Wellness Unpacked Ep. 13 : Understanding PCOS Part 1

Transcript

 Welcome back to the podcast, as per usual, it has been a hot minute but I’m really excited to say that I just wrapped up my first semester of my grad program. So I finally have a couple weeks off before I start my summer semester. And of course, I made a list of things I wanted to get done and one of those things was to do a podcast episode on PCOS.

So that’s what we’re doing today. I am really pumped to be diving into this because I feel like a lot of people that I talk to have been recently diagnosed with PCOS. They think they might have PCOS and they’re not really sure what role diet and nutrition play as an intervention for PCOS. So today we’re gonna talk a little bit about that.

The good news is there actually is a lot that nutrition can do and. Diet and nutrition is actually one of the first strategies that we can really utilize for PCOS, so that’s what we’re gonna be talking about today. But before we begin, I wanna remind everybody this is meant for educational purposes only.

This is not meant to diagnose or give medical advice. It is literally just looking at some of the nutrition guidelines that have come out and some of the research that currently. Exists around PCOS. So we’re gonna be talking a little bit about what PCOS is, how it presents, how it’s diagnosed, and then we’re gonna dive into nutrition strategies and we’ll talk a little bit about supplements at the end because I know a lot of people have questions about that.

And yeah, I think that’s enough of a preamble. Let’s dive right in. So first things first. What is PCOS? PCOS or polycystic ovary syndrome is a hormonal condition that impacts ovulation androgen levels. It’s one of the most common endocrine disorders among women and people assigned female at birth affecting up to 13% of individuals globally.

So despite the name, not everyone with PCOS has ovs, and not everyone with ovarian S has PCOS. And we’ll talk a little bit about the diagnosis criteria for PCOS and also what those symptoms of PCOS look like. But when thinking about why this is important to know why we wanna understand PCOS. It’s important to recognize that there’s also some risks associated with having PCOS because PCOS is primarily a metabolic issue, and people with PCOS tend to have higher insulin resistance.

They’re also at an increased risk of type two diabetes and cardiovascular disease, along with other things like sleep apnea, fatty liver disease, and even mood disorders. We’ll talk a little bit about what that looks like. So it’s estimated that somewhere between 35 to 80% of people with PCOS have insulin resistance.

So like I said, it is a metabolic issue and it seems that insulin resistance is often at the root. The cause of this insulin resistance in PCOS is not fully understood, but it’s thought that the cells might not be properly receiving the signals from insulin to take in that glucose. So it leads to the pancreas sending need out more insulin to.

Sweep up to clear that glucose outta the blood, and the end result is something called hyperinsulinemia, which is this high level of insulin. Hyperinsulinemia may also be a key trigger of hyperandrogenism. So this high insulin activity might lead to this increase in androgen production. So when we’re talking about androgens, we’re talking about these male hormones like testosterone.

And it can also cause a decrease in sex hormone binding globulin, which binds to sex hormones like testosterone to help keep it in check. And this ends up becoming a vicious cycle of having high. Insulin levels in the blood, which causes high androgens, which leads to more insulin resistance, and it ends up being this nonstop cycle that’s really hard to get out of.

So how is PCOS diagnosed as of 2023? The internationally accepted Rotterdam criteria, which is what is typically used as diagnostic criteria required two of the following, three features for PCOS diagnosis. The first is ovulatory dysfunction. So either no period or an irregular period. And an irregular period is anything under 21 days or over 35 days, or having fewer than eight per periods per year.

The second thing is having clinical or biochemical signs of hyperandrogenism. So this is the high testosterone levels that can look like hrsm. So excessive hair growth, specifically on the face, acne or scalp hair thinning. And then it can also be measured biochemically. So by looking at lab work to look at total and free testosterone and D-H-E-A-S.

And then the third diagnostic criteria is having this polycystic ovarian morphology. So in other words, having these cysts that we typically think of with PCOS, and that can be determined by a ultrasound. Although in the 2023 update, one of the biggest changes was that now another, instead of getting this ultrasound, you could also look at having elevated anti-malaria hormone.

So A MH levels, so elevated A MH levels or this ultrasound to determine polycystic ovarian morphology could both be used for this third diagnostic criteria. And again, because you only need to have two of the three. If you already have ovulatory dysfunction and you already have these clinical or biochemical signs of excess testosterone, excess this hyper androgyn, then there is no need to get this ultrasound or.

Test your A MH levels, but if you only have one, this is where this third step comes in. And of course, it’s also really important to rule out any other underlying causes. So anything like potentially hypotheic amenorrhea, which is complete loss of menstrual cycle. And usually that is related more to low energy availability.

So it could be seen with people with eating disorders or high performance athletes. So that’s not having a period at all. And usually that’s as a result of inadequate nutrition intake also thyroid dysfunction adrenal hyperplasia. So we wanna make sure we rule out any other underlying causes first before making sure to diagnose with PCOS.

And so when we’re talking about these symptoms of PCOS and what that looks like I would say the most common thing is to have an irregular or absent period. This absent period is often why sometimes it does get mistaken for hypotheic amenorrhea because there’s a loss of menstruation.

And for a lot of women, they don’t actually realize that they have an irregular absent period, especially if they take. Oral contraceptives if they’re on birth control. And so oftentimes it’s not until they come off birth control and they’re trying to conceive that, it becomes obvious that there’s this underlying hormonal issue going on.

