PCOS- What works?
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Elevated blood glucose, full stop, is not a bad thing (notice you didn't quantify how elevated blood glucose must be before it is considered detrimental).
More than 7.8mmol/L two hours postprandial is likely prediabetes.
Prediabetes and IR don't go hand-in-hand, though IR is a risk factor and a symptom of it. Chronic levels of blood glucose above 7.8mmol/L is damaging to organs. Peaks and troughs, even for sustained periods [read: hours], of blood glucose levels are completely normal. Like I said, it happens to everyone.
There is no need to be so alarmist. You do not have to diligently monitor or control your blood glucose with IR. You simply need to have a healthy diet and lifestyle.Actually, research concludes it is a superior diet.
I would like to see this research, because in my near 10-years of researching the condition I suffer from, I have never once seen a peer-reviewed study specifically targeting research on women with PCOS stating that a keto or low-carb diet is the best choice. (In fact, there have been studies that specifically say there is no clear one-size-fits-all dietary recommendation other than to assume a healthy lifestyle: http://www.andjrnl.org/article/S2212-2672(12)01925-9/abstract and http://humupd.oxfordjournals.org/content/19/5/432.short?rss=1)
I have seen studies that say keto/low-carb is best for people with diabetes, perhaps even to quickly reverse IR. Not for PCOS as an all-encompassing condition. So I'd be very interested to see what you've found that says otherwise.
What about this pilot study?
http://www.nutritionandmetabolism.com/content/2/1/350 -
+ research beyond PCOS
http://www.nature.com/ejcn/journal/v67/n8/full/ejcn2013116a.html#bib770 -
A pilot study partially funded by the Atkins Foundation (high risk of bias), and the studies I posted also took note of depression and quality of life factors. It found no benefit of using keto/low-carb over a more conventional diet for this purpose, and took note that losing weight at all improved depression, hirsutism, and quality of life irrespective of dietary composition.
ETA: If the risk of bias isn't enough, I'd draw your attention to this part of the discussion in the study itself:This pilot study showed that adherence to a low-carbohydrate, ketogenic diet led to improvement in body weight, percent free testosterone, LH/FSH ratio, fasting serum insulin, and symptoms in women diagnosed with PCOS over a six-month period. Further research is needed to determine if the benefits were from weight loss or from carbohydrate restriction specifically.0 -
You asked for studies out there and now you are saying it is highly biased and there is more needed. (which is usually the case with pilot studies). There is always more needed. It is totally called for: low carbs-fat loss-weight loss. The way I understood it is there is more research at a hormonal level related to a restriction of carbs/ weight loss. But again I might be biased because I am a Ketoer.
Some members have given you facts here. Yes high level of glucose is toxic (and "it depends" is misleading information). Carbs are a quick fuel: liver-muscles-out-liver-muscles out and now when it's stored as fat, there will be issues. Knowledge, facts, research don't seem to be what you are looking for. PCOS- what works? You mention a healthy lifestyle and diet. What is it? Please facts, knowledge, pilot studies, more research rather than your attempts to to say "I don't agree" whenever the K word is being mentioned.
I am not sure how far you've got at university, subject you are pursuing, how you've researched for 10 years (which at your age is commendable) but if you ever wish to research nutrition in relation to hyperinsulinemia diseases and others, here 's what the foundation says. BTW kudos to the researchers (whatever diet) for working their butts off for our health while we chat on MFP and your accusations are predictable and distasteful.
"The Robert C. and Veronica Atkins Foundation seeks to fund organizations that support scientific, evidence-based and clinical research that examines the role of metabolic and nutrition protocols in obesity, cancer, heart disease, Alzheimer’s disease, diabetes and other major health issues confronting our society today.
The Foundation also focuses on issues of obesity, diabetes, coronary artery disease and their broad reaching influences to overall health and wellness of children in particular, and adults in general."
I will leave it at that!0 -
Bump0
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You asked for studies out there and now you are saying it is highly biased and there is more needed. (which is usually the case with pilot studies). There is always more needed. It is totally called for: low carbs-fat loss-weight loss. The way I understood it is there is more research at a hormonal level related to a restriction of carbs/ weight loss. But again I might be biased because I am a Ketoer.
Some members have given you facts here. Yes high level of glucose is toxic (and "it depends" is misleading information). Carbs are a quick fuel: liver-muscles-out-liver-muscles out and now when it's stored as fat, there will be issues. Knowledge, facts, research don't seem to be what you are looking for. PCOS- what works? You mention a healthy lifestyle and diet. What is it? Please facts, knowledge, pilot studies, more research rather than your attempts to to say "I don't agree" whenever the K word is being mentioned.
