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hhmmmm posted:
Hello! I was just diagnosed today and put on metformin. I'm not happy about it but I'm relieved to finally have some answers that makes sense and a new doctor that listens to me, explains well, and explores things thoroughly. I was still absorbing the information in the office and didn't think of questions unti on the way home. I have insulin resistance from PCOS and have already been eating extremely well and working out consistantly but after the diagnoses today I realized that a healthy diet doesn't look the same for people trying to lose weight and people dealing with insulin issues. I understand that overall amount of calories, and servings of each food group that I need each day-but now that I'm trying to balance the carbs and protein I'm confused. Do you match gram for gram? Everything I read today says people with insulin resistance from PCOS should start at getting 40% of their calories a day from carbs and keep working backwards. I guess what I don't understand is the ratio. For a normal person that eats balanced meals and has an apple for one snack and nuts for another thats fine, but do you need to combine them? I guess im just confused...lol. Any help explaining the basics would be appreciated.
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phototaker responded:
Hi,
I wished I knew more about PCOS to help you. On the weekends, it's usually a bit slower, so if you don't get an answer now, maybe someone can help you on the weekend or next week. Hang in there.
I'm diabetic but not on medicine. I always eat protein of some sort with a 1/2 an apple. It's usually nuts with the apple. I spike higher on most fruits. Having a protein with it for a snack helps me not to spike as high. I used to love pineapple, but I have to be careful with that too. If I have a chicken caesar salad, I can have a few pieces of pineapple with that afterward. I mostly stick to berries and melons though, or a small apple.
What I do basically is count my carbs for each meal and snack and try to keep the meals at 35-40 carbs at the most.
That's me. I don't have PCOS or know what it is. I do know that my system is pretty sensitive since I'm not on medicine and I have to be very careful not to overload on carbs like bread, pasta, rice, etc. I only have one slice of whole grain bread at a time, and try to have less of that during the day, and stick to mostly vegetables, protein,like fish, eggs, chicken, lean beef, etc. I sometimes have a small red potato(tiny) with my meal.
 
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mhall6252 responded:
I suggest you ask your doctor for a referral to a registered dietitian. I will assume that you need to lose weight. A RD will be able to provide you the proper guidance for a diet appropriate for your situation. As an alternative, check out Dr. Dansinger's recommendations for reversing T2 diabetes. You want to reduce circulating insulin and improve insulin sensitivity. Metformin helps some, but so does proper diet and exercise. The links to the doctor's advice are on the right side of this page.

Bottom line, eat healthy lean proteins, non-starchy fruits and veggies, legumes, and limited whole grains. Avoid the white stuff except cauliflower. So avoid sugar, flour, white pasta, potatoes, white bread, etc. The more you avoid processed food and stick to fresh stuff, the better.

Michelle
 
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hhmmmm replied to mhall6252's response:
Thanks guys. I'm just a little overwhelmed! I'm only 24 and spent most of my life not struggling at all to maintain a very healthy weight. PCOS is polycystic ovarian syndrome. They have found recently that insulin resistance wasn't just a correlation but perhaps even the cause of PCOS. My doctor said losing weight is still the goal but based on my blood work results insulin resistance is probably more a cause of my sudden weight gain than a result of it. It seems to me that I'm caught in a revolving door, hopefully adjustments in the diet and medication along with the 1 of cardio I have already been doing 5 days a week for some time will be what breaks it. I'm ready to be healthy and feel my age. I gained 60lbs in the last 8 weeks of my pregnancy for basically no reason ( I wasn't eating buckets of fried chicken or anything) and have continued gaining ever since despite regular exersize and a very healthy diet. I went to the doctor every other month complaining of relentless fatigue, desperate thirst, blurred vision, dizziness, and infections in my mouth and feet. They always told me to lose weight and didn't believe me when I told them how hard I was already working to do so. I even brought in meal logs for the week. I finally switched doctors, and doctor # 3 was a life saver! She found elevated DHEA, LDL, and fasting glucose-did some follow up tests once she suspected pcos, and confirmed it.
 
