Low Carb vs Keto for PCOS: Which Diet is Better for Managing Symptoms?

For women with PCOS (Polycystic Ovary Syndrome), the constant battle with symptoms like weight gain, fatigue, and irregular periods can feel overwhelming. Every woman’s experience with PCOS is unique, and managing these symptoms can often be frustrating. One powerful tool in managing PCOS is diet, but what works for one woman may not work for another. Here, we’ll explore two popular approaches—low carb and keto—so you can make an informed decision about what might work best for your body.

Both low carb and ketogenic diets focus on reducing carbohydrate intake, which can improve insulin sensitivity and help manage weight, but they differ in approach.

Understanding PCOS and insulin resistance

PCOS is a hormonal disorder that affects how a woman’s ovaries function, and one of the hallmark issues is insulin resistance. Insulin resistance occurs when the body’s cells don’t respond properly to insulin, causing the pancreas to produce more insulin to keep blood sugar levels in check. Think of insulin as a key that opens the door to your cells so they can use glucose for energy. In women with PCOS, insulin resistance is like having a key that doesn’t fit well in the lock, forcing the pancreas to produce more insulin.

This extra insulin can lead to weight gain, increased hunger, and higher levels of androgens (male hormones like testosterone), worsening symptoms like acne, irregular periods, and unwanted hair growth. If insulin resistance is left unchecked, it can even lead to type 2 diabetes, making dietary changes crucial for managing PCOS.

Reducing carbohydrate intake can help manage insulin resistance by lowering blood sugar levels and making the body more sensitive to insulin. This is where low carb and keto diets can be particularly beneficial.

What is a low carb diet?

A low carb diet typically involves reducing carbohydrate intake to anywhere between 100-150 grams per day. The focus is on limiting starchy foods, grains, and sugars while prioritizing protein, healthy fats, and non-starchy vegetables.

On a low carb diet, you’ll focus on limiting starchy foods like bread, pasta, rice, and sweets. Instead, you’ll eat nutrient-dense, low-carb options like leafy greens, broccoli, nuts, seeds, and healthy fats. It’s important to keep an eye on your carb intake—using a carb-tracking app can help. A low carb diet can stabilize blood sugar, which may not only support weight loss but also help reduce fatigue and improve mood swings, which are common in PCOS.

Foods allowed on a low carb diet include:

• Lean meats like chicken, turkey, and fish.
• Non-starchy vegetables such as leafy greens, broccoli, and cauliflower.
• Healthy fats like olive oil, avocado, and nuts.

By reducing your intake of carbohydrates, you lower the amount of insulin your body needs, improving insulin sensitivity and reducing PCOS symptoms.

What is the keto diet?

The ketogenic diet takes carbohydrate restriction to the next level by limiting carbs to about 20-50 grams per day. This pushes the body into a state of ketosis, where it starts using fat as its primary fuel source instead of carbohydrates. This can lead to rapid fat burning and significant weight loss, which can be beneficial for women with PCOS who struggle with weight management.

Achieving ketosis requires careful tracking of carbs, often under 20-50 grams per day. Some women use ketone testing strips to see if they’re in ketosis. While the keto diet can offer rapid weight loss and improved insulin sensitivity, the first few days can be tough, leading to ‘keto flu’—a period of fatigue, headaches, and nausea as your body adapts to burning fat for fuel. Staying hydrated and consuming enough electrolytes can ease these symptoms.

Typical keto foods include:

• High-fat foods like avocados, fatty fish, nuts, and oils.
• Very low-carb vegetables like spinach, kale, and zucchini.
• Moderate protein from meat, poultry, and eggs.

Keto’s strict guidelines can make long-term adherence challenging, but its benefits for women with severe insulin resistance are often significant.

Low carb vs keto: Key differences

Both diets aim to lower carbohydrate intake, but they differ in how restrictive they are and how they affect the body.

• Carb intake: Low carb diets allow more flexibility with carbs (up to 150 grams), while keto restricts carbs to 20-50 grams per day.
• Fat intake: The keto diet emphasizes a high-fat intake (up to 70-80% of total calories), while low carb diets are not necessarily high-fat.
• Ketosis: Keto puts the body into a state of ketosis, whereas low carb diets typically do not.
• Flexibility: A low carb diet allows more food variety and may be easier to maintain long-term, while keto is much more restrictive.

Who might benefit most from each diet?

• Keto: Women with severe insulin resistance or who need rapid weight loss might find keto more effective, as it quickly improves insulin sensitivity.
• Low carb: If you’re looking for a diet that allows for more food variety and is easier to follow in social situations, a low carb approach may be more sustainable.

