Eating for hormonal health, without giving up roti

The diet advice given to South Asian patients is often written for someone else, salmon and quinoa three times a day, no rice, no dairy, no lentils. It is not realistic, and frankly not necessary.

What the evidence actually supports is an anti-inflammatory dietary pattern, Mediterranean-style, DASH-style, or any pattern that is plant-forward, wholegrain, rich in fibre, and low in ultra-processed foods. This is a framework, not a prescription. You can keep the roti. You can keep the daal. Most of our traditional cooking is closer to this pattern than the typical British-supermarket plate.

Chronic low-grade inflammation creates a persistent internal environment that disrupts reproduction through several mechanisms: it interferes with the hormonal signalling needed for regular ovulation, affects the uterine environment for implantation, and impairs egg quality during the 75–85 days eggs take to mature. In men, it affects sperm production and DNA integrity over a similar window.

The Nurses' Health Study II (Chavarro et al 2016) found women following anti-inflammatory dietary patterns had lower rates of ovulatory infertility than those on more pro-inflammatory patterns. In IVF, closer adherence to a Mediterranean pattern was associated with higher clinical pregnancy and live birth rates (Karayiannis et al 2018). For men, adherence to Mediterranean, DASH, and anti-inflammatory patterns is associated with higher sperm concentration, total count, and motility (Cao et al 2022). In PMOS, 8–12 weeks of a Mediterranean-style pattern improves insulin sensitivity, reduces inflammatory markers, and supports hormone balance (Scannell et al 2022).

• Make half your plate vegetables (saag, bhindi, cauliflower, salad), this is the biggest single lever • Lentils, beans, or chickpeas at most meals, these are already the backbone of South Asian cooking • Switch white rice to brown or basmati-mixed where you can; keep portions to a fist • One or two rotis instead of three, with the same curry • Oily fish (salmon, mackerel, sardines) twice a week for omega-3 if you eat fish • Nuts, seeds, and berries as snacks instead of namkeen and biscuits • Olive oil, or ghee in moderation, rather than vegetable oils used for deep frying • Swap sugar in chai from 2 spoons to 1, then to half over a few weeks • Water or plain chai instead of fruit juice, lassi with sugar, or fizzy drinks

You do not need to do all of this at once. Pick one and keep it for a month.

These changes reduce the glycaemic load of your meals, increase fibre and plant protein, shift the fat balance towards omega-3, lower blood pressure, and improve insulin sensitivity. Blood sugar stability matters, pairing protein or healthy fats with carbohydrates, and eating regular meals rather than skipping then overeating, directly addresses the insulin-PMOS pathway.

For most women the improvements in cycle regularity, ovulation quality, and metabolic markers appear within 8 to 12 weeks. This is not a diet. It is a pattern that compounds.