PCOS Nutrition: Following the PCOS Plate Method

Have you ever wondered what it means to have a “balanced” diet? Now more than ever, there seems to be an increasing number of popular diets, like keto, veganism, paleo, Atkins, and so on, that have only been further propagated by the rise of the internet, food influencers, and self-help gurus. And navigating what ‘healthy’ and ‘balanced’ mean for you can get more than a little confusing, as you Google questions like “should I eat more raw foods?” and “is cow’s milk bad for you?” with little consensus. That’s why in this article we’re going to be breaking down what a balanced diet looks like, and what an anti-inflammatory PCOS plate might consist of.

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What is a “PCOS diet”?

We have an entire article dedicated to this particular topic (including the driving factors behind PCOS, and how this can impact what foods you choose to consume more of), but in a nutshell: a PCOS diet isn’t that far off from what would generally be considered a healthy diet for the average individual. So what does that mean, exactly? Well, it typically means a fair share of carbohydrates, fats, fiber, and protein throughout the day.

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What does a balanced diet look like?

First things first: let’s define what we mean by “balanced.”

A balanced diet is one that works for you: your lifestyle, hunger cues, energy needs, and wellbeing. A great question to ask after a change is: “did that change make me feel good, increase my energy, improve my symptoms?” As to what this means you’re putting in your grocery cart each week, this will look different from person to person, depending on any preferences, allergies, and/or health considerations you have (that’s why we pair each Allara patient with their own Registered Dietitian as part of a comprehensive PCOS treatment plan).

Typically, though, a balanced diet is characterized by a mix of carbohydrates, protein, fats, and fiber.  

• Carbohydrates are best found in vegetables, fruits, and grains.  Fruits and vegetables contain great things for your body, like fiber, micronutrients (like minerals and vitamins), and antioxidants. To get enough of those precious micronutrients, we recommend aiming to fill ½ of your plate or meal volume with them. Grains offer some of the most accessible complex carbohydrates, which act as the best form of fuel for the body, and in turn aid in mealtime satisfaction and healthy blood sugar. They should make up about ¼-⅓ of one’s plate. At least half of grain consumption should come from whole grains such as brown rice, oats, whole wheat, quinoa, millet, etc. Whole grains are some of our best sources of fiber.  Carbohydrates contribute most to elevating blood sugar, which is normal and healthy after mealtime. However, having blood sugar that often increases rapidly can contribute to insulin resistance, a main driver for PCOS. When possible, pair carbs (especially high glycemic index carbs, like sweets) with protein, fat, and fiber, to prevent the spike.
• The Dietary Guidelines for Americans recommends that carbohydrates consist of 45% to 65% of your total daily calories. For the average woman eating 2000 calories a day, this would equate to 225-325 grams of carbohydrates a day. As long as you’re getting about ½ of your plate from fruits and/or veggies, and ¼-⅓ of your plate from grains, it is nearly certain that you will effortlessly reach these targets.
• Though there’s been much discussion of a high-protein, low-fat diet, versus a low-protein, high-fat diet, the fact is: both protein and fats are major components  for your health and overall diet. Protein keeps you satiated for longer and helps build muscle.
• The Dietary Reference Intake is 0.36 grams of protein per pound of body weight. If you don’t weigh yourself, not to worry – you can estimate approximately in what ballpark you might need. Athletes or active individuals may need closer to double this amount, as protein can help you build and preserve muscle mass.  
• Fat plays an integral role in maintaining and building cell and skin integrity. Additionally, approximately half of vitamins are fat soluble (meaning they are better absorbed when digested with a source of fat).
• When it comes to fat, aim to include a source at all meals (and snacks) when possible. This could mean choosing full-fat dairy, adding nuts and seeds, using dressing on vegetables and salads, or cooking in oils. Some especially nutrient-dense fats include extra-virgin olive oil, avocado oil (better for cooking), and nut or seed oils. The Dietary Guidelines for Americans recommends that fats consist of 20% to 35% of your total daily calories.
• Fiber is a type of carbohydrate that the body can’t digest. However, it is prebiotic, meaning our gut bacteria need it for fuel. Additionally, it is a wonderful regulator for gut health and regular bowel movements. It even helps prevent the resorption of cholester, thus reducing blood cholesterol labs, so remember to get in plenty of whole grains, veggies, fruits, and legumes! Lastly, it always has a place in a balanced diet thanks to its role in regulating the body’s use of sugars (helping to keep hunger and blood sugar in check).
• Women should shoot for at least 25g of fiber per day, while men need about 38g or more. This decreases to more like 20-30g for all people over the age of 50 years old.

