Polycystic Ovarian Syndrome
Many women with PCOS struggle with pregnancy. We are glad you were successful in conceiving a baby. Now that you are finally pregnant, you may be wondering if your PCOS diet needs to change. After all, you fought long and hard to get pregnant, and now you want to do everything in your power to nurture the little life growing inside of you. The right PCOS pregnancy diet helps to keep your PCOS symptoms at bay during pregnancy, while keeping you and your baby nourished during the next 9 months. So with that in mind, let’s take a look at this complete guide to PCOS pregnancy diet.
Because of your hormonal imbalances and weight issues, you may be concerned about a healthy pregnancy with PCOS. And you’re right; PCOS can affect your pregnancy and it increases your risk for:
Your PCOS pregnancy diet focuses on mitigating these risks and ensuring a healthy pregnancy despite PCOS. By eating well, and eating right, you ensure that fluctuating insulin, blood sugar, and hormone levels don’t pose any additional risks to your little one. A good diet also makes sure you have the energy to stay healthy, fit and strong throughout the pregnancy and are ready to deliver a healthy baby.
Many PCOS patients face a real challenge with unexplained weight gain. It is this excess weight that also increases the risk to pregnancy-related complications like miscarriage, gestation diabetes, pre-eclampsia and premature birth.
Your PCOS pregnancy diet focuses on gaining a healthy amount of weight during pregnancy.
Research tells us that women with PCOs have a reduce BMR (Basal Metabolic Rate), with or without insulin resistance. This is why they need fewer calories (only around 1445 Kcals/day on an average) when compared to PCOS-free women. But what about increasing caloric intake during pregnancy? We highly recommend you throw the old adage ‘Eat for Two during Pregnancy’ out the window. This paper discusses the rationale for healthy nutrition during pregnancy, so give it a read.
You need to ensure healthy weight gain throughout your pregnancy, but that doesn’t mean you need twice the calories. However, you do need to increase caloric intake later in your pregnancy so that you and your baby have the necessary fuel and energy needed for all the growth taking place. We recommend that you:
However, these are only generalized guidelines and may not work for everyone. It is always advisable to discuss your caloric intake with your gynecologist/healthcare provider so they can monitor healthy weight gain during pregnancy. If needed, they can also recommend changes based on your individual situation.
A high-fiber diet improves blood sugar control and keeps insulin levels in check. Fiber slows down digestion, and thus the carbohydrates we eat take longer to be broken down into glucose (or blood sugar.) This helps in keeping your blood sugar in check. Dietary fiber also helps you feel full for longer which ensures appetite control. This is why eating more high fiber foods is important for your PCOS pregnancy diet.
A Harvard study found that 10g/day increment in total fiber intake was associated with 26% reduction in the rsk of Gestational Diabetes. On the other hand, the combination of high-glycemic load and low-fiber diet was associated with a 2.15-fold increased risk compared with the reciprocal diet. The best sources of dietary fiber for pregnant women with PCOS are fruits and vegetables eaten with skin. Other good sources are seeds like chia seeds, flaxseeds, sunflower seeds and pumpkin seeds, nuts and pseudo-cereals like buckwheat, chestnut flour, quinoa, barley, millets and oats.
A good PCOS diet focuses eating a diet that’s high in whole foods –fiber-rich vegetables and fruits, along with lean proteins and healthy fats. Most PCOS diets are not high-protein diets. However, you will need to increase your protein slightly during pregnancy. Protein fuels growth and aids healthy development of your baby. A quick note: The type of protein is just as important as the amount of protein you eat.
You can eat a combination of both good quality proteins from animals and plants. Vegetarian proteins like beans, lentils, legumes, quinoa, buckwheat, nuts, seeds, and nut butters also come with added fiber, which help in keeping blood sugar levels under control.
On the other hand, good quality animal proteins like grass-fed organic meat, oily fish, and organ meats are a must-add as they are a good source of iron. Fatty fish is particularly good, because it’s such a good source of Omega 3 fatty acids. Eat more salmon, tuna, mackerel, trout, halibut, sardines, and herring. Be careful of shellfish, swordfish, and marlin. If you are a non-vegetarian, don’t be afraid to add organ meats to your PCOS pregnancy diet. Organ meats are a great source of fat-soluble vitamins A and D, Vitamin B12, copper, zinc, iron, as well as essential fatty acids.
