertility
People with PCOS tend to have reduced fertility as a result of irregular or no ovulation (3). Eating more plants has been associated in helping with fertility. Evidence suggests that women who consume diets high in monounsaturated fat like avocados, nuts and olive oil, have higher fertility rates whilst plant proteins have been associated with lower rates of ovulation infertility (8). Additionally, evidence has demonstrated that women who consume higher amounts of non-haem iron (iron found in plant foods) are at a decreased risk of ovulatory infertility (8). Furthermore, eating more fruit and vegetables in your diet can help with oxidative stress leading to fertility benefits (8).
Reducing the risk of developing chronic health conditions
Plant-based diets have been associated with improving health outcomes with the potential to lower your risk of developing hypertension, type 2 diabetes, cardiovascular disease, and some cancers (9). This is great news as people with PCOS can be at higher risk of developing these conditions (3).
The study mentioned previously that followed over 200,000 male and females in the US for more than 20 years found that a diet high in plant foods and low in animal foods reduced the risk of developing diabetes by 20% (7). This study explained how a plant-based diet high in fibre and antioxidants can help with glucose management and insulin sensitivity (7). Additionally, a recent review discussed reductions observed in cardiovascular mortality with plant based diets as diets low in animal products can reduce your intakes of foods high in saturated fat which can then reduce inflammation (10).
Nutrients to consider with plant-based diets
Planning your plant-based eating is key to ensuring a well balanced healthy diet as some nutrients may be present in higher quantities and more accessible in animal products than plant products. Therefore, we’ve done the research on what foods can help you get these important nutrients into your diet when mainly eating plants and having PCOS.
Protein
Protein has been shown to reduce insulin and suppress androgen levels more than high carbohydrate diets in women with PCOS (2). Increased protein intakes can also help reduce appetite and energy intakes when paired with low GI foods (2).
There are lots of great plant protein foods including:
Tofu
Tempeh
Beans
Chickpeas
Lentils
Seeds
Nuts and nut butters
Quorn
Soya burgers/ sausages
Watch out with the meat substitutes like quorn and soya as even though these can be high-quality protein sources, they can be high in salt and fat so moderation is key (9). If you are including dairy and eggs in your diet then these are also good sources of protein (9).
Chickpeas: Our chickpea and aubergine stew recipe uses this versatile plant protein and can be served both warm and cold.
Beans: Our white bean dip can be great for hosting with friends or family round when paired with some cucumbers or carrots dipped in, or perhaps even on the side of salad bowls.
Plant-based protein powder: Check out our protein pancakes recipe on how to use plant protein powders in your diet.
Calcium and Vitamin D
A systematic review found that calcium and vitamin D co-supplementation in women with PCOS improved menstrual disturbances and metabolic factors over a long period of time (11). They also found that calcium and vitamin D combined improved the effect of drugs like metformin improving menstrual regulation and follicle maturation (11).
Some studies have reported that women with PCOS are at an increased risk of calcium deficiency so ensuring good calcium and vitamin D sources in a plant-based diet is recommended (2).
Dairy foods like milk, cheese, and yoghurt are great sources of calcium but if you are avoiding animal products then some plant foods high in calcium include (12):
Leafy green vegetables
Pulses
Sesame seeds
Tahini
Fortified unsweetened plant drinks with soy, pea or oat
Dried fruit
Calcium-enriched tofu
Vitamin D is needed to regulate the amount of calcium in the body (12). Therefore ensuring adequate Vitamin D intake is important too. Good plant sources of vitamin D are fortified unsweetened soya drinks and breakfast cereals (12). However, it is additionally recommended to take a vitamin D supplement during the winter and autumn months in the UK due to the lack of sunlight exposure (12). You can find out more about Vitamin D supplements and PCOS in our blog post.
Iron
Some people with PCOS have been found to have an iron overload, although this tends to be mild and there is conflicting evidence on why this happens (13). Women are more likely to be at increased risk of iron deficiency due to menstrual losses from heavy periods and the deficiency can lead to fertility problems (10). Therefore, let’s see how to ensure you can get sufficient iron in your diet from plant based foods.
