Keto Diet: A Solution For Hirsutism?

Hirsutism is a common symptom of polycystic ovary syndrome (PCOS), a hormonal condition that affects one in ten women in their childbearing years. Women with PCOS may have higher levels of testosterone than expected, which can lead to excessive body hair on the face or chin. PCOS is usually managed through a combination of medications and lifestyle changes, including weight loss plans.

The keto diet is a low-carb, high-fat diet that can improve insulin sensitivity and has been found to help balance hunger hormones and promote weight loss in people with obesity and type 2 diabetes.

A handful of recent studies have investigated the effects of keto diets on PCOS. In one 12-week study of 14 women with PCOS, a keto diet high in plant foods resulted in significantly lower blood sugar and insulin levels, as well as better insulin resistance scores. In another study of 18 women with PCOS, liver dysfunction, and obesity, participants who consumed a ketogenic diet for 12 weeks experienced significant improvements in blood sugar levels, indicating an improvement in insulin sensitivity.

In addition to improving insulin resistance, the keto diet has also been found to help women with PCOS lose weight, improve their balance of sex hormones, reduce triglyceride and cholesterol levels, normalize their menstrual cycles, and improve their fertility.

However, the keto diet is extremely restrictive and may be difficult to follow long-term. A less restrictive low-carb approach may offer similar benefits. More research on the effects of keto on PCOS is needed.

Dairy and keto

Dairy is a broad term for any food produced from or containing the milk of mammals. This includes milk, yoghurt, cheese, butter, ghee, cream, custard, kefir, casein, whey, ice cream, frozen yoghurt, and more.

The ketogenic diet is based on swapping the body's main source of energy from carbohydrates to fat. This means eating a diet very low in carbs, high in fat, and moderate in protein.

So, can you have dairy on the keto diet? Yes, with caveats.

Some dairy products are great sources of protein, fat, potassium, and calcium, and make a lot of sense for keto. But the keto diet is more restrictive when it comes to other dairy foods—and that's mostly due to sugar, which equals carbs.

Pros of eating dairy on the keto diet:

• Dairy contains fat, which takes longer to digest and helps us stay full for longer.
• Most dairy products adequately supply the body with valuable protein, fat, and calories, so you may be less likely to snack between meals.
• Dairy supplies calcium, phosphorus, and vitamin D, which are needed for maintaining healthy bones and are integral to balancing mood and regulating hormones.

Cons of eating dairy on the keto diet:

• Dairy products contain sugar in the form of lactose. Lactose breaks down into glucose, which is the sugar that pushes you out of ketosis.
• Some people have a hard time tolerating lactose due to lactose intolerance or lactose sensitivity, which can lead to gastrointestinal side effects like bloating or diarrhoea.
• It's easy to overdo it with dairy, especially with soft serve, milk, or ice cream.

Dairy foods that don't work on a keto diet:

• Higher-carb dairy products like ice cream and flavoured milk will have a higher sugar content compared to cheese or plain milk.
• Sweetened yoghurts can pack close to 40 grams of carbs per serving, so they may need to be enjoyed in smaller portions or swapped for a lower-carb alternative.

Dairy foods that do work on a keto diet:

• Butter is an ideal source of fat on the keto diet, with zero carbs and about 11 grams of fat per tablespoon.
• Hard and soft cheeses get the green light on the keto diet. Harder cheeses like Parmesan typically have fewer carbs than soft cheeses.
• Semi-hard cheeses like Swiss are also keto-friendly.
• Brie cheese has less than a gram of carbs per ounce.
• Mascarpone and crème fraîche give you tons of added flavour and creaminess for very few carbs.
• Cottage cheese, sour cream, and Greek yoghurt have similar carb content—about 11 grams of carbs per cup—so they're doable, as long as you keep your carb content in check.

Non-dairy alternatives:

You can absolutely do keto without dairy. Unsweetened almond milk, for example, is a good dairy-free alternative to regular milk, and you can also find plant-based yoghurt alternatives.