If you are on a PCOS diet that is relatively low carb, you may need to increase your carbohydrate intake during pregnancy. Note that a very strict LCHF or ketogenic diet is not your best choice during pregnancy. Studies have investigated the impact of a ketogenic diet during pregnancy on embryonic development in rats. It was found that such a diet has an impact on embryonic organ growth. Such alterations may be associated with organ dysfunction and potentially behavioral changes in postnatal life. While these are animal studies, it is possible that human babies born to mothers on a Keto diet can have relatively larger heart but smaller brain. They can also have a smaller pharynx, cervical spinal cord, hypothalamus, midbrain, and pons.
On the flip side, there is good evidence to suggest that eating too many carbs can also be harmful to your developing baby. Not only will a high-carb diet increase your risk to gestational diabetes, it can also lead to larger fetal weight. it will also put the newborns at risk of breathing difficulties and can lead to higher rates of admission to the neonatal intensive care unit.
Since your PCOS is still VERY REAL, we recommend a moderate carb diet that includes up to 75-150g carbs a day. Make sure you choose good sources of carbs; low GI sources are still preferable. Some good options are – healthy fruits eaten with skin and gluten-free sources of grains and legumes. Lentils, beans, quinoa, buckwheat, brown rice, steel-cut oats and vegetables such as green beans, broccoli, cauliflower, sweet potatoes, and zucchini are all good choices. Avoid all refined carbs that will cause wild insulin spikes and crashes.
If you are suffering from nausea and food aversions in your 1st trimester, don’t worry if your stomach feels more settled on a higher-carb diet. You can balance out the carbs later on in your pregnancy.
Fats are crucial for hormone health and the development of your baby during pregnancy. Healthy fats with plenty of EFA (Essential Fatty Acids) will ensure healthy brain and eye development of your baby as well as ensure good birth weight. Good quality fats also help make rich, nourishing breast milk once your baby is born and make the baby rely completely on your breastmilk for nutrition. Also, fat-soluble vitamins like A, D, E, and K are all crucial for a healthy pregnancy. Nutritional deficiencies can lead to miscarriage and/or underdeveloped organs in the baby.
It’s very important that you eat GOOD FATS during pregnancy. Hydrogenated, partially-hydrogenated and trans-fats have no business being a part of your PCOS pregnancy diet. Instead, eat omega-3 rich fats from fatty fish, egg yolks, avocados, nuts, coconut oil, coconut cream/milk, grass-fed butter, ghee, nuts, and seeds.
We don’t believe that you need to drink milk in order to make rich, nourishing breast milk once your baby is born. Yes, you will benefit from calcium-rich foods for a healthy pregnancy. But that doesn’t mean you have to rely on dairy to get your daily recommended allowance of calcium.
We still recommend that you avoid dairy if you have PCOS. Cow’s milk contains Insulin Growth Factor-1 (IGF-1) that mimics the role of insulin and causes hormonal imbalances, which is why dairy is best avoided in PCOS. There are plenty of other dairy-free sources of calcium to choose from. Salmon, sardines, kale, bok choy, almonds, figs, tofu, seaweed, oranges, sesame seeds and turnip greens are all rich in calcium too.
However, if you want to add natural probiotics to your diet, fermented dairy products can be added to your PCOS pregnancy diet in small quantities. The fermenting process partly destroys the harmful IGF-1, so it is fairly safe for PCOS. Add a bowl to probiotic yogurt to your diet and see how that goes. If that goes well, buttermilk, cream cheese, and cottage cheese are other options worth trying.
The right supplements can support a healthy pregnancy. For PCOS patients who are pregnant, we recommend:
Dietary Fiber Intake, Dietary Glycemic Load, and the Risk for Gestational Diabetes Mellitus – http://care.diabetesjournals.org/content/29/10/2223.short
Nutritional Requirements During Pregnancy – http://samples.jbpub.com/9780763777920/77920_CH01_001_024.pdf
Effects of a ketogenic diet during pregnancy on embryonic growth in the mouse – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3685567/
Nutrition During Pregnancy and the Effect of Carbohydrates on the Offspring’s Metabolic Profile: In Search of the “Perfect Maternal Diet” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111740/
Myo-inositol may prevent gestational diabetes in PCOS women – https://www.ncbi.nlm.nih.gov/pubmed/22122627