Grant’s healthcare providers initially advised her to count calories and limit eating fatty foods to manage the health conditions, which come with fertility problems and high blood sugar, respectively. But it was only when Grant began addressing insulin resistance — a condition that usually accompanies both PCOS and prediabetes — by adopting ancient eating habits, she says, that she found the relief she’d sought for so long. In fact, the so-called primal diet helped her lose more than 120 pounds (lbs). “I felt amazing,” she says of the diet and the lifestyle changes that accompanied it. “Every aspect of my life is different, from the way I socialize to the way I sleep.”
How Diet May Play a Role in PCOS Management
PCOS is a hormone disorder affecting an estimated 1 in 10 women of childbearing age in the United States, according to the U.S. Department of Health and Human Services. Symptoms include irregular periods, excessive hair growth, acne, and obesity. This condition can lead to infertility, insulin resistance, and type 2 diabetes, and may increase the risk for heart disease, says Adrienne Youdim, MD, a physician nutrition specialist in Beverly Hills, California, and associate clinical professor of medicine at the David Geffen School of Medicine at UCLA. There’s no cure for PCOS, but losing weight may help manage the condition. Studies show that losing as little as 10 percent of your weight may help restore ovulation and improve symptoms. “The great thing is that lifestyle change — diet and exercise — is the treatment for PCOS,” Dr. Youdim says. “And of course, the more weight loss the better,” she adds. So what is the most effective way to trim when you have PCOS? Hormonal changes brought on by PCOS can make shedding pounds more difficult than for the average person. But a low-carb, high-protein “caveman”-type diet, such as the primal diet, may help. At least that was the case for Grant, who is a writer and spiritual guidance counselor in Vancouver Island, Canada. RELATED: 7 Simple Steps for Building a PCOS Meal Plan
The Association Among Insulin Resistance, Diabetes, and PCOS
Although research suggests there is a link between PCOS and type 2 diabetes, and insulin resistance plays a role in the development of this type of diabetes, the link between the two — and which occurs first — remains unclear. Women who have PCOS struggle with weight because of insulin resistance and higher-than-normal levels of testosterone. Insulin is a hormone that helps your body turn the glucose (the product of carbohydrate digestion) you consume from food into energy, by regulating your cells’ absorption of glucose. When cells in your muscles, fat, and liver don’t respond well to insulin, they can’t convert glucose into energy as effectively. This is called insulin resistance. The excess glucose accumulates as fat. Carrying extra weight increases the risk of insulin resistance in anyone, but women with PCOS appear to have a defect in their insulin receptor, which is responsible for controlling how the cells use glucose, Youdim says. “In addition, the higher level of insulin further affects the production of male hormones by directly stimulating androgen producing cells in the ovary,” she says. Not only do women with PCOS tend to carry weight in their midsection, much like men, they are also more likely to have visceral fat, the abdominal fat that surrounds the organs. This visceral fat is more harmful because it releases cytokines, or chemicals that lead to inflammation, promote blood clotting factors, and stimulate hormones that lead to insulin resistance, high blood pressure, and cardiovascular health problems, Youdim says. RELATED: How PCOS and Type 2 Diabetes May Be Linked, and Why It Matters
How Cutting Carbs and Adding Protein Might Help
Despite logging everything she ate and working out six days a week for two hours a day, Grant couldn’t make the scale budge. She decided to cut carbs, which helped her lose 40 lbs and relieved her symptoms. But once she started to eat grains again on a “cheat day,” her symptoms returned. And in 2008, after undergoing in vitro fertilization (IVF) and giving birth to twins, Grant found herself 80 lbs heavier and continuing to gain. She stopped weighing herself but was certain she was well over 300 lbs, and she was scared. Desperate for a solution, Grant read The Primal Blueprint by Mark Sisson, and decided to try it. The book details a paleo-based diet plan, and Sisson’s theory is that nutrition is 80 percent of weight loss. He promotes the idea that eating less sugar and more fat can reverse insulin resistance, and that working out smarter, not harder, is the way to go. Sisson says his approach is based on epigenetics, the study of how lifestyle factors can “turn on” and “turn off” genes, regardless of a person’s genetic code or predisposition for a certain health condition. Eating the right foods and giving the body the nutrients it needs can help to repair damage to our DNA. Grant immediately cut out processed foods and all sources of sugar, grains, and legumes and ate a whole-foods diet. The new plan allowed her to eat as much as she wanted provided she ate from the list of approved foods, which included butter, eggs, steak, bacon, avocado, and sweet potatoes and other vegetables. As Grant became more accustomed to the plan, she also cut out nuts from her diet, as well as all fruit except bananas. She was satiated after eating meals and no longer eating snacks. For exercise, Grant put her children in the stroller and took long walks, and later, added functional training, including squats, lunges, and burpees, as well as strength training with kettlebells. “I finally for the first time had energy to do these things,” she says. After about a year making these new changes, Grant had lost 100 lbs and all of her symptoms gradually improved. She was so inspired by Sisson’s Primal Blueprint brand, she sent the company her testimonial and became involved in their community as a speaker and a published author. “What I learned was that all of these issues I had were really just symptoms of an underlying problem, and that was insulin resistance,” she explains. RELATED: Study Suggests How Weight Loss Can Reverse Type 2 Diabetes in Some People
Is There an Ideal Diet for Losing Weight When You Have PCOS?