The bottom line:

To make dairy work on the keto diet, choose dairy products that are low in carbs and without added sugar.

Weight loss and keto

The ketogenic diet is a low-carbohydrate, high-fat eating plan that has been used for centuries to treat specific medical conditions. The diet has been shown to produce beneficial metabolic changes in the short term, including weight loss, and improvements in total cholesterol, blood sugar, and blood pressure.

How it works

The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose—the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods—an alternative fuel called ketones is produced from stored fat. The brain demands the most glucose in a steady supply because it cannot store glucose. During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose.

When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise.

Weight loss

The ketogenic diet has been shown to produce beneficial metabolic changes in the short term. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides.

Challenges

The keto diet can be challenging to maintain. Possible symptoms of extreme carbohydrate restriction that may last days to weeks include hunger, fatigue, low mood, irritability, constipation, headaches, and brain “fog.” Though these uncomfortable feelings may subside, staying satisfied with the limited variety of foods available and being restricted from otherwise enjoyable foods like a crunchy apple or creamy sweet potato may present new challenges.

Tips for success

• Focus on carbs only: The keto diet is an HFLC (high-fat and low-carb) diet. It's extremely low-carb—you're "allowed" to eat just 20 grams in a day, which is super low.
• Plan, plan, plan: The key to hitting your number was to plan, plan, plan. I planned out all three meals, condiments, and snacks on the weekends for the next week.
• Be creative in the kitchen: Eating at a restaurant and keeping your keto status is almost impossible—and after asking the server to hold the onions from your chicken fajitas for the third time, you'll never want to go into a restaurant again. Luckily, I consider myself an adventurous cook and love trying new recipes.
• Be realistic: It's important to remember that when you are on a low-carb diet of any type, you will lose several pounds in the first few days. That's because your body is dropping water weight.
• Manage stress and get enough sleep: Research shows that stress, especially chronic stress, and lack of sleep can negatively impact weight loss.
• Get moving: Incorporating more physical activity into your lifestyle is vital when trying to lose weight on a ketogenic diet.

Insulin resistance and keto

Insulin resistance is defined as a defect in the insulin-mediated control of glucose metabolism, predominantly in muscle, fat, and liver tissues. It is a pre-stage for type 2 diabetes and is associated with non-alcoholic fatty liver disease. Insulin resistance is related to overweight/obesity tissues' exposure to high energy density foods and the accumulation of related toxic by-products.

The ketogenic diet (KD) is a diet in which the amount of carbohydrate is limited to less than 50 g per day, while the intake of fat is increased to assure an adequate energy intake. The term "Therapeutic Ketogenic Diet" refers to severely restricted diets in both carbohydrate and protein, which are typically used in the treatment of epilepsy and cancer.

The KD has been considered an interesting alternative to improve insulin resistance. However, most studies do not allow a clear distinction between its effects on insulin sensitivity per se and the effects of weight loss induced by KDs on insulin sensitivity.

The restriction in digestible carbohydrates decreases intestinal absorption of monosaccharides, leading to reduced postprandial glycemia, decreased insulin requirements from the pancreas, and lower insulin levels and insulin-to-glucagon ratio. The effectiveness of the KD in lowering fasting blood glucose was confirmed in a recent meta-analysis including type 2 diabetes patients, which showed a decrease of about 1.29 mmol/L in fasting blood glucose and 1.07 in glycated hemoglobin (HbA1c).

The KD also improves fat oxidation and, therefore, lowers the respiratory quotient (RQ). This suggests an increase in fat metabolism for energy use as one of the most important mechanisms of the KD on fat loss.

The KD has been shown to improve skeletal muscle mitochondrial capacity and efficiency, optimizing fat oxidation and improving metabolic health markers.

The KD is capable of significantly reducing the amount of visceral adipose tissue depots, both in sedentary and active/athletic subjects.

The KD increases hepatic mitochondrial redox state in the liver in humans and, in a rat model, its anti-steatogenic effects are mediated by the increased liver expression of genes involved in mitochondrial biogenesis and fatty acid oxidation.

