Vegan Diet for PCOS: Helpful or Harmful?
There is no doubt that the vegan diet is increasing in popularity.
From the environmental benefits and ethical reasons, to the multitude of health claims, I'm not surprised people are ditching the steak for plant based alternatives.
But is the vegan diet suitable for someone with Polycystic Ovarian Syndrome (PCOS), which is the most common reproductive/metabolic disorder in women of child-bearing age?
Are you being told about the possible negative effects of a vegan diet?
In this blog post, I will cover both the pro's and con's of a vegan diet specifically for women with PCOS, which should allow you to what's right for you.
Vegan diet health 'claims'...
> Increases longevity
> Helps to tackle obesity
> Avoids many environmental toxins
> Greater nutrient intake
> Reduces inflammation
> Disease prevention
Notice how I put the word "claims" in air quotes?
There are studies that both support and argue these claims, however as with everything, it depends on many other factors.
You can be a junk food vegan who eats oreo's, pasta and processed meat alternatives all day long, or a whole food vegan who eats a ton of veggies, healthy fats and sprouted legumes.
These two people have the same diet 'label', however they are making completely different food choices, therefore influencing their health in opposite ways.
It is possible to experience those health benefits by following a diet that contains a lot of plant foods PLUS animal products! It does depend on quality though.
The biggest drivers of PCOS are insulin resistance (in around 70% of cases) and inflammation (likely present to some degree in all cases).
Surely the vegan diet must be amazing for someone with this condition, right?!
To simplify this, I'm going to focus on the pro's and con's of someone eating a wholefood vegan diet, and is already avoiding processed, refined junk foods.
Rich in fibre and plants Fruits and vegetables are rich in fibre, antioxidants and micronutrients which support our body in many different ways. Fibre feeds our gut bacteria, which in turn supports our immune system. Our immune system is primarily located in the gut, and is responsible for controlling inflammation throughout the body. Remember this is one of the biggest drivers of PCOS. Fibre also helps to stabilise blood sugar levels by slowing the absorption of glucose and preventing spikes of insulin. We also need fibre to bulk our stools and promote the elimination of toxins and excess/ 'used' hormones from the body. If we are constipated, this can lead to recirculation of hormones such as oestrogen and testosterone, which can contribute to PCOS symptoms such as acne, irregular cycles and weight gain. Poor gut health and bacterial dysbiosis is common in women with PCOS, therefore supporting gut health through a range of plant fibres can be helpful. Unless you have a chronic gut infection, as increasing fibre intake can make things worse.
Eliminates some possible food sensitivities A lot of the time, people notice they feel amazing after moving to a vegan diet. This is mainly due to the fact they start to avoid junk food, increase their intake of vegetables and begin other health promoting practices such as exercise at the same time. They are also eliminating foods such as dairy and eggs which are common food sensitivities. If they have been eating those things for their entire life then finally eliminate them, there is no wonder they feel better! Refined sugar, sweeteners and artificial preservatives are other ingredients that a real food vegan diet eliminates and that people commonly have sensitivities to.
Reduced exposure to certain environmental toxins
Conventionally raised meat, farmed fish and dairy products are higher in environmental pollutants such as dioxins. Because these animals are higher in the food chain, they tend to bio-accumulate toxins in their tissues, from the foods they eat. If they are raised in huge feedlots or unhealthy and unsanitary environments, they are much more likely to be exposed to pesticides and antibiotics, amongst other things. Organic, grass-fed meat or pastured dairy products are much less contaminated because of the environment and quality of food these animals are exposed to. Even if you go vegan, you can still be exposed to many environmental toxins, especially if you are eating non-organic produce, drinking unfiltered tap water and using chemical laden beauty products.
Higher in carbohydrates One of the biggest downsides of a vegan diet for women with PCOS, is that it's naturally higher in carbohydrates. This is due to the type (and amount) of food you need to consume, in order to reach your protein and nutrient requirements. Even though you may be consuming healthy, complex sources such as sweet potato, lentils, beans and quinoa, these foods still elevate our blood sugar and stimulate an insulin response. Insulin resistance occurs when our body becomes 'numb' to the signals of insulin. These means that the cells can no longer uptake glucose efficiently, leading to excess glucose levels in the blood stream. The reason that a low carb or ketogenic diet works so well for women with PCOS is that they regulate blood glucose levels and keep the production of insulin to a minimum. If you do not have insulin resistant PCOS and have ruled this out through a range of blood tests, you may be more tolerant of a vegan diet.
Lacking in crucial nutrients Another downside of the vegan diet is that it can lack several nutrients that are not just important for hormone health, but for our entire body! Vitamin B12, the omega 3 fatty acids EPA & DHA, zinc, vitamin A and iron are commonly deficient in people following a vegan diet, as these nutrients are mainly found in animal products. Although we can get the omega 3 fat ALA from plant sources such as flax and chia seeds, the conversion rate to the active, beneficial fats EPA & DHA is highly ineffective, as is the conversion of beta carotene to vitamin A. Because of this, the only real option is to use supplements to provide your body with these nutrients. Otherwise, processes such as thyroid function, hormone detoxification, energy levels and mental health are likely to be negatively impacted over time. This is because we need those vitamins and minerals to act as co-factors for hundreds of processes within the body.
