Also, I find that smoked salmon in the morning is very satisfying and a great protein boost in the AM.

I like the term Cysters too. LOL

I'm new to this group (I was Dx'ed with PCOS about 6 years ago though) but found this thread very helpful and informative. Thank you!

I have done the low carbthing in the past. It's not for me. I ended up with horrible heartburn, and periods that sent me to the hospital they were so heavy.

I saw a nutritionist who talked about glycemic index and nutrition. The recommended diet was to use the my plate judgments for each meal. Take your plate, divide it in half. Fill one half with non-starchy veggies (corn, peas are starch). Then fill half of the remaining half with healthy protein. The remaining portion should be filled with a healthy starch. So, a pasta dinner would become a salad on half of the plate, a marinated chicken breast and maybe 1/2 cup of cooked noodles. Also she said snacks in between meals should have a serving of protein. She said protein helps the digestion process in relation to starches. For every 15gram serving of carbohydrates you should have a serving or 7 or more grams of protein with it.

If you're looking for decent recipe information look for diabetic recipes. These will involve a healthy balance of foods.

Holy insulin spikes, Batman!

The issue I have with the above is that our insulin problems aren't generally tied to our glucose intake (ie - our insulin isn't high because our glucose is high, necessarily). Additionally, the above meal example is full of things that raise insulin, including the meat (protein causes an insulin response). While the protein with every starch recommendation isn't bad, per se (it slows the processing of the carbs, keeping the glucose from spiking too high, too quickly), I think it misses half of the issue that those of us with PCOS face. It also seems to seriously miss the role of fats in hormonal balance and keeping the body healthy (notice that the above example is pretty much devoid of fats, it's all protein and carbs).

Can the above help? Possibly (especially if your elevated insulin is due to elevated glucose), but while PCOS has a lot in common with Diabetes, they're not identical, and shouldn't necessarily be treated as such, in my opinion.

That's interesting, DragonWolf. I had read the Insulin Resistance book and tried following the IR Diet for a while and it didn't really seem to help, i.e. I didn't lose weight on it.
I saw your earlier post and it was the first time I'd heard about the importance of fat (or realized that protein raises insulin!); what would you recommend for fat intake or macro ratios for those with PCOS? All my dr really said was that low-carb was a good idea for PCOSers.

Carbs and fat are fuel sources, so when you lower the one, you have to raise the other. I usually use the following:

Protein - about 1g/lb of lean body mass (especially if you're working out, more if you do a lot, less if you do not so much). You need this amount to retain lean body mass and properly repair/recover from workouts (as far as insulin goes, this is a "necessary evil").

Carbs - whatever your chosen grams of carbs is. I personally follow the Primal Blueprint eating framework, which has a "carb curve" - 0-50g is keto, 50-100g is the "weight loss sweet spot", 100g-150g is "maintenance range" (higher only if you do a lot of endurance cardio type of stuff), 150g+ is the weight gain zone. Regardless of what anyone else thinks, I've found it to be a good guide. A good starting number for reducing carbs is about 75g-100g (max), but set it to whatever you want/need to (you can always tweak it later). The farther you reduce this, the less insulin your body needs to release for dealing with your food, ultimately lowering it overall.

Fill the rest in with fat. Try to get at least .45g/lb of body weight, so that you have enough to support your hormone balance, and to properly absorb nutrients. With the other two numbers, above, and as long as you're not overly restricting your calories, you should be easily able to hit this number for fat (to compare, I'm able to lose weight on about 1800 calories at 5'9"/250lb, whereas on a more "standard" not-so-high-fat way of eating, I'd have to drop down to 1200 to lose anything, and couldn't sustain that number for more than a few days without it wrecking me).

For me, with about 130 lbs of lean body mass and requires the full 1g/lb for protein, my numbers look something like 75g-100g carbs, 130g protein, 135g fat or 10%/25%/65% (c/p/f). Yes, it seems like a lot fat, especially if you're used to the fat-phobic stuff, but it's very filling and results in not much in the way of cravings after the initial adjustment period (your body basically throws a temper tantrum like a little child when you deprive it of sugar).