I am not sure how far you've got at university, subject you are pursuing, how you've researched for 10 years (which at your age is commendable) but if you ever wish to research nutrition in relation to hyperinsulinemia diseases and others, here 's what the foundation says. BTW kudos to the researchers (whatever diet) for working their butts off for our health while we chat on MFP and your accusations are predictable and distasteful.
"The Robert C. and Veronica Atkins Foundation seeks to fund organizations that support scientific, evidence-based and clinical research that examines the role of metabolic and nutrition protocols in obesity, cancer, heart disease, Alzheimer’s disease, diabetes and other major health issues confronting our society today.
The Foundation also focuses on issues of obesity, diabetes, coronary artery disease and their broad reaching influences to overall health and wellness of children in particular, and adults in general."
I will leave it at that!
Well, I asked for peer-reviewed studies that say a low-carb/keto diet is superior for losing weight with PCOS and/or managing the symptoms of PCOS, as the other poster has claimed. There aren't any, at least that I'm aware of, which is why I asked for them to be provided.
As I pointed out, the studies you provided don't make that claim, either.
A healthy lifestyle, one that is prescribed to any other human being - unless contraindicated by a medical condition that can come with PCOS, but does not define PCOS - is sufficient to achieve weight loss and reverse the predicating factors to developing the metabolic syndrome.
I've posted this before, but here is a well-cited article on lifestyle factors affecting PCOS, weight loss, and quality of life: http://www.managingpcos.org.au/pcos-evidence-based-guidelines/5-lifestyle-management-in-pcos
There are many more out there, but this one is very well condensed.
As for the time I've spent researching, I don't paint myself as an expert by any stretch of the imagination... but I've spent a lot of time since I was 16, when I first suspected I had PCOS after consulting Dr. Google about my lack of periods, obesity and excess body hair, researching it, what causes it and what can be done to lessen or reverse symptoms. I wasn't formerly diagnosed until I was 21, but by that time I had enough knowledge behind me (and the eventual freedom that came with moving out of the family home) to put all I'd learnt into practice. I don't prostrate myself as a female with PCOS first and foremost because it doesn't affect my dietary needs, and it doesn't affect the dietary needs of women with PCOS unless they have other confounding factors.
I'm not just trying to be belligerent and "right"... the point here is that if there is or was a superior way to lose weight, as a female with PCOS, I'd welcome it and use it. There just simply isn't.
I'm not saying low-carb doesn't work for weight loss, it does... of course it does. I'm just saying it isn't necessary, nor is it proven to be better than any other method. Saying that it is, is problematic and depressing for people who can't stick to it.0 -
Just wanted to say thank you to the posters in this thread, your ideas have been incredibly informative to me. I really would love to find out if I'm insulin resistant but my GP refuses to run any tests 'because I'm a normal weight and clearly don't have as much of a problem as other pcos patients' :grumble: as such I try to keep my carbs under 100g a day, I personally find it quite hard, since I don't really like fatty products too much, but the scale did move a bit in the last month, so going to keep it up longer before deciding whether to stick with it.
Get a new doctor. Nothing's worse than a doctor that isn't willing to work with you, especially when it comes to PCOS.0 -
Hmm, my endocrinologist is also a professor in a well known university. When I asked about a low carb diet for insulin resistance, she rolled her eyes and said something about stop googling and jumping to conclusions. When I asked whether the individual numbers, insulin resistance results etc needed anything to be done, the answer was that as long as you are exercising, have a normal weight, and hBA1C tests come back fine, change nothing.
And it doesn't matter if they're a professor or not, they're likely still teaching the lipid hypothesis which has been disproven. My medical school still teaches theories that have been disproven as-if they are fact, even though research conclusions simply do not support the theory.I had several times consulted with the dieticians in the hospital for diabetes control (know some personally) and their nutrition plans never restricted carbs, or anything else. Restrict (but not eliminate) sugar, yes, distribute carbs throughout the day, yes, go to extremes never.This is a quote from the nhs official site (http://www.nhs.uk/Conditions/Diabetes-type2/Pages/Living-with.aspx):
"It is not true that if you have diabetes you will need to eat a special diet. You should eat a healthy diet high in fibre, fruit and vegetables and low in fat, salt and sugar."Possibly some people need avoiding entire food groups, after all low carb, or low fat or low whatever exist for a reason. But claiming to have found the magic diet that everyone needs to follow, without even knowing the person's medical history, I do not get it. I have seen many people preach about the benefits of X or Y restrictions to control or even better prevent certain medical issues. I have never seen the actual research (as in advocated by the appropriate medical organisations, not by blogs, individual drs etc) supporting such views as universal cures.
