Women with PCOS can harness the power of foods to manage their symptoms healthfully. Choosing foods that are high in fibre, lean protein, and rich in anti-inflammatory properties can help combat insulin resistance and keep inflammation levels in check.
When it comes to finding the optimal PCOS diet, there is no one-size-fits-all. Managing PCOS with genetic testing can provide the information you need to take the guesswork out of your diet.
In this article, we discuss what PCOS is, the conditions associated with PCOS, and genetic factors that may affect your response to certain foods and nutrients associated with PCOS.
What is PCOS?
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder that affects 2% to 27% of women that are of childbearing age.
Women suffering from PCOS exhibit a group of symptoms associated with irregular menses, cysts in the ovaries, and high androgen (male hormone) levels (1).
Women with PCOS may experience different symptoms that can vary from mild to severe. Some women experience menstrual problems or are unable to conceive, though not all.
Symptoms of PCOS include:
- irregular periods or amenorrhea (no periods)
- hirsutism (excessive male-patterned hair growth)
- weight gain or difficulty in losing weight
- thinning hair and hair loss from the head
- sleep apnea
- high blood pressure and high cholesterol
PCOS and Hormonal Imbalance
PCOS affects a woman’s ovaries. The ovaries regulate the production of estrogen and progesterone – these hormones regulate the menstrual cycle. The ovaries are also responsible for producing androgens, the male hormones.
The release of reproductive hormones is needed to control and regulate ovulation. Follicle-stimulating hormone (FSH) stimulates the ovary to produce a follicle – a sac that contains an egg – and luteinizing hormone (LH) triggers the ovary to release a mature egg.
In PCOS, the sacs are follicles that contain an immature egg. The eggs do not mature enough to trigger ovulation, leading to many small, fluid-filled sacs that form ‘cysts’ in the ovaries.
Due to a disrupted ovulation cycle, estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual. Higher androgen levels in women may lead to acne, extra facial and body hair, and infertility.
PCOS and Insulin Resistance
Insulin is a hormone responsible for using glucose for energy. It plays a crucial role in regulating blood sugar balance.
Insulin resistance occurs when the cells can’t use insulin properly. As a result, the body compensates by producing more insulin to increase glucose uptake.
Insulin resistance affects 65-70% of women with PCOS (2).
Extra insulin triggers the ovaries to produce more androgens (male hormones) and may lead to the development of type 2 diabetes (3).
Obesity may play a role in the development of PCOS due to disturbances in insulin and androgen levels. Roughly 70-80% of women with PCOS are overweight or obese (4).
PCOS and Inflammation
Excess inflammation is more common in women with PCOS; this attributes to the prevalence of insulin resistance, glucose intolerance, obesity, and type 2 diabetes.
Similarly, many women with PCOS demonstrate signs of metabolic syndrome, elevated triglycerides and LDL levels, and decreased HDL levels (5).
PCOS and Genetic Factors
While the genetics of PCOS is not fully understood, a study looked at proteins involved in PCOS and the mutations in these proteins that are inherited or related to environmental factors.
IGF1: Insulin-Like Growth Factor 1
IGF1 has growth-promoting effects on almost every cell in the body. The IGF1 variant is associated with decreased IGF1 levels. Low levels of IGF1 are associated with increased insulin resistance, metabolic syndrome and predict the development of glucose intolerance and type 2 diabetes.
If you have genetic variations in the IGF1 gene, consider increasing dietary protein intake to increase IGF1 levels.
FTO: Risk of overating
The FTO gene encodes the fat mass and obesity-associated protein. It affects the hypothalamus region of the brain, which regulates appetite, energy intake and satiety. Associated with difficulty feeling full and risk of obesity. However, physical activity minimizes these effects.
Increasing exercise and decreasing saturated fat reduce the risks associated with variants in this gene.
Managing PCOS with Genetic Testing
Limiting foods high in refined carbohydrates such as white bread and muffins, sugary snacks and drinks like soda, and inflammatory foods such as processed meats are one of the first steps in managing PCOS with food.
Simple elimination or restriction of specific foods can improve PCOS symptoms, but may not provide the full picture.
Taking it one step further, understanding genetic factors related to one’s ability to process specific nutrients may significantly improve the outcome of managing PCOS through dietary means.
Here is a list of genes related to the metabolism of nutrients that may impact PCOS conditions such as insulin resistance, risk of obesity, food intolerances, and inflammation:
Genes That Impact Carbohydrate Metabolism
ABCC9: Variation in this gene is associated with poor insulin sensitivity and weight gain around your waist.
PPARG: Influences the regulation of genes involved in carbohydrate and fat metabolism and insulin production, which moderate the risk of obesity and type 2 diabetes. Plays a key role in fat cell formation and metabolism.
Genes that Impact Insulin Metabolism
CEBPA: Modulates the expression of genes involved in cell cycle regulation and body weight homeostasis. Involved in the creation of fat cells and energy homeostasis. Caloric restriction reduces CEBPA protein expression in patients with metabolic syndrome. Variation is associated with an increased risk of insulin resistance and lower insulin production.
SH2B1: Expressed in the hypothalamus, a crucial center for energy balance and regulation of food intake. Variations can disrupt hormonal signalling and are associated with obesity, increased snacking and fat intake, type 2 diabetes, insulin dependence, and BMI.
Genes that Impact the Need for Protein to Regulate Insulin
NADSYN1: Variation is associated with more significant positive changes in insulin regulation (fasting insulin and insulin resistance) in response to a high protein diet.
PPARGC1A: Regulates mitochondrial biogenesis, fatty acid oxidation, glucose utilization and thermogenesis. The variant tested here has been associated with a greater reduction of cholesterol on a high-protein diet than on a low-fat diet.
Gene that Impacts Lactose Tolerance
MCM6: Helps control the activity of a nearby lactase gene. It determines whether the lactase gene is turned on or off. This gene provides instructions for making the enzyme lactase, which is responsible for breaking down lactose.
Genes that Impact Inflammation from Food
BCMO1: Involved in the conversion of beta-carotene to a bio-available form of vitamin A
CETP: A key determinant in lipid metabolism, facilitates the transport of cholesteryl esters and triglycerides between the lipoproteins. Antioxidants – like vitamin E prevent a decrease in CETP by radical-induced damage.
SLC23A1 and SLC23A2: Responsible for tissue-specific absorption of vitamin C.
NOS3: An inflammatory agent and oxidant in free radical-mediated lipid breakdown. It is associated with responsiveness to fatty acids and the beneficial effect of omega 3 supplementation. Variations result in decreased protection following a damage-causing injury to cells.
Coping with PCOS presents its challenges in many ways, especially when it comes to nutrition.
It is essential to choose foods high in fibre, lean protein, and anti-inflammatory properties. By doing so, symptoms of insulin resistance and inflammatory conditions may improve over time.
If you’re following a healthy diet low in refined carbohydrates, sugar, and inflammatory foods, and is still suffering from severe symptoms, you may want to consider getting your DNA tested to get a deeper understanding of what nutrients your body needs.
Managing PCOS with genetic testing may provide the answers to a diet that’s right for you.