Is a Ketogenic Diet Right for Me? Exploring Your Options with PCOS
When it comes to the textbook PCOS diet, the headlines are littered with conflicting advice – and this can be extremely confusing. The low-carbohydrate, ketogenic diet isn’t anything novel in the world of weight loss. The Atkins Diet or LCHF (low carb high fat) have been in vogue for a while now, often lauded as the answer to all our slimming qualms. But what’s the nitty-gritty science behind it, and more importantly, how can it help manage your PCOS?
What is a ketogenic diet?
In very simple terms, the ketogenic diet is a high-fat, low carbohydrate style of eating – yes, you read that properly – high FAT! Several things happen to the body when you make this dietary shift. Firstly, it improves your insulin resistance; and secondly, your body starts to use fat for fuel instead of glucose – a process that creates a by-product called ‘ketones’i. Can you see the connection now?
A low carb diet doesn’t have to be boring – oh no. You can load up on organic, grass-fed meat; bacon (can you believe it?); organic, free range eggs; lashing of butter, extra virgin olive oil, and coconut oil; oily fish like salmon and tuna; shellfish; tons of veggies, especially the green and leafy kind; and a limited amount of fruit including avocados, strawberries and blueberries. In terms of ratios, think 20 grams of carbohydrates or less per day, 50-70 grams of protein per day, and a 1:2 ratio of protein to fatii.
As with any diet, hydration is key too, so aim to drink at least ten glasses of water each day. Of course, there’s no ‘one-size-fits-all’ dietary programme for PCOS sufferers – everyone is built differently, therefore these quantities may vary from person to person. Simply view this nutritional guideline as a starting point. To put this into context for you, a day in the life of a ketogenic dieter could look something like this.
Breakfast: 3 egg omelette with spinach and ham
Lunch: Bacon, lettuce, tomato and avocado salad
Dinner: Baked salmon with asparagus
How can it help PCOS?
The ketogenic diet offers a myriad of health benefits, with schools of thought now suggesting it is the best way to manage your PCOS symptoms. Here are just some of the reasons why it’s been widely touted for supporting the physical and emotional changes your body may experience with this condition.
Aid weight loss
Where the keto diet really shines is its promising weight loss properties. This way of eating essentially recalibrates your body to burn fat as fuel, meaning it will more readily utilise your own fat stores for energy instead of glucoseiii. The ketogenic diet comes with the added benefit of stabilising your insulin levels too, which plays a significant role in keeping those pesky cravings at bay. You see, when you eat carbohydrates, your insulin levels spike and thus causes your body to crave even more carbs. As soon as you satisfy that craving, your insulin levels shoot up, and the vicious cycle continues and continues and continues. But the ketogenic diet breaks this. In a study performed on PCOS sufferers who followed a ketogenic diet for 6-months, the subjects lost 12.1% of their entire body weight and a reduction of insulin from 23.5µIU/ml to 8.2µIU/mliv. There’s proof in the pudding! Take a look at our guide to PCOS and weight loss for more information.
Alongside this, there’s also mounting research to suggest a ketogenic diet can help you feel fuller for longer, thereby supporting body weight regulation. Although scientists haven’t fully cracked why eating quality fats can improve the hunger-reduction phenomenon, with the underlying cellular and molecular mechanisms remaining ambiguous, it’s well-documented in the literature that a ketogenic diet supports appetite controlv.
Supports hormone profile
Elevated insulin will spark your ovaries to produce unhealthy levels of testosterone, which can aggravate your PCOS symptoms and lead to hirsutism, hair loss and menstrual issues. But in the aforementioned study, the subjects’ testosterone levels were significantly reduced and their luteinizing hormone (LH)/follicle-stimulating hormone: FSH ratio was considerably improved after eating a ketogenic diet for 6-monthsvi. Researchers have proposed, therefore, that this diet can restore your hormones to a harmonious equilibrium. Hormone-happy foods can also help to regulate your hormone profile.