Additionally, don't be afraid of animal fats, and don't just fill in the fats with seed/nut oils. Seed and nut oils are high in omega-6 fats and low in omega-3 fats, generally, which leads to inflammation, which in turn elevates cholesterol. Animal fats actually have a lot of monounsaturated fats, and the proper balance of O3-O6 fats, as well as the saturated fats (which aren't bad, anyway, and have never actually been linked to heart disease).

Your carbs should come from complex sources, as well. Things like vegetables and low sugar fruits (such as berries). Try to limit starchy (potatoes, grains, etc) and sugary (high sugar fruits like bananas and citrus, juices, and of course candy or anything else with a bunch of added sugar) foods.

Hope this helps.

Gotta say, I don't appreciate your tone with your response. PCOS and nutrition very from person to person. Inferring from one bare bones example that the advice given by a professional, college educated nutritionist who specifically deals with insulin, glucose issues is bad and unhealthy is a little unfair.

I never said you should avoid fat and neither did she. Was there oil on the noodles? Or on the chicken? Or dressing the veggies? You had no idea. A smallish portion of healthy carbohydrates will not cause your insulin or glucose to be out of control. Following a diet that is very restrictive on carbohydrates and starches can really lead to falling off of the bandwagon and binging. So many women just seem to say, oh you have PCOS just go low carbohydrate. Well, I have yet to meet a person who truly lives low carb long term.

Learning to keep your food in balance is something that can be maintained. I am pointing out to anyone reading this thread that low carbohydrate diets don't cure PCOS or work for everyone. In fact my obgyn informed me that many women do experience abnormally heavy periods while doing a low carb diet. I ended up in the ER. Not to mention the heart burn. Be aware that the diet you are recommending can work for you. The diet that works for me, works for me.

Also, once again, every one is different. Giving mathematical formulas to calculate what should eat is as silly as the people who judge and say that PCOS sufferers would lose if we just weren't lazy. There is no magic formula. While your advice to include enough healthy fats is good, please, don't treat me as if I am unintelligent because my experience doesn't line up with your formula.

This is a support group. I shared my experience with no judgment and was responded to in a disrespectful way. In no way did I say diabetes and PCOS are the same. But, many diabetes recipes are geared towards healthy carbohydrates in a balance with healthy protein and plenty of healthy veggies. I thinks you inferred that I said boiled skinless chicken with plain noodles and dry lettuce. To be more clear my salad would have spring greens, nuts or sunflower seeds, fruit, and some varied veggies and is dressed with full fat olive oil based dressing. The sauce on the noodles (which for me are rice noodles since I'm allergic to wheat) is a healthy marinara with onions and peppers added. The chicken is sauteed in olive oil and might even have some cheese on it. This is loaded with nutrients and is very satisfying. I also didn't say to have a bag of potato chips or a candy bar, but balance it with some nuts. Instead I'm talking about some multigrain tortilla chips with salsa and some cheese or meat.

Gotta say, I don't appreciate your tone with your response. PCOS and nutrition very from person to person. Inferring from one bare bones example that the advice given by a professional, college educated nutritionist who specifically deals with insulin, glucose issues is bad and unhealthy is a little unfair.

I never said you should avoid fat and neither did she. Was there oil on the noodles? Or on the chicken? Or dressing the veggies? You had no idea. A smallish portion of healthy carbohydrates will not cause your insulin or glucose to be out of control. Following a diet that is very restrictive on carbohydrates and starches can really lead to falling off of the bandwagon and binging. So many women just seem to say, oh you have PCOS just go low carbohydrate. Well, I have yet to meet a person who truly lives low carb long term.

Learning to keep your food in balance is something that can be maintained. I am pointing out to anyone reading this thread that low carbohydrate diets don't cure PCOS or work for everyone. In fact my obgyn informed me that many women do experience abnormally heavy periods while doing a low carb diet. I ended up in the ER. Not to mention the heart burn. Be aware that the diet you are recommending can work for you. The diet that works for me, works for me.

Also, once again, every one is different. Giving mathematical formulas to calculate what should eat is as silly as the people who judge and say that PCOS sufferers would lose if we just weren't lazy. There is no magic formula. While your advice to include enough healthy fats is good, please, don't treat me as if I am unintelligent because my experience doesn't line up with your formula.