Plant sources of iron include (9):
Wholegrains
Dried fruits
Green leafy vegetables
Nuts
Lentils
Peas
Beans
Seeds
The form of iron in plant foods (non-haem iron) is absorbed less efficiently than iron found in animal products (haem-iron) (9). However, you can increase the iron availability from plant foods to your body by eating vitamin C-containing fruit and vegetables at the same time like citrus fruits, berries, green leafy vegetables, and peppers (9). For example, you could drink a glass of orange juice (vitamin C) whilst eating a lentil dish (iron) paired with some green leafy vegetables (iron) and a berry fruit salad (vitamin C) for dessert.
Vitamin B12
Vitamin B12 is critical for several biological processes involved in the metabolic and reproductive features of PCOS (2). However, metformin, which is one of the drugs used to treat PCOS, has been found to reduce vitamin B12 levels as a side effect when taking this medication (14). Therefore, it is important to plan for this, especially when on a plant-based diet as vitamin B12 is not available from plants, therefore fortified foods or a supplement is how you can get adequate amounts of this nutrient (9).
Fortified plant foods like breakfast cereals, unsweetened soya drinks and yeast extracts like marmite and nutritional yeast flakes (these are great to add on top of most dishes whether it is pasta or a stew) can be a good way of helping get vitamin B12 in your plant-based diet (12).
Zinc has a role in balancing lipids and insulin resistance in women with PCOS but some studies have found women with PCOS to be at risk of being deficient (15).
Plant sources for zinc include (9):
Beans
Nuts
Mushrooms
Seeds
Wheat germ
Some fortified breakfast cereals
Zinc is like iron in terms of its absorption being reduced in plant foods compared to animal products (9). Eating foods like fermented soya (tempeh and miso), soaking and rinsing dried beans before cooking, and sprouting grains and seeds can help increase zinc absorption (9).
If you are concerned that you are not getting adequate amounts of zinc in your diet, read more about zinc supplements and PCOS.
Omega 3 fats can help reduce inflammation which is commonly seen in people with PCOS (4). However, oily fish is a very rich source for omega-3 therefore it is important to keep in mind some plant alternatives like seaweed, algae, walnuts, chia and flaxseeds (4). Try to add these into meals to aim for two portions a week (4). Walnuts, chia and flaxseeds could be added to your daily morning porridge and become a part of your everyday routine.
Check out our blog post on omega 3 supplements for PCOS if you are considering taking an omega 3 supplement.
Plant-Based Meal Plan
So now we know how plant foods can help our PCOS symptoms and which foods can help us get the nutrients that our body needs for our health, but how do we create lots of lovely meals to help us achieve all this in our day to day lives? Well, look no further, we’ve got a meal plan to start you off and you can keep an eye on our recipes and other blog posts every month for more delicious recipe ideas.
Breakfast: Berry Oats
Start your day with a bowl of low GI oats to help with your insulin sensitivity paired with a fortified and unsweetened plant-based milk. Top it off with berries, dried fruit, any seeds, and a nut butter of your choice for all the extra vitamins and minerals. The toppings make all the difference! If you’re not sure which plant-based milk to use, find out which one might be best for you in our post about plant-based milks and PCOS.
Lunch: Nourish Bowl
What’s better than a bowl packed with goodness to keep you going throughout the day. Nourish bowls are great because you can add lots of different ingredients depending on what is in your fridge.
You could start with a layer of leafy greens and low GI quinoa and top with some plant protein like calcium-enriched tofu or chickpeas. Add in some tomatoes, walnuts, cucumber or any other vegetables, nuts and seeds of your choice and top with a delicious dressing!
Dinner: Lentil bolognese
Not only is bolognese such a comforting meal but it’s also a way of adding in lots of great nutrients into your diet. Using lentils means you are getting lots of plant protein. You can use different vegetables like peppers, mushrooms, and carrots with some kidney beans bringing lots of wonderful nutrients together. Serve with some low GI brown rice and salad, all topped off with some nutritional yeast flakes for the added B12.
So what’s the bottom line on PCOS and a plant-based diet?
In summary, eating more plants has been shown to help manage PCOS symptoms by helping with insulin resistance, weight control, inflammation, hormonal and metabolic processes, fertility and your gut microbial diversity whilst also helping to reduce the risk of developing a variety of health conditions (2). As with all diets, being aware of different nutrients can encourage a well balanced and planned out diet to help you reach your goal of reducing PCOS symptoms and improving overall health whilst eating mainly plants - which if there is one takeaway from this blog post - it is possible!
If you would like 1-1 support in your PCOS journey, get in touch to book a free discovery call.