As you may know, PCOS can often cause breakouts in bouts of hormonal acne, which can persist despite the use of topical treatments. Fortunately, this is another area the ketogenic diet truly outdoes itself, as data suggests it can indeed slash stubborn spots. High amounts of insulin can decrease levels of the IGF-1 binding protein the body. If you have PCOS, you will usually have higher levels of this compound, which can exacerbate acne. So, if you lower your insulin levels, as the ketogenic diet does, you can boost your IGF-1 stores and perfect your pores: simplevii. If PCOS-related acne is something you constantly struggle with, take a look at our suggestions for natural remedies.
Too good to be true?
In many ways, the ketogenic diet couldn’t be a better way to manage your PCOS, right? Well, not entirely. While there’s overwhelming evidence suggesting it can quash several of the condition’s problematic symptoms such as weight gain, hormone imbalance, and acne, there’s a catch-22 you should consider before diving nose deep into it.
In the first few weeks of the ketogenic diet, you may experience the infamous ‘keto flu’ – headaches, digestive issues, nausea, brain fog, drowsiness and fatigue. These symptoms are merely a result of you adjusting to a low carbohydrate diet but still challenging nonetheless. Thankfully, these feelings should pass as soon as your body learns to burn fat for energy over your typical fuel source, glucose.
Since the ketogenic diet restricts certain carbs, your fibre intake tends to diminish too (which we all know is the secret to keeping your bowel movements regular!) Much like the ‘keto flu’, this is not a pleasant side effect of the ketogenic diet, but it can be managed by eating plenty of non-starchy veggies and dark, leafy greens.
You may want to steer clear of the ketogenic diet if you have hypothyroidism – a condition that many women with PCOS also suffer with. To support the normal function of your thyroid, your body relies on the production of insulin. Therefore, significantly lowering your insulin levels, as the ketogenic diet does, may not be such a good idea. If this is the case, it might be worth sticking to a moderate carbohydrate diet insteadviii.
Hard to maintain
As with many diets, there’s an element of sacrifice and compromise – that’s a no-brainer. But the ketogenic diet can be especially restrictive and difficult to maintain. Essentially, you’re limiting a large number of carbohydrates, which are found in all sorts of ‘healthy’ food groups, including vegetables, fruits, and grains. In this way, the ketogenic diet may not be that sustainable.
So, what’s the verdict?
In many respects, the ketogenic diet seems a promising way to manage your PCOS, with plenty of scientifically-backed data championing its cause. However, be mindful that your condition is chronic, so your method of eating needs to be sustainable. Ask yourself this: can I really give up a large percentage of carbohydrates for the foreseeable future? And will I be truly happy living on such a restrictive diet? If your weight loss efforts have stagnated or PCOS symptoms are simply too much to bear, then you may want to consider the ketogenic diet for a short period of time, after which you could begin reintroducing carbohydrates to about 100 grams per day. However, lower your carbohydrate intake gradually, gently ease yourself into it, and always discuss it with your doctor. That way, you shouldn’t be hit by many of the uncomfortable side effects. Another notable point to stress is that this isn’t the only diet to effectively manage your PCOS. In fact, many sufferers find eating a low GI diet, avoiding gluten, and reducing dairy to be just as successful, so you may want to explore those options if the ketogenic diet isn’t for you.
For more information on nutrition and PCOS and other ways to manage your condition, explore our PCOS hub.
Ketone Bodies. [Last accessed 06/02/2018.] Available online: https://www.sciencedaily.com/terms/ketone_bodies.htm
Mavropoulos, J.C., et al. (2005). The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: A pilot study. Nutrition and Metabolism. (2) 35.
Yancy, W.S., et al. (2004). A lower carbohydrate ketogenic diet versus a low-fat diet to treat obesity and hyperlipidaemia. Anna Intern Med. 140: 769-777.
Mavropoulos, , (2005).
Paoli, A., et al. (2015). Ketosis, ketogenic diet and food intake control: a complex relationship. Front Psychol. (6) 27.
Kresser, C.. (2014). Is a Low-Carb Diet Ruining Your Health? J Clin Invest. [Last accessed 06/02/2018.] Available online: https://chriskresser.com/is-a-low-carb-diet-ruining-your-health/