However, we are talking about Low-Carb for Insulin-Resistance for PCOS ... so we DO know medical history in this case.
Research that shows the benefits - whether advocated by any specific "appropriate medical organization" or not is freely available. If you understood medical organizations you'd understand they're political organizations and they adopt change slowly. Very slowly. And often are more political than medical. If you don't understand that, you need to look at it. I look at it from INSIDE the industry, not as a layperson.
And no doctor has ever suggested a "low-carb" diet is truly a 'cure' for anything. It *can* be an important non-pharmacological intervention to aid control. In the case of many conditions it can be the *most* important intervention.
TLDR; Regardless of individual opinions on the diet, or the fact that dieticians and specific organizations don't adopt/endorse it for political reasons, it doesn't change the fact that VLCKD are proven superior for insulin-resistance and overall glycaemic control. Not to mention aiding in retaining lean mass, improving triglycerides and cholesterol ratio. Opinions and political ideology don't change that fact.0 -
A pilot study partially funded by the Atkins Foundation (high risk of bias), and the studies I posted also took note of depression and quality of life factors. It found no benefit of using keto/low-carb over a more conventional diet for this purpose, and took note that losing weight at all improved depression, hirsutism, and quality of life irrespective of dietary composition.
ETA: If the risk of bias isn't enough, I'd draw your attention to this part of the discussion in the study itself:This pilot study showed that adherence to a low-carbohydrate, ketogenic diet led to improvement in body weight, percent free testosterone, LH/FSH ratio, fasting serum insulin, and symptoms in women diagnosed with PCOS over a six-month period. Further research is needed to determine if the benefits were from weight loss or from carbohydrate restriction specifically.
There are hundreds of studies available on Insulin-resistance and VLCKD. There are very few thusfar on PCOS and more are needed. This doesn't mean we should discount the available research on what helps a major component of the syndrome itself - Insulin Resistance.
That's like saying if your car isn't running smoothly you shouldn't bother changing the oil because you don't know if that'll help, even when we know changing the oil is important to it's maintenance and longevity.
The thing about PCOS is, both lean and obese women with PCOS do/can have chronic inflammation. This inflammation is responsible for long term cardio-metabolic complications (and comorbidities) in women with PCOS, including metabolic syndrome and/or Type II diabetes, dyslipidemia and cardiovascular disease. I'm looking a this from much more than just an IR perspective. As the VLCKD is shown to assist in all of the above, why would anyone discount it simply because they "don't like low-carb" ?? It's medically irresponsible.0 -
More than anything else, the biggest thing that helped me was regular, vigorous exercise. I won't say my PCOS is gone, because it's not, but I now cycle regularly without medication.
My personal story: I started on the pill to control cycles at 24, because they were monstrous -- we're talking 3 months between them and then a 2-week long period. About 3 years later (at 27), I started exercising frequently and vigorously. Since I did not control my diet at all, I did not lose any weight, but I still became significantly more fit. About a year after that (at 28), I stopped taking the pill due to lack of income/insurance. I did not gain or lose any more weight because I was still not tracking eating and was pretty much at my body's set point. 3 years after that (at 31) I went through a rough breakup and decided it was really time to get serious about my health. I started cutting calories to lose weight. It's been about 2 years, and there were setbacks along the way (mostly caused by mental health issues and overeating) but I've lost 60 lbs. I credit the exercise above all. I found when I started cutting calories (so before I lost the weight) that I'm far less carb-sensitive than I used to be, and going long times between meals doesn't bother me anymore.
As always, YMMV. But I'd still recommend exercise, as vigorous as you can handle, non-weight-bearing if necessary, along with whatever treatment options you decide to go with. It sure can't hurt.0 -
I'm not saying low-carb doesn't work for weight loss, it does... of course it does. I'm just saying it isn't necessary, nor is it proven to be better than any other method. Saying that it is, is problematic and depressing for people who can't stick to it.
In the case of those with Insulin-Resistance or Diabetes Mellitus, it *IS* superior. There is no doubt in all clinical research. You've posted nothing to the contrary. There are HUNDREDS of studies to it's affirmative.
