Not everyone with PCOS is obviously overweight. But the health of everyone with PCOS is threatened by the body chemistry that results from eating either a standard American-type diet, or a vegetarian diet.
PCOS is a version of what is also known as Metabolic Syndrome, or Syndrome X. This is the condition that results in men, women and sadly in recent years more and more children, when we overeat a highly processed, artificially flavored and preserved, high refined flour and simple carbohydrate diet.
The excess of sweets, breads, pastas, cereals, and packaged foods too often provides many more calories than the average person uses in a day. Even organically grown grains, eaten whole or manufactured into ‘wholesome’ forms of old favorites like chips and cookies etc, will create the same problems as excess sugar, when over eaten. The insulin required to process all the blood sugar that results from a high sweet, high flour products diet, is what in turn causes higher levels of testosterone in women. This is what then leads to the hormone imbalances that cause polycystic ovaries, infertility, acne and facial hair, plus scalp hair thinning. Left unchanged, this diet will eventually cause obesity, diabetes and heart disease. It creates a higher risk for certain cancers as well.
High carbohydrate food:
– Elevated insulin
– Elevated testosterone
– Menstrual disorders
– Facial and body hair coarsens and darkens
– Scalp hair thins
– Increased risk for infertility, obesity, diabetes heart disease and certain cancers
Vegetarian diets are by definition high in plant food carbohydrates and low in good quality protein of the sort required by the human body to function optimally. If a person eats a poor quality diet for a long time, and then switches to vegetarian diet, the increase in fresh vegetables and fruits and nuts is a smart and healthy addition that will lead to greater well being. However, as a long term choice, a vegetarian diet will always lead to malnutrition.
Whoever you are and whatever your weight loss needs are there are three things that will always be true:
* There is a way we eat to get fat,
* There is a way we eat to lose fat, and
* There is a third way, different from the other two, that we eat for the rest of our lives to maintain a lean, healthy body.
This last step has been a neglected and is key feature in most people’s weight loss and re-gain history.
How we eat to lose weight is different from a healthy life long diet.
Transitioning to a life long healthy diet is a life long effort that asks you to learn new information, change some habits, commit to using some form of ongoing, skillful support.
Very regular exercise is an absolute requirement for restoring your good health. In order to be able to eat a satisfying and nutritious diet without gaining fat, we all have to have good muscle tone that we maintain with regular exercise. When you don’t have enough muscle to use up the fuel you eat, you will store it as fat. The more muscle you have, the more you can eat to fuel your muscles, without storing fat.
As we age, our metabolic rate naturally slows down. Dieting to lose fat also slows down the rate at which we burn calories to fuel our body’s activities.
Once you have extra fat, you have to eat in a special way, for what I call a ‘therapeutic interval”. There are certain changes you have to make and a certain amount of time is required, for fat loss to be fully successful. This special way of eating is NOT the way you will eat the rest of your life, IF you include building muscle and using your muscle, while you are losing this fat. The more muscle you have, the more you must eat to be healthy. With little muscle and not much exercise, there is not much you can eat without making fat.
A sad fact is that 90% of people who lose weight do not keep it off. Research shows us that this is because most people do not have the necessary information, and the long term support needed to complete a weight loss effort. In one study that was typical of all similar research on overweight people, we see that follow up support with a health care professional makes all the difference in long term success:
* Attending more than 75% of follow up support visits = 92% kept weight off.
* Attending 51 – 75% of follow up visits = 90% kept weight off.
* Attending less than 51% of follow up visits = 72% kept weight off
* Self monitored patients = zero kept weight off.
Staying in touch, either as part of a mutual support group with a skilled facilitator, or with an ongoing, individualized relationship with your health care provider, is essential.
How we eat to lose weight
The most reliable and straightforward way to use up stored fat is a diet that eliminates unnecessary sweets and starchy carbohydrates, and provides plenty of fresh whole vegetables, fruit, nuts, good quality oils and lean, clean animal protein.
Every successful weight loss diet is a ketogenic diet. A ketogenic diet is one in which we reduce our total calories eaten to below the amount of calories our bodies use in a day. This will always trigger the release of energy stored as fat in our body cells. This fat is in the form of chemistry called ketones, which our muscles use as fuel. Of course, there is a big difference between semi-starving yourself, and reducing your calories in a way that keeps you satisfied and healthy!
Ultimately our long term success at maintaining fat loss requires that we feel good during and after weight loss. Maintaining steady energy levels, enjoying stable moods and having the fun and excitement of creating your own desired changes is key to your successful.
