Low carb, low fat, high protein is generally discouraged around these parts. This is because the body is not designed to run on protein, but on carbs and fats. When the body is forced to run almost entirely on protein, the body rebels in an effort to preserve itself. This is especially a concern when severely restricting calories ((120*4)+(30*9)+(20*4) = 830 calories -- way too low for nearly anyone, and unnecessary, even with PCOS). (See also: rabbit starvation.)

Safety risks aside, if you suffer from insulin resistance, then high protein is counterproductive. Protein, when used for fuel, gets turned to glucose. Since the point of a low carb diet for insulin resistance is to decrease glucose levels in the blood, going high protein defeats the purpose.

If it's so dangerous, then where did the idea of low carb, high protein come from? Very likely, it's the conflation of the low fat crap that's been pounded into our skulls for the past 60 years and the realization that a high carb diet is detrimental to some people (regardless of where the carbs come from). People's default position is "fat is bad, keep fat as low as possible," then they go "well, carbs are detrimental to you, so you need to reduce them." Combine the two ideas and what's left? Boneless, skinless chicken breast, pretty much.

The more recommended route of this sort is at the very least, moderate fat, but the more favored one is high fat. A moderate to high fat, moderate protein diet is the most sustainable route of low carb, and also the least likely to cause nutrient deficiencies, of the low carb combinations.

The recommendation from that is more along these lines:

Set your calories to the amount determined by any one of the calculators out there (MFP's is fine). Do a 1 or 1.5lb per week loss, so that you have a sane amount of calories to work with.
The carb setting of your choice (in this case, the 20g is fine, and we'll go with it).
About 100g of protein (.5-1g of protein per pound of lean mass; I've found that for most women, it's about 60-100g, depending on height).
Fill the rest in with fat. Yes, this will seem like a lot, and may go over 100g (mine's about 135g, to give you an idea), this is a good thing.

This way of eating will take some getting used to. If you've been low fat for some time, jumping up to that level of fat will probably be a shock to your system. Don't sweat it, you can either bull through the GI discomfort for the first week or so (fats can have a sort of...laxative effect, if your body's not used to them), or you can slowly increase your fats as you slowly decrease your carbs. The slow route will make the transition easier, but will take longer and isn't a great idea if you're prone to backsliding (binges, etc). The fast route is kind of like ripping off a band-aid -- it sucks horribly for a short time, but it gets it over and done with.

So...what to eat on this plan? Everything the USDA, FDA, ADA, and AHA tell you not to, I kid you not.

Breakfast: bulletproof coffee (coffee + butter + coconut oil + blender) or omelet with ham, bacon, peppers, etc. and cheese. Yep, you can get back to the old bacon and eggs classic breakfast and not only is it not frowned upon, but it's encouraged.

Lunch: salad with avocado, sunflower seeds, choice of meat, topped with an oil or cream based dressing (or mayo; I've become fond of may on my salads, especially since my salads are basically breadless hoagies). Or left over meat and veggie from last night's dinner.

Dinner: Fatty meat (chicken with skin, 80/20 or 75/25 hamburger, ribeye steak, pork chop or tenderloin without trimming the fat, etc) and one or more types of non-starchy vegetables (asparagus, broccoli, brussels sprouts, kale, spinach, etc) in butter, cream, lard, olive oil or other choice of fatty or creamy dressing.

Sounds pretty good, doesn't it? Nothing like being able to go to a steakhouse or burger joint and get the juiciest, fattiest item on the menu and have it as part of your way of eating, without falling outside of its bounds and "cheating." Nothing like eating in a way that doesn't make you feel like you're "on a diet."

What about snacks? (You may ask.) When you get used to this way of eating, you'll very likely find that you don't need snacks. In fact, you may find the struggle more in eating enough or remembering to eat at least once or twice in a day. Until then, though, things like jerky and meat sticks (watch the ingredients, though, they tend to sneak sugar into them), hard boiled eggs, a handful of nuts, and other similar foods are fair game for snacks (as is any other compliant food, really).

For support and more information (including what to expect when adjusting to this way of eating), I highly recommend checking out the other groups here on MFP:

http://community.myfitnesspal.com/en/group/394-low-carber-daily-forum-the-lcd-group
http://community.myfitnesspal.com/en/group/1143-keto

It may seem daunting right now, but take it one day at a time. Start by trying to make a meal fully compliant, or try to make your overall day as compliant as you can. Don't worry in the first month or so about calories, especially if you go the "quick adjustment" approach. Just focus on getting the food in line, then if the calories don't fall into place themselves, tweak as needed.