If you take the time to at-least read this independent review (I don't believe the full article is available to most of you unless you go to a university library, but I have it all here) http://www.ncbi.nlm.nih.gov/pubmed/23420000 you'll see that :
for low-carb and/or low-glycemic diets (FYI low-carb is also low-glycemic ...) the subjects enjoyed
* improved menstrual regularity;
* improved quality of life;
* greater reductions in insulin resistance,
* greater reductions in fibrinogen,
* greater reductions in total, and high-density lipoprotein cholesterol;
vs. other diets tested against.
Dietary intervention for PCOS is still being researched, true. And as such evidence-based recommendations are still "old school" and follow old dietary advice - much of which is political rather than health-motivated. However there is considerable research now that simply cannot and should not be ignored.
If you truly care about yours or another's health - you shouldn't ignore current research simply because a political organization hasn't changed it's mind yet. If you don't care about research for your OWN case, that's fine. But you shouldn't recommend against it for another with absolutely nothing but your opinion to back you up.0 -
Maca Maca Maca Maca Maca. If you know me, you'll know how much I love and am a huge advocate for this stuff.
I have PCOS, decided not to go on bc (for obvious reasons... that stuff messes you up) and I'm currently on Maca (2500mg capsules daily).
For me personally I've noticed that it's helped tremendously with my insulin resistance and balancing out hormones in general (which includes getting my body back to regular cycles).
I also embrace an intermittent fasting lifestyle (17:7 weekdays, weekends vary). It works wonderful with my schedule, I feel great, and from what I read about IF it helps with people with leptin imbalances and insulin resistance (which women may have if they do have PCOS).
Also, cardio in combination with resistance or weight training seems to help me a lot.
Let me throw a disclaimer out there and say that what works for one woman might not work out necessarily work for another (ie tried the whole low carb thing, didn't quite work out for me). These are things that worked for me personally and things I do advocate as a fellow polysister. I will say though that women just need to experiment and see what works best for them.
Best of luck hun!0 -
I'm not saying low-carb doesn't work for weight loss, it does... of course it does. I'm just saying it isn't necessary, nor is it proven to be better than any other method. Saying that it is, is problematic and depressing for people who can't stick to it.
You keep saying this, but it's untrue.
In the case of those with Insulin-Resistance or Diabetes Mellitus, it *IS* superior. There is no doubt in all clinical research. You've posted nothing to the contrary. There are HUNDREDS of studies to it's affirmative.
OP hasn't been diagnosed with PCOS, let alone PCOS and IR, nor diabetes, and you recommended low-carb, high-fat, moderate protein diet as the most beneficial diet for all women with PCOS. I don't disagree that low-carb is beneficial for diabetes... but as has been said previously, not all women with PCOS have diabetes, IR, prediabetes, or even cysts.
And that's not even addressing new-ish research that suggests high intakes of fat could potentially worsen insulin resistance (lab rats, not exactly reliable... but interesting nonetheless: http://diabetes.diabetesjournals.org/content/40/11/1397.short).
You still haven't provided proof that in the case of straightforward PCOS, low-carb or keto is better than any other approach, despite continually making claims that it is.
I also refer you to the quote from the discussion of the Atkins study itself. The method of implementation was sound, but the data collected can't explicitly be attributed to a low-carb diet, and therefore simply correlates with practically (in my experience) all other studies specifically on lifestyle management of PCOS that say a simple reduction in weight and undertaking of regular exercise reverses and/or improves the symptoms, inclusive of insulin resistance. These are far more pressing matters to deal with to improve insulin sensitivity than the amount of carbs you consume.0 -
I'm not saying low-carb doesn't work for weight loss, it does... of course it does. I'm just saying it isn't necessary, nor is it proven to be better than any other method. Saying that it is, is problematic and depressing for people who can't stick to it.
You keep saying this, but it's untrue.
In the case of those with Insulin-Resistance or Diabetes Mellitus, it *IS* superior. There is no doubt in all clinical research. You've posted nothing to the contrary. There are HUNDREDS of studies to it's affirmative.
OP hasn't been diagnosed with PCOS, let alone PCOS and IR, nor diabetes, and you recommended low-carb, high-fat, moderate protein diet as the most beneficial diet for all women with PCOS. I don't disagree that low-carb is beneficial for diabetes... but as has been said previously, not all women with PCOS have diabetes, IR, prediabetes, or even cysts.
Yes, I've stated a low-carb/high-fat/moderate-protein diet is an excellent diet for the majority of women with PCOS (especially so if they are insulin-resistant and/or have glycaemic control issues), and research backs that up.
If you notice, the two are unrelated.
As for it being beneficial for diabetes - I'm glad you realize that, but you're ignoring the FACT it's the most-beneficial diet for insulin-resistance. If you dispute that, you NEED to research it. I can't do it for you.
