I have PCOS do I need to go Gluten Free and Dairy Free?  

Polycystic ovarian syndrome (PCOS) affects approximately 15% of women of reproductive age and 70% of women living with the condition are estimated to remain undiagnosed! PCOS is a complex hormonal disorder which presents itself differently from one woman to another. Therefore anyone pushing a blanket approach such as cutting out all gluten and dairy to help all women with PCOS just isn’t true and the science backs that up.  

The symptoms of PCOS range from irregular cycles, ovulatory disorder, higher amounts of testosterone leading to unwanted facial hair, hair thinning, difficulty losing weight, insulin resistance, acne and or the appearance of cysts on the ovaries.  This is not a comprehensive list of symptoms but a brief insight to the possible combinations of symptoms that affect women with PCOS.  

PCOS also impacts women who are lean and to date most of the research data is targeted at women losing weight to manage the condition, therefore may not be appropriate methods to treat PCOS. This highlights the importance of a tailored approach to managing the condition to each woman’s unique combination of symptoms and what is driving her PCOS.  

In addition women with PCOS are also at a higher risk long term health complications such as diabetes, obesity, higher cholesterol, poor gut health, micronutrient and vitamin deficiencies, poor mental health and body image.  The research and the current guidelines recommend that diet and lifestyle strategies are first line therapy for managing the condition to prevent these poor health outcomes later in life. This is also important to consider when determining if cutting out major food groups is a sustainable solution to achieving hormonal balance and supporting long term health.  

Read more on how PCOS is diagnosed here: How is PCOS diagnosed? | Jean Hailes

Let’s have a closer look at why cutting out dairy and gluten may not be the answer:  

Gluten Free 

A gluten free diet typically results in cutting out the intake of cereals and grains like oats, noodles, pasta, bulgur, and couscous- which are important sources of carbohydrate, dietary fibre, B-group vitamins, Iodine and vitamin E. A gluten free diet can be limiting and often gluten free convenience foods tend to be more processed. Unless you have coeliac disease going gluten free is unnecessary as there is no current evidence that it useful for managing PCOS. In fact a diet that has carbohydrates in the right amounts and are slow releasing known as  low GI provide sustained energy and have been found to be helpful in managing women who have PCOS and in particular that suffer from insulin resistance as well.  

In addition, if you are trying to conceive (TTC) it is important to be aware that Australian law does not require gluten-free breads to be fortified with folic acid (unlike wheat-based breads), thus women of childbearing age who follow a gluten-free diet have an increased risk of folate deficiency. Folate is incredibly important for preventing neural tube defects and folate levels should be optimized before TTC.  

Dairy Free  

Unfortunately there just isn’t enough evidence that cutting out dairy will help to manage PCOS so this is also unnecessary. Particularly when there is so many other evidenced based dietary interventions that may have a greater impact on managing PCOS for the long-term.  Therefore the role of seeing prenatal dietitian who specializes in PCOS is key in determining, what dietary intervention is appropriate for you.  

What we do know about dairy is women who were following a “fertility diet” which included full fat dairy products have been shown to have a lower risk of ovulatory infertility (not releasing an egg during your cycle).  

The study highlighted that women who followed this diet which consisted of plant protein, sources of iron, full fat dairy and monounsaturated fats had a 66% lower risk of ovulatory infertility and a 27% lower risk of infertility compared to women who did not adopt this dietary pattern during the time of preconception (chevarro, 2017 Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility)

Sources of full fat dairy are highly nutritious and are great low GI option these include: milk, yoghurt and cheese.  The current research links dairy consumption to improved fertility.  Meeting your daily intake can be achieved by aiming for 2-3 serves a day or 1000mg per day.  

However if you have an intolerance to dairy then yes go dairy free and you should absolutely get personalized  advice by a prenatal dietitian to ensure your diet is adequately meeting your dietary needs and is beneficial for your fertility.