Polycystic Ovarian Syndrome (PCOS) is a complex hormonal disorder that affects approximately 5-15% of women. Women with PCOS have an excess amount of male reproductive hormones or androgens produced in the ovaries. This leads to a range of symptoms that can include irregular periods, infertility, acne, hair growth, and weight gain.
Insulin and PCOS
Insulin is an important hormone whose main job is to help glucose, or energy, move from the bloodstream into the cells for use. This is a very important role, as too much glucose in our blood is hard on the body and can result in poor health outcomes, especially in the long-term.
When we eat, our blood sugars increase, meaning more glucose enters our blood. Glucose is sort of like a demanding boss that requires an assistant to open doors for it, otherwise it remains in the bloodstream. This assistant is insulin. Once glucose enters the bloodstream, a signal is then sent to the pancreas (the producer of insulin) to send out some insulin and ultimately distribute glucose to the rest of the body. When things are running smoothly, this signal is received promptly and insulin efficiently comes in to get the job done.
But things aren’t always so smooth and simple – sometimes the signal between elevated glucose and insulin can get disrupted or there can be an error along the pathway. Insulin isn’t able to open the doors for glucose as well as it should. In response, the body releases more insulin resulting in hyperinsulinemia. This is also referred to as insulin resistance. On the flip side, insulin sensitivity is defined as how well we respond to increasing blood glucose levels. Someone who is insulin sensitive requires less insulin to bring their blood glucose levels back to normal.
Hyperinsulinemia is responsible for many PCOS symptoms, therefore many of the dietary treatment options for PCOS are aimed at improving insulin resistance, which can in turn improve menstruation, inflammation, ovulation, and more! Today I will be reviewing our top three strategies for improving insulin resistance with diet.
Balanced Meals and Snacks
When eating for insulin resistance, there is no need to avoid specific macronutrients. Protein, carbohydrates and fat all play an important role in managing our insulin levels. Research shows that a balance of these macronutrients works AS WELL as a carbohydrate restricted diet – meaning restricting carbs is unnecessary (and likely to make you feel deprived). Instead of restriction, we encourage our clients to focus on a healthy balance of each!
“Instead of restriction, we encourage our clients to focus on a healthy balance of each.”
By eating a combination of complex carbohydrates, protein, and healthy fats, we can stabilize our blood glucose and therefore our insulin as well.
On their own, carbohydrates (think bread, rice, potatoes, and fruit) are easily converted to glucose in the body, giving us a quick boost of energy. However, carbs alone can also lead to the dreaded ‘sugar crash’ – what goes up must also come down (and usually quickly). To avoid the blood sugar roller coaster, combine foods that take longer to break down with carbohydrate foods. This would include protein foods and healthy fats. For example, an apple with peanut butter will stabilize your blood sugars more than just an apple alone. Bonus – you will also be more full and energized with the added protein and/or fat!
You can also use this tip at meal times. Balance out pasta by adding a side salad and focusing more on added protein like chicken, shrimp, or chickpeas.
Carbohydrate foods such as grains, fruit, starchy root vegetables, sweets, and baked goods are most likely to raise our blood glucose and insulin levels. However, not all carbohydrates raise our blood glucose in the same way. In fact, many hardly raise our blood glucose at all!
Rather than saying “avoid all carbohydrates” it is much more reasonable, sustainable, and healthy to simply limit our intake of high glycemic carbohydrates – ie. foods that raise our blood glucose and insulin the most. Think of it like this: you aren’t aiming for NO changes in blood glucose, but rather a more sustained and gradual increase in blood glucose levels.
The Glycemic Index is a numeric scale on which all carbohydrate foods are ranked based on how much they raise our blood glucose levels after consuming them. Each food gets a ranking from 0 to 100, and the lower rankings mean a food affects our blood sugars less.
In general, foods that tend to be lowest on the glycemic index are foods that are higher in fibre, less refined, and lower in simple sugars. For example, steel cut oats have a lower glycemic index than rice crisp cereal or other sugary breakfast cereals. We want to choose these foods must often and limit high glycemic foods to only occasional consumption. For more information on glycemic index, you can also visit this link.
Pattern & Spacing of Meals and Snacks
Not only are the types of foods we choose important for managing insulin resistance, but so is when we choose to eat them. With large gaps between meals and/or snacks, we are likely to experience more peaks and valleys in our blood glucose levels. Not only does this result in drastic spikes in insulin, it also leaves us extremely hungry, moody, and tired.
Being over-hungry and low energy often results in eating larger-than-normal portions and choosing foods that are more processed for the sake of convenience.
Moral of the story – eating regularly (at least every 4 hours or so) helps us to manage insulin resistance. Try eating 3 meals and a couple snacks each day to avoid lots of fluctuations in your insulin response. Below is a one-day sample menu to get you started:
Looking for help improving your insulin resistance?
Talk to one of our registered dietitians that are specialized in women’s health issues like PCOS. We can help you to plan and prepare foods that work for improving insulin resistance, ultimately helping you improve symptoms such as infertility, acne, and more!