PCOS

Plant-Based Diets and PCOS

This is the final post in a series of posts on popular diets and their effects on PCOS symptoms. So far, we have covered ketogenic diets, the Mediterranean diet, low glycemic index/load diets, and bean-based diets.

Given the rising popularity of plant-based eating, I thought it was important to include this way of eating. Unfortunately, the literature is seriously lacking on the topic. For nutrition interventions, we can best trust the results of randomized control trials. In these trials, a large group of people are recruited. Then half of the group is randomly assigned to the diet of interest and the other half are assigned to the control group (usually just continuing to eat as they had previously). For a plant-based diet intervention, we’d ideally recruit a large group of meat eaters, and then randomly assign half of them to switch to a plant-based diet. We’d measure important metrics before and after the intervention period to see if anything changed in those people who switched diets. We’d also track the same metrics in the control group, in case there are factors that affect both groups that also affect outcomes. For example, maybe the intervention spans the holidays and both groups end up eating more food than normal. We can net out the effects of these external factors by comparing the changes across the two groups.

The Use of the Ketogenic Diet for Polycystic Ovary Syndrome (PCOS)

The post is the first in a series that will discuss the peer-reviewed research on the potential of popular diets to address PCOS symptoms.

Due to the prevalence of insulin resistance among women with PCOS, the ketogenic diet is often suggested for women with PCOS. Insulin resistance impairs the body’s ability to regulate blood sugar, and this is particularly problematic when large amounts of carbohydrates are consumed. The body has to pump out large amounts of insulin, and these large amounts of insulin cause increased production of testosterone in women with PCOS. Keeping carbohydrates minimal is one (but not the only!) way to keep blood sugar stable without the need for a large release of insulin, and this can reduce many of the symptoms of PCOS.

PCOS & Insulin Resistance: Part II

When I first started using a continuous glucose monitor (CGM), my blood sugar control looked excellent for the first couple of weeks. Then one day, when I was competing in a K9 Nosework Trial with my dog, by blood sugar was soaring all day long. I assumed it was a stress response from the nerves I always feel when trialing. But the next day, my blood sugar was still spiking easily and staying high for an extended period of time.

Confused, I turned to Google. Realizing that I was in the phase when I usually start experiencing PMS, I googled “PMS insulin resistance,” and sure enough, it was a thing! (Note, this applies to women who are cycling natural, without hormonal birth control. There’s a whole literature exploring hormonal birth control and its impacts on insulin resistance, and that is a post for another day.)

PCOS & Insulin Resistance: Part I

It is estimated that about 75% of women with PCOS have some degree of insulin resistance (Moghetti and Tosi 2021). From my own experiences, I have a working hypothesis that this is an underestimate of the incidence, and that perhaps all women with PCOS have some degree of insulin resistance, during at least some portion of their cycle. I say this because for about 75% of my cycle, my blood work looks amazing. And indeed, whenever I’ve had blood drawn, it’s (not surprisingly) fallen in this larger portion of my cycle. Wearing a continuous glucose monitor for the duration of my cycle, however, tells a very different story.

Given my hypothesis that insulin resistance underpins pretty much every woman’s experience with PCOS, I’m devoting a few posts on different aspects of the problem (and there will surely be plenty more coming in the future).

This first post provides an overview of the basic problem of insulin resistance.