Hello! New here. Love your thoughts on this diet and ideas!

alfiedn

Hi!

I have been at the doctors and doing research for about 2 weeks now. I have PCOS and insulin resistance, but am working on getting my own copy of my bloodwork.

When I visited my doctor yesterday, she mentioned metformin and also recommended this diet. I decided I'd like to see if I can clean up my eating enough to prevent medication. I usually have very strong reactions to medication, but understand that I may need it! So, trying out the diet and upping my exercise for 2-3 months and then getting a new set of bloodwork.

She recommended (keeping in mind that I'm vegetarian with a small amount of fish on occasion):
2-4 servings of veggies every meal
palm sized amount of protein every meal

no flours or processed grains, very little of unprocessed grains

2-3 servings of fruit a day, but could be further reduced. If 3 servings eaten, 2 must be citrus

2-3 tablespoons of seeds a day

do not eat much cheese (if eaten, crumbly cheeses and farmer's cheese are best)

1-2 eggs a day is fine

eat more food at the beginning of the day and less as the day wears on

no alcohol, no juice, no sugar

This is combined with 60 minutes of exercise a day (30-45 min. of which must be aerobic). She'd also love to see my BMI down to 24.

Do you guys have any thoughts or recipe ideas? I really want to try and make it work and see what happens. At the end of 2-3 months, I can also evaluate if this is sustainable for me.

Dragonwolf

alfiedn wrote: »

2-4 servings of veggies every meal

This is a pretty good goal. I'd add to that to make sure they're usually non-starchy vegetables (ie - veggies that grow above ground) and primarily low-sugar ones (ie - favor leafy greens over bell peppers).

palm sized amount of protein every meal

This is pretty good, too. Do keep in mind, though, that most soy-based products made in the US are a) GMO and b) not fermented. The end result is that it could be exacerbating your issue, between the unknown effects of being GMO and the known effects of the high phytoestrogen content in soy. So be sure to keep an eye out for non-soy vegetarian protein sources. I found one in my Kroger's organic section the other day, that was based on nuts and a few other ingredients, as a substitute for meat -- http://eatneat.com/ -- it still uses corn and oats (see the grains section for my thoughts), but still a decent occasional choice (hell, it sounds like a half-decent savory granola-like thing).

One thing to keep in mind is that it might be beneficial to your health to revisit your reasons for being vegetarian. I'm not saying you have to eat meat, but saying to make sure you weren't misguided in that decision -- namely, if you did so for health reasons. While a vegetarian diet can be healthy, at least for some people, it may not be a fit for you, so if you're doing it to be healthier, keep in mind that it may be healthier for you to consume meat sometimes (and that's not a failing on your part). If you find that eating some meat is best for your health, but you have trouble reconciling it with your beliefs on animal treatment, that's okay, too. It's not a decision between no meat at all and feedlot meat. Odds are, you have farms around you, which you can visit and ensure the animals are treated well and their deaths are as humane as possible.

You don't have to answer to me about it, I'm not here to judge your way of eating. Just think about your reasons and see if they still line up with what you now know about your health and health-related goals, then make the decision from there.

no flours or processed grains, very little of unprocessed grains

I agree with this. I would add that if you do grains at all, consider the ancient/heirloom grains. The modern ones like wheat and corn are very likely GMO (and US wheat is soaked down with RoundUp before harvest...ick).

2-3 servings of fruit a day, but could be further reduced. If 3 servings eaten, 2 must be citrus

The 2 must be citrus rule is odd to me, but I agree with the rest. Stick with low sugar fruits -- berries and stone fruit primarily. You may be able to get away with some of the meatier melons, too (musk melon, cantaloupe, etc). If you do citrus, I recommend favoring lemons and limes over oranges, due to the sugar content differences.

2-3 tablespoons of seeds a day

Sounds about right. I'd include nuts in this category, too. A good source of fat, but it is polyunsaturated fat, which we don't need much of. Try to work things like walnuts and flax in, to reduce the amount of Omega-6 fats you're taking in and help maintain your Omega-3:6 ratio (which is further helped by your fish intake). Also, a single Brazil nut gives you your RDA for selenium, which isn't a bad idea to include in your daily routine.

do not eat much cheese (if eaten, crumbly cheeses and farmer's cheese are best)

I'm not totally sure of the rationale behind this one. It might be worth asking for more information as to why. I'm more lenient with this and would say favor hard cheeses (like cheddar) and cream-based cheeses (cream cheese) over soft non-cream (mozzarella) and protein-based cheeses (ricotta). The latter tend to have a higher whey content (ricotta is basically a whey protein supplement in a tub), which can cause your insulin to go higher than anticipated for the protein and carb load of the food item. Likewise, favor cream or whole milk over lower fat versions if you drink milk (and full fat dairy of any kind if you consume other products), and don't shy away from butter (within reason, of course, don't blow your calories out of the water).

1-2 eggs a day is fine

No reason to limit egg intake, in my opinion. The fat and cholesterol things are myths (hell, even mainstream is figuring that out, at least for the cholesterol thing). To compare, I regularly eat 4-6 in a single meal, and my lipid panel is pristine.

eat more food at the beginning of the day and less as the day wears on

I'd ask about rationale for this, too. There isn't really any evidence to suggest that meal timing has much effect on anything, to my knowledge. There is, however, evidence that extended fasting windows have positive effects on blood sugar (so, for example, instead of eating three meals a day at 6, 12, and 5, you eat two meals a day at 11 and 5), but it's the extended time in a fasted state, not the timing of when you leave said state, that has the effect. In my opinion, listen to your body and play around with meal sizes throughout the day and find what works for you.

no alcohol, no juice, no sugar

Sounds good to me. Juice is basically sugar, so there's that, and alcohol is the only thing that ranks higher on the "must deal with it NOW" priority list the body has.

