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Why Women with PCOS Need to Eat Carbohydrates

Yes, you read the title correctly:  women with PCOS need to eat carbohydrates. Usually vilified for contributing to weight gain and spiking insulin levels, carbohydrates are not always viewed as a PCOS friendly food. But certain carbohydrates need to be included into the diets of women with PCOS for optimal health. Here’s 4 main reasons why.

Helps Maintain Blood Sugar

Carbohydrates get broken down to glucose (blood sugar) and are the body’s main energy source. The brain relies on glucose for energy. So do our muscles, tissues, and organs and all processes that happen in the body that we never think about.

A big reason women with PCOS need carbohydrates is to keep their blood sugar levels stable. Regulating blood sugar levels can be a problem in women with PCOS. If you have ever experienced hypoglycemia (or low blood sugar) you know what I am talking about. Those feelings of lightheadedness, dizziness, and hangry aren’t something to mess around with. In some cases if blood sugar levels get too low, it can be dangerous as it can cause you to pass out, faint, or worse.

Carbohydrates work to increase blood sugar levels. This is why when you do have symptoms of low blood sugar, you should have something with carbs to bring it up. People with diabetes are commonly told to carry glucose tablets with them or have something that can quickly enter the blood stream like orange juice if they get low blood sugar.

But Angela, you may ask, don’t women with PCOS already have high glucose levels? Why would they want to increase their blood sugar?

Yes, women with PCOS tend to have higher levels of glucose and insulin. But including the right carbohydrates and at the right times, can help to maintain healthy blood sugar levels. Just as blood sugar levels rise, they can also fall. Having really high levels of glucose in the blood requires a lot of insulin needed to be secreted to get the glucose into your cells. When this occurs, insulin quickly pushes glucose into your cells, leaving your blood sugar levels to plummet.

To avoid this, it is best to eat regular meals and snacks throughout the day with moderate amounts of high fiber carbohydrates that won’t spike up glucose levels.

Examples of high fiber “whole” carbs include fruits, vegetables, beans, quinoa and oats.

It’s ok for women with PCOS to eat carbohydrates and at every meal or snack, just be sure to include enough protein and fat. Some of the patients I work with find they need to have carbohydrates each time they eat to keep their blood sugar levels stable. Without them they keep having hypoglycemia.

Prevents Binge Eating

Low blood sugar is a risk factor for binge eating in women with PCOS. When your blood sugar is low, all your body thinks about is food. This is a physiological response to tell your brain to eat and to eat now! Why? Carbohydrates are the foods needed to bring up blood sugar levels quickly. If your blood sugar gets too low, you tend to need to eat more foods (including more carbohydrates) to bring it up. This can then cause high blood sugar levels and a cycle ensues. Carbohydrate cravings are often associated with low blood sugar as well. One way to avoid binge eating is to eat balanced meals and snacks if needed.

Improves Gut Health

Whole carbohydrates are a good sources of fiber. Fiber helps to keep our digestive track working properly and prevent constipation. It also helps to lower cholesterol. Research now shows the benefits of fiber of helping to improve the functioning our gut microbiome, which influences our weight, immune system and physical health. Prebiotics, for example, are fiber-rich foods such as onions and garlic, which are needed to feed our microbiome to keep us healthy.

Supplies Important Nutrients

Carbohydrates provide the nutrients needed to reduce insulin and glucose such as magnesium and zinc, which women with PCOS tend to be deficient in. Whole carbohydrates also provide antioxidants needed to keep our cells healthy and fight free radicals which cause cancer. Antioxidant rich diets which focus on incorporating fruits, vegetables, and whole grains, such as DASH, have been shown to greatly benefit women with PCOS by reducing glucose, cholesterol, and inflammation and improving fertility.

Pulses (grains, beans, and nuts) and fruit are good sources of inositol, which has been shown to reduce insulin and improve fertility.

Bottom line: Women with PCOS shouldn’t fear eating carbohydrates. Carbohydrates, in moderate amounts, are needed to provide optimal health benefits such as antioxidants, improving the gut microbiome, regulating glucose levels, and preventing cravings and binge eating.

Do you feel better eating carbohydrates? Share with us!

Angela Grassi, MS, RDN, LDN is the founder of The PCOS Nutrition Center where she provides evidence-based nutrition information and coaching to women with PCOS. Angela is the author of several books on PCOS including PCOS: The Dietitian’s Guide, The PCOS Workbook: Your Guide to Complete Physical and Emotional Health, and The PCOS Nutrition Center Cookbook Recognized by Today’s Dietitian as one of the Top 10 Incredible Dietitian’s making a difference in 2014, Angela is the past recipient for The Outstanding Nutrition Entrepreneur Award, The Award in Excellence in Practice in Women’s Health and The Award for Excellence in Graduate Research, from the Academy of Nutrition and Dietetics. Having PCOS herself, Angela has been dedicated to advocacy, education, and research of the syndrome.

 

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Comments (15)
  • Amy

    September 21, 2017 at 5:07 pm

    Thank you for this article! When I was diagnosed with PCOS, I cut out all refined carbs (whole wheat flour, any flours) and sugar, but started to eat a plant-based diet, including fruit, veggies, oats, quinoa, and beans. I think my body has greatly benefited from this change, even my IBS has lessened.