It turns out that you can burn up more fat while eating a larger number of calories when you eat fewer of your calories from carbohydrates and more from good quality protein and fat. This type of ketogenic diet does not mean over-eating huge slabs of meat. It does not mean over-indulging in fried or fatty foods or completely eliminating carbohydrates.
Some people have misused the idea of lower carbohydrate ketogenic diets, by misinterpreting the intention of the clinicians promoting this method. As a result the media and some medical authorities have seemed to emphasize the ‘dangers’ or failures that followed the extreme behaviors chosen by some people. In fact, overwhelmingly, the research shows that a lower carbohydrate ketogenic diet is safe and effective for fat loss.
Remember, we can only lose fat by reducing our calories from food to less than the amount of calories we use in our daily activities. This is a fundamental truth. However, there are any number of additional details that make this strategy more or less likely to succeed, especially over time. Some conditions that complicate the basic calories reduced= fat reduced equation include:
* Chronic stress that fatigues your adrenal function
* Chronic pain that keeps your nervous system on high alert
* Insomnia that reduces the opportunity for your organs to perform restorative functions that will not happen except during deep sleep
* Perimenopause or other conditions that alter your reproductive hormone functions (including the use of contraceptive hormones, hormone replacement therapy, hysterectomy, breastfeeding for instance)
* Thyroid disorders
* Kidney disease
* Any immobilizing condition
All of these conditions can be addressed with a diet plan and a transition plan that is personalized to your situation.
One detail important to our success at weight loss has to do with how we feel -physically, mentally and emotionally-when we reduce calories. If we just eat less, without regard to the composition of our diet-that is, the fat, protein and carbohydrate content, as well as the vitamins, minerals we need – we can have a pretty unpleasant experience. Between meals hunger, fatigue, headaches, muscle spasms, mental fogginess, emotional depression or irritability and insomnia are the common experiences shared by all dieters who use low fat, low calorie, high carbohydrate diets. With these diets, we can also find ourselves losing weight that includes our muscle mass, and not just the fat we intended to lose.
A lower carbohydrate ketogenic diet, in which we reduce our calories from starchy carbohydrates in particular and nourish our selves with appropriate amounts of water, vegetables, fruit, eggs, poultry, fish, meat, nuts and good quality oils, creates fat loss without the usual unpleasant side effects. It also helps identify problem foods, so that when we transition from a fat loss to a healthy weight maintenance way of eating, we can do so without returning to old food-related problems.
Ketosis is not ketoacidosis
Ketones are a product of fat metabolism, and function as a source of energy for the body. Our muscles and other tissues can use ketones for fuel instead of glucose, or blood sugar. Ketones are released from stored fat and are used for energy when there is not enough glucose available. Your brain requires blood sugar for fuel, whereas muscle and other metabolic processes will take up ketones instead. We can make blood glucose from everything we eat, including by transforming proteins from animal foods. We can not however, make protein for our bodies from plant foods. What we make from the carbohydrates of plant food is fat. The excess carbohydrates we eat every day beyond what we use in the exercise of our muscles, is transformed to fat and stored. This is a great system for people (like our human ancestors) who do not have a reliable food supply and are subject to regular periods of feast or famine. For most of us it means an ever enlarging “storage bin” of accumulated fat.
There is some confusion regarding the ketosis that occurs when we are eating less carbohydrates than we need for daily fuel and begin to burn stored fat instead. Some people confuse normal and beneficial ketosis with another situation, called ketoacidosis. Ketoacidosis occurs when people with high levels of blood sugar (diabetics) produce high levels of ketones at the same time.
People with diabetes do not produce enough insulin from their pancreas, or have a condition called insulin resistance, in which the tissues will no longer respond to the presence of insulin bearing glucose to be delivered into storage. Ketones are formed in response to the tissues need for some fuel other than the glucose, which is collecting in the blood attached to insulin molecules but can’t be delivered into cells any more. Normally our body will adjust the blood pH level to balance this shifting chemistry. In diabetics the imbalance is too great and ketoacidosis, or increased acidity of the blood occurs. Metabolic ketoacidosis in people with diabetes is a dangerous condition and should be avoided with very strict control and attention to diet and blood sugar levels.
When a person with normal blood sugar levels is producing ketones by breaking down fat for fuel, and is not eating excess carbohydrates, the blood glucose is delivered elegantly, primarily to the brain, and the rest of the body happily uses ketones to run the show.