This is a support group. I shared my experience with no judgment and was responded to in a disrespectful way. In no way did I say diabetes and PCOS are the same. But, many diabetes recipes are geared towards healthy carbohydrates in a balance with healthy protein and plenty of healthy veggies. I thinks you inferred that I said boiled skinless chicken with plain noodles and dry lettuce. To be more clear my salad would have spring greens, nuts or sunflower seeds, fruit, and some varied veggies and is dressed with full fat olive oil based dressing. The sauce on the noodles (which for me are rice noodles since I'm allergic to wheat) is a healthy marinara with onions and peppers added. The chicken is sauteed in olive oil and might even have some cheese on it. This is loaded with nutrients and is very satisfying. I also didn't say to have a bag of potato chips or a candy bar, but balance it with some nuts. Instead I'm talking about some multigrain tortilla chips with salsa and some cheese or meat.

I said nothing personal about you or your doctor, nor was I judging either of you as people, and I certainly said nothing about your intelligence. I was disagreeing with the recommendation for a meal that contains so many carbs and no mention of fat. Your original recommendation said "fill half the plate with non-starchy vegetables, a quarter with protein, and a quarter with starch." There is zero mention of fats in that, at all. Yes, one could assume that there may be some things that include fat, but given that your protein example was a "marinated chicken" (which most marinades aren't fatty, and any oil they might have in them usually gets cooked off), there wasn't really anything in your recommendation to suggest just about any amount of fat. Even your response here (bolded) says nothing about including fats, and even if you assume that fats were added in cooking and whatnot, it's very likely that it's still too little fat even for proper vitamin absorption. And given that "low fat!" has been indoctrinated into us and has permeated our society for the past 35 years, without some specific indication of fat within the meal information, most people will default to little, if any.

In my experience, the underlying cause of most people's failure on "low carb" diets is that they generally result in low carb, low fat, high protein, which very much is a recipe for disaster for anyone, due to the lack of a preferred fuel source (carbs or fat) and vitamin absorption vehicle, and it's known to cause insatiable cravings until the body gets a food that is heavy in fats and/or carbs.

Also, while you may not know people that have been successful on low carb diets, it doesn't mean they don't exist. Just look in the success stories section of any keto diet board and you'll find dozens, if not hundreds, on each one you look at. Then, of course, there's whole groups of people (namely, the Inuit) who thrive on a diet that is nearly devoid of carbohydrates in general and live off of animal meat and fat for the vast majority of their calories and nutrition (which is basically one giant success story for LC/HF in general).

Regarding the first part of your response, college education is very quickly outdated in any field, and doctors are not omniscient. Even many PubMed articles acknowledge that many patients are more knowledgable on any given specific matter than their doctors. And as you and I both know, PCOS isn't a simple matter in pretty much any respect, and most doctors don't even have an inkling of the complexities (as evidenced by the amount of doctors who basically say "you have PCOS, here's a prescription for The Pill. Good luck and have fun," and even by the at least two doctors that your very own PCOS Diva had visited that didn't even consider PCOS), that's if you can even get them past the idea that your inability to lose weight isn't just you being a lazy glutton. Now, not all of them are like that, and some are more knowledgable than others, but as I mentioned, the difference between Diabetes and PCOS is that the elevated insulin levels that often come with PCOS (and is often the primary culprit in one's inability to lose weight), is not necessarily tied to elevated glucose levels, as it usually is in Diabetics. As such, the same diet may or may not work for someone with PCOS, hence the entire last paragraph of my initial response ("will it work? Possibly, especially if your elevated insulin is due to elevated glucose," which is entirely possible).

Additionally, I'm fully aware that not everyone with PCOS has to follow the same diet. If a cyster does well on the usual "CICO is all that matters," then obviously, they have no need for any other diet (but that's not who we're addressing when we talk about specialty diets, anyway). Likewise, if one's elevated insulin is due to elevated glucose, a Diabetic-oriented way of eating may be best. Again, that's why I mentioned that the way of eating that you outlined might work. I went into more detail about what I recommend (including the formulas that you are dismissing as "silly" -- now who's being disrespectful?), because someone asked. If you look, you'll see that I did not say anything even remotely along the lines of "the plate method is stupid, here's a bunch of formulas for finding exactly what you need." Someone asked what I'd recommend for intake and I responded with how I come up with the amounts that I've found work not only for me, but for many others (including many with PCOS). In no way was my method an insult to your plate method.

