All you heard your doctor say was that you have PCOS and high cholesterol and your ears shut off. Your mind is going a mile a minute.

Your period has been a little wonky, and you’re worried what that would mean for your ability to conceive. You were dismissed at first by your doctors and told to lose weight.

You’ve been trying so hard to watch what you’re eating and “be better” with your nutrition. Every time you try to diet, it backfires (like it always does). This has left you guilt-ridden and deep into your binge-restrict cycle extremes. 

At last, your doctor finally started investigating the causes.

Since it’s one of the most common causes of female infertility, your doctors thought PCOS might be a possibility (1). 

What does this mean for your health long term? Why is your doctor talking about your cholesterol levels? What is A1C and why are they watching it?

I’m Melissa and I’m a Registered Dietitian that specializes in Intuitive Eating for special health concerns such as PCOS. I validate your feelings and your fear and I want to let you know that you can absolutely improve your health without dieting and all the guilt.
Let’s get into PCOS, what it means for your health, and how my non-diet approach can help you sort out how to improve your health without the same old diets of your past.

PCOS and high cholesterol

There are a lot of components to PCOS but today’s post will specifically help you to consider cholesterol. We’ll talk about how to manage it and what to do if you’re told your numbers are out of whack.

Cholesterol has gotten a bit of bad wrap but it’s actually needed for our health. 

Your body needs cholesterol to perform its daily functions such as making hormones and digesting fatty foods. 

Your body can make the cholesterol that it needs but we also get cholesterol from food.

Interestingly, your blood cholesterol may have more to do with the types of fat you eat than the cholesterol you eat (more on this a bit later).

Cholesterol becomes a problem when it builds up in your blood. Over time, it can accumulate on the walls of your arteries and form plaque. 
As the plaque builds up, your arteries get narrower, and your blood can’t flow as well to your heart, which can cause chest pain or a heart attack if not addressed. (4).

With PCOS, you can be at increased risk for high cholesterol and therefore heart disease later on. 

You can ask your doctor to assess your cholesterol levels. This will give you a baseline to track what impact your behaviors have on your levels. Talk to them about how often you should have it checked to monitor for any changes. 

Your doctor may order a lipid panel to check your levels of cholesterol (good and bad) and fats in your blood. Here’s what levels you’ll get back:

  • Low-density lipoprotein (LDL) is known as the “unhelpful” cholesterol. High levels can increase your risk of heart disease and stroke
  • High-density lipoprotein (HDL) is known as the “helpful” cholesterol. This cholesterol helps to take cholesterol out of your blood and can reduce your risk of heart disease and stroke
  • Triglycerides are a type of fat in your blood. If you have high LDL cholesterol and low HDL cholesterol with high triglycerides, you may be at increased risk of heart attack and stroke
  • Total cholesterol is a measure of the total amount of cholesterol in your blood (4, 5).

If you get these values back and they are suboptimal, you can review them with your doctor and dietitian (that’s me!) to decide how to combine medication and/or lifestyle changes to support your health.

If you feel some kind of way about needing medication, I want to let you know that you are not a failure, and you’re not alone.

You don’t need to be ashamed of taking medications. Listen to my talk with a fellow dietitian about making informed decisions about how medication may fit into your health care plan.

Unfortunately, some people may stigmatize high cholesterol and high blood sugar because society has come to associate these with folks in larger bodies.

But this is just untrue! Folks in smaller bodies can have high cholesterol and diabetes too. And folks in smaller bodies have PCOS. Regardless of your size, it is no one’s fault when PCOS or altered lab values happen. With awareness – you can address it in line with your personal and health values. 

I encourage you to remind yourself that a diagnosis is not a death sentence, it’s simply the way your unique body works and you can make empowered choices to work with your body and reduce your risk in line with your personal and health values.

Keep reading for some lifestyle changes that can help positively impact your cholesterol – no diet needed!

lifestyle Changes (not a diet) to improve your cholesterol

Even if you have a genetic predisposition to high cholesterol because you have PCOS or a family history, making lifestyle changes can still have an impact on helping your body work better (with or without medications).

The exciting bonus is that even though we’re not talking specifically about improving insulin resistance or your A1C levels, these behaviors will often improve blood sugars as well!

If you want to know more about managing blood sugars and the risk of diabetes, check out my post on how to reverse your risk of prediabetes…without a diet.

Let’s talk about ways (other than focusing on weight) to help improve your cholesterol and risk of cardiovascular disease down the road.

Replace saturated fat with unsaturated fat

Being aware of the types of fat you are eating can help to modify your cholesterol numbers.

Saturated fat is the type of fat that has been shown to increase your LDL cholesterol. And replacing saturated fat with unsaturated fats can help to lower your LDL cholesterol (6).

How do you identify which fats are saturated or unsaturated?

Well, saturated fats are usually solid at room temperature like butter. They are also in animal products like dairy and meat.

