PCOS and Nutrition - part 1

A recent study performed by scientists in Poland (http://www.ncbi.nlm.nih.gov/pubmed/22801903) has proven that defects of the FTO gene (a protein in our DNA that regulates body size, body fat accumulation and metabolic rate) in women with PCOS have twice the impact on obesity-related traits than women without PCOS who have the same gene-specific defects.

What does this mean for Cysters?  

If you’re a Plus Size Cyster, take all of the risks associated with obesity (heart disease, stroke, sleep apnea, and, yes, infertility....just to name a few) and double that risk. Add that to the risks that PCOS is associated with and, well, it's a pretty scary picture!

Whether you’re a Plus Size Cyster or a Thin Cyster, we thought that the release of this study would be a good platform to use to launch into a frank discussion about PCOS and nutrition.

What is Nutrition?

Nutrition, at its most basic definition, is the supply of materials (food) required by organisms and cells to stay alive.  Nutrition also focuses on how diseases, conditions and problems or lessened with a healthy diet, and how certain diseases, conditions or problems may be caused by dietary factors, food allergies, metabolic diseases, etc.  In our case, the “problem” is PCOS.

While we still do not know the cause of, and therefor do not have a cure for, PCOS, over the past 20 years scientists have made great strides in understanding the many facets of the condition.  One of the most frequently talked about facets of PCOS is the link between PCOS and insulin - more specifically, insulin resistance.

Recent studies have shown that all women with PCOS have some degree of insulin resistance, but the degree of insulin resistance is not the same in all women with PCOS.  In a nutshell, insulin resistance is a condition where the hormone insulin becomes less effective at lowering blood sugars.

What does this have to do with PCOS?

Simply put, everything.  We’re constantly bombarded by nutrition information and recommendations.  By our governments, by our physicians, by our friends and loved ones – but what they all fail to realize is that the nutrition required for our bodies to function properly is dependent on our own specific health condition and can’t be grouped into a “one size fits all” pyramid, chart or list.  The very same reasons why people with Celiac Disease need to avoid gluten and people with a lactose intolerance need to avoid dairy is why women with PCOS need to lower their carbohydrate intake.  There is a fundamental flaw in the way that our bodies process what we put into them.

Insulin is a powerful hormone that is released by the body's pancreas in response to eating food - especially carbohydrates. It transports sugar out of the blood and into muscle, fat and liver cells, where it is converted to energy or stored as fat. Many women with PCOS have insulin resistance. This means that the process of getting the sugar out of the blood and into the cells is defective – the cells are "resistant" to insulin. The pancreas must secrete more and more insulin to get sugar out of the blood and into the cells. High levels of insulin or hyperinsulinemia, can wreak havoc in the body, causing any or all of the following conditions: polycystic ovaries, weight gain and/or difficulty losing weight, increased risk of heart disease by increasing LDL and triglycerides, decreasing HDL and increasing clotting factors. In addition, it can increase risk of diabetes by up to 40% by age 40 - independently of the added risk associated with a PCOS diagnosis.

The discovery of insulin's role in PCOS has brought hopes for better treatment. Treatment is no longer just aimed at treating the individual concerns (ie: erratic menses, hirsutism, acne, etc.), but instead is now aimed at treating one of the underlying causes – insulin resistance. If insulin resistance is present, it is best treated with diet, exercise and weight loss if needed. Insulin sensitizing medications may be used as well. Most physicians prefer to start with diet and exercise and turn to drugs if needed. Keep in mind that not all women with PCOS have the same degree of hyperinsulinemia.

Approximately 50 – 60% of women with PCOS are obese. It has been shown that losing even 5% of body weight can lead to an improvement in skin, regularity of menstrual cycles and decreased insulin levels. However many women with PCOS experience difficulty losing weight, possibly due to high insulin levels promoting fat storage. The standard low fat high carbohydrate weight loss diet may not be the best approach for women with PCOS. High intakes of carbohydrates, especially refined carbohydrates (ie. sweets, white bread, white rice, etc.) will quickly turn to sugar and cause elevated levels of insulin.

For the approximately 40% of women with PCOS who aren’t overweight – our “Thin Cysters” – watching your carbohydrate intake is just as important.  The risks of developing conditions linked to high carbohydrate consumption (pre-diabetes, Type 2 Diabetes, Dental diseases, Metabolic Syndrome and even some Cardiac Diseases, just to name a few) is the same for Cysters, regardless of weight.

- In tomorrow's post, we'll explain the difference between how a "normal body" processes carbohydrates and how a "PCOS body" processes them, how carbohydrates relate to inflammation, fat storage and obesity, and how controlling your carb intake can help lessen some of your PCOS symptoms.