Polycystic ovary syndrome, PCOS, affects very many people; around 1 in 5 women. It can show up unexpectedly, and usually the first-identified sign is irregular vaginal bleeding. We say “vaginal” rather than “menstrual” as it’s not technically menses, although it’ll look (and can feel) the same.

Like many “affects mostly women” conditions, science’s general position is “we don’t know what causes it or how to cure it”.

Quick book recommendation before we continue:

Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn

…is a top-tier book about medical misogyny. We’d say more here, but well, you can read our review there 🙂

What doesn’t work

Since PCOS is characterized by excessive androgen production, it is reasonable to expect that foods containing phytoestrogens (such as soy) may help. They won’t. The human body can’t use those as estrogen, and in fact, consuming unusually large quantities of phytoestrogens can actually get in the way of your own (or bioidentical) estrogen, by competing for the same receptors but not really doing the job.

But, you won’t get that problem from moderate consumption of soy; the warning is more for those tempted to self-medicate with megadoses, or are opting for dubious supplements such as Pueraria mirifica ← will have to do a research review on that one of these days, but suffice it to say meanwhile, it has some serious drawbacks

See also: What Does “Balance Your Hormones” Even Mean?

What can work

There are some supplement-based approaches that actually can help, and those are the ones that rather than trying to manufacture estrogen out of thin air, work to reduce testosterone and/or reduce the conversion of free testosterone to its more potent form, dihydrogen testosterone (DHT); here are two examples:

• Licorice, Digestion, & Hormones
• One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens ← this one has the most evidence of the two

What will work

…or at least, barring additional confounding factors, what the evidence strongly supports working. Here’s where we get into diet properly, and there are three main dietary approaches:

Low-GI diet: focus on high-fiber, low-carb foods (e.g. whole grains, legumes, berries, leafy greens). Eating this way results in improved insulin sensitivity, lower fasting insulin, cholesterol, triglycerides, waist circumference, and (for women) yes, lower testosterone levels.

See: What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest

High antioxidant diet: focus on foods rich in antioxidants (e.g. vitamin A, α-tocopherol specifically, vitamins C and D, and polyphenols) as these lower PCOS incidence.

See: 21 Most Beneficial Polyphenols & What Foods Have Them

Ketogenic diet: focus on high-fat, very low-carb foods (e.g. fatty fish, dairy, leafy greens). This significantly reduces androgen levels, improves insulin sensitivity, and regulates hormones. But… It’s recommended for short-term use only due to its negative health impacts from poor (i.e. narrow) nutritional coverage:

See: Ketogenic Diet: Burning Fat, Or Burning Out?

It is also reasonable to supplement, for example:

❝Omega-3 fatty acids and vitamin D have powerful anti-inflammatory and antioxidant properties that significantly improve insulin sensitivity and reduce androgen levels in metabolic syndromes like PCOS. A higher intake of omega-3 and vitamin E also alleviates mental health parameters and gene expression of PPAR-γ, IL-8, and TNF-α in women with PCOS.

Dietary supplements, such as antioxidants like N-acetylcysteine (NAC), vitamin D, inositol, and omega-3 fatty acids, and mineral supplements (zinc, magnesium selenium, and chromium) help in reducing insulin resistance. These supplements also enhance ovulatory function and decrease inflammation in PCOS patients.

Omega-3 fatty acid supplements improve biochemical parameters LH, LH/FSH, lipid profiles, and adiponectin levels and regularize the menstrual cycle in women with PCOS. A recent RCT also indicated that probiotic/symbiotic supplementation significantly improves triglyceride, insulin, and HDL levels in women with PCOS.❞

Source: The Role of Lifestyle Interventions in PCOS Management: A Systematic Review

Want to know more?

You might like this book that we reviewed a little while back:

PCOS Repair Protocol – by Tamika Woods

Take care!

Ultraprocessed foods are a) ubiquitous in industrialized nations b) generally not fabulous for the health. See for example:

• Eat To Beat Cancer ← skipping the ultraprocessed foods is one main point
• What To Leave Off Your Table (To Stay Off This Surgeon’s) ← have a guess

Abstaining from ultraprocessed food can also be difficult psychologically, because they are generally engineered specifically to trigger certain physiological responses, often with their combination of sweet and/or salty flavors with simple carbohydrates that will zip straight into one’s veins and feel immediately rewarding, even if there is a health price to pay later.

And worse, being habituated to ultraprocessed food can make unprocessed or minimally-processed food seem less appealing:

What causes food cravings? And what can we do about them?

Fortunately, we can reverse this, and once we get habituated to unprocessed or minimally-processed food, the ultraprocessed will start to seem like not-food to us. You will wonder: how did I ever eat that crap?

Now, one other thing to bear in mind:

There is a scale of “badness”

You might recall this article:

Not all ultra-processed foods are bad for your health, whatever you might have heard

For example, Reese’s confectionary and Huel nutrition powder are both ultra-processed, but one is definitely better than the other.

See also: Are plant-based burgers really bad for your heart? Here’s what’s behind the scary headlines

Some comparisons are obvious; others, not so much. So, how to tell the difference?

The “True Food” Scale

A large study analyzed ingredient lists, nutrition facts, and prices of over 50,000 food items from Target, Whole Foods, and Walmart. Using a rigorous statistical method, they assigned processing scores and compiled data into a giant database, with results published publicly.

You can find the study here:

Prevalence of processed foods in major US grocery stores

That in and of itself doesn’t tell a lot that’s useful to the consumer, because the paper itself does not have all of the data from all 50,000 food items, just the aggregate results, trends, implications for public health, and suggestions for public health policy.

However, what does tell a lot, is the public face of the database itself, which you can browse for free, and look up your regular shopping items, if you are wondering “are these textured soy pieces basically a step away from soy beans, or a frankenfood that will murder me in my sleep?”

How it works: it examines each food, its listed ingredients, and what is known about the processedness of such ingredients. It also draws a distinction between ingredients and additives, rendering the entire process of the production of the food into an “ingredient tree”, showing what was added to what along the way. Minimally-processed foods will have barely an ingredient sapling, while ultraprocessed foods will have an ingredient tree whose branches can barely be counted, they are so numerous. It’s not just about the number of ingredients though; it’s about the processes that each underwent.

How it represents this data: you can look at the food in the database, and it’ll tell you the ingredients and nutritional facts (which you probably knew already; it’s written on the packaging), and then show you how processed it is, and then ranking that against all other foods in the database of the same kind.

So for example, if you are looking at a pizza (have you ever noticed how some are marketed with bright flashy colors, and others in natural tones to suggest minimal processing? This is marketing, not reliable information! Sometimes the product that looks healthier, isn’t!), then it’ll give it a score reflecting how it ranks compared to all other pizze in the database. This number is out of a hundred, and it reflects the percentile into which it falls.

So for example, if the score your pizza gets is 47, then that means that if you looked at it next to 99 others, on average your pizza would would rank better than 46 of them and worse than 53 of them.

In other words, the lower the score, the less processed it is on the whole.

Here’s a side-by-side example of two cakes, one of which got a score of 3, and the other got a score of 61:

Mini No Sugar Added Cheesecake vs EDWARDS Desserts Original Whipped Cheesecake

And here is the main menu of the database, in which you can use the search function to look up the food you want to check, or else browse by category:

The TrueFood Database: Search or Browse (it’s free!)

Enjoy!

Want to know more?

You might like this book that we reviewed a little while back:

Ultra-Processed People: The Science Behind Food That Isn’t Food – by Dr. Chris van Tulleken

Enjoy!