Nutrition and PCOS

PCOS is a chronic condition which means that the symptoms are ongoing and lasting, however both studies and the experiences of women with PCOS have revealed that diet plays an important role in the management of symptoms.  Diet is important not just as a weight loss tool, but as a way to feel better both mentally and physically.  Limiting or reducing carbohydrates seems to be the principal way that PCOS afflicted women make changes in their diets. Therefore, I have outlined below the eating plans used most frequently by cysters. The diet plans are listed  in order of how severely they limit carbohydrates. I do not advocate any particular diet, however, I do believe that everyone should cut out or reduce the amount of sugar and refined carbohydrates in their diet. Here are 78 reasons why. Various plans are covered here, but more information on low carbing in general can be found on the links page. NOTE: Those with kidney or liver impairment should not follow the very high-protein diets listed here without medical supervision. 

The Atkins Diet

This was the one of the first popular low-carb diets and is the most well known one. Since his first book in the 1970´s Atkin's diet has been criticised for being too high in saturated fat, but it  doesn't have to be as poultry and fish which are low in saturated fat can be eaten freely on the plan. Also, the critics fail to note that this high-meat consumption dominates only the induction phase which is 2 weeks. During maintenance most vegetables can be eaten freely and a moderate amount of fruit is allowed, along with meat, poultry, fish, nuts, seeds and eggs. In essence it becomes a wholefood diet, limiting processed junk food. Also, there is increasing evidence that fat is not the dietary demon anyhow.

Despite popular misconception Atkins is not just an extremely low carb diet. It is only the first two weeks that severely restrict carbohydrates. Stage 1 is necessarily strict in order to kickstart weight loss and detox the body. The four stages are as follows:

Induction: During this phase a person eats 20g of carbohydrate or less a day. Meat, poultry, fish, eggs and cheese are eaten daily along with healthy fats (non hydrogenated) and 2or 3 servings of salad.

Ongoing Weight Loss: After two weeks of induction carbohydrates are added back into the diet in increments of  5g per week until weight loss stops. In order to continue losing weight a person must backtrack until they find how much carbohydrate they can consume daily while still losing weight. This is known as the Critical Carbohydrate Level for Losing (CCLFL).

Pre-Maintenance: When one is very close to goal weight carbs are again increased in 10g increments per week until weight loss slows down to just 1 or 2 lbs a month. 

Lifetime Maintenance: One reaches this phase when they are at goal weight. By this time the Critical Carbohydrate Level for Maintenance (CCLFM) will have been identified and one will know how much or how little carbohydrates are needed to maintain weight. Sugar, white flour and trans fat are still avoided in this stage however.

Atkins plan works by sending people into ketosis which is the burning of stored fat for energy. It is important to note that ketosis is entirely different from ketoacidosis, which occurs in untreated diabetics and which is extremely dangerous. Ketosis is desirable but can have side effects such as bad breath and leg cramps while the body adjusts to its new fuel source. Atkins recommends supplements be used during the induction phase for these reasons.

Atkins is the most restrictive of the low-carb diets, but it is very effective, so if other diets have not worked for you this one most likely will. More information on Atkins and support from those following his plan can be found at http://www.atkinscenter.com/, http://www.lowcarb.ca, http://www.atkinsfriends.com/, and http://www.atkinsdiethelp.com/. Atkins comments that his diet is very difficult for vegetarians to follow, but it is possible. For information on how to adapt the diet to a vegetarian lifestyle see http://www.geocities.com/msweathe/veggie.html   and http://www.holdthetoast.com/cgi-bin/faqnewz/faqnewz.cgi?config=httfaq&format=faq#httfaq9496098208124faq.

Protein Power

This is a plan which is most similar to Atkins in that it sends people into ketosis, however it allows more vegetables and certain low G.I.* fruits such as berries. It limits sugar, grains and starches. The book emphasises a natural approach, encouraging only hunter-gatherer type foods. It also encourages the drinking of copious amounts of water. As the book suggests it emphasises the role of protein in  the diet so there are charts and tables in the book for a person to measure how much protein they need each day. It is a good read for anyone wanting to fully understand the scientific reasoning behind low carb eating. It may be difficult for vegetarians and vegans to follow. However, the two links above on vegetarian low carbing may help in adapting the diet if following this plan is desired. More information on Protein Power can be found at http://www.eatprotein.com/ 

The Carbohydrate Addicts Diet

This plan allows for two extremely low carb meals (less than 4g carb per food item in each meal) and one reward meal (where carbohydrates are allowed as long as they are eaten within an hour) a day. The theory of the reward meal is that the level of insulin is determined by the previous low-carb meals so that when the high-carb meal is consumed only a small amount of insulin is released. Less insulin means less fat storage so weight is lost. I followed this diet for months and lost 1/2 a stone (7lbs), but plateaued after that. Also, I like many people following this diet binged during the reward meal which was not a good idea because (i) it slows weight loss and (ii) it encourages an unhealthy attitude towards food by deeming it a reward. Having said all that though, this plan freed me from my insulin-induced constant hunger so I must state that it is good at balancing insulin levels.