Finally, if you use MFP at all for tracking your intake, or if you pay any attention at all to nutrition labels to make sure you're getting enough vitamins or any kind of nutrient, then you're relying on mathematical formulas. How do you think MFP calculates the amount of calories you're supposed to have? How do you think the BMI scale is calculated? Mathematical formulas. The only difference between those and what I posted is that the ones I posted were in convenient "give me my answer" form, precisely because we all have our differences. Someone who does a lot of strength training needs more protein than someone who's not exercising at all. Likewise, someone who's choosing a higher amount of goal carbs (because there are *gasp!* differences in the different way of eating frameworks that people use) would set it differently than someone who is doing a deep ketogenic diet. The numbers for protein and fat are based on research for what is required for maintaining lean body mass (protein) and supporting hormone balance and nutrient absorption (fat), not some magical formula for weight loss (though the reduced need for insulin that a LC/HF diet usually creates does often have that effect, but the numbers for the minimums themselves are not particularly LC/HF). We cysters may be different in numerous ways, but these two things aren't really among them, and even so, there is still quite a bit of room for manipulation in most people's total calorie allotment (unless the person is 200+lbs and trying to only eat 1200 calories, the numbers I put forth for protein and fat leave a fair amount of room for adjusting values up and down as desired/needed).

tl;dr Whether you agree with my opinion on the matter or not, my disagreement was not personal, nor disrespectful. If you read that into my response, then it's purely your interpretation of it. Most people default to low fat, thanks to 35 years of that philosophy getting shoved down our throats, and will default to it with any dietary recommendations that don't explicitly say to eat fats, which is why I think many fail at lower carb diets.

http://ajcn.nutrition.org/content/80/3/550.full?sid=07ca36c5-62d8-4c97-8315-34c1e3133529 <- paper on dietary fat, with various references to pertinent studies

I'm just going to say that my nutritionist was well informed on the needs specific to PCOS. My OB, not so much. The woman who's blog and business is all about healthy lives for women with PCOS, is well informed about PCOS nutrition. She also doesn't advocate super low carbohydrate diets.

If you try this "primal blueprint" or whichever low carbohydrate diet and it's not for you, don't lose hope.

I didn't advocate a "super low carbohydrate diet." Nowhere did I say that anyone had to eat only 20g of carbs or some such in order to be successful (hell, I don't even do that). 100g of carbs isn't actually "super low," and really, the primary difference between the Primal Blueprint framework and what you're advocating is that on PB, starches are limited until you've brought things (including weight) under control (the role of fat in the diet might also be higher on PB, from what little I could see of the recipes on PCOS Diva). You can fit a ton of vegetables, some fruit, and maybe even a few tubers into 100g. The only thing you can't do with 100g is eat a ton of sugar and starches, but I never said you had to eat that level, nor did I say anything about it being the only way. However, even modest reductions (from 55% USDA recommended to 40%) in carbohydrates have proven, in clinical testing, to be very successful in helping women with PCOS.

I see your article on androgens in women with PCOS and raise you this one - http://www.medscape.com/viewarticle/812199

Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic ('first-phase') β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC ( P < 0·05).

and this one - http://www.thatsfit.com/2010/04/12/do-low-carb-diets-affect-pcos/

According to the study, the fat tissue in women with PCOS produces an inadequate amount of an important hormone known as adiponectin. Adiponectin helps the body to make use of insulin, helping to metabolize fats and sugars and also -- not incidentally -- reducing inflammation. Women with PCOS produce less adiponectin than women without PCOS.

and this one (who is, like your PCOS Diva, very informed on PCOS nutrition) - http://www.paleoforwomen.com/category/pcos/ (I'll even give you a link that specifically talks about carbs, though I don't entirely agree with the amount of glucose and starchy carbs, for reasons I've already stated, but it still goes toward the "I never advocated that women with PCOS must (or even should) eat very, very low carb" end - http://www.paleoforwomen.com/carbohydrates-for-fertility-and-health/ )

Oh, and also, I don't appreciate the tone in your responses, either. You have been responding in the very ways you've been accusing me of, including acting like your way is the only way for cysters and that the recommendations I've made are invariably doomed to fail.