Hope this helps!

rockin_the_30s wrote: »

I was diagnosed with PCOS a few years ago but didn't take it seriously until recently. I am just now trying to figure out what it all means. I'm also struggling with the best approach to take to changing how I eat.

A good way to start is by eating whole foods. Drop the boxed foods, sugary foods, and store bought breads and whatnot (the heavily processed stuff, basically). Base your meals around meats, non-starchy vegetables, some fruits, etc. If you want to do bread or starches, treat them as a side dish and stick to one serving. For breads, go with the highest quality you can swing (the "old" grains, like Ezekiel bread, are a good option, as are the sprouted grains), or make your own with things like sprouted grain flour and sourdough starter (see also: WAPF style eating). Also -- naturally full fat items are better than artificially reduced fat items (ie - if you buy sour cream, get the full fat version, not the fat free; real butter is better than fake "buttery spread"). The items with fat removed have a bunch of crap added to it to restore the taste and texture, and are largely devoid of the nutrients the full-fat product provides. A good rule of thumb -- the fewer ingredients, the better.

Doing that should make a pretty big impact for starters. From there, you'll be able to tweak things to best suit your personal lifestyle and needs.

I am very new here, very fat and have been suffering with PCOS too, and as a thumb rule every doctor I've been to (gynecologist, dermatologist, homeopath, physician...) suggested to kill the processed foods completely, optimize the carb content, increase the protein and stuff as much fiber as possible.. (well that's what I've summed up in my mind). Having said that, what you are about to do sounds unhealthy and impractical (to me) in the long run.
Dragonwolf has given some amazing suggestions which I intend to follow too.
Also, I'd say take a second opinion with the diet from another doctor, things should not be so rigid...

I have my questions with the low carb, high protein diet...
1. I don't eat flesh (as in its only fruits+grains/pulses+veggies+eggs+milk for me), and I've also been reading that egg consumption should be limited to 3-4 a day. How do I increase the protein content ? Can I have a lot of egg whites if not whole eggs. Is having 2-3 cups of milk (I love milk) everyday, good for this diet?
2. Fruits. Does low carb mean low natural sugar as well? Can I have 2 cups of watermelon pieces every day or every second day (they are quite high in sugar)? Can I have an apple occasionally? Same for papaya, strawberries and pomegranate.
3. If I cut out wheat, whole wheat and rice completely, can I still have pulses? Like green lentil, yellow lentil, beans... sprouts etc. ? When I add them to my daily diary, they shoot up the carb and calorie column... even when sprouted! But as I can not have meat, I feel this is all I can have (after eggs) to feel satiated.
4. Coffee. I love having my perfect cup of homemade cappuccino everyday (1/2 Milk, 1/2 water, 2 shots of espresso and 1/4 tbsp. of sugar). Can I have 1/4th tbsp of granulated sugar every day, or should I give it up?
5. Excess of fat/oil/butter/cheese gives me acidity/heartburn ... even plain coffee does that. I am used to have my coffee with one biscuit.. but I can give that up! So, will it still work if I can't consume a lot of fat?
6. Once I follow this diet do I still need to stick to my 1200 calories a day?

Sorry for an awful lot of questions.. It'll really help if someone could take the time to answer.
Thanks a lot!

Thanks a lot for all your suggestions KnitOrMiss, and also for taking out the time to answer... I've visited your profile and you have done some great progress... It's very motivating!

DivyaManaktola wrote: »

I have my questions with the low carb, high protein diet...

Hopefully @Dragonwolf will chime in here again too as she's the most knowledgeable about PCOS but It isnt a low carb high protein diet, it is a low carb high fat diet, or LCHF as @KnitOrMiss Pointed out. Your body uses carbs first, then fats as fuel. High protein can cause problems. Can be hard on your kidneys depending on other health issues and more importantly for us PCOS, can be insulinogenic at high levels, meaning it can raise insulin like a carb would, which in turn raises your hormone imbalance and can cause more pcos problems.

Fat is NOT the enemy and if you look at the groups @KnitOrMiss linked, you will see many many studies showing that a high fat diet is actually beneficial for cholesterol, blood pressure, etc. It is the carbs that are hurting us, not the fat. Even Sweden changed their food recommendations to be lower in carbs and higher in fats.