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Laurie Anderson, MSN, RNP, CDOE responded:
Hi, it's great that you have found a health care provider who is comfortable to work with; this is SO important to your overall care and well-being.

I am a little confused by this information: "everything I read today says people with insulin resistance from PCOS should start at getting 40% of their calories a day from carbs and keep working backwards." It's the working backward part that I don't understand. The recommendations are 45-65% of overall calories should come from carbs, 10-35% from protein, and 20-35% from fat. These are very general recommendations, for example a person with heart disease or diabetes should eat few calories from fat, in the 20-25% range, and this range is likely to result in weight loss. For most people it's also helpful to spread out their carbohydrate servings fairly evenly through the day. This helps the body and the medications to match the carbohydrate intake and to control the blood glucose rise. Depending on your particular situation, very specific recommendations would be made as to how many grams of carbohydrate you should eat in order to help you meet your goals. One set of general recommendations is that a person eat 45-60 grams of carbohydrate per meal (the lower number for women and the higher for men), and 15 grams of carbohydrate for any snacks. If you read the labels on any canned or boxed products you'll be able to see what a serving size is and how many grams of carbohydrate that serving represents. I also recommend that you seek the assistance of a dietitian to help you to meet your individual goals.

Kind regards, Laurie
 
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hhmmmm replied to Laurie Anderson, MSN, RNP, CDOE's response:
Thanks! The working backwords part was something I read on a PCOS site about starting with the recommended 40% for some time but reduce it in small increments if you still can't get sugar to stabilize. I know that carbs are neccesary and what kinds matters quite a bit in the effect on your sugar, so I take that advice with a grain of salt. Thanks for the meal/ snack carb information-that is the type of guideline I was looking for-a general idea of how best to spread the daily amount of carbs, and how best to pair them.
 
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Laurie Anderson, MSN, RNP, CDOE replied to hhmmmm's response:
Great, I'm glad it helped! Laurie
 
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MSUphysicsFRIB replied to hhmmmm's response:
I wrote a lengthy response yesterday, but it did not appear. :(

I have PCOS too. I was diagnosed with both PCOS and prediabetes at the age of 18, and right now I'm 24.

You're right--in most cases, PCOS is caused by insulin resistance. This is because insulin resistance results in high insulin levels, and since the ovaries are very sensitive to insulin, high insulin levels cause them to produce lots of androgen. Usually the enzymes in the ovaries that are responsible for converting the androgen to estrogen can't keep up with really high androgen levels, so some of the androgen "spills over" into the bloodstream. This androgen then binds to androgen receptors in the hair follicles, oil glands, etc., resulting in some of the very unpleasant symptoms of PCOS (acne, hirsutism, scalp hair loss, etc.)

I like a book called "The New Glucose Revolution Guide to Living Well with PCOS." They do a really great job explaining what causes PCOS, and they also break down the glycemic index, making it easy to pick "good carbs." They recommend eating 45-65% carbs, depending on one's activity level (some women with PCOS are athletic and require more carbs).

I personally consume 30-35% of my calories from carbs. When I have attempted to consume more of my calories from carbs, I have felt sleepy, achy, and irritable. BUT going too low-carb actually increases insulin resistance! I'm not sure if my diet is low-carb enough to increase insulin resistance--I sure hope not!

FYI, when I was diagnosed with prediabetes and PCOS I was probably consuming ~50-60% of my calories from carbs. I was a vegan. My diet consisted of sprouted grains, legumes, unsweetened soy milk, flax oil, pumpkin seeds, raw nuts, etc. Since I have switched to a lower-carb, higher protein and fat "hunter/gatherer" diet, I have felt much better, and I haven't seen a blood sugar level over 200 in a long time. I am not pure hunter/gatherer; I eat/drink 1-2 servings of dairy per day, and I also eat 1-2 servings of whole grains (where a serving size contains ~15 net carbs).

Everyone's body is different. I would start out with the recommended level of carbs, and then adjust up or down depending on your symptoms.

