Episode #150: PCOS and Diet: The Latest Research of Crafting the Optimal Nutritional Strategy

Welcome back to the PCOS Repair Podcast, where today we’re diving into a research article review. This article is titled “Nutrition Strategy and Lifestyle in Polycystic Ovarian Syndrome: A Narrative Review.” It covers a variety of lifestyle approaches, including dietary strategies, supplements, and other adjustments that have shown promise in managing PCOS.

Before we get into it, I want to share a couple of caveats. This article is a survey of research—it looks at what’s being done in lifestyle management for PCOS and what results are being observed. That’s exciting! It’s amazing that this is being studied and published so that both practitioners and women with PCOS can stay informed. But it’s important to remember that what works for many doesn’t always work for every individual.

Just because something works in a study doesn’t make it the right approach for you. And even when something works—say it helps someone go from 200 pounds to 150 pounds—it might not be what helps them maintain that weight or reach a different goal. The key takeaway here is that health interventions must be tailored. Research gives us broad insights, not specific prescriptions.

The article starts with an overview of PCOS. It notes that up to 18% of women of reproductive age may be affected. That number keeps climbing—older estimates put it at 6%, then 8–10%. And PCOS symptoms vary significantly. One woman may struggle with weight, another with excess hair, another with acne or irregular cycles, while others might not show any of those signs. This variety is one reason why diagnosis and treatment can be so elusive.

What overlaps, however, are the root causes. This article frames PCOS as a metabolic condition, with hormone imbalances resulting from insulin resistance, chronic inflammation, and oxidative stress. On this podcast, we talk a lot about the insulin effect—even before full-blown insulin resistance—and how inflammation and stress responses play a role. These all contribute to hormone imbalance, which then drives PCOS symptoms.

The hormone disruptions in PCOS often involve imbalances in LH and FSH, throwing off the typical menstrual cycle—no clear ovulation in the middle, just a kind of hormonal chaos. Insulin and excess body fat both amplify inflammation and hormone disruption. The article also highlights how genetic tendencies and metabolic pathway issues make certain people more vulnerable when exposed to particular environmental stressors—like poor diet, low activity, or high stress—especially if those patterns start in childhood.

And that’s a growing concern. Kids today are exposed to a lot of ultra-processed foods—school snacks, classroom rewards, celebratory cupcakes, fast meals between sports. These habits affect long-term health and may contribute to higher rates of PCOS by activating those genetic predispositions.

The article describes how inflammation, insulin resistance, and oxidative stress create a vicious cycle. These three not only make it easier to gain weight, but excess weight then worsens all three, disrupting gut health and nutrient absorption, and accelerating hormonal issues. But the good news is: all of these things can be improved.

Ovulation and fertility are impacted not only by hormone levels but also by oxidative stress and inflammation, which reduce egg quality. This perfect storm of internal stressors highlights how addressing even one root cause can have a ripple effect, calming the entire system.

Next, the article explores dietary strategies. It highlights low glycemic index diets, ketogenic diets, high-fiber diets, and reduced saturated fat intake. Now, I’ll point out—some of these recommendations contradict each other. For example, a ketogenic diet is typically high in saturated fat, so it doesn’t align with reducing saturated fat.

What I take from this is that different dietary strategies work for different people. That’s why my approach is to pull from multiple models—emphasizing whole foods, low-glycemic options, healthy fats, high fiber, and plenty of protein. That combination tends to be sustainable and effective.

Have I ever recommended ketogenic diets to clients? Yes, but only short term, and only when appropriate. It’s not an ideal long-term lifestyle for most people. Research can’t always capture nuance. Studies need strict parameters—like “low glycemic” or “ketogenic”—but in real life, balance and sustainability matter more.

Then there’s exercise and sleep—two critical lifestyle pieces. Exercise is essential for improving insulin sensitivity, body composition, and ovulation quality. Despite some PCOS communities warning against intense exercise due to cortisol, the research shows that aerobic and resistance training are highly beneficial. Cortisol does matter, but avoiding exercise isn’t the solution. The goal is to build a smart, gradual routine.

Rather than going all out and burning out, a better approach is to build in 8–10 week training cycles. Gradually increase intensity or weights, then pull back for a week before building again. This protects your body, reduces injury risk, and supports muscle growth and hormone balance—without burnout.

Now, this doesn’t mean doing only intense workouts. Power walking counts. It just means raising your heart rate and building strength in a way that fits your life and capacity.

Sleep is another huge piece. Poor sleep worsens insulin resistance, raises inflammation, and disrupts hormones—including cortisol. Many women with PCOS also have low melatonin levels, particularly during the follicular phase. Supplementing with melatonin might help improve sleep and egg quality, but that’s something to discuss with your healthcare provider. We’ve covered melatonin in a previous episode if you want more detail on that.

The article also looked at supplements. Some of the standouts include:

• Vitamin D – supports insulin sensitivity, reduces inflammation, and may help regulate cycles.
• Myo-inositol – especially in the correct 40:1 ratio with D-chiro-inositol (like in Ovasitol). It can improve ovulation and blood sugar, with fewer side effects than metformin.
• CoQ10 – supports cellular function and reduces inflammation, especially useful for some women with PCOS.
• Zinc and selenium – help regulate insulin, support ovulation, and reduce oxidative stress.
• Berberine – works similarly to metformin, improving insulin sensitivity and ovulation, though caution is needed to avoid combining too many blood sugar-lowering supplements.
• Omega-3 fatty acids – help reduce inflammation and androgen levels and support mood.

Now, herbs were also discussed, though research in this area is limited. Some that showed potential include:

• Spearmint, licorice root, green tea – to reduce androgens
• Vitex, flaxseed – to support ovulation
• Milk thistle, dandelion, black cumin – to support liver function and reduce inflammation
• Berberine, cinnamon, turmeric – for weight and insulin regulation

Important note: many herbs and supplements are not safe during pregnancy. Always speak with your healthcare provider before starting or continuing them, especially if you’re trying to conceive.

Finally, the article touched on gut health. The gut microbiome plays a growing role in our understanding of metabolic and hormonal health. It’s not the only factor in PCOS, but it’s an important one—especially related to inflammation.

Fiber, prebiotics, and probiotics are all beneficial. They help improve insulin sensitivity, reduce inflammation, and support a healthier appetite. As your gut heals, your cravings and hunger often become more manageable. You’ll also start to notice improvements in energy and mood. Your physiology starts working with you instead of against you, and even your mindset around food begins to shift.

Many women I’ve worked with—including myself in my 20s—feel like food has control over them. That’s often due to dysregulated hunger hormones, blood sugar crashes, and underlying inflammation. But with time, as you eat better, heal your gut, and improve insulin sensitivity, those overwhelming cravings and energy slumps start to fade. You begin to feel more satisfied, more in control, and more energized.

The biggest takeaway from this research review is how interconnected everything is: metabolism, inflammation, gut health, genetics, lifestyle habits, and hormone regulation. When we take a root-cause-based, whole-person approach that includes nutrition, movement, sleep, stress management, and targeted supplements, we start to see massive improvements. Not just in one area—but across the board.

And best of all, as your body feels better, it helps you make even more progress. You’re not fighting as many battles—whether it’s cravings, energy dips, or stubborn symptoms.

That wraps up the highlights from today’s article. I’ve included the full study in the show notes if you want to read it for yourself. It’s exciting to see lifestyle strategies gaining so much validation in research. We are finally seeing evidence that what we’re doing—what you’re doing—makes a difference.

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Until next time, bye for now.