Benefits of low carb diet for PCOS

• Improved insulin sensitivity: By reducing carbs, the body requires less insulin, which can help lower insulin resistance and manage PCOS symptoms.
• Sustainable weight loss: Low carb diets offer moderate weight loss, but the flexibility makes it easier for long-term adherence.
• Hormonal balance: Studies show that a low carb diet can help regulate hormones and improve menstrual regularity for women with PCOS.
• Mental clarity and reduced inflammation: Many women report that a low carb diet helps reduce brain fog and improve mental clarity. Additionally, lowering inflammation can reduce bloating and joint pain.
• Dietary flexibility: A low carb diet offers more food choices and is easier to stick to compared to keto, which can feel restrictive.

Benefits of keto diet for PCOS

• Enhanced insulin sensitivity: The ketogenic diet is highly effective at reducing insulin levels and improving insulin sensitivity, which is key for managing PCOS.
• Rapid weight loss: The state of ketosis allows the body to burn fat more efficiently, leading to quicker weight loss.
• Hormonal balance: Keto can help reduce testosterone levels and alleviate symptoms like acne, excessive hair growth, and irregular periods.
• Anti-inflammatory effects and gut health: Keto’s anti-inflammatory effects can also help reduce joint pain and acne. Additionally, keto may improve gut health by promoting healthy bacteria in the gut.

However, keto’s restrictive nature can make long-term adherence difficult, especially when eating out or attending social events. It’s essential to monitor your nutrient intake to avoid deficiencies, particularly in fiber, vitamins, and minerals.

Potential drawbacks of low carb and keto diets

• Low carb diet: While less restrictive, low carb diets may not reduce carbs enough for some women with severe insulin resistance, meaning it could take longer to see significant results.
• Keto diet: The keto diet can be difficult to maintain long-term due to its strict nature. Side effects like “keto flu” (fatigue, headache, nausea) may occur in the early stages. It also requires careful planning to avoid nutrient deficiencies.
• Nutrient deficiencies: Both diets can limit certain food groups, such as fruits and whole grains, which may lead to a lack of important vitamins, minerals, and fiber if not carefully managed.
• Social flexibility: When dining out or attending social events, sticking to either diet may be challenging. Planning ahead can help you stay on track without feeling left out.

Tips for overcoming challenges

• Combat nutrient deficiencies by focusing on fiber-rich low-carb vegetables and taking a multivitamin if necessary.
• If you experience keto flu, stay hydrated, increase your salt intake, and consider adding a magnesium supplement.
• When dining out, choose restaurants with low-carb options or bring your own snacks to avoid falling off track.

Real-life success stories

Many women with PCOS have found success using both low carb and keto diets. Some report that starting with a low carb diet helped them ease into dietary changes, while transitioning to keto provided additional benefits, especially for managing weight and improving energy levels.

Example:
Emily, a 29-year-old woman with PCOS, struggled with weight gain and acne for years. She started with a low carb diet, seeing steady improvements in her energy levels and regular menstrual cycles. After a few months, she transitioned to keto for more rapid weight loss, and within six months, she had lost 30 pounds and saw significant improvements in her skin. Emily says that balancing the two diets over time has helped her find a healthy routine she can maintain long-term.

How to choose the right diet for you

Choosing between low carb and keto depends on your personal health needs, preferences, and lifestyle. It’s important to consult with a healthcare provider or dietitian before starting any new diet, especially if you have PCOS. Both diets offer significant benefits, but the best choice is the one that you can maintain in the long run. You might want to start with a low carb approach and transition to keto if needed, depending on your symptoms and results.

Checklist: Which diet is right for you?

• Do you have severe insulin resistance? → Consider Keto
• Do you prefer more food flexibility? → Consider Low Carb
• Are you aiming for rapid weight loss? → Consider Keto
• Do you need a diet that works in social settings? → Consider Low Carb
• Are you okay with strict guidelines? → Consider Keto
• Do you want a diet you can follow long-term with less restriction? → Consider Low Carb

Conclusion

Both the low carb and keto diets offer promising solutions for managing PCOS symptoms, but the key is finding what works best for you. Start by making small changes—whether it’s reducing carbs or increasing healthy fats—and see how your body responds. Remember, there’s no one-size-fits-all approach, and what matters most is that you find a sustainable path to better health. As always, consult your healthcare provider before making significant dietary changes.

FAQ