Should All Women with PCOS Eat Gluten-Free?

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Are you thinking of changing your diet to one that’s gluten-free? You’re not alone. The number of gluten-free diet books and products available are exploding. Some gluten-free products claim to promote everything from better sleep, increased energy, weight loss and even thinner thighs and cleaner skin. Some gluten-free claims offer treatment for autism and rheumatoid arthritis. It’s no surprise that the primary reason many buy gluten-free foods is a belief that they are viewed as healthier than other foods. Women with PCOS may particularly benefit from a gluten-free diet because the majority of the acceptable grains are low in glycemic index and won’t spike insulin levels. But are gluten-free diets really necessary for all women with PCOS? Let’s look a the (lack) of evidence.

Gluten-free And Weight loss

If you have PCOS, you can’t avoid hearing about women with the syndrome who have shared on the internet that they have gone gluten-free and lost weight Or maybe even referred to gluten containing foods as “evil” or “garbage”. But the reality is, eating gluten-free foods is probably not causing the weight loss. It’s common for individuals who adopt a gluten-free diet to have a lower carbohydrate intake overall (no more bread basket) which results in them shedding pounds.

On the other hand, if not followed correctly, gluten-free diets can result in weight gain as gluten-free products sometimes can have more calories (and sugar) than their counterparts. For example, a single serving of regular pretzels provides 108 calories. Compare this to a serving of gluten-free pretzels which have 140 calories.

PCOS, Gluten and Inflammation

PCOS is a state of inflammation correlated with insulin resistance. Women with PCOS have higher CRP values, independent of BMI. It has been suggested that the daily consumption of wheat products and other related cereal grains may contribute to chronic inflammation and autoimmune diseases.  Reducing gluten consumption or avoiding it therefore could lessen inflammation in PCOS, although there are no studies to support this. A double-blind RCT examined the effects of dietary gluten on inflammation in individuals with irritable bowel syndrome. Participants who received gluten reported significantly more symptoms compared with the placebo group.  No significant changes in CRP levels were observed.

A Gluten-Free Necessity

For the millions of individuals who suffer from celiac disease, eating a gluten-free diet isn’t a choice; it’s a necessity. Celiac disease is an autoimmune disorder in which the body can’t process gluten, the protein in wheat, barley, rye, malt, brewer’s yeast and, in most cases, oats. Often overlooked, Celiac disease can cause significant long-term health problems if a gluten-free diet isn’t followed.

Some people feel gluten causes their health problems, such as upset stomach and fatigue. A sensitivity to gluten, also known as gluten intolerance, may involve bloating, abdominal pain, and fatigue. Those who claim to be gluten intolerant and who omit gluten feel better and experience less bloating and abdominal weight loss.Those individuals should follow a gluten-free diet.

Sometimes it’s not the gluten at all that makes people feel better but instead, it’s their reduction of high FODMAP foods which can cause the GI symptoms mentioned above.

It may be tempting to stop eating bread and other gluten-containing foods if you believe they’re bothering you but you should wait until you get tested by a doctor as going gluten-free makes it harder to diagnose celiac disease.

The Disadvantages Of A Gluten-Free Diet

A gluten-free diet is not an easy diet to follow and has some disadvantages. If not followed correctly, a gluten-free diet can result in a diet that is low in iron, folate, niacin, zinc and fiber. Many gluten-free foods have added sugars to add flavor. Women who have yo-yo dieted, have distorted eating or an eating disorder, may find a gluten-free diet very restrictive and worsen eating disorder behaviors.

Gluten-Free Eating Tips

If you are considering a gluten-free diet, here are some tips to do it healthfully:

  • Before beginning a gluten-free diet, be sure to do some research so you know what you are getting into. You may find the resources below useful.
  • Substitute gluten-containing foods for a variety of gluten-free whole grains such as amaranth, quinoa, buckwheat, corn, millet, sorghum, brown or wild rice and teff.
  • Don’t be afraid to experiment in your own kitchen. Gluten-free flours can easily be substituted into your favorite dishes.
  • Read food labels carefully to make sure you are getting the whole grain benefits. Food ingredients list from the largest amount to smallest.
  • Watch out for added sugar. Look at the amount of sugar on the label and check the ingredient list. If sugar or a sugar word is one of the first three ingredients, opt for another food.
  • Be careful not to rely on packaged, canned or frozen gluten-free foods. These products contain a significant amount of sodium.

Bottom line: There is a significant lack of evidence to support a gluten-free diet for all women with PCOS. The best nutrition approach for women with PCOS is a personalized one that takes into account a woman’s symptoms, lifestyle, and metabolic issues. Weight loss associated with a gluten-free diet is most likely due to a reduction in total carbohydrate intake rather than the gluten-free foods itself. If you do have a gluten intolerance or celiac disease, a gluten-free diet is a necessity. 

Gluten-Free Resources

American Celiac Disease Alliance: http://americanceliac.org
Celiac Disease Awareness Campaign: http://celiac.nih.gov
Food Allergy and Anaphylaxis Network: www.foodallergy.org
Academy of Food and Nutrition: www.eatright.org
National Foundation for Celiac Awareness: www.celiaccentral.org
Gluten Freely: www.glutenfreely.com

Source

Biesiekierski JR, Newnham ED, Irving PM, et al. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011;106(3):508-514.

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Comments (4)
  • Dr Pamela Frank, BSc(Hons), ND

    January 4, 2012 at 9:09 pm

    Personally I think PCOS women ought to be eating a grain free diet, which by virtue of being grain free would also be gluten free. Grains don’t provide anything that can’t be obtained more healthfully from other sources like fruits and vegetables. We can get fiber, carbohydrate, iron, B vitamins and zinc from eating 8-10 servings of fruits and vegetables every day, including my all-time favourite food – dark green leafy vegetables like kale, Swiss chard, spinach and collard greens. Aside from often being full of sugar and/or salt, gluten free products are often made from high glycemic index carbs like rice, definitely not suitable for PCOS ladies.

  • R. Williams

    July 27, 2014 at 9:09 pm

    I totally agree with Dr. Frank. I’ve learned that my body cannot process yeast properly, which caused severe edema in my feet, nausea and topical skin itching with no rash. As soon as eliminated bread from my diet all of those symptoms vanished. I eat kale, spinach and collards for my fiber and plenty of fruit. I do not miss the feeling I suffered from eating breads/gluten. Bye bye bread!

  • onestoppaleoshop

    November 22, 2016 at 4:51 am

    Thanks Angela..
    sharing for all woman’s with PCOS eat glutenfree with advantages & disadvantages gluten free tips.

  • Toove

    January 7, 2019 at 5:53 pm

    You write that there is a serious lack of evidence that a gluten free diet will help. There is also a serious lack of evidence that gluten free diet will NOT help, so how all these doctors can say with such certainty that it is stupid to follow a diet … it is just because they are in general against diets.

    There are a lot of other possible ways it could affect us apart from the glycemic index. I am glad at least that you show people to some resources for gluten free diet.

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