Nutrition Tips for Lean Women with PCOS

Updated February 26, 2018
woman with healthy fruits and vegetables
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Read any information regarding polycystic ovary syndrome (PCOS) and you will be sure to come across recommendations for weight loss. Indeed, weight reduction can improve both metabolic aspects of PCOS (lowering glucose, insulin, and reduced diabetes risk) as well reproductive aspects (regulating menstrual cycles and improving ovulation). But what if you have PCOS and aren’t overweight?

High insulin levels can still occur in lean women putting them at risk for type 2 diabetes. Certainly being underweight can affect ovulation as too little body fat can cause menstrual cycles to stop. Weight loss, therefore, isn’t a treatment option for women with PCOS who are lean. So what can be done?

Here are 4 tips lean women with PCOS can do to improve their fertility, manage symptoms, and overall improve the quality of their health.

Make Breakfast Your Biggest Meal of the Day

In a study published in Clinical Science, 60 lean PCOS women were randomized into two groups of meal distributions: One group ate a high calorie breakfast with smaller amounts at lunch and dinner (980 calories breakfast, 640 calories lunch and 190 calories at dinner), and another group that ate more later in the day (190 calories at breakfast, 640 calories at lunch and 980 calories at dinner). Those who started the day with the bigger breakfast saw reductions in insulin, glucose, and testosterone as well as increased ovulation rates.

Take Vitamin D

Vitamin D, both a hormone and a vitamin, is showing promise in helping women conceive and reduce the risk for diabetes. An assessment of studies that evaluated the relationship between vitamin D and fertility, published in the European Journal of Endocrinology, showed evidence that vitamin D is involved in female reproduction including IVF outcome and PCOS.

The authors suggested that in PCOS women, vitamin D supplementation might improve menstrual frequency and metabolic disturbances.

Vitamin D deficiency is common in women with PCOS. One study in the European Journal of Endocrinology found that the prevalence of vitamin D deficiency was 73% in women with PCOS. Many factors can affect vitamin D status including poor intake of vitamin D foods, sunscreen, and geographical location (northern territories receive less sunlight). Women with PCOS should have their vitamin D levels monitored annually and take supplements if appropriate. To find out how much vitamin D you should take, contact your doctor or registered dietitian nutritionist.

Don’t Forget Omega-3 Fats

Omega-3 fats may be effective in improving insulin resistance and hirsutism in lean women with PCOS. In a study published in the Journal of Obstetrics and Gynecology, forty-five non-obese women with PCOS were given 1,500 milligrams of omega-3 fats for six months. Reductions in BMI and insulin levels were found along with improvements in LH, testosterone, and SHBG levels.

Plant-based sources of omega-3 fats include avocado, nuts, and seeds. Cold water fish such as salmon, tuna, and trout are excellent sources of omega-3 fats.

Government guidelines recommend American’s consume two servings of fish each week to obtain the essential amounts of omega-3 fats needed for health. In addition, fish oil supplements may also help to meet requirements.

Consider Inositol

One of the most widely studied dietary supplements in the PCOS population is inositol. And with good reason: both Myo (MYO) and d-Chiro-inositol (DCI) inositol types have been shown to improve many of the metabolic and reproductive aspects of PCOS. These benefits include improvements to cholesterol, insulin, and androgens. Best of all, MYO has been shown to boost fertility by improving egg quality and restoring menstrual regularity.

In a study published in the Journal of Archives of Gynecology and Obstetrics, women with PCOS undergoing IVF were treated with a combination of MYO and DCI in the physiologic ratio of 40:1 or 500 milligrams of DCI alone. The combined therapy was able to improve egg and embryo quality, as well as pregnancy rates, showing that MYO plays a crucial role in the ovary in PCOS women and the benefits of MYO and DCI in the optimal ratio.

View Article Sources
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  • Jakubowicz D, Barnea M, Wainstein J, Froy O. Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome. Clin Sci. 2013 Nov;125(9):423-32.Lerchbaum E, Obermayer-Pietsch B. Vitamin D and fertility: a systematic review. European J Endocrinol. 2012;166(5):765-778.
  • Oner G, Muderris, II. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. J Obstet Gynaecol. 2013;33(3):289-291.Wehr E, Schweighofer N, Giuliani A. Association of hypovitaminosis D with metabolic disturbances in polycystic ovary syndrome. Europ J Endo. 2009;161:575-582.