PCOS Diet Book: How you can use the nutritional approach to deal with polycystic ovary syndrome. Theresa Cheung
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of a diabetes diet to regulate blood-sugar levels are well known. When you have diabetes, your main concern is always how what you eat affects your blood-sugar and insulin levels. Since insulin resistance and excess androgen are strongly linked to PCOS, the key to treating or avoiding PCOS through nutrition is to achieve balanced blood-sugar levels while nourishing your body in such a way that it can maintain an appropriate balance of hormones.
Changing my diet changed my life. It took being diagnosed with PCOS for me to fully appreciate the incredible impact food can have on my health and my symptoms. I’ve really learned the hard way that you are what you eat.
Samantha, 36
Once I started to make the connection between the food I was eating and my symptoms, I saw a remarkable improvement in my symptoms. I lost weight and I lost the cravings I had when my blood sugar dropped. Best of all, I got my energy back.
Diana, 40
EATING TO HELP WEIGHT CONTROL
A second reason food can be a powerful tool for managing PCOS is its role in weight control. How much you weigh and the amount of body fat you have are two of the most important factors in determining how severe your symptoms of PCOS are. Repeated studies show that losing weight can result in improvements.2 Many of us with PCOS know only too well that this can be really difficult (more on that in a moment), but weight loss – if you are presently overweight – can really help.
Research shows that overweight women with PCOS have more fertility problems than lean women with PCOS.3 Overweight women with PCOS who diet and lose weight find that their testosterone levels fall and PCOS symptoms diminish. The weight loss doesn’t have to be dramatic, either. Some women lost just a few pounds, others lost much more. In both cases weight loss lead to remarkable improvements in fertility: 82 per cent of the women who were not previously ovulating ovulated, with a number of successful pregnancies, even though these women had had long-standing histories of infertility.
No one really knows why PCOS responds so well to weight loss. It may be linked with the fact that overweight women (without PCOS) can dramatically increase their fertility by losing weight.4 It may also be that weight loss lowers insulin levels, which in turn reduces the ovaries’ production of testosterone. When you gain weight, levels of insulin and testosterone increase; the hormonal chaos this creates can make symptoms of PCOS worse. It could also be because fat itself gives out more oestrogen, adding to the hormonal imbalance.
Whatever the reason, avoiding anything that can trigger weight gain, insulin resistance and an overproduction of male hormones is important in helping to manage PCOS symptoms.
In addition to a reduction in severity of symptoms, there is another reason why weight loss is a really positive step for overweight women with PCOS. If you have PCOS you are more likely than those without to have weight-management problems. Research shows that obesity is four times more likely in women who have PCOS and irregular periods than those without.5 The tendency in women with PCOS is to put on weight around the waist rather than the hips – making for an apple shape as opposed to a pear shape.6 In a recent review, PCOS expert Professor Gabor T Kovacs from Monash Medical School, Box Hill Hospital, Melbourne, Australia cites studies that confirm that ‘Women with PCOS appear to remain centrally obese when approaching the menopause.’7
Gaining weight around the middle is associated with a higher risk of poor health according to a 25-year study at Gothenburg University in Sweden. No one is really sure why being an ‘apple’ carries with it more health risks than being a pear, but it may be due to the way the body processes fat stored in different parts of the body. Fat around the tummy is constantly being broken down and circulated around the body, while fat around the bottom is not. Higher levels of circulating fat increase the risk of heart disease and narrowing of the arteries. Abdominal fat can also put pressure on internal organs such as the heart.
With insulin resistance and excess weight already putting a strain on the heart, the fat-distribution problem is another incentive for keeping to a healthy weight if you have PCOS.
So is losing weight the answer? Unfortunately it isn’t that simple.
THE PCOS METABOLISM – WHY DIETS DON’T WORK
It’s the weight gain that’s caused me most problems. I used to joke about being fat but inside I felt miserable and desperate. At my biggest I rocketed up to 16 stone 3 lb. I’m trapped in a vicious cycle. I know that losing weight will improve my symptoms, but I’m finding it virtually impossible.
Catherine, 30
If you have always felt you only need look at food to put on weight, your feelings are shared by many women with PCOS. You may have tried to diet and found it doesn’t work in the long run. At first you might see an improvement, but soon, the more you restrict your calories the more your body goes into starvation mode, conserving even more energy and storing away the calories it does get as fat reserves in case the ‘starvation’ carries on. You eventually reach a point where dieting doesn’t seem to help you lose weight.
If you have PCOS, in addition to your body’s typical reaction to restricted food intake you have another hurdle to face: women with PCOS store fat more efficiently and burn up calories more slowly than women who don’t have PCOS, even when they’re not on a diet.
I stopped having periods when I was about 17. My doctor put me on the Pill to balance my hormones. I have always been a little overweight. I used to be able to lose weight by dieting, but in the last few years however hard I try I just can’t shift the weight. It isn’t fair. I eat the same as my skinny friends but I’m putting on weight. And the fatter I get, the more facial hair I get. There are days when I just can’t face the world and want to hide from everyone.
Emma, 33
Your metabolic rate is the rate at which your body burns calories. The faster your metabolic rate, the more you can eat without putting on weight. The slower your metabolic rate, the more you need to watch your food intake. Metabolic rate is increased by any form of activity, including eating. The rate at which food is metabolized after a meal is called postprandial thermogenesis.
For most people, postprandial thermogenesis accounts for a large percentage of their daily calorie burning. But studies show that postprandial thermogenesis in women with PCOS is significantly reduced.8 Basically, after you eat a meal your body doesn’t burn up the calories as quickly as it would if you didn’t have PCOS. Your slower metabolism means you store more calories from the food you eat.
And if you have PCOS and insulin resistance, you also have to deal with the consequence of insulin preventing you from burning the calories off. According to Dr Richard S Legro in the American Journal of Obstetrics and Gynecology, women with PCOS showed as much as a 40 per cent lower response to the stress hormones that trigger the breakdown of fat than did healthy women, whether or not the PCOS women were obese.9
So not only does being overweight make you more likely to develop an increasing number and severity of symptoms, but if you have polycystic ovaries you are more likely to put on weight.
The PCOS Catch-22
The inability to lose weight can lead to stress, which in turn leads to comfort eating. You can end up feeling trapped in a vicious cycle, with the pounds piling on.