The Hellers have obviously realised the flaw in their plan and have since modified their diet resulting in 'The Carbohydrate Addicts Lifespan Plan' where low-carb snacks and meals are allowed alongside the more balanced reward meal which is made up of 1/3 protein, 1/3 carbohydrate and 1/3 vegetable along with a salad. Also, more attention is paid to exercise in the newer book. Another plus is that both the authors suffered severe weight problems themselves, so they really care about how people feel on the diet and whether it works for them, instead of just how many books they can sell. The most recent books are packed with information on how this plan can be adopted to fit into people's lifestyle, and solutions to various problems that can occur with the plan. Overall, I would rate this plan as being good for weight loss. It can work for vegetarians, but may be more difficult for vegans. More information about the Carbohydrate Addicts Diet can be found at http://www.carbohydrateaddicts.com/ and http://www.cadis.org/ 

The Zone

There has been much talk about this book and articles about it have graced many magazines. In my opinion it most certainly does not live up to the hype. The diet consists of six very small meals consisting of 30% protein, 40% low G.I. carbohydrates and 30% fat. It is very difficult to balance the meals unless much planning has been done, so that living in ‘The Zone’ permanently requires time and patience. Sears (the author) claims that the diet uses the correct ratio of nutrients resulting in optimum performance and steady weight loss. However, many critics including Samuel Thatcher have stated that it is more likely that it is the small amount of calories (1000) which results in weight loss rather than the perfect ratio of carbs :protein: fat. Nonetheless, this diet has worked for many people and if you have the time and motivation to plan ahead then this moderate-carb plan will most likely prove to be of use to you. It is suitable for vegetarians, but may prove to be more difficult for vegans. More information on this diet can be found at http://www.zoneperfect.com and http://www.he.net/~zone/ .

Sugar Busters

According to Sugar Busters, sugar is a poison and the aim of this diet is to eliminate it from ones life. So, all refined carbs and high G.I. foods such as bananas, carrots, potatoes, pineapples and corn are banned because the body reacts to these food as if they are sugar. However, there are some inconsistencies in the plan. The authors state that their diet attempts to control insulin levels, and so they focus on reducing sugar and high G.I. foods. This is a good idea in theory, but they obviously have not researched the Glycemic Index very well since brown rice which is allowed on the diet has a G.I. almost as high as white rice. Another similar example is the fact that white pasta is not allowed on the plan when in fact most types of pasta typically have a G.I. ranging from 30-50. The authors have the right idea in trying to encourage people to consume wholegrains rather than refined carbohydrates, however some wholegrains such as bread have a much worse impact on insulin levels than refined products such as pasta. This flaw is implicit in the G.I. system as a whole. Hence, a low G.I. diet where one exclusively pays attention to type and not amount of carbohydrate may only work for those with mild PCOS. Sugar Busters is a moderate-carb diet, and is suitable for vegetarians and vegans. Some good Sugar Busters sites are http://www.sugarbusters.com/ and http://www.sugarbusters.net/                          

The Insulin Resistance Diet

This diet has proved very successful for many cysters, helping them both to lose weight and manage their symptoms. According to this plan, it is not carbohydrates which are responsible for weight gain and insulin resistance, but an excess amount of carbs at each meal and too little protein with the carbs. Therefore, all meals and snacks must contain at least 7g protein per 14g carbs and the maximum amount of carbs allowed in any 2 hour period is 32g. There is no limit on the amount of protein or vegetables (excluding potatoes) which can be eaten however. Also, milk and legumes are counted as proteins so that this diet is suitable for vegetarians and vegans. Sweets and chocolate can even be consumed on this diet, and since there are no banned foods this is a  very livable plan. I know of many cysters who are followng this plan, and they report great results. I have combined this plan with another; The Schwartzbein Principle (details below) and it has been instrumental in me losing 22lbs as well as decreasing my hunger levels, improving my skin and lessening my pelvic pain. A review of this plan can be found here.
There is also a support forum for this plan at http://www.thecanuck.org/index.php.

The Schwartzbein Principle

This is a fantastic book, full of scientifically substantiated facts on the principles of a low carbohydrate diet. Diana Schwartzbein explains in great detail the health benefits of a low/moderate carbohydrate diet and conversely the dangers of a high carbohydrate one. She also elaborates on the dangers of eating processed food. The amount of carbohydrate recommended for a person depends on whether they are aiming to lose weight, their activity level and whether they exhibit signs of insulin resistance. So an inactive person aiming to lose weight who already exhibits signs of insulin resistance has 15 carbs per meal and 7 and a half carbs per snack. She also recommends that one eat fairly often which is a pleasant change from calorie counting. This book belongs on everyone’s shelf and her plan is great. However eating a diet containing absolutely no processed food can be difficult. In general though this is an excellent plan for those suffering from PCOS.

The Glucose Revolution

This book encourages followers to  consume only foods which have a low or moderate G.I. The Glycemic Index of a food is a measure of how quickly it raises blood sugar; white rice for example has a very high G.I. while beans and green vegetables have a very low G.I. If blood sugar levels are kept steady there are not wild fluctuations in insulin levels so there is less fat storage and people have more energy. This plan is very adaptable and can be followed by both vegetarians and vegans. It tends to harp on a bit about low fat though, so if you are a cyster following this plan, add some more protein and also a moderate amount of good fat such as olive oil. I use this book mainly for reference as it has a table of all the GI's of foods that have been studied by researchers so far.  The tables also contain information on the amount of  fat and carbohydrate in each food item. This plan has more support from the medical community, so that is easier to get a dietician to recommend this plan rather than Atkins. This DOES NOT mean however that it is perfect!!! As I stated above, most cysters need to increase protein and consume far more of this VITAL nutrient than the book recommends. In fact, Diana Carpenter, the author of ‘How I gave up my low fat diet and lost 40lbs’ states that even people on a moderate carb diet need to get at least 70g of protein daily.  Overall, this plan should be used as a reference when choosing carbohydrates, but not followed religiously. In fact if you have a low carb tolerance (which many cysters do) some of the more high-protein diets will suit you better. Information on the diet can be found at http://www.glucoserevolution.com/ 

*The Glycemic Index of a food is a measure of how quickly it raises blood sugar; white rice for example has a very high G.I. while soy beans and green vegetables have a very low GI (back)