DivyaManaktola wrote: »

1. I don't eat flesh (as in its only fruits+grains/pulses+veggies+eggs+milk for me), and I've also been reading that egg consumption should be limited to 3-4 a day. How do I increase the protein content ? Can I have a lot of egg whites if not whole eggs. Is having 2-3 cups of milk (I love milk) everyday, good for this diet?

It will be tougher to do a LCHF diet as a vegetarian but on the forums @KnitOrMiss linked there are at least 3 people who have posted they have been successfully doing a vegetarian LCHF diet for awhile now. Id check in with them on some ideas, pointers and support if you are committed to this lifestyle.

Milk is an issue for PCOS for a couple reasons. 1. the sugar and carb content is higher than many of us can fit in a day. I second the idea of adding heavy whipping cream (HWC) to make it high fat but lower in carbs. I have in the past drank some HWC mixed with milk until I could drink HWC by itself as a quick calorie and fat fix if i was in a hurry and needed to boost my fats for the day. 2. Dairy causes issues with PCOS ladies many times, especially Milk. Something in it, I cant remember what but @Dragonwolf will know, reacts to us and our crazy hormones, making it hard to digest. Many pcos women have reported less tummy bloat, heartburn and nausea once they cut out milk. Butter, ghee, HWC, sour cream, cream cheese, etc seem to have less problems than straight milk does but there are some who have to limit all milk products.

DivyaManaktola wrote: »

2. Fruits. Does low carb mean low natural sugar as well? Can I have 2 cups of watermelon pieces every day or every second day (they are quite high in sugar)? Can I have an apple occasionally? Same for papaya, strawberries and pomegranate.

Your body does not differentiate between sugar from fruit and table sugar. It reacts the same exact way, by increasing insulin and often glucose too. If you can fit a little fruit in your macros then go for it. But I also second @KnitOrMiss's suggestion you pair it with a fat. Dont be afraid to use HWC liberally. Whip it up and put it on top of a few raspberries or blueberries if you want those. The reason those fruits are considered 'low carb' is because they have a higher amount of fiber, with the idea that your body cant digest fiber so it reacts less to the total carb count in those fruits than it would in say watermelon which has virtually NO fiber and is all usable carbs. Many count net carbs when they do a really low carb lifestyle, so they'd count total carbs minus any fiber in the food. You'd have to see if total or net carbs work best for your weightloss and lifestyle.

DivyaManaktola wrote: »

3. If I cut out wheat, whole wheat and rice completely, can I still have pulses? Like green lentil, yellow lentil, beans... sprouts etc. ? When I add them to my daily diary, they shoot up the carb and calorie column... even when sprouted! But as I can not have meat, I feel this is all I can have (after eggs) to feel satiated.

Again, if it fits into your macros you can. PCOS is a group of symptoms, with not all women having all or even most symptoms. Heck even most women have different hormone imbalances. So some are high on estrogen and low on progesterone and others are the opposite or maybe high on testosterone and low on fsh, yet they all have PCOS. So what works for them may not work for you. If you can fit it into your macros, still lose weight, find symptom relief and it fits your lifestyle, do it.

I cant have those at all, but I need a very low carb plus Metformin and Inositol to keep my insulin levels in a near normal range. But many PCOS women can have a few more carbs than I can. Maybe those can be a once a week planned treat?

DivyaManaktola wrote: »

4. Coffee. I love having my perfect cup of homemade cappuccino everyday (1/2 Milk, 1/2 water, 2 shots of espresso and 1/4 tbsp. of sugar). Can I have 1/4th tbsp of granulated sugar every day, or should I give it up?

Ok, you will see bulletproof coffee or tea a lot on the low carb and keto forums. Basically, switch your milk for HWC and your sugar for stevia or other natural low carb sweetner, add butter and coconut oil, mix with an immersion blender and enjoy. The fat content will help you stay full for a long time and the carbs are very low. Whether or not you can keep the table sugar instead is really, again, up to you, your goals, your lifestyle and your macros.

If you are interested in Bulletproof Coffee (BPC) check out those forums or ask around. I drink it often and I can give you my amounts. @KnitOrMiss has been trying it with coffee but has used it in her tea for awhile and she can give you her amounts.

DivyaManaktola wrote: »

5. Excess of fat/oil/butter/cheese gives me acidity/heartburn ... even plain coffee does that. I am used to have my coffee with one biscuit.. but I can give that up! So, will it still work if I can't consume a lot of fat?