To put together a snack/meal that is 50% carbs, 25% protein, and 25% fat, follow this rule of thumb: eat the carbs, protein, and fat in a 4:2:1 ratio, in terms of number of grams.

In other words, a "balanced" snack would contain 16 g of carbs, 8 grams of protein, and 4 grams of fat.

I smiled as I read your original post, because I frequently eat apple slices and raw almonds as a snack. :) It is a good idea to eat fruit (or any carbs) with some fat and protein. Cheese would also be a good thing to eat with an apple (I avoid cheese due to sinus migraines).

Here is a list of carbs that are low on the glycemic index (<50):
All-bran cereal
apples, oranges, plums, pears, green grapes, grapefruit
milk
yogurt
Uncle Ben's converted rice
cooked legumes (pintos, black beans, lentils)
"al dente" (firm-cooked) pasta
most vegetables (excludes potatoes)
cooked yams
whole rye sour dough bread
fructose

ice cream
chocolate cake with icing
chocolate pudding (made from powder w/ whole milk)
custard
supreme pizza
oatmeal cookies

Moderate GI carbs 51-60:
banana, apricot
brown rice
white basmati rice
whole wheat sour dough bread
whole rye bread (not sour dough)
sweet corn
cheese pizza

oatmeal cookies
potato chips
Coca Cola
honey
maple syrup

High (61-80):
oatmeal
sweetened dry cereals (cocoa puffs, frosted flakes, corn pops)
watermelon
instant rice
most yeast-raised breads, whether white or whole grain
bran muffin

sucrose (table sugar)
orange soda
french fries
rice krispies treat bar
tortilla chips (corn chips)

Super-high glycemic carbs (>80):
Some unsweetened dry cereals (corn flakes, rice krispies)
puffed rice cakes
puffed corn cakes
baked potato (russet)
boiled red-skin potato
pretzels
gatorade
glucose (dextrose)
 
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MSUphysicsFRIB replied to MSUphysicsFRIB's response:
As you can see, "low GI" does not necessarily mean low-carb or low-calorie! Cake and ice cream are low GI foods, but they contain lots of carbs and calories, so they won't help you lose weight or lower your insulin levels.
 
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MSUphysicsFRIB replied to MSUphysicsFRIB's response:
Here's a link to the book I mentioned:

http://www.amazon.com/Glucose-Revolution-Guide-Living-Well/dp/156924457X
 
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hhmmmm replied to MSUphysicsFRIB's response:
I posted a reply thanking you all but I hit post now instead of reply so its on the big board and no one knows who Im talking to! LOLOL. I guess Ill copy it here or something! LOLOL My brain toilet flushed or something.
 
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hhmmmm replied to hhmmmm's response:
Here is what i posted....not just once but TWICE, in the wrong spot. Hehehe.
Thank you so much, this is such helpful information! I have been amazed at how helpful and supportive even random strangers that also have diabetes/PCOS have been. Just as an update, my sugar is very stable, I have been losing weight slowly and steadily. It is hard not to get discouraged at how slowly it comes off when I have so far to go and others dieting around me seem to drop it so quickly. I hang on to the fact that I feel amazing, and even though it has been slow every ounce I have lost has STAYED off. I just keep reminding myself...look at that number on the scale because you will never EVER have to see it again. Slow and steady is healthy, slow and steady is permanent, slow and steady wins the race. Its taken about two months and I have lost right at about 11 lbs. So to anyone else struggling...HANG IN THERE. What you are doing is worth the effort, and worth resisting unhealthy yo yo weight loss. I am gonna have to get that book!
 
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MSUphysicsFRIB replied to hhmmmm's response:
Keep up the good work! I definitely agree that slower weight loss is more likely to be permanent weight loss. And a low glycemic diet really does make one's body feel much better--less pain and inflammation, and more energy. :)
 
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hhmmmm replied to MSUphysicsFRIB's response:
I feel my age (25) for the first time in years. It was depressing to feel so tired and sick all the time. I'm looking fw to a happy healthy future having the energy to play with my daughter, take part in outdoor summer time fun, and losing weight to look the way I feel and maybe even have more children when my body is healthy enough =)


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