As for your assertion not all women with PCOS are insulin-resistant - I dispute that, as it's the major factor in almost all the complications of the disorder. Just because you may have very little insulin-resistance, and it's not manifesting itself in glycaemic tests yet, doesn't mean you don't have insulin-resistance. It just means it's not as advanced. Without proper treatment, insulin-resistance is a deteriorating condition.
The following quote is from the International Journal of Reproductive Medicine, paper titled: "Polycystic Ovary Syndrome, Insulin Resistance, and Obesity: Navigating the Pathophysiologic Labyrinth"... IR, defined as a metabolic state characterized by a decrease in cellular ability to respond to insulin signaling, appears to be an essential pathophysiologic mechanism in the development of all metabolic complications of PCOS ...And that's not even addressing new-ish research that suggests high intakes of fat could potentially worsen insulin resistance (lab rats, not exactly reliable... but interesting nonetheless: http://diabetes.diabetesjournals.org/content/40/11/1397.short).You still haven't provided proof that in the case of straightforward PCOS, low-carb or keto is better than any other approach, despite continually making claims that it is.
No offense, but you need to learn to read. Please show me ANYWHERE that I've stated that low-carb/keto is the better diet than any other for PCOS. I haven't. I've said it's the best for Insulin-resitance and glycaemic control, and never anything else. I've also clearly stated that if you don't have an HbA1c outside of the 4.6 to 5.4% range and aren't having spikes, that you probably don't need a VLCKD. Do you even read what I write before posting rabid anti-low-carb rants with no basis in science?
Again, there is no better dietary intervention for insulin-resistance and accompanying glycaemic problems than VLCKD. I've also stated exercise, specifically HIIT (but that would also include strength/resistance-training) is an important component.
Forgive my bluntness, but you seem so rabid in your anti-low-carb stance (or so determined to seem correct?) that you don't even realize you're arguing against points I've never made. FYI - I spend my life researching things like this, and have 12 years of advanced education in the subjects we're talking about, and you've yet to show anything that disproves anything I've said.0 -
I love how dieticians are clueless, drs are clueless, peer reviewed medical studies are clueless, national health organisations are old school and advocating disastrous diets, but a telephone review over a total of 25 people funded by Atkins, must be unbiased. I just honestly hope that the OP and any one else researching about PCOS or any other health issue, gets an appointment with their dr, not rely on internet forums...
Also one thing that really really really annoys me:
When people claim to be nutrition experts, with decades of research to back this up, yet their tickers indicate a big weight loss (which means a big weight gain in the past to begin with). No offence, but this makes no sense. Someone with such a deep personal interest in nutrition which starts decades in the past, should not end up overweight to begin with, no? Hardcore enthusiasts for any lifestyle, when their ticker indicates a recent big weight loss, they do not convince me they are not just new enthusiasts convinced they found the magic cure for all, or that their lifestyle was not that easy to follow or effective to begin with, for them.
Sure, if you have 100+ lbs to lose and lose them, your diabetes will get under control. If you do this on a ketogenic diet, or a "eat beans, sardines and pineapple only" diet, or whatever else seems appealing at the time, the results will be the same. This still does not make the specific diet any more magical and all drs clueless. It just proves what drs have been saying for decades: obesity and no exercise causes diabetes, lose weight, and this will control your blood sugar.0 -
Just wanted to say thank you to the posters in this thread, your ideas have been incredibly informative to me. I really would love to find out if I'm insulin resistant but my GP refuses to run any tests 'because I'm a normal weight and clearly don't have as much of a problem as other pcos patients' :grumble: as such I try to keep my carbs under 100g a day, I personally find it quite hard, since I don't really like fatty products too much, but the scale did move a bit in the last month, so going to keep it up longer before deciding whether to stick with it.
Get a new doctor. Nothing's worse than a doctor that isn't willing to work with you, especially when it comes to PCOS.
Oh, yes. This, this, THIS!!! ^^^ Was in the same boat here. Got myself a new ship's captain (doc). Boat's finally sailing in the *right* direction now.0 -
I'm not saying low-carb doesn't work for weight loss, it does... of course it does. I'm just saying it isn't necessary, nor is it proven to be better than any other method. Saying that it is, is problematic and depressing for people who can't stick to it.
You keep saying this, but it's untrue.
In the case of those with Insulin-Resistance or Diabetes Mellitus, it *IS* superior. There is no doubt in all clinical research. You've posted nothing to the contrary. There are HUNDREDS of studies to it's affirmative.
