Following on from a few posts we’ve seen, there have been lots of questions about PCOS and Keto, its effectiveness and the benefits. So at the risk of sounding condescending coming from a male who doesn’t suffer from it – I wanted to broadly touch base with some of the females who may be umming and ahhing about keto in regards to helping with PCOS.
So grab a nice cup of tea, a chicken drumstick and settle in because this is another long one.
For people that don’t know – Polycystic Ovary Syndrome is a term that describes a wide array of symptoms in females, that correlate with a higher production of male hormones with both environmental and hereditary causes.
It is very much a hormonal condition and the symptoms include irregular menstrual cycles and infertility which can lead to higher risk of Endometrial cancer, as well as enlarged ovaries with cysts. Masculine features such as more body hair, balding and acne also present themselves along with mood swings, depression and anxiety issues – just to name a few.
One of the biggest symptoms and also one of the triggers – up to 80% of females who are diagnosed with PCOS are obese, show signs of insulin resistance and are at risk of developing diabetes. That is a huge correlation that cannot be ignored.
Obesity and insulin resistance are not only symptoms, it makes the problem exponentially worse and has commonly been attributed as a cause. Obesity and everything it brings along for the ride is the vicious cycle we really want to tackle and although there is no cure, we can look at the correlation between the symptoms and treat PCOS as a form of pre-diabetes or similarly to Type 2.
But first we need to understand the logic.
Male and female hormones compete with each other, naturally, in all of us. In females with PCOS, your male hormones are winning. There are a couple of reasons for this – and let me preface this with a personal note – I despise insulin fear mongering. Insulin is a required cog in a large metabolic machine. With that being said – Insulin is one part of this equation, the more insulin you excrete to deal with incoming energy, the more your male hormones drive their legs.
Because many people with PCOS show signs of resistance, you are having to continually excrete more and more to deal with incoming sources of glucose. So by eating front loaded energy dense carbs, you are quite literally feeding your symptoms and your body is getting exponentially worse at dealing with it.
So how does Keto help? In the same way that keto does wonderful things for Type 2 Diabetics. It helps level blood glucose and takes away the frequent, large releases of insulin.
It does this by limiting a lot of the carbs that are filled with sugar (a lot of them also contain a huge whack of fat) and have a high gi. In doing this we start to return some normalcy to how that hormone behaves. This allows your body to burn stored energy rather than continually turning that switch off.
This begins to reduce the competition between your male and female hormones which in turn drives many of the physical and mental symptoms and has a flow on effect to weight loss.
So we know that Nutritional Ketosis helps with the insulin resistance – but how else can it help? Keto is a fantastic weight loss tool when paired with a calorie deficit – low carb is one of the most effective ways of weight loss with PCOS.
Drawing on our own body fat to drive fat loss and through adequate protein we are promoting a healthy metabolic rate. An adequate protein intake and exercise also helps with depression and anxiety symptoms.
How exercise can help!
There is a plethora of studies that show that not only does 30 minutes of exercise, 3 times a week create a better head space, it burns calories, promotes lean muscle retention and helps with insulin resistance.
Diet and exercise, I know it sounds like a drag and many roll their eyes because you’ve heard it before and there’s a long road ahead. Small goals – losing just 5-10% of your bodyweight can help greatly in returning normalcy to your cycle and many see an increase in fertility rates, this means it doesn’t take long to start seeing some benefits – additionally, with the focus on adequate protein and fats, you promote healthy eggs if children are apart of your long term aspirations.
Hormones aren’t only affected by carbs. Lets look at a whole food approach. A well formulated keto diet isn’t fat fat fat. It can be so much more and if you’ve got PCOS you really should be looking at ways you can get back to wholefoods.
Inflammation plays a role in hormonal imbalance which feeds PCOS. It can be brought on by foods such as soy, wheat and diary. Whilst the evidence that dairy is bad for PCOS is largely anecdotal, it is quite commonly linked to inflammation which is a secondary part to the syndrome. Keto tends to steer away from Soy and Gluten/Wheat naturally and you can approach dairy with a “see how it effects me” – I suggest that if you’re aiming for fat loss you would be trying to limit cheese and cream anyway and I suggest soy milk be traded for almond/coconut.
So through 1) restricting carbs to help fix your metabolic hormones 2) promoting a calorie deficit 3) adequate protein and usage of body fat 4) getting rid of a lot of heavily processed foods – keto quickly starts to address many of the symptoms and causes of PCOS and begins to deliver results. Pair that with weight training or even high intensity cardio for lots of added benefits on top.
Anecdotally, these results begin to snowball. Whilst the early days are difficult and can seem painfully slow, the more you lose and the more those hormones begin to become normalised, the easier the results come – so I find it very important to set short and medium term goals to help keep that carrot on a stick.
So, you’ve got PCOS, what are some things you can do to maximise your results?
Call this my cheat sheet.
Focus on whole foods and avoid chemical shitstorms. I am a huge advocate of keeping it simple. Does that mean it needs to be boring? Hell no. Learn to love spices and rubs, there are some really good paleo/keto sauces out there. I hate Pete Evans, but he has got a nice Jamaican Chicken.
Avoid inflammatory foods or limit them to treats, Soy, Wheat/Gluten (that means you, ketofied bread) and be mindful of dairy. Counter to this, learn to love Chilli, Green Tea, Salmon, Tuna, Olive Oil, Spinach and Kale are all keto staples that help. Corinne Armstrong has had some really good posts on this as she leans far more towards the paleo spectrum than I do (im all about the dirty calories).
Set some realistic goals and targets. Remember that weight loss is harder as a female due to hormonal cycles and harder again with PCOS. It’s a bit like a snowball though, the more you repair your body, the easier it gets. The early days are hard but set yourself small milestones.
You need to be tracking or at very least keeping a food journal. I know, Im like the nagging parent with tracking but you need to set yourself up with the best possible chance.
Yes, you may initially lose some weight and yes you may reverse some symptoms by simply eating better. You will stall, you need to know how to counter it and by tweaking calories and knowing where you’ve slipped up is the best way to get over the hump.
If you aren’t tracking, I suggest at least keeping a journal or log – it may uncover eating habits such as snacking that you put in the back in of your mind and forget.
Be strong. Because insulin resistance plays a part, cheating and “slip ups” are more profoundly felt. Whilst you may not stack the weight on, short term adherence is very important in setting the body up for this way of eating, not only from a keto point of view but from a hormonal balance point as well.
Be prepared. You will get “that time of the month” again and it will hit you hard initially, many females also notice they will have a couple of “irregular” cycles. We have seen this manifest in an extra, smaller cycle and/or a very long one.
Have a strategy in place to deal with cravings instead of resorting to junk – lindt 90% for example. I also recommend looking at some of the “Treat” recipes in the files section of our facebook page by Madeline Youngs as there are a lot of really foods in there that are a much smarter alternative to “fat bombs”.
If you would like any specific advice, clarification or reading please ask.
References & Further Reading: