PCOS AND INTERMITTENT FASTING
Did you know that Polycystic Ovarian Syndrome or PCOS affects 12-18% of women of childbearing age? With lifestyle and diet the first port of call when it comes to the management of PCOS, many of those affected are jumping at anything to lose weight and get on top of their symptoms.
A common question I receive from my clients is whether women with PCOS should try intermittent fasting to lose weight and manage symptoms. Keep reading to find out what a dietitian thinks.
What is PCOS?
For those of you who may not know, PCOS is a hormonal disorder affecting a significant proportion of women. PCOS can present as a multitude of symptoms, some women will experience many, while others experience very few.
Symptoms include:
Irregular, infrequent or non-existent menstruation
Ovulation issues and infertility
Multiple ‘cysts’ on ovaries (contrary to the name, this is not the case for all women)
Weight gain
Excessive hair growth or hair loss
Skin changes, e.g. acne
Mood changes, anxiety, depression
Sleep apnoea
Statistics tell us that up to 80% of women with PCOS will have insulin resistance.
What is insulin resistance?
When we eat carbohydrates they are broken down into glucose, move to our bloodstream and from there are transported into our cells. Insulin is the hormone that is responsible for moving glucose from our bloodstream into our cells to use for energy. Insulin resistance means that the hormone is becoming less effective at performing its role, the pancreas is trying to create more insulin to combat this and ultimately less glucose is taken out the bloodstream, which leads to high blood glucose levels.
This unfortunately means that those with PCOS have an increased risk of developing Type 2 Diabetes, so diet and lifestyle factors are a very important factor in the management of PCOS and insulin resistance.
Additionally, PCOS being a hormonal disorder means that there are higher levels of circulating hormones; insulin and androgens in particular. High levels of circulating androgens are responsible for some of the symptoms of PCOS, such as excess hair growth, acne and lack of ovulation.
What is intermittent fasting?
On a completely different note, many of you may have heard of intermittent fasting (or some variation of it). Fasting has been around for many years now. Intermittent fasting means to cycle between periods of eating and fasting, either over the day or week.
We have many variations, two of the most common being the 5:2 diet, which means to eat regularly 5/7 days and fast (very low kJ) on the other 2/7 days. We also have the 16:8 diet, which means limiting your eating to an 8 hour time window each day and fasting for the remaining 16 hours. The benefit of Intermittent Fasting is to decrease overall energy intake leading to an energy deficit (hopefully leading to weight loss) and training your body to become more efficient at using stored body fat for energy.
PCOS and intermittent fasting - do they fit together?
At present, there is a lack of research on this topic as well as no consensus on the best diet for PCOS. So from an evidence-based point of view, we need more research.
Some considerations of Intermittent Fasting in PCOS include:
General reduction in overall energy consumption could result in weight loss. In women with PCOS who are overweight, this could be beneficial in terms of insulin resistance, fertility and managing symptoms.
Depending on what type of Intermittent Fasting, this could lead to the consumption of larger meals within the eating window, in particular large amounts of carbohydrates. Too much glucose entering the bloodstream and inefficient insulin could result in larger increases in blood glucose levels, increased strain on insulin and ultimately heightened insulin resistance.
If you are trying to conceive it may not be a great idea as it is not recommended to be on any strict ‘diets’ during pregnancy, therefore starting a new diet during this time is not recommended.
For those with a history of an eating disorder, following a strict diet or fasting regime may trigger disordered eating patterns.
Making sustainable dietary and lifestyle changes that you can maintain in the long term is the gold standard. If you have struggled to achieve this on your own, perhaps try working with a Dietitian to develop an individualised approach that will work for you.