OP hasn't been diagnosed with PCOS, let alone PCOS and IR, nor diabetes, and you recommended low-carb, high-fat, moderate protein diet as the most beneficial diet for all women with PCOS. I don't disagree that low-carb is beneficial for diabetes... but as has been said previously, not all women with PCOS have diabetes, IR, prediabetes, or even cysts.
Yes, I've stated a low-carb/high-fat/moderate-protein diet is an excellent diet for the majority of women with PCOS (especially so if they are insulin-resistant and/or have glycaemic control issues), and research backs that up.
If you notice, the two are unrelated.
As for it being beneficial for diabetes - I'm glad you realize that, but you're ignoring the FACT it's the most-beneficial diet for insulin-resistance. If you dispute that, you NEED to research it. I can't do it for you.
As for your assertion not all women with PCOS are insulin-resistant - I dispute that, as it's the major factor in almost all the complications of the disorder. Just because you may have very little insulin-resistance, and it's not manifesting itself in glycaemic tests yet, doesn't mean you don't have insulin-resistance. It just means it's not as advanced. Without proper treatment, insulin-resistance is a deteriorating condition.
Perhaps I do have an issue with reading. But you seem to be making contradictory statements, so that might explain it.
I will admit on the first page I had actually confused something someone else had said as something you had said, so I'd initially unfairly attributed it to you... but the above emboldened seems to suggest you believe what I thought you had said, anyway.
Perhaps before we continue, you might want to clear that up?
(As for the age of the rat study, I'd say a 20-or so year-old study - in the grand scheme of the progression of medicine - is, yes, new-ish. And the methodology is, of course, questionable but the same can be said for any non-human study contributing to carb/gluten/fructose/dietary fat-based alarmism. I did read it. The complications seen in their high-fat diet is probably more due to the fact they were being overfed and therefore gained excess weight, but "probably" doesn't fly in science.)
I'm also not against going low-carb if you want to go low-carb. I even gave advice on low-carbing in my first post. It's by no means my first thing to recommend to someone, and it never will be, but I don't ever say that it doesn't work, is bad or that nobody should do it.
As I said to someone else, if it was the case that low-carb was best for PCOS sufferers, I would be advocating it too. It just simply is not.0 -
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I suffer from PCOS too. I was diagnosed last year and had the some of the same symptoms as you. I was really badly bloated and tried really hard to lose weight but I found nothing worked, the weight just wouldn't budge. After taking the pill I found that weight loss became a lot easier and I just don't feel bloated anymore.
You sound like you've come very far given your condition, you should be proud of yourself. But I would say get tested out, it may not even be the case that you have PCOS but it's best to double check. It's not a reversible condition, the Doctor will only give you something to manage the symptoms.0 -
this is v hopefup fr me.me too have pco.0
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Perhaps before we continue...
Have you both ever heard of this concept, by chance?
http://www.urbandictionary.com/define.php?term=thread+hijacking0 -
As for your assertion not all women with PCOS are insulin-resistant - I dispute that, as it's the major factor in almost all the complications of the disorder. Just because you may have very little insulin-resistance, and it's not manifesting itself in glycaemic tests yet, doesn't mean you don't have insulin-resistance. It just means it's not as advanced. Without proper treatment, insulin-resistance is a deteriorating condition.
Eh, while I agree with most of the information you've posted, there is actually emerging evidence that there is a type of PCOS that isn't insulin resistant. This supports/is supported by the fact that a significant portion of women with PCOS don't respond to Metformin. Some sources say there are two types, some say there are as many as 5, more information is still needed on this front, but it's pretty clear that there are at least two -- with and without insulin resistance. The insulin resistance is often the underlying cause of the other issues in those with PCOS with IR, but the issues for those that aren't are often at least partially caused by insufficient estrogen or progesterone production (the underlying cause of that is as yet unknown). Thyroid issues also seem to be a comorbid in a number of cases (hinting at the possibility of a third type).
That said, I still favor carb restriction, since 300g+ or 50% calories from carbs is overkill for the vast majority of people, and is doing our entire population as a whole, PCOS or not, a disservice to our health. It need not be to ketogenic levels, but I do think that the ballpark of 150g is ample for most people (and is easily obtained simply by cutting out the processed crap and limiting intake of starchy carb sources), if for no other reason than to keep triglycerides down and HDL up.0 -
As for your assertion not all women with PCOS are insulin-resistant - I dispute that, as it's the major factor in almost all the complications of the disorder. Just because you may have very little insulin-resistance, and it's not manifesting itself in glycaemic tests yet, doesn't mean you don't have insulin-resistance. It just means it's not as advanced. Without proper treatment, insulin-resistance is a deteriorating condition.