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The PCOS Plate Method

Polycystic ovarian syndrome, commonly shortened to PCOS, is a hormonal condition that is also “multifactorial.” This means it’s caused by more than one thing: as of right now, experts believe there is an interplay between inflammation, genetics, androgen excess, and insulin resistance, of which PCOS symptoms like hirsutism (excess hair growth), acne, hair loss, unexplained weight changes, and elevated androgen levels are a result.

As well, since inflammation seems to be a characteristic of PCOS, it is worth paying attention to anti-inflammatory foods that promote healing from the inside out. Anti-inflammatory foods include colorful fruits, vegetables, plant-based proteins (like combining whole grains and legumes,beans, nuts, seeds), full-fat dairy, and nutrient-dense fats like avocado, fatty fish, and extra virgin olive oil.

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What a PCOS Plate Looks Like

So what might a PCOS plate look like? And why?

Vegetables and fruit take up half of the example plate above, and for good reason. Vegetables and fruits are both full of vitamins, minerals, and antioxidants; research indicates antioxidants help prevent free radical damage and the triggering of oxidation, “which is a form of inflammation.” As a good rule of thumb for a balanced diet, try to make this half of your plate as colorful as possible: leafy greens, bell peppers, avocados, carrots, sweet potato, berries, and eggplant are all great options that you can whip up in salads or put on a baking sheet in the oven for easy preparation. Check out Harvard’s list of anti-inflammatory superstars for a seasonal take on vegetables and fruit.

The protein portion of the above PCOS plate can include animal-based proteins or plant-based proteins. Protein can be particularly helpful for women with PCOS thanks to its role in aiding satiability, and its ability to potentially increase insulin sensitivity. Different studies have shown that a high-protein diet may be helpful in improving glucose metabolism, and decreasing high-sensitivity C-reactive protein (hsCRP) which is a marker of cardiovascular inflammation. For sources of protein, we recommend fresh meats and fish, such as chicken, beef, turkey, salmon, and tuna, as well as plant-based sources like tempeh and tofu. Note, plant based proteins must be eaten with whole grains, to ensure all of the amino acids are present to make a complete protein.

Grains, legumes, and starches are a great place to load up on your fiber, while increasing  protein and vitamin intake. At least half of the time, opt for whole grains, such as oatmeal, brown or black rice, whole-wheat bread or pasta, and quinoa. Legumes, also called pulses, are a type of vegetable that encompass chickpeas, black beans, lentils, and peanuts.

Dairy has become controversial in recent years, but a review of 15 randomized controlled trials from 2012 to 2018 found no inflammatory effect of milk or dairy products in healthy adults, or even those with health conditions like obesity, type 2 diabetes, or metabolic syndrome. On the contrary, dairy can be an excellent addition to your PCOS plate if you are looking to ovulate (which is an important step in working towards a regular period). This comes with the caveat that this finding is only for full-fat dairy foods: these have a pro-ovulation effect, while skim or low-fat dairy sources may “increase the risk of anovulatory infertility.” As such, consider high-fat dairy sources like Greek yogurt, whole milk, butter, and whole milk cottage cheese.

Oils are an excellent addition to your plate thanks to their ease of inclusion and health benefits. For instance, you can drizzle your vegetables with avocado oil during cooking preparation, add an extra-virgin olive  oil based dressing to your salad.. Nutrient dense-fats can also come from foods like full-fat dairy, fatty fish (think salmon, herring, mackerel, sardines, etc.), nuts, seeds, eggs, and more. Nuts, seeds, and fish are especially high in omega-3: an essential fatty acid. Indeed, studies indicate omega-3s have anti-inflammatory properties, and have been linked in a recent Harvard research review to increased chances of fertility among couples who may have troubles conceiving.

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Prioritizing Your Diet & Nutrition with PCOS

Though the question of what constitutes a balanced diet can be fraught with uncertainty and questions like “am I doing this right?” – it doesn’t have to be. As a good rule of thumb for finding a balanced diet, we recommend: filling your plate at least half full with vegetables and fruits, prioritizing healthy fats and high protein sources, and making an effort to include nutrient-dense oils that contain omega-3 fatty acids.

We also want to emphasize that a balanced diet is one that you feel satiated and content by. If a diet requires you to track your calories, restrict, and remove all enjoyment from your food, then it isn’t going to be positive for your physical or mental health. (Not to mention, it won’t be sustainable and may even lead to or trigger unhealthy eating habits). Instead, consider making room for more satiating, whole foods at each meal.

Finally, consider the prospect of “setting yourself up for success”: realistically speaking, what do you have time for each day? Do you enjoy cooking? Do you have a tight budget when it comes to groceries? The answers to these questions will impact what your version of a balanced diet will look like, and that’s a good thing. It means that it’s tailored to your needs, not someone else’s.

Need help cultivating a balanced diet that works for you? Get in touch with Allara to get paired with a Registered Dietitian who can help!

Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.

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