I also get heartburn with coffee as Ive had an ulcer since i was 12 years old. But I find the LCHF diet helps a WHOLE lot with heartburn overall. Since Ive been sticking with this lifestyle, I have been able to come off my daily nexium ive been on for over 10 years and only occasionally use a Tums if I get a little heartburn. Coffee more than 2 days in a row will do it to me. But your body processing the carbs and the fats at the same time can cause the heartburn. Many on the low carb and keto groups have reported that their heartburn is much much MUCH less on lower carbs and higher fats as your body isnt trying to process both.

DivyaManaktola wrote: »

6. Once I follow this diet do I still need to stick to my 1200 calories a day?

Again, you will have to find what works for you, but typically unless you are 120lbs and 5'3 this is fairly low for you, even with PCOS which lowers your bmr considerably. Many find on the LCHF diet, they can eat a lot more calories, stay full and still lose weight. IF i do a regular Standard American Diet (SAD) with the higher carbs, i had to eat about 800 calories a day and exercise a whole lot to lose any weight at all. On a LCHF diet i can eat 1500+ calories a day and still lose weight even without exercise. So you will have to find what works for you personally, but Id think on a LCHF you can probably eat a little more.

DivyaManaktola wrote: »

Sorry for an awful lot of questions.. It'll really help if someone could take the time to answer.
Thanks a lot!

Welcome to the PCOS board and no worries about the questions. Read many of the thread here in the PCOS group and you will find a wealth of information that might answer some questions you didnt know you had. If not, ask away. Remember what works for one or two of us might not work for you but you get a general idea on what works for the majority of PCOS women. Check out the Low Carb and Keto boards @KnitOrMiss linked and read thru some of their threads then ask questions over there, especially about LCHF and vegetarianism.

You can do this but it takes time, patience and the ability to adjust things slowly to see what works and doesnt work before you give up.

I spent most of last year getting my head and straight and getting myself geared up. I lost the first 80 some pounds over a period of 7 years, gained 20 some back, lost it mostly, then finally got fully in the game this year. I only finally started LCHF back in January, and shifted to Keto about 2 weeks ago, but I've done a ton of research and just absorbed a lot of info from the two groups above. Everyone has a starting point, and every one has their own struggles, so don't let any of it get you down. If you have any questions at all, don't hesitate to ask. If someone doesn't know, someone else can probably find a related answer.

I have to say, I my minions.

@DivyaManaktola‌ -- What is your reason for being vegetarian? If it's religious or ethics, then feel free to disregard the next paragraph, and either way, you don't need to answer me. (The intent here isn't to judge you or make you go against what you believe.)

If you did it to be healthy, then you might want to consider at least adding fish or bivalves back in (the healthiest populations -- the so-called "Blue Zone" populations are actually only semi-vegetarian and generally eat a fair amount of seafood or pork), due to their nutrient and Omega-3 content. If you did it because of another health condition, then depending on what it is, you may be able to add some meat back in on LCHF -- the most likely candidates being chicken and maybe pork.

This sounds backwards, but the heartburn may actually be caused by the wheat and/or carbs in your diet. Sugar's actually a neurotoxin and its benefits (ie - energy) are outweighed by its damaging effects after about 120-140mg/dL concentrations. There's also some evidence that various compounds in wheat and other grains are neurotoxins, as well.

Between the two, part of the cause for your heartburn is that they weaken the valve between your esophagus and stomach. Eating fat requires the body to increase the stomach acid content to deal with it (not, in and of itself, a bad thing), and the weakened valve allows it to come back up.

Add to that the fact that a high carb diet decreases overall stomach acid content, and that low stomach acid is nearly always the cause of acid reflux disorders, not excess stomach acid, and you end up taking Nexium for life, instead of curing the problem entirely.

And that doesn't even get into the issues of gluten and wheat on the rest of the GI tract. From what I've found, there appears to be a lot of association between PCOS and gluten intolerance (this hasn't been formally studied yet, though). Gluten intolerance leads to leaky gut, which allows improperly digested particles into the body, causing a host of other problems.