Eating carbohydrate foods in amounts that allow for the release of ketones from stored fat is a safe and effective way to reduce body fat while maintaining an even blood sugar levels. Stable blood sugar means you will have plenty of physical energy, mental alertness and restful sleep. Most people can eat this way for the rest of their life and be quite well, and, most people will want to diversify their diet after having lost excess fat. Expanding your diet to include more fruits and grains as well as appropriate celebratory treats, can be accomplished with out regaining fat.
This transition has to be done thoughtfully and with close attention to the impact of certain foods. Some people will not be able to eat certain foods, ever, without negative consequences, because of our genetic make up. All of us have to reintroduce foods carefully and maintain exercise levels life long, in order not to regain lost fat.
A ketogenic fat loss diet is not appropriate for pregnancy and breastfeeding. These are times when fat stores are very important to mother and baby’s well being. People with kidney damage should not use this diet unless they will be closely supervised by their physician. People with diabetes, epilepsy, and gall bladder problems also need special care and support to use a ketogenic diet successfully.
Women lose weight somewhat slower than men; feminine hormones effect how women hold onto water and fat. Men in general have greater muscle mass, even when quite fat. This fact plus masculine hormones help them burn fat somewhat more effectively than women. Regular exercise is absolutely necessary for everyone’s long term health.
How we transition from fat loss to long term healthy diet determines our long term success.
Transitioning successfully from a fat loss diet to a healthy life long diet is only beginning to be understood. Specifics for success include:
* A metabolic readjustment period (5 to 10 or more weeks), and
* Educational support that works with the habits of thought and feelings surrounding body image and our learned eating and exercise behaviors.
Whenever we let go of stored energy (aka fat) by reducing our caloric intake, primitive protective mechanisms in our brains kick in. Our basic metabolic rate starts to slow down. We actually start using less fat to protect us from what our ancient brain thinks is a famine. For the original humans, an unreliable food supply made this trait essential for survival. For those of us who are eating less by choice, this mechanism is what will cause us to regain weight we have lost as soon as we start eating ‘normally”‘ again.
That ‘normal’ eating concept is key. If you get fat, then eat to lose fat, and when you have reached your goal weight, you resume eating the way you did that got you fat in the first place… well, there you have it. Not only are you eating fat-making food again, you are piling this into a body that is programmed to burn less energy doing your regular daily activities. You have also have lost muscle mass To complete the change to a forever-leaner you, losing the fat is only Step One.
Step Two is working to re-set your metabolic rate to where is was or higher than it was, when you were fat. How that is done has been a mystery that frustrated the vast majority of dieters and caused a great deal of unhealthy and frustrating yo-yo patterns of weight loss and regain.
Remember that we know that 90% of people who lose weight regain what they lost, plus more. Some people do not regain however and recent research has examined what is different about this fascinating 10%. In a nutshell, what these folks do differently is to be acutely aware of small amounts weight regained, and they return to their weight loss behaviors for brief periods of time to correct the small regains. Eventually, as long as they maintain essentially healthy habits, including their food choices and exercise levels, the episodes of regain stop and they stabilize at their new weight.
Transitioning to healthy eating after losing weight requires:
* You arrive at you goal weight having established a regular, fun exercise habit
* You keep very close tabs on your weight and on your inches at waist and hips, and
* You return to weight loss behaviors whenever you have regained 2 to 3 pounds.
* You make this return to weight loss behavior then expanding out you food choices again and again until eventually you have stabilized at you goal weight with your new commitment to and enjoyment of regular exercise.
* You continue to maintain a healthy muscle mass, activity level and always adjusting diet of fresh whole foods as you age and/or encounter new circumstances or health challenges
Remember – there is one way we need to eat to lose fat, and then another, more generous and complex way we can eat once our goal is attained. The nature of the transition between these two ways of eating is essential to long term success. The ability to lose weight, change the diet to a less stringent, more varied one and return as often as needed to the weight loss regime for brief periods until stabilized, is apparently a rare ability. Most people do not seem to discover this behavior spontaneously. Thus long term guiding support seems crucial.
A number of studies on successful weight loss have clarified that knowledgeable support helps people remember not only the basic straightforward steps of the diet cha-cha, but also expands your skills for stress management, your exercise options and your cooking skills. Often you whole family benefits from what you have learned and how you alter your own habits.
We have many behaviors and beliefs that affect our sense of self and our ability to pursue loving self discipline over a long term. It is clear that ongoing and specific support, in the form of an individual counseling relationship or a similar support group experience, makes success much more likely. We encourage you to use both the weight loss and maintenance aspects of the program described here, and to make it all the more likely to be useful to you by adding in regular exercise as well as regular contact with a knowledgeable and skilled support system.