A great first step toward an effective PCOS diet plan is to minimize or remove convenience junk foods from your diet.
An easy rule of thumb for eating right is to start with smart shopping. Always buy your groceries around the edges of the store: the produce section for lots of fruits and veggies, the meat counter, the bulk nuts and grains, etc. This works because the inside aisles of the store are where all the processed foods are located – anything in a box, can, or bag. Consider most of these items less “food” than “junk food.”
Processed foods have poor nutritional content. They tend to be high calorie, high fat, high sugar, and are laden with toxic chemicals that your PCOS body can’t safely process. We all know that a bag of poofed, fried “veggie chips” are nowhere near the quality of carrot and yellow pepper sticks, or a stir-fry sautéed lightly in sesame oil.
Convenience foods present additional health problems because they are likely to contain:
In addition, processed foods contain something called "advanced glycation end-products," or AGEs. They are also sometimes referred to as "glycotoxins". AGEs are a complex family of compounds that are created through a number of different chemical processes. The most common process is called the "Maillard reaction", where certain sugars react with proteins, fats or DNA to create AGEs. The Maillard reaction can occur inside your body, or in cooked foods.
The Maillard reaction is used intentionally in the production of processed foods because it changes the appearance and flavor of these foods. Take pretzels for example. Have you noticed they are white on the inside but brown and crusty on the outside? The Maillard reaction made that possible. Tasty, but dangerous!
Whether AGEs are created internally or consumed in your food, they are highly reactive. They cause structural and vascular changes in tissues because of irreversible cross-link formation and induction of oxidative stress. Oxidative stress is essentially an increased instability of molecules in your body. That’s a lot of technical language to say: the end result is tissue damage and inflammation.
Medical research is showing that both lean and overweight women with PCOS have higher levels of AGEs than other women do. AGEs contribute to insulin resistance and chronic inflammation, the underlying suspects for causing PCOS. There is also evidence that AGEs adversely affect the ovaries, and can interfere with your ability to have a successful pregnancy.
It’s critical that you limit your intake of AGEs and foods that cause them. Here’s how:
1. Be very moderate with fats, especially land animal fats. They appear to contain the highest levels of AGEs in food.
2. Be moderate with high-protein foods, especially meats. They are a significant source of AGEs.
3. Consume plenty of vegetables. In general, vegetables, whole fruit, whole grains, raw nuts and seeds contain the lowest levels. Dairy also seems to be mostly OK.
4. Avoid fructose added to food products. Fructose promotes the formation of AGEs. The fructose in whole fruit is fine. But juice and sweets will make your PCOS symptoms worse. Your best strategy is to stay completely away from any food sweetened with fructose.
5. Change how you cook your food. The cooking of food increases the AGE level by 10-100 times…the hotter and longer it’s cooked, the higher it gets! Broiling and frying appear to product the most AGEs, followed by roasting and boiling. Try cooking with moist heat, using shorter cooking times, cooking at lower temperatures, and use acidic ingredients such as lemon juice or vinegar. Animal-derived foods that are high in fat and protein are generally AGE-rich and are prone to new AGE formation during cooking. In contrast, carbohydrate-rich foods such as vegetables, fruits, whole grains, and milk contain relatively few AGEs, even after cooking.
But processed foods are a bad idea not just because of AGEs. Highly processed foods are some of the most unhealthy foods you could possibly eat. The nutritional label you see on the package doesn't fully describe what you're getting.
Advanced glycation products in your food is definitely NOT a part of your PCOS diet plan!
Here's my personal story. About 10 years ago, I joined a small team of people to try to create a truly healthy snack food, a processed food made into a certain shape and texture. I spent quite a bit of time in a food processing facility to create a prototype.
We took the healthiest ingredients and loaded them into the front end of a gigantic food processing machine. The ingredients were subjected to unbelievable heat, pressure and moisture. The product that came out the other end of the processor was totally unrecognizable. And it was so hot that you couldn't get too close to it. (And what's more, it didn't taste good.) The intense heat plus the extraordinary pressure combined with moisture forced the food molecules in the ingredients to combine and rearrange themselves in strange ways. Based on what I saw, my guess is that this product was loaded with AGEs. How could it not be? Plus, all the micronutrients had been destroyed in the processing.
The healthy ingredients did not work well. So we tried some UNhealthy ones, like table sugar and vegetable oil. Well, we got a much better result. It looked better and tasted better. And it was much cheaper to produce! Never mind that it had cross-linked proteins and toxic fats. We were able to disguise that with added flavorings.
We eventually gave up our project because we could not create a product that retained the healthy properties of the original ingredients. They were simply destroyed during processing and some new UNhealthy compounds were created instead. I have seen what goes on behind the scenes. My personal motto is: If you don't understand how a food was made, don't eat it.
In closing, try to eat “real” food – fill your plate with items that are still recognizable, like vegetables and lean meats and whole fruits. The is the basis of a good PCOS diet plan. A great rule of thumb is to read labels and only buy products that have five or less ingredients, and make sure you know what each of those ingredients are. If you find a long list of chemicals, or straight sugar as an ingredient, put it back on the shelf.
Uribarri J et al, Restriction of advanced glycation end products improves insulin resistance in human type 2 diabetes: potential role of AGER1 and SIRT1. Diabetes Care. 2011 Jul;34(7):1610-6.
Diamanti-Kandarakis E et al, Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf). 2008 Oct;69(4):634-41.
Diamanti-Kandarakis E et al, Anti-mullerian hormone is associated with advanced glycosylated end products in lean women with polycystic ovary syndrome. Eur J Endocrinol. 2009 May;160(5):847-53.
Kaya C et al, Advanced oxidation protein products are increased in women with polycystic ovary syndrome: relationship with traditional and nontraditional cardiovascular risk factors in patients with polycystic ovary syndrome. Fertil Steril. 2009 Oct;92(4):1372-7.
Gaby AR, Adverse effects of dietary fructose. Altern Med Rev. 2005 Dec;10(4):294-306.
Li SY et al, High-fat diet enhances visceral advanced glycation end products, nuclear O-Glc-Nac modification, p38 mitogen-activated protein kinase activation and apoptosis. Diabetes Obes Metab. 2005 Jul;7(4):448-54.
Yamagishi S et al, Low-density lipoprotein levels are one of the independent determinants of circulating levels of advanced glycation end products in nondiabetic subjects. Clin Cardiol. 2009 Sep;32(9):E12-5.
Diamanti-Kandarakis E et al, Phenotypes and environmental factors: their influence in PCOS. Curr Pharm Des. 2012;18(3):270-82
Uribarri J et al, Advanced glycation end products in foods and a practical guide to their reduction in the diet. J Am Diet Assoc. 2010 Jun;110(6):911-16.e12
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