Since the primal diet and the paleo diet are purportedly anti-inflammatory, they may be effective for women with PCOS to lose weight and regulate their hormones, according to Neil Paulvin, DO, a family medicine physician in Freehold, New Jersey, and New York City. Dr. Paulvin recommends the ketogenic diet with or without intermittent fasting (IF), or going for long periods of time without eating, which studies suggest may improve fasting glucose. A study published in June 2018 in the journal JAMA Network Open found people with type 2 diabetes who did IF for two days a week were just as likely to lower their A1C than those who followed an ongoing calorie-restriction diet. Keto and paleo diets are similar in that they eliminate processed foods, grains, and sugar, but have some differences when it comes to eating fruit and dairy, for example. Studies suggest that that low-carb diets may help women with PCOS. In fact, according to a study published in April 2015 in the Journal of Obesity and Weight Loss Therapy, women with PCOS who followed a low-starch and low-dairy diet for eight weeks lost weight, had increased insulin sensitivity, and reduced testosterone. Of course, foods high in refined carbohydrates and simple sugars cause spikes in blood sugar, lack nutrients, and lead to weight gain, so cutting them is ideal. Yet carbohydrates from foods like beans, legumes, and whole grains are packed with vitamins and minerals that help improve energy levels. They also contain fiber, which promotes satiety, is heart-healthy, and contributes to a steadier rise in blood sugar, according to Youdim. Intermittent fasting, Youdim says, may not be the best idea for women with PCOS because skipping breakfast, for example, is associated with obesity and eating a well-balanced diet it is associated with weight loss. “When people tend to skip daytime meals, they tend to arrive at the next meal famished. And when you arrive at the next meal famished, it is much harder to pause and make mindful choices, and it’s much harder to get full,” she says. RELATED: How Is PCOS Treated Exactly? Although paleo, keto, and IF may all help someone manage PCOS, other diet plans may work just as well. In fact, a study published in April 2013 in the Journal of the Academy of Nutrition and Dietetics found that while some diet approaches, like high-protein and low-carbohydrate, were beneficial overall, all of the diets improved weight loss in women with PCOS. “I don’t know if there is enough evidence to say one diet is better than the other. It’s individual,” Youdim says. Women with PCOS who plan to embark on a new diet plan should first speak to their doctors and have their hormone levels and fasting insulin levels checked, Paulvin says. What’s more, significantly reducing the amount of carbohydrates you consume, as you would on the keto diet, can be harmful, especially if you’re taking medication for diabetes, Youdim says. And a paleo-type “caveman” diet, especially one that is heavy on red meat and low on whole grains, can be detrimental to your heart health. The American Heart Association notes that eating whole grains can lower cholesterol and reduce the risk of stroke, type 2 diabetes, and obesity. The most important thing Grant realized was that losing weight and regaining her health wasn’t going to be a quick fix. “In order to maintain any losses, in order to regain my health and vitality, it had to be a lifestyle change,” she says.
