According to the National Institutes of Health, around 5 million women in the United States suffer from Polycystic Ovary Syndrome (PCOS). Unfortunately, many women remain unaware of the effects a healthy diet has on the sustainable management of PCOS.

As part of our segment on PCOS, Dreaming of Baby acquired professional insight from Angela Grassi, MS, RDN, LDN, author of The PCOS Workbook: Your Guide to Complete Physical and Emotional Health, and founder of the PCOS Nutrition Center. Angela Grassi shares how basic lifestyle changes can do wonders in helping you deal with this syndrome.

Daniela: Good morning Angela, it’s a pleasure to welcome you on Dreaming of Baby! Today we will be discussing Polycystic Ovary Syndrome (PCOS) from a diet and nutrition perspective, with a specific focus on treatment and its effects on fertility. To start with, it would be great if you could tell us a little about your experience in dealing with PCOS, both personally and professionally.

Angela Grassi, MS, RDN, LDN: I was diagnosed with PCOS one year after getting married. I always had a hunch I had PCOS even though I didn’t have the classic symptom of irregular periods. I did gain a rapid amount of weight (40 Lbs in under 3 months) and had no reason why. I gained the weight despite exercising daily and eating an average diet. I saw three doctors before seeing Dr. Katherine Sherif in Philadelphia who specializes in PCOS. She ran the appropriate tests and it turned out that I had high insulin, was on the verge of pre-diabetes, and did have PCOS.

I wanted to know if I had it or not because my husband and I wanted to try to start a family. I knew PCOS was the leading cause of infertility. Driving home the day of my diagnosis, I knew I wanted and needed to educate others about PCOS. So I wrote PCOS: The Dietitian’s Guide to start with, and then came the PCOS Workbook and PCOS Nutrition Center Cookbook. Today I counsel hundreds of women each year to improve their fertility and take control over PCOS through their lifestyle.

I was able to conceive both of my sons, now 10 and 7, with no difficulty as a result of making lifestyle changes.

Daniela: Wow, it’s impressive how you changed such a diagnosis into something very positive, also helping others in the process. In your view, how important is nutrition in dealing with PCOS?

Angela Grassi, MS, RDN, LDN: Yes, it was a way for me to cope and deal with it.

Nutrition is the first line of treatment for PCOS. A woman can change her exercise and take medicine, but she really needs to improve her diet for best results.

Daniela: Can changes in diet replace the need for other medical treatments, or they go together? Basically, can a woman opt solely for changes in nutrition rather than go on a more medicalized route?

Angela Grassi, MS, RDN, LDN: Sometimes. It can depend on the woman. If she is really insulin resistant, she may need medications but often times, diet changes and supplements can really make a difference, especially when it comes to fertility.

Daniela: That’s encouraging to hear. For the woman who has just been diagnosed with PCOS, what would be the first step in terms of dietary choices?

Angela Grassi, MS, RDN, LDN: I recommend cutting out sugary drinks and foods as much as possible. Maybe switch that morning macchiato to a regular latte for example. But sometimes women with PCOS focus too much on foods they shouldn’t be eating instead of foods that can improve their egg quality and lower insulin, like antioxidants. Antioxidants come from fruits, vegetables, whole grains, and unsaturated fats like fish and olive oil.

‘Nutrition is the first line of treatment for PCOS. A woman can change her exercise and take medicine, but she really needs to improve her diet for best results.’

Daniela: How do antioxidants, specifically, help improve fertility in women suffering from PCOS?

Angela Grassi, MS, RDN, LDN: It is believed that women with PCOS, because of their hormone imbalance, don’t have good quality eggs. A lot of times, their eggs are immature and don’t fully develop. Antioxidants have been shown to improve egg quality and ovulation.

Daniela: And how long does it take for symptoms related to PCOS to improve, following dietary changes and better nutritional choices?

Angela Grassi, MS, RDN, LDN: It really depends on the woman and the severity of her symptoms but in as little as a few weeks’ time, she may experience reduced cravings for sugar and her weight may go down. In a month to three months, most see improvement in menstrual regularity.

Daniela: Does this mean that for the woman who is trying for baby, such dietary changes lead to better chances for conception in a few months’ time?

Angela Grassi, MS, RDN, LDN: Yes! And I wish all reproductive endocrinologists/fertility experts would recommend women with PCOS to consult with registered dietitians who specialize in PCOS for this reason. Not only will a healthy diet improve her fertility, but it will also prepare her body for the demands of pregnancy.

Daniela: In this regard then, what would be the ideal first step in efforts to treat PCOS?

Angela Grassi, MS, RDN, LDN: It depends on factors like her age, how long she has been trying already but ideally, taking a few months to work on your diet if you have the time, may help with fertility significantly.

Best food to manage PCOS

Daniela: Turning to food choices again, how would the ideal day look like – food choice wise – for someone on the journey towards treating PCOS and also trying for baby?

Angela Grassi, MS, RDN, LDN: Start the day with an omelet with veggies, and a slice of sprouted grain toast; for lunch, a salad with chickpeas, shrimp, veggies, olive-oil based dressing and fruit; an afternoon snack of apple and nut butter; followed by a dinner of grilled salmon, veggies, and quinoa.

Daniela: Sounds very good! I’m sure this will help many women on their journeys. You mentioned earlier that following a healthy diet would also prepare a woman’s body for the demands of pregnancy. In which ways is this so?

Angela Grassi, MS, RDN, LDN: A healthy diet would get her iron stores up as well as vitamin D and omega-3s, all of which tend to be depleted by the end of pregnancy. Lowering insulin before pregnancy is also recommended in order to reduce the risk of gestational diabetes.

Daniela: In relation to insulin levels, does this mean nothing sugary then?

Angela Grassi, MS, RDN, LDN: Sugar as well as processed foods tend to raise insulin more than other foods.

Daniela: In that case, opting for whole foods is a safer bet for treating PCOS, improving fertility, and preparing your body for pregnancy?

Angela Grassi, MS, RDN, LDN: Yes, absolutely! I also recommend organic when possible.

Daniela: Thank you for all the insight you shared with us today! If there is one final message that you could impart to a woman wishing to conceive but who is also suffering from PCOS, what would it be?

Angela Grassi, MS, RDN, LDN: There is so much that feels out of control when you are going through infertility. How you feed and care for your body is something you can control that can increase your chances of pregnancy.

Let the Professionals inform you about PCOS. Read more here:

What you need to know about Polycystic Ovary Syndrome (PCOS)

How Lifestyle Choices Affect Fertility in PCOS patients

PCOS: The Truth About Your Eggs

Diagnosing PCOS in Adolescence

PCOS: A Personal Journey to Motherhood

The Emotional and Mental Effects of PCOS

PCOS: Preparing for your OB-GYN Appointment