As for milk, it's a problem on a few different fronts:

1. Whey, the primary protein in milk, is abnormally insulinogenic. That means it increases insulin more than one would expect for the protein and carb content of milk. For a growing infant or someone trying to gain mass, this is a good thing (insulin is a growth hormone). For us, especially when trying to lose weight? Not so much.
2. Lactose is a rather simple sugar. It's a disaccharide of galactose and glucose, which means it breaks down very easily. You're, for all intents and purposes, drinking sugar water, especially if you drink "low fat" or "fat free" milk.
3. Casein, the other protein in milk, is generally cross-reactive with gluten, so if you find you're intolerant to gluten, you may also react to casein.

As a result, the best dairy products are the higher fat ones. The higher the fat content, the better -- cream based anything, butter, etc. The more sensitive you are to any of the non-fat components, the more you'll want to stick with the more pure fat options, or avoid dairy altogether. Butter can be more purified, and its purified version is called clarified butter or ghee. Ghee is almost pure butter fat and may be usable even if you find yourself sensitive even to regular butter.

And like has been mentioned, you don't need to limit eggs, especially not the yolks. I don't eat as many as some of the guys in the LCHF group, but I go through times where I eat 4 a day. I'm actually finding that, as my cycle starts coming back "online" and trying to get back to something normal, I need eggs on a regular basis. I seem to need the choline and other nutrients in it to help keep my mood stable, at least during the week before TOM (choline helps with estrogen dominance, which is one of the big causes of PMS and PMDD). Also, the yolk has all the good nutrients in the eggs -- choline, folate, Omega-3, selenium, phosphorous. By comparison, the whites are just pure protein. In fact, if anything, you want to add more yolks, instead of whites, if you're going to only add part of an egg.

And no worries on the questions. Ask away! That's what we're here for!

@KnitOrMiss‌ , @Alliwan, and @Dragonwolf... so much help you guys

True!
Eggs for me = guilt free protein!!!, after @dragonwolf 's info, its guilt free nutrition!

Alliwan wrote: »

DivyaManaktola wrote: »

Now as for the vegetarian part, well I loved meat as a child, in fact I used to tell my mom that I will only eat a meal if it had chicken/fish with it... But eventually I started loving animals much more. I've kept chicks/hen, rats, fish, tortoise, different other birds, cats, dogs... as pets, literally served them all my childhood and feel that they respond to pain and death just as we do ... wont want to feed on them unless absolutely necessary. (Just sharing my personal reason for this choice, in no way do I want to disturb anyone, I sincerely apologize if I did )

Not disturbing, empathetic. I get it, I do. Raised around animals my whole life also, dogs, cats, birds, hermit crabs, rats, fish, even had an endangered Desert Tortoise stay in our yard for a couple years when I was a kid. Have paired down on my pet list now, only have ferrets, cats, dog as in the house type pets.

But we raise pigs, chickens, turkeys, and ducks for eggs and meat. Well no pig eggs, havent invented that yet. While I get sad when it is time for butcher, it is easier because we treat our animals like kings. The pigs have a shower in their pen they can pull themselves and bathe anytime they want. In the summer its pretty much constant as pigs love water. They get grocery store fresh cut fruit and veggie scraps every week, sometimes two or 3 times a week. We go out there and clean poo everyday and when we are done, we spend quality pig petting time. So I know when my pigs to go butcher, they have lived the best pig life they could.

We do the same with the chickens, ducks and turkeys we raise. They get fresh fruit and veggie and bread scraps a few times a week. They are free range and are so friendly they come when we call and some of my laying hens will perch on your shoulder as you feed them. They have a heated coop in the winter and a nice open breezy forest to run in the summer. So when the meat birds to go butcher, i know they've lived the best life they could too.

My husbands cousin raises our cows since he has pasture land and we've got forest. But those are treated like kings too and so friendly you can pet them and give them a good brush down too.

My point is, if it gets to the point where you, or any one else who is an ethical vegetarian, has to eat meat for heath reasons, maybe find a farm where the animals are treated right before butcher. Not those places you've seen on the news where they are kept in tiny pens away from their babies. I know you dont live in the States, but I hope you could find some farms where you live that treat their animals humanely. I dont know if it helps you, but for me, if they've lived a good life and been treated well, I have a lot less problem using them for my health.

ETA: Eggs Rock!!

@Alliwan This whole thing made me smile so big. I love your stories about loving your animals. I've a friend who lives about 45 minutes from me, and she raises bunnies and chickens and geese. Those eggs were seriously some of the best I've ever tasted!!! (The bunnies are for show - she does trade shows and wins awards...) I positively love that this type of farming is your passion.