  • marie

    September 21, 2017 at 10:49 pm

    “Examples of high fiber “whole” carbs include fruits, vegetables, beans, quinoa and oats.”

    So we can have quinoa, beans, and oats? That would greatly change my life if I could have those in my diet more often. I would like to learn more about the carbs we’re allowed. I’ve been staying away from those carbs as much as possible. Mainly been doing just protein, vegetables, nuts and a little fruit for breakfast, lunch, and snack. It’s the evenings I tend to have brown rice or beans or quinoa since I cook for my husband and I for that meal.

  • Angela Grassi

    September 22, 2017 at 9:18 am

    Marie, Yes, you can eat quinoa, beans and oats. These are great examples of whole grains that don’t spike up glucose and insulin very high. If you’re looking for recipes or meal plans, may I suggest our cookbook: http://www.pcosnutrition.com/product/cookbook/

  • Becky parrish

    September 22, 2017 at 1:37 pm

    I need help with a menu for my 18 yr. old daughter with pics and thyroid issues . She needs to lose a few pounds and I can’t seem to find a diet to help her ! Please help me !!!

  • Angela Grassi

    September 22, 2017 at 1:40 pm

    Hi Becky,
    We have a 4 week meal plan, shopping list, and 100 recipes in The PCOS Nutrition Center Cookbook: http://www.pcosnutrition.com/product/cookbook/

  • Amanda

    October 9, 2017 at 10:53 pm

    I’m not sure of your credentials as I don’t see them listed but I feel compelled to say that I have PCOS and have found a ketogenic diet to be the best solution. This evidence based study that I have attached confirms that the ketogenic diet is a good approach to PCOS and it makes statements that contradict your information.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334192/

  • Angela Grassi

    October 10, 2017 at 1:53 pm

    Hi Amanda,
    I updated the post to reflect my credentials and bio. I hold a masters in nutrition and dietetics and founded the PCOS Nutrition Center.

    The study you link to does show benefit from a keto diet, however, its a very small sample size and short duration. Many more studies need to be done on this before it’s even considered as an option for women with PCOS. The biggest problem with keto that i see in my PCOS patients is that it is very difficult to follow. As soon as you start eating normal food, you will regain the weight and make PCOS worse. Keto diets, along with any restrictive diet, promotes eating disorders. These reasons alone are why we don’t recommend keto diets for women with PCOS.

  • Stacy Holland

    January 22, 2018 at 7:08 pm

    I have to eat carbs because my blood sugar drops or won’t come up if I dont. If it’s something like bread or cornbread or potatoes, I will eat it at the end of my meal after I’ve had the better stuff; vegetables and protein etc lol like it’s a treat.

  • Heather

    January 22, 2018 at 10:40 pm

    I have PCOS and am insulin resistant. I’ve found that the only way I can feel satisfied is to have very, very limited grains and beans—as in rarely. They seem to spike my hunger levels. I try to keep my carbohydrates between 70-100 per day or about 30-35% of my caloric intake.

    What is your recommendation for PCOS patients who are severely insulin resistant? If I eat oatmeal or other grains, even paired with protein, I feel so hungry later.

  • Angela Grassi

    January 23, 2018 at 8:30 pm

    Heather that is great that you noticed how different foods affect your hunger levels. Every woman is different and have different requirements. We recommend going with what you notice works for your body.

  • shannon lynch

    March 20, 2018 at 3:57 pm

    Thanks for putting this out there! I am a dietetic intern and after my diagnosis with PCOS, I discovered why I would crash if I didn’t eat carbohydrates consistently throughout the day. Carbs are our friends! I always have an apple on hand now to make sure I don’t crash.

  • Max

    June 10, 2018 at 2:17 am

    Hi Angela,

    Thanks for this resource, it’s really interesting. I wanted to ask if there were other carbohydrates that were good staples, aside from those you mentioned? I was curious about millet and barley, in particular.

    Thank you!

  • Angela Grassi

    June 11, 2018 at 4:29 pm

    Those are great! As are all the ancient grains too!

  • Steve Foley

    June 15, 2018 at 3:45 pm

    What level of carbs are you recommend?
    The best way to stabilize blood glucose is protein. Also if a PCOS Pt is on metformin carbs will cause them to be sick. Fiber and antioxidants can be taken other ways. Being a OB /GYN for the past 30 years I’ve really seen very little good with carbs in PCOS
    Just my thoughts

  • Angela Grassi

    June 22, 2018 at 12:29 pm

    Hi Dr. Foley,
    Thanks for your comment. I tend to individualize carbohydrate recommendations based on the patient, her lifestyle, activity and needs. Very active women tend to need more carbs. Too little carbs does not stabilize blood sugar, it can lower it which can result in binge eating. Up to 60% of women binge eat and carbohydrate cravings are often reported in PCOS women. Surprisingly, when looking at the nutrition studies done with PCOS women, the majority of them use around 50% carbohydrates and show good results. There is no good data to suggest a very low carb diet is any better than a moderate carb diet. Studies that use the DASH diet and Mediterranean style diets contain a good amount of carbs and show great results. It’s not just the total amount of carbs but how much at a meal and they type of carb that modifications can show a difference. I really feel all women with PCOS should meet with a registered dietitian nutritionist who specializes in PCOS to find what carb amount and eating style works best for her.

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