Eh, while I agree with most of the information you've posted, there is actually emerging evidence that there is a type of PCOS that isn't insulin resistant. This supports/is supported by the fact that a significant portion of women with PCOS don't respond to Metformin. Some sources say there are two types, some say there are as many as 5, more information is still needed on this front, but it's pretty clear that there are at least two -- with and without insulin resistance. The insulin resistance is often the underlying cause of the other issues in those with PCOS with IR, but the issues for those that aren't are often at least partially caused by insufficient estrogen or progesterone production (the underlying cause of that is as yet unknown). Thyroid issues also seem to be a comorbid in a number of cases (hinting at the possibility of a third type).
That said, I still favor carb restriction, since 300g+ or 50% calories from carbs is overkill for the vast majority of people, and is doing our entire population as a whole, PCOS or not, a disservice to our health. It need not be to ketogenic levels, but I do think that the ballpark of 150g is ample for most people (and is easily obtained simply by cutting out the processed crap and limiting intake of starchy carb sources), if for no other reason than to keep triglycerides down and HDL up.
^^^ THIS!!! I like you, Dragonwolf, I really do... Thanks for pointing out that not every PCOS woman has the exact same profile - so there's likely no one perfect solution for PCOS. I'm PCOS and *not* IR. Also not hypothyroid. I have benefitted from a lower-carb diet (almost exactly what you are suggesting) for the reasons you have stated.0 -
Perhaps before we continue...
Have you both ever heard of this concept, by chance?
http://www.urbandictionary.com/define.php?term=thread+hijacking
It's pertinent to the OP, though maybe more comprehensive than the original question seemed to want. I don't see why it would be considered hijacking. It hasn't gone off-topic like the majority of other long-ish threads on MFP... in fact, it's curiously stayed topical for a thread here.
ETA: I should add that "low-carb" for me is the traditionally defined 20-or-so percent carb intake.
150g is moderate. I also consider the 200g I take in, on average, to be moderate.0 -
I love how dieticians are clueless, drs are clueless, peer reviewed medical studies are clueless, national health organisations are old school and advocating disastrous diets, but a telephone review over a total of 25 people funded by Atkins, must be unbiased. I just honestly hope that the OP and any one else researching about PCOS or any other health issue, gets an appointment with their dr, not rely on internet forums...
Also one thing that really really really annoys me:
When people claim to be nutrition experts, with decades of research to back this up, yet their tickers indicate a big weight loss (which means a big weight gain in the past to begin with). No offence, but this makes no sense. Someone with such a deep personal interest in nutrition which starts decades in the past, should not end up overweight to begin with, no? Hardcore enthusiasts for any lifestyle, when their ticker indicates a recent big weight loss, they do not convince me they are not just new enthusiasts convinced they found the magic cure for all, or that their lifestyle was not that easy to follow or effective to begin with, for them.
Sure, if you have 100+ lbs to lose and lose them, your diabetes will get under control. If you do this on a ketogenic diet, or a "eat beans, sardines and pineapple only" diet, or whatever else seems appealing at the time, the results will be the same. This still does not make the specific diet any more magical and all drs clueless. It just proves what drs have been saying for decades: obesity and no exercise causes diabetes, lose weight, and this will control your blood sugar.
Unfortunately, a great percentage of doctors are clueless when it comes to PCOS. Go to a PCOS board and ask how many had to fight with doctors to even get them to run tests. I can pretty much guarantee that a good 90% of them had to at least talk their doctor into it (we're not even talking treatment, here, just blood tests), if they didn't have to fire their doctor and find another. I've seen some women go through half a dozen doctors before they could find one that would actually help them.
As I recall, general doctors only get about 25 hours worth of nutrition education, and most of information for which is politically motivated in one way or another. As someone mentioned, they still teach the lipid hypothesis as though it were fact, despite the fact that it has been disproven time and time again for the past 50 years (including in the well-renowned Framingham Heart Study). Why? Because of all the politics intertwined in medicine.
The lipid hypothesis came about, because Ancel Keys put out a couple of studies that supposedly proved that saturated fat = high cholesterol = heart disease. It was heavily cherry-picked to support the conclusion he had already come to (which gave rise to the so-called "French Paradox," "Inuit Paradox," and others, which are really only paradoxes if Keys' conclusion was legitimately true, and of course, his conclusion wouldn't be true if those high-fat, low-disease groups were included in the studies), but the media got a hold of it, and eventually Congress got a hold of it. Before you knew it, you have the USDA food pyramid, saying to get 6-11 servings of grain a day, avoid fats in general, and replace saturated fats with trans fats. It wasn't until a few decades later that the USDA realized that trans fats weren't so healthy after all, but instead of questioning the basis for the original recommendation (Keys' "research"), they simply band-aided their recommendations to "replace saturated and trans fats with polyunsaturated fats."
