PCOS - Nutritional Management For Weight Loss, Fertility, AND Health

About 1 in 10, to 1 in 20 women of childbearing age has PCOS (polycystic ovary syndrome).  The main symptoms include fertility issues, abnormal menstrual cycle, cysts on the ovaries, insulin resistance, poor blood glucose levels, and obesity or weight gain. You may also experience skewed thyroid levels, acne, excess hair growth, and even male-pattern baldness.

Insulin Resistance – Insulin signals to the body that there is excess energy available to be taken up by the cells. If you have insulin resistance, the body secretes more insulin than typically necessary after you eat carbohydrates in an effort to get the energy out of the blood and into the tissues. Because the tissues are resisting the insulin (or ignoring it, in other words), the body takes the high levels of insulin to mean that it should start storing the blood sugar as fat.  This leads to weight gain. Weight gain leads to excess fat, which in turn, increases insulin resistance. So…

PCOS Insulin resistance --> fat storage --> weight gain --> insulin resistance --> fat storage --> weight gain…

Slower Metabolism – Those with PCOS have been found to also have lower metabolism. This means that someone with PCOS burns fewer calories than an “identical” person without PCOS. In other words, if you have PCOS, you can’t eat as much as someone without PCOS without gaining weight.

Disordered satiety – PCOS sufferers tend to not respond to the same satiety cues as most people do.  Whether that’s because of other imbalances or something else, the end result is that PCOS individuals are likely to not feel full even after eating a sufficient or even excess amount.

Hormone Imbalance – Excess insulin causes the ovaries to release more testosterone (yep, women have testosterone too!), and excess estrogen, leading to suppressed ovulation and, potentially, increased facial hair, baldness, acne, and, oh, infertility.

Essentially, the focus of PCOS treatment is managing insulin levels. (The majority of these suggestions, however, apply to EVERYONE, men and women, trying to loose weight, as higher insulin levels, whether from a disorder like PCOS, or poor eating habits, will lead to the fat storage, weight gain, insulin resistance cycle).  So, what to do about high insulin levels? Well, there are several things you can do from a diet/lifestyle perspective. 

1) Carb balance. Try not to eat carbs in isolation. Eat with protein or fat, but especially protein to help prevent surges in blood sugar levels which will encourage surges in insulin levels. Bonus: increased protein has been correlated with improved fertility!

2) Right Carbs. Whole fruits (not juice), whole veggies, and whole grains (when you have grains). NOT processed carbs/food, sugar, etc. This also increases the fiber in your diet, which slows down the absorption of sugar from your digestive system into the blood stream, reducing the change of an insulin spike. Plus, vegetables and fruit contain antioxidants, which help reduce inflammation.

3) Consistent fuel. Eat at regular intervals, keeping some carbs in the mix so that your blood sugar levels stay pretty level, as opposed to spiking and dropping. The highs and lows of blood sugar encourage improper insulin release and excess insulin. This means 3 meals and at least 2 snacks per day for most women.

4) More protein. This helps with hormone synthesis as well as curbing sugar spikes. Aim to have a strong (10+ grams) dose of protein with every snack and meal (meals should really be at least double!). 

5) Increase magnesium and chromium intake. This may require a supplement. Both help with blood sugar metabolism/usage and can assist in maintaining balanced insulin levels. Natural sources of magnesium include nuts, seeds, spinach, black beans, molasses, bananas. Chromium can be found in broccoli, barely, oats, black pepper, brewers yeast (the latter can also be a good source of B12, which may be lacking in your diet if you are a vegetarian). Also make sure your vitamin D intake is sufficient. Dairy (WITH FAT) is a good source, as is fatty fish and cod liver oil. Or, go outside and get some sunshine!

6) Exercise! Walking/moving after meals may help, as it increases insulin sensitivity, which may help your body produce less and still get the job done. Additionally, because those with PCOS have lower metabolisms to start, building up lean body tissue (which is more metabolically active than fat tissue), can help increase your metabolism.

7) Hormone Balancing. Assuming estrogen levels are out of balance with progesterone, (since increased circulating insulin causes increased estrogen release) increasing progesterone levels can also prove beneficial for hormone balance and infertility issues. The initial approach is identical to the one listed here for insulin control. Adding in some liver-loving foods to help support estrogen detoxification can also help (cruciferous, berries, ground flaxseed, green tea…).

8) Sufficient and healthy fats. Fat is good! Your brain is almost exclusively fat. Your cell walls are made up of fat. Hormones are made from, yep, that’s right, fat! Just make sure you’re choosing healthy fats, like omega-3 fatty acids found in fish, flaxseed, chia seeds, and walnuts. Avocados and olive oil are also good fat sources. Primrose oil is great, especially to help with PMS symptoms. I'm starting to use fermented cod liver oil, which is a great way to get vitamin A and D, as well as omega-3s, which reduce inflammation. Increased inflammation (from stress, lack of sleep, poor food choices, excess weight) can increase insulin resistance. Additionally, fat helps encourage satiety signals, which may encourage your body to feel full faster.

Although, as mentioned above, most of these tips can apply to any healthy lifestyle, if you are concerned you may have PCOS, it’s important to consult your doc and get tested.  In any case, weight loss and improved nutrition and exercise can only help your health, regardless of a PCOS diagnosis.

Not sure if you’re choosing the right carbs, getting enough protein, or selecting the best fats? Contact me for an assessment and get your healthy cycle and fertility journey off to the best start.