PCOS/PCOD

PCOS Diet Suggestions in an Indian Context

PCOS is a common lifestyle disorder with a prevalence ranging from 2.2% to 26%. Metabolic risk factors that play a key role in the pathophysiology of PCOS include hyperinsulinemia, hyperandrogenism, low-grade inflammation, and an unhealthy diet. The Indian diet is naturally very high in simple carbohydrates the consumption of which leads to acute hyperglycemia contributing to low-grade inflammation and oxidative stress. This contributes to the pathophysiology behind PCOS.

Identifying the association between diet and inflammation and its combined effect on health makes it imperative to adopt a healthy nutritional approach both, as a primary preventive and as a therapeutic option in PCOS patients. Women should try to maintain a PCOS diet chart to ensure that they are including adequate essential nutrients and variety of foods to prevent diet fatigue. The diet options for PCOS must be customized for women based on their individual BMI and BMR parameters.

Low Glycemic Index Diet

The glycemic index (GI) assigns a number to carbohydrate-rich foods according to how much each food increases blood sugar. Essentially, it compares how much a food item raises blood glucose levels with how much pure glucose raises blood glucose. Food with low GI raises blood glucose levels in the body, slowly as compared to those with a higher GI.

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The Low GI index ranges from 1 to 55. This includes food like:

  • Vegetables – Green leafy vegetables (spinach, cabbage, kale), mushrooms, tomatoes, okra
  • Pulses – Kidney beans(rajma), lentils (masoor, moong), chickpeas(chana)
  • Cereals – Barley, Pearl Millet (bajra), oats, brown rice
  • Fruits – Cherries, strawberries, apple, pear
  • Dairy – Curd, low-fat milk

Fish and other seafood are good alternatives to chicken/red meat for those with a mixed diet. Although chicken and red meat do not have a GI (they have no carbohydrates), the antioxidant and vitamin benefit in fish and seafood would be much greater as compared to the former.

Limitations with the GI Diet:

  • GI values don’t reflect the exact quantity you would eat of a particular food. Somebody would need to eat a large quantity of a high GI value food (has less digestible carbohydrates) for it to significantly increase their blood glucose level.
  • It gives limited information regarding the other nutritional components of a food item.

Even a moderate reduction in dietary carbohydrates have helped to reduce the fasting and postprandial insulin concentrations among PCOS patients, which over time, may improve reproductive/endocrine outcomes.

DASH Diet

Dietary Approaches to Stop Hypertension (DASH) diet was originally developed to control high blood pressure levels. However, studies have observed its benefits in patients suffering from PCOS. A 2013 Journal of the Academy of Nutrition and Dietetics review found that when obese and overweight PCOS patients followed a DASH eating pattern for 8 weeks, it resulted in lowered insulin resistance, serum hs-CRP levels, and abdominal fat accumulation.

What are the principles of this diet?

  • Eating vegetables, fruits, and whole grains is encouraged.
  • Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils.
  • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.
  • Limiting sugar-sweetened beverages and sweets.
  • It is important to choose foods that are low in saturated and trans fats and sodium but rich in potassium, calcium, magnesium, fiber, protein.

Limitations of the DASH diet:

  • It focuses on drastically reducing sodium consumption, which is difficult to follow on a long-term basis.
  • Measuring portions and counting servings of foods that fall into different categories is tedious.

Anti-Inflammatory Diet (Mediterranean Diet)

The Mediterranean diet is based on the traditional cuisines of Greece, Italy, and other countries that border the Mediterranean Sea. The diet is rich in antioxidant and anti-inflammatory properties which makes it ideal for PCOS patients.

Which foods does this include?

  • Vegetables – Tomatoes, carrots, spinach, onion, sprouts, broccoli, cucumber, potatoes.
  • Fruits – Banana, apple, strawberry, dates, oranges
  • Dairy – Curd, cheese
  • Cereals – whole wheat (Atta) bread and chapati, whole wheat pasta, oats, barley, buckwheat
  • Legumes – Lentils, chickpeas

This diet also recommends the consumption of fish, seafood, eggs, and chicken, along with replacing vegetable oil with olive oil.

Limitations of the Mediterranean Diet

  • Does not follow a particular calorie-based or nutrition-based structure.
  • Poor availability and high cost of the suggested foods makes it hard to follow in an Indian market.

Author

Rupali Sachdev

Rupali Sachdev is an intern doctor at Grant Medical College and Sir JJ Group of Hospitals in Mumbai. With experience in writing, design, medical technology, public speaking, and social service, she believes that doctors need to broaden their horizons and look at patient care more holistically.

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