Lower protein quality It is true that plant foods can provide us with protein, however there is a big difference between the quality of the amino acids. Animal foods are known as 'complete' proteins, whereas plant sources are 'incomplete', meaning that they do not contain an adequate proportion of the nine essential amino acids, which are necessary in the human diet. It is possible to combine certain foods such as tofu and quinoa, peanut butter and wholemeal bread or rice and beans, to provide your body with a full set of amino acids in one meal or throughout the day. However, in my opinion these options are much less nutrient dense than animal products and also contain more carbohydrate per serving, compared to eggs or chicken for example. We need around 30 grams of protein with each meal to trigger muscle protein synthesis. Muscle is a very important aspect of managing PCOS symptoms as it is a way for the body to uptake glucose from the bloodstream, plus it increases our metabolic rate. This means that the more muscle we have on our body, the more we can tolerate carbohydrates/sugars and we will be burning more calories at rest.
In my experience of working with women who have PCOS, I have found a plant-focused diet, with the use of high quality animal protein as a condiment, to work best.
This isn't to say that veganism won't work great for you! It's all individual. Plus you may have different requirements throughout different stages of your life! What works for you now, may not be suitable in 10-15 years.
What I would say is, if you are currently consuming a vegan diet and feel like you are 'doing everything right' in terms of sleeping well, exercising, managing stress and avoiding environmental toxins, however you're still struggling with symptoms such as acne, missing periods, infertility or hair loss, consider reintroducing animal protein for a short period of time to see if you notice any improvement.
The Importance of Gut Health
Digestive issues commonly occur alongside hormone imbalances, like PCOS. They can be both a driver and a symptom of 'out of whack' hormones. For many people with poor gut health, especially in extreme cases, a lot of fibre rich food, grains, nuts, legumes and seeds can cause or worsen symptoms like bloating, reflux, pain and diarrhoea.
This is one of the many reasons why a paleo, ketogenic or autoimmune diet can be so helpful for these people by reducing symptoms and healing intestinal permeability (aka 'leaky gut'). These diets eliminate common food sensitivities like gluten and dairy, but also possible gut irritants like grains, beans, pulses and soy (common staples of a vegan diet).
Feel like you can't digest meat or lost your appetite for it? If you have lost your appetite for animal protein or feel like you don't digest it well, this is a common symptom of low stomach acid. When your body cannot digest meat well, it can sit in the stomach for too long, leading to a feeling of discomfort, nausea, reflux or heaviness.
Once you eliminate meat, you may actually feel better, however you haven't actually addressed the root cause which is low hydrochloric acid (HCL).
If you try to reintroduce animal protein again in the future you may feel even worse! This is because your stomach acid levels have likely reduced even more, because you haven't been consuming adequate amounts of nutrients like zinc, which are needed for the creation of HCL!
This is a vicious cycle.
Want to go vegan for the health benefits? Contrary to what many fear mongering documentaries and websites may tell you, high quality animal protein does not cause cancer, cholesterol rich fats like grass-fed butter do not clog arteries, and eating an egg is not equivalent to smoking 5 cigarettes a day!
As I have already mentioned, there are several nutrients that we just cannot get enough of, from a strict vegan diet, without the use of supplementation. B12 in particular, may not show as a deficiency right away as it can be stored in the body, however if left unchecked, a B12 deficiency can result in irreversible damage to the nervous system.
An anti-inflammatory, real food diet that contains both plant and animal foods can be highly beneficial for women with PCOS.
Veganism and the environment I'm not an expert on this subject, but I do know there is a lot of false information and statistics being shared online. I am totally against factory farming, feedlots and conventionally raised meat, however I believe that organic farming practices can actually benefit the planet and obviously, our health.
For more information on this subject, check out the work of Diana Rodgers of Sustainable Dish. Everyone needs to read this article.
Veganism for ethical reasons Again, Diana has a ton of information on this subject. I am against the inhumane, unsanitary and cruel living conditions of many conventional feedlots. The meat and animal products I buy are from a local organic farm where the animals are treated well, cared for and respected.
It is impossible to follow a diet that doesn't harm or kill a living organism. When tractors are collecting crops on the field, mice, birds, insects and rabbits are killed during the process. It can also be argued that plants have feelings and are 'living beings' too.
By eating a vegan diet are you therefore saying that the life of a field mouse is less than that of a chicken?
Mother nature isn't all sunshine and rainbows. (You just need to watch a wildlife documentary to see that!) In my opinion it is more humane for an animal to be killed quickly after being stunned , than for it to be savaged in nature by a group of wild coyotes.
Obviously this is a very sensitive subject and I totally support anyone who chooses to eat a vegan diet, however I like to ensure the individual is fully aware of the possible downsides and their other options.
If you've got 4 hours to spare I recommend you listen to this episode of the Joe Rogan podcast for a paleo vs vegan diet debate. Chris Kresser (paleo diet) was absolutely amazing in this podcast and debunked a lot of myths about the 'harmful' effects of meat.
If you are struggling with your PCOS and would like 1-on-1 support, in order to find the best diet for you and address the root causes of your hormone imbalances, click here.