Hormone balance and keto

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women during their reproductive years. It is associated with insulin resistance, hyperandrogenism, and the presence of polycystic ovaries. Insulin resistance is a key factor in the onset of PCOS, and it is characterised by the body's inability to respond appropriately to the hormone insulin, which helps regulate blood sugar levels and fat storage. Insulin resistance can lead to elevated blood sugar and insulin levels, resulting in weight gain and obesity.

The keto diet is a low-carb, high-fat diet that has been found to improve insulin sensitivity and promote weight loss. By reducing carb intake, the body is forced into a state of ketosis, where it burns fat for energy instead of carbohydrates. This can be beneficial for people with PCOS as it helps regulate insulin levels and promote hormonal balance.

Several studies have investigated the effects of keto diets on PCOS. In a 12-week study, 14 women with PCOS who followed a keto diet high in plant foods experienced significantly lower blood sugar and insulin levels, indicating improved insulin sensitivity. Another study found that a keto diet improved blood sugar levels and liver function in women with PCOS and obesity. Furthermore, a 45-day study showed that a keto diet reduced blood sugar and insulin levels, improved insulin sensitivity, and promoted weight loss and hormonal balance in women with PCOS and obesity.

While the keto diet may provide benefits for people with PCOS, there are also some potential downsides. Some studies have found that keto diets can increase cholesterol levels, which may be a concern for those with high cholesterol. Additionally, the restrictive nature of the keto diet may make it difficult to follow long-term. A less restrictive low-carb diet may offer similar benefits while being easier to adopt as a long-term lifestyle change.

Overall, the keto diet may be a useful tool for managing PCOS by improving insulin sensitivity, promoting weight loss, and balancing hormones. However, larger and longer-term studies are needed to fully understand the effects of keto on PCOS. It is important for individuals with PCOS to work closely with healthcare professionals to monitor their progress and make any necessary adjustments.

Fertility and keto

The ketogenic (keto) diet is a high-fat, low-carbohydrate diet that has been shown to have promising effects on women with Polycystic Ovary Syndrome (PCOS). PCOS is a common endocrine disorder in women of childbearing age, affecting their fertility.

Keto and PCOS

PCOS is characterised by clinical signs such as elevated levels of testosterone and other androgen hormones, irregular periods, and large ovaries with many small follicles. The keto diet has been found to help women with PCOS lose weight and maintain weight loss, improve their fertility, optimise their cholesterol levels, and normalise their menstrual cycles.

A meta-analysis of clinical trials in women with PCOS on the keto diet showed that the diet improved reproductive hormone levels, which influence fertility. The women on the keto diet for at least 45 days saw significant weight loss and a lower follicle-stimulating hormone ratio, which means they may have a better chance of ovulating. The women also had lower testosterone levels, which could help with excess hair growth and other symptoms of excess male sex hormones.

Other Diets for PCOS

Other dietary approaches to managing PCOS include the low-glycemic index diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the Mediterranean diet.

The low-glycemic index diet is characterised by most carbohydrates coming from low-glycemic index sources. This type of diet has been found to decrease inflammation in women with PCOS by increasing uric acid concentration and glutathione peroxidase activity.

The DASH diet is a dietary pattern high in carbohydrates and fibres, magnesium, potassium, and calcium, and low in fats. It was designed primarily for blood pressure control, but it has also been found to have beneficial effects on markers of insulin resistance, inflammation, oxidative stress, and hormonal profile in women with PCOS.

The Mediterranean diet has been found to have anti-inflammatory effects and help decrease body weight in women with PCOS. The diet is based on the regular consumption of fibre, vitamins, antioxidants, unsaturated fats, carbohydrates with a low glycaemic index, and a moderate intake of animal protein.

The keto diet has been shown to have positive effects on fertility in women with PCOS. However, other dietary approaches, such as the low-glycemic index diet, the DASH diet, and the Mediterranean diet, have also been found to have benefits for women with PCOS. More research is needed to determine the optimal dietary approach for managing PCOS and improving fertility.

Frequently asked questions