In my previous article, we looked at what makes intermittent fasting (IF) an effective tool for managing PCOS. However, for IF to be successful, it needs to become a habit and a lifestyle. Here are some tips based on my clinical experience that will help you create a long-term PCOS management plan.

Choosing Suitable Fasting Methods

You have a number of options when it comes to choosing the length of your fast. Because different methods work for different people, it’s a good idea to try out a few options before committing to a single method.

• Daily 12:12 Method: For this method, fasting and eating windows are both 12 hours. This is the easiest form of intermittent fasting since the fasting window includes sleep time. As a PCOS patient, you should use the 12:12 method to train your body before moving on to a more intense fast. Due to the fact that you often have uncontrollable cravings caused by high levels of insulin and low levels of glucose in the bloodstream, I would suggest training before taking on long fasts. A failure to train will likely increase your stress levels and aggravate the symptoms of PCOS.

• Daily 14:10 Method: This method involves a fasting window of 14 hours, which is a 2-hour increase from the 12:12 method. It is typically used as a transition between the 12:12 and 16:8 methods, for good reason. It’s a good idea for you to practice the 14:10 method for a few weeks before moving on to the 16:8 method. The 14:10 method improves PCOS through greater weight loss and better blood glucose control as compared to the 12:12 method. ^[1]

• Daily 16:8 Method: This method is the best option for managing PCOS. With a 16-hour fast, this approach provides a fast long enough to cause autophagy to occur^[2]. The 16:8 method also reduces PCOS symptoms by improving insulin resistance, increasing metabolism, and restricting calories.

• Crescendo Fasting: This method is a version of the 16:8 method, but instead of fasting every day, you’ll  fast on 3 non-consecutive days each week. This is a good option if you want the benefits of intermittent fasting, but find the daily 16:8 method to be too intense. Find more details about crescendo fasting here.

• Extended Fasting Hours: You may choose to fast for longer hours, such as a 24-hour fast, once a week or once a month. Long fasts may increase autophagy. However, many people struggle to be consistent about extended fasting and making it a lifestyle.  Keep in mind that prolonged fasting might cause micronutrient deficiency, electrolyte imbalance, and fatigue if it’s not done properly ^[3]. If your body can handle it and you want to take full advantage of extended fasting, combine once a month extended fasting with a daily 16:8 practice.

Choosing The Right Foods

When using intermittent fasting to improve PCOS, it is important to intake the appropriate calories and nourish your body with healthy food choices during the eating windows. Here are some of the best foods that I often recommend to my patients to maximize the benefits of IF.

Carbohydrates

Although carbohydrates provide the body with necessary energy, you need to limit your carbohydrate intake to manage PCOS effectively. When you eat carbohydrates, choose complex carbohydrates over simple carbohydrates. Complex carbohydrates include whole grains (wheat, brown rice, whole wheat, oatmeal, etc.) and legumes (kidney beans, black beans, lentils, etc.). Avoid simple carbohydrates like sugar, candies, fruit juices, sugary drinks, or processed foods.

You also need to avoid gluten as much as possible, since gluten increases inflammation in the body and elevates PCOS symptoms ^[4]. Wheat, rye, and barley are the major sources of gluten. You need to avoid all the foods made from these grains, including loaves of bread, cereals, pasta, crackers, soups, gravies, or canned items.

Vegetables and Fruits

Vegetables and fruits are healthy options; however, it is always better to choose non-starchy vegetables (kale, spinach, cauliflower, asparagus, etc.) rather than starchy vegetables (potatoes, peas, corn, etc.). In the case of fruits, select low-GI fruits (GI stands for Glycemic Index. It’s a value assigned to foods based on how quickly and how high those foods cause increases in blood sugar). Examples of low-GI fruits are berries, citrus fruits, avocado, etc. Eating those fruits is better than high-GI fruits such as dates, mangoes, etc.

Dairy

Consumption of dairy products such as milk, cheese, and yogurt can increase cortisol levels in female bodies suffering from PCOS. It would cause irritability, weight gain, headaches, bloating, constipation, and a rise in stress levels. In fact, there is a link between milk intake and risk for PCOS ^[5].

You don’t need to skip dairy altogether, but consumption should be limited when you can.

Seeds

Seeds such as hemp seeds, sunflower seeds, chia seeds, pumpkin seeds, and sesame seeds have essential fatty acids, minerals, vitamins, proteins, and fibers that can help reduce PCOS symptoms ^[6].

REMEMBER, always try to choose the right foods following these guidelines:

• Limit sugary items
• Avoid processed foods
• Eat low-GI fruits. Also, eat real fruits instead of juice (Don’t squeeze them!)
• Opt for non-starchy vegetables over starchy vegetables.
• Incorporate natural and whole foods
• Avoid low fiber cereals such as white flour, white rice, etc
• Increase intake of green leafy vegetables
• Include lean source of protein in every major meal
• Stay hydrated, especially during fasting hours

References:

^[1] Peeke PM, Greenway FL, Billes SK, Zhang D, Fujioka K. Effect of time restricted eating on body weight and fasting glucose in participants with obesity: results of a randomized, controlled, virtual clinical trial. Nutrition & diabetes. 2021 Jan 15;11(1):1-1.

^[2] Moro T, Tinsley G, Bianco A, Marcolin G, Pacelli QF, Battaglia G, Palma A, Gentil P, Neri M, Paoli A. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of translational medicine. 2016 Dec;14(1):1-0.

^[3] Jackson JM, Blaine D, Powell-Tuck J, Korbonits M, Carey A, Elia M. Macro-and micronutrient losses and nutritional status resulting from 44 days of total fasting in a non-obese man. Nutrition. 2006 Sep 1;22(9):889-97.

^[4] Golub SA, Cantor A, Smith KS. Polycystic Ovarian Syndrome (PCOS). InAdolescent Nutrition 2020 (pp. 631-662). Springer, Cham.

^[5] Rajaeieh G, Marasi M, Shahshahan Z, Hassanbeigi F, Safavi SM. The relationship between intake of dairy products and polycystic ovary syndrome in women who referred to Isfahan University of Medical Science Clinics in 2013. International Journal of Preventive Medicine. 2014 Jun;5(6):687.

^[6] Irfan T, Seher K, Rizwan B, Fatima S, Sani A. Role of Seed Cycling in Polycystic Ovarian Syndrome: Seed Cycling in PCOS. Pakistan BioMedical Journal. 2021 Dec 31;4(2):21-5.