Misc. thoughts:

Make sure to get in a fair amount of fats. The eggs, fish, and nuts are a good start. I'd also add avocado and coconut (whole form and oils, ideally unrefined) for good sources of monounsaturated and saturated fats (no, saturated fats are not bad, in fact, they're vital to proper functioning; besides, why would our body store half of our fat as saturated if it was bad?). As I mentioned, I'd also make use of butter, since it's a great source of the bioactive forms of Vitamins A (same form as found in liver) and K (K2, the only one that has been shown to reverse arterial calcification).

A 40%c/30%f/30%p macro split (what the Zone Diet uses) might be a good split to try, and you can always tweak from there, based on satiety/hunger and compliance. If you find yourself hungry all the time and have trouble staying within your calories, try decreasing carbs and increasing fats until you find a setup that works for you.

This is combined with 60 minutes of exercise a day (30-45 min. of which must be aerobic). She'd also love to see my BMI down to 24.

Can't speak to the BMI, since I don't know where you're at now, though I'd argue that body fat percentage is more important. BMI, unfortunately, does not take composition into account, especially when used the way your doctor is using it. I wouldn't sweat that number too much if you're getting the fat moving.

I have mixed feelings on the 60 minutes every day thing, for a few reasons.

1. It gets mixed results. Some women find success with it, some don't. It's worth a try, but don't burn yourself out, either.
2. If you include low-level aerobic activity, like walking, then it's a lot more attainable, but moderate to intense level activity is just asking for adrenal fatigue and excess cortisol.
3. 15-20 minutes of high intensity intervals is worth more than hours of moderate steady state cardio.

That said, I do highly recommend taking up strength training, ideally weight lifting. It makes a huge impact on hormones and can, by itself, go a long way to balancing them. It's actually one of only two things (Inositol being the other) that got my cycle going again.

And no, you won't turn into She-Hulk -- http://www.nerdfitness.com/blog/2011/07/21/meet-staci-your-new-powerlifting-super-hero/

Do you guys have any thoughts or recipe ideas? I really want to try and make it work and see what happens. At the end of 2-3 months, I can also evaluate if this is sustainable for me.

I'm personally a big fan of the LCHF (low carb, high fat) and Paleo ways of eating. You can, to a degree, reconcile both with a vegetarian way of eating (see also: http://drhyman.com/blog/2014/11/07/pegan-paleo-vegan/ -- he also touches on some of the parts that each "side" drops and provides a decent pro/con comparison). Paleo recipes will generally be pretty close to the goals you have above, especially on the vegetable front. LCHF and keto recipes will be low glycemic/low sugar by default, though you're more likely to have to tweak recipes or specifically seek out LCHF veg*n sites. Between the two and other vegetarian recipe collections you probably already have, you can probably throw some awesome stuff together.

Also, check out http://community.myfitnesspal.com/en/discussion/10089832/diet-tips-for-pcos-friendly-eating-as-a-vegetarian-is-it-possible-to-balance-low-carb-w-veg-diet , there's a couple awesome recipes, as well as a few people who can relate with balancing vegetarian with PCOS-related restrictions.

alfiedn

Wow! Thank for taking so much time to respond! I love your thoughts and am agreeing mostly. It's also really good to know that I'm on the right track.

Love your comment about she-hulk. I'm not worried at all! However, I don't really enjoy much in the way of strength training, but I guess I should get used to it and learn to love it more. I just don't find it very fun.

Thank you so much for the advice on good fats, etc. I am actually eating an avocado a day right now and am super enjoying it! I like to cook with olive oil a lot because I find it tasty, but perhaps can switch to some things being coconut instead.

My doctor did say I could eat more eggs if I'd like. So that wasn't really a huge issue. I'm not concerned about the cholesterol and it didn't seem like she was either. Neither was the cheese, it seemed. However, she seemed to think that consuming too much cheese (which I admittedly do/did eat too much) might increase cholesterol levels. Not something I was familiar with.

As for the timing, she did cite a research study in which a group ate most of their calories at the beginning of the day, a group ate most in the middle, and a group ate most at the end of the day. Consuming the same amount, the group at the beginning of the day lost, the group at the end of the day gained, and the group in the middle stayed the same. I was really surprised to hear her say she'd read a study on this as I've always thought it made no difference! I may want to do a bit more research on this for myself.

Thanks for your advice on soy products. I'm with you. I actually consume very little. I'd rather get my protein from other bean sources, lentils, nuts, and such.

Do you think carrots are too high in sugar to eat super regularly? I know their pretty sweet compared to some other veggies, although I don't think they fall in the starchy veg category. I'm definitely feeling I'm going to need a WIDE variety of veggies to stay interested and satisfied with all the other restrictions I'm feeling.

Thanks again for all your time and energy! I really appreciate it as I am still learning to navigate this.

I'm in food survival mode for one more week and then I have some time to really put together some recipe ideas that I can seriously deal with. I do have some ideas that I think I can alter slightly or are just fine as is, but I'm definitely going to need do some research and put stuff together!