You also have a disease that affects nearly a third of the adult US population and only continues to deteriorate when following medical advice, to the point that people are seriously considering using gastric bypass as a legitimate treatment (some say "cure") for. I kid you not.
On a side note, it's unbecoming to resort to ad hominem attacks.0 -
Perhaps before we continue...
Have you both ever heard of this concept, by chance?
http://www.urbandictionary.com/define.php?term=thread+hijacking
It's pertinent to the OP, though maybe more comprehensive than the original question seemed to want. I don't see why it would be considered hijacking. It hasn't gone off-topic like the majority of other long-ish threads on MFP... in fact, it's curiously stayed topical for a thread here.
ETA: I should add that "low-carb" for me is the traditionally defined 20-or-so percent carb intake.
150g is moderate. I also consider the 200g I take in, on average, to be moderate.
Yeah, I think that's one issue, too. "Low-carb" means different things to different people. A lot of people think low-carb = ketogenic, but that's actually not the case.
The exact numbers are different, depending on source, but from what I've seen, anything under about 150g is considered "low carb," and anything under 50g is "ketogenic." I personally favor a range closer to 100g for the upper end, which is still pretty easily attainable, while providing a lot of benefits of controlled insulin and glucose.0 -
Yeah, I think that's one issue, too. "Low-carb" means different things to different people. A lot of people think low-carb = ketogenic, but that's actually not the case.
The exact numbers are different, depending on source, but from what I've seen, anything under about 150g is considered "low carb," and anything under 50g is "ketogenic." I personally favor a range closer to 100g for the upper end, which is still pretty easily attainable, while providing a lot of benefits of controlled insulin and glucose.
This is true.
100g is counting NET carb intake, not total though, right?0 -
Yeah, I think that's one issue, too. "Low-carb" means different things to different people. A lot of people think low-carb = ketogenic, but that's actually not the case.
The exact numbers are different, depending on source, but from what I've seen, anything under about 150g is considered "low carb," and anything under 50g is "ketogenic." I personally favor a range closer to 100g for the upper end, which is still pretty easily attainable, while providing a lot of benefits of controlled insulin and glucose.
This is true.
100g is counting NET carb intake, not total though, right?
Haha, then there's that, too. I don't do the net carb thing, just total carbs. To my knowledge, most of the sources I've seen that have the numbers I mentioned are using total carbs, but I could be wrong.0 -
It's definitely a confounding subject to discuss just using the words "low-carb or keto" alone, haha.
For me, personally, a low-carb high-fat diet doesn't work at all mainly due to having lost my gallbladder. A diet too high in fat can cause similar pain to what I had prior to having my gallbladder removed, and in general I can't eat that many calories in protein to make up the difference. Well, I can, but it's uncomfortable, lol.
I've read somewhere, might have to find it again to make absolutely sure, that women with PCOS are also at greater risk of developing gallstones... particularly during pregnancy (might be attributed to gestational diabetes). Moderate to high fat diets seem to help prevent this from happening, so that's a plus for the moderate-/high-fat diet approach.0 -
Perhaps I do have an issue with reading. But you seem to be making contradictory statements, so that might explain it.
...
Perhaps before we continue, you might want to clear that up?
It's the same with me - I'm a diabetic, yet i have absolutely normal, non-diabetic HbA1c levels. If I were to see another physician tomorrow with no knowledge of my medical history, they could run lab tests and never diagnose me as diabetic. (Unless, of course, they were to run an OGGT - but that's a HUGE rarity for physical exams.)
A woman with PCOS may say she's not insulin-resistant - but it's very possible she's simply not manifesting the symptoms of it. She may never if she maintains healthy control - it may never deteriorate to the point it shows as glycaemic problems.
I don't appear to have insulin-resistance - yet I do. That's the point I'm getting at.
For those who mentioned not being helped by metformin - there's also a subset of Type II diabetics not helped by it. Nobody is really sure why at this point. It *would* be nice to know. That doesn't mean those diabetics aren't insulin-resistant either.... As I said to someone else, if it was the case that low-carb was best for PCOS sufferers, I would be advocating it too. It just simply is not.
/end hijack0
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