Unsaturated fats can be found in foods such as vegetable oils, nuts, and seeds (such as flax and chia).

A handful of mixed nuts on a wooden spoon.

Flaxseed oil omega-3 supplementation has been found to decrease LDL cholesterol, decrease triglycerides, and decrease inflammation in people with PCOS (7).

I’m not saying you need to completely eliminate food with saturated fat from your life – it depends on how often you eat these foods.

My approach is to help you consider ways you can add unsaturated fats into your diet so you can avoid feelings of restriction.

It can help to talk to a dietitian to get personalized advice on adjusting the way you include fats so you don’t feel deprived and fall into old binge and restrict patterns.

Not feeling restricted or deprived helps build sustainable habits, so you can feel happy and satisfied and keep moving forward.

There are other foods and nutrients that we can look at as well.

increase whole grains, vegetables, and beans

What do whole grains, vegetables, and beans have in common? They all contain fiber.

Fiber has many health benefits, one being its beneficial effects on cholesterol and fat in our bodies.

Fiber has been shown to help lower LDL (the unhelpful cholesterol), total cholesterol, and triglycerides (8).

The trouble is that most of us are not eating enough fiber (9). 

If you are looking for some tips on choosing high-fiber foods, and how to include them, check out my blog on interpreting nutrition labels for intuitive eaters.There’s a free worksheet available in this post you might like to use!

Other beneficial nutrients from foods such as almonds, flaxseeds, avocados, and soy protein have been shown to have a lowering effect on LDL cholesterol as well (10).

Here are some ideas to help increase fiber and other helpful nutrients to help lower LDL cholesterol:

  • Enjoy hummus and veggies for a snack
  • Use flaxseed and whole wheat flour in baking
  • Add roasted chickpeas to a salad
  • Nosh on whole grain crackers with carrot sticks and hard-boiled egg
  • Start your day with avocado and smashed edamame on whole-grain toast

Adding new foods into your routine doesn’t have to happen all at once but making small adjustments makes a big impact over time.

There are also lifestyle habits we can look at outside of the food we eat.

if you smoke, get support to quit

Research has shown that smoking can significantly increase total cholesterol, LDL cholesterol, and triglyceride levels (11) but smoking can be a very difficult habit to kick.

Ask your doctor about support programs and if medication is appropriate to help you with quitting.

Three women huddled together and smiling after finishing a long race.

find joyful movement

This doesn’t have to be running a marathon or doing HIIT workouts at the gym 6 days a week. The point is to find joyful movement that you enjoy and can continue doing long-term. 

You don’t have to be hardcore to get the benefits of movement. 

I work with you to consider sustainable activities and ways to move your body that you are naturally drawn to.

Here are some ideas that might inspire you:

  • You could go for a walk around your neighborhood. This could be on your own for some quiet time or you could ask a family member or friend to join you for some social time.
  • Do you enjoy cleaning? Housework like vacuuming, dusting, and mopping can get you moving.
  • Find an exercise or dance class online or in your community
  • Want to be outside? Mow your lawn or do some gardening
  • Kids asking you to play? Take them up on a game of tag or catch in the yard
  • Turn on some music and dance around
  • Stretch

If you’re not used to a lot of movement, then look for ways to start slow and build so you don’t burn out or have an injury. Just get started! From there, I work with clients to determine how to get enough movement to impact their lab values and health goals effectively over the long term.

decrease stress and get enough sleep

Sometimes the value of sleep and stress reduction can be overlooked in our hustle culture.

Consider sleep a time for your body to repair, and recover because increased stress and disruptions in sleep have been found to increase LDL cholesterol levels and risk of metabolic syndrome (12, 13).

Of course, sleep and stress reduction work together with an improved relationship with food. 

Letting go of the guilt and shame you may have with eating will also help to decrease stress, resulting in better rest.

When you are well-rested and not stressed, you may also find that you’re better at regulating your hunger cues while you become more in tune with your body as an intuitive eater. 

key takeaways

If you find that trying to introduce a new lifestyle, nutrition habit or movement behavior causes you to return to dieting extremes or emotional binge eating, you may need help healing your relationship with food before you can move forward.

When we work together, you’ll discover joy and satisfaction with your food in ways that also support your unique body.

PCOS is just a different way your body works and it’s not bad or wrong. We can find a way of being around food and movement that works best for you.

I don’t just recommend blanket diets to reach your goals because they don’t see you as a whole person. They employ black-and-white thinking and that just doesn’t work. 

Diets just worsen anxiety and guilt, and even depression, which is more prevalent in women with PCOS. 

I would love to help you develop a healthy relationship with food and get to a place where you have a tailored plan that best supports the health outcomes that YOU want.

Apply to work with me 1:1 and let’s unblock those barriers for you and find a plan that works for you…without the same old diet that’s failed you in the past.