And of course, if you are not having a regular period, or if you’re not menstruating at all, it becomes really challenging, if not impossible to get pregnant. So a lot of times that’s when. Women with PCOS start to really seek out a diagnosis and seek extra support. Some other really common symptoms include weight gain or difficulty losing weight, and that’s ’cause of this insulin resistance piece.

That makes it a lot more challenging to lose weight, and in fact might cause weight gain. Acne is also a really big one, as is excessive hair growth, especially on the face and chest. Hair loss or thinning hair along your scalp is another symptom. And of course, insulin resistance, as we mentioned. And with that.

An increase in cravings. And something else that comes up a lot is depression and anxiety. That is actually a really big symptom in people with PCOS. So if any of these symptoms are sounding true to you, sounding familiar to you, especially if you’re seeing, like I said, any of these clinical signs of hyper androgynous, especially if it’s looking like excessive facial hair.

Hair on your chest definitely might be worth going to see your family doctor and just getting a diagnosis and. Ruling it out. And I would say this is true regardless of whether or not you want kids. Because I think sometimes people think I don’t have a period and that’s not the worst. And I’m not trying to conceive.

So maybe, we’ll just leave it. But as a reminder, you wanna be ovulating. If you’re not ovulating, you’re not producing perone, which means that you are already running the risk of having this estrogen, progesterone imbalance. And that in and of itself can cause some health consequences if you’re, we’ll talk a little bit.

About the role of androgens and how excessively high androgens can also negatively impact your health and maybe feed the cycle of insulin resistance. And again, because PCS is this metabolic condition in which you typically do see high insulin resistance. That can set the stage for things like type two diabetes later on.

So we really wanna get to the root cause even if having kids is not the end goal. So before we talk about the nutrition and dietary strategies for PCOS, we’ll talk a little bit about the typical interventions or medications that are typically prescribed for people with PCOS. The first one, the most common one is metformin.

And so Metformin is a drug that helps to regulate to, normalize your blood glucose levels by preventing the liver from making too much sugar, and it also helps to increase insulin sensitivity. So that is how receptive those cells are to that insulin to really help them take up all that blood that’s in your.

That your blood to help take up the glucose that’s in your blood and get that into the cell and out of your bloodstream. So some of the benefits to metformin is of course it’s going to help regulate your blood sugar. It’s going to help with this insulin resistance and it can also have a positive impact on herm, so on that excessive hair growth and really curbing that.

Beyond that, it can improve menstrual irregularity and improve ovulation rate. And then in thinking of some of the cons with it, I would say the biggest one is the side effects. So side effects include nausea, diarrhea, flatulence, bloating abdominal pain, things like that.

And metformin can also lead to vitamin B12 malabsorption. And that’s something we really wanna consider. So if you end up going on Metformin, it might be worthwhile to supplement with B12, and we’ll talk a little bit about why B12 is important. And then of course the other commonly prescribed medication is oral contraceptives.

So that can obviously be used to help with menstrual irregularities and even reduce androgen production. So that can help with things like hair loss herm, and even acne. So a lot of times this is a first line approach to PCOS or to any hormonal issues. It’s to go on oral contraceptives. But of course, if you’re somebody who’s looking to conceive.

Then this is not a viable option and we wanna be looking elsewhere for solutions. And I do wanna say that even though we’ll be talking about nutrition and dietary strategies, that there’s nothing wrong if you decide to go on oral contraceptives, if you decide to take Metformin if you decide to take any medications or drugs to help with your condition, that is akay.

The goal of this podcast is really to show you what is available to you, especially when it comes to nutrition strategies. I’m just talking about some of the. Medication that exists because oftentimes there are nutritional consequences to taking these things, or nutritional considerations is probably a better way to say that.

So in thinking like I said, with Metformin, you might wanna consider taking a B12 supplement. And with oral contraceptives, oftentimes there are vitamin and mineral deficiencies that can come along with it. So there’s some considerations there, but it’s also really interesting to note that oral estrogen can contribute to leaky gut, and studies have shown that it can actually modify the gut microbiome.

And that it may also contribute to insulin resistance directly. So that’s just something to consider. So if you do decide to take oral contraceptive, you may need to assess gut health and maybe add in some additional gut loving foods and really focus on that. Blood sugar balancing component of your diet.

You could also think about something like a progestin only pill, so that doesn’t have this estrogen. But it is worth noting that progestin only pills might not improve acne or herm, which is often a lot of the reasons that people go on. Oral contraceptives for PCOS in the first place.

Like I said, with any strategy there is always gonna be pros and cons, and it’s really just about finding what works best for you. And there’s no shame if that looks like medication. There’s no shame if that doesn’t look like medication. It’s really just, here are the tools and how can you utilize them to have the best possible outcomes.

And then some other medications that are often used include spironolactone which is often used to help reduce androgens. And it can also be used to help lower blood pressure and then topical steroids, which can help reduce excessive hair growth. But we’re not really gonna be talking about those.

That’s a little beyond the scope of this podcast. Okay. So when we are thinking about nutrition and dietary interventions, what are some of the key things we’re trying to accomplish here? So I’d say that there are a couple goals that we’re really trying to nail down. The first, of course, first and foremost is we really do wanna be balancing that blood sugar and we’re reducing insulin resistance.

That is always going to be one of the first line strategies for PCOS. It’s really. Getting that blood sugar under control. The second, of course, is going to be reducing androgens. We’ll talk a little bit about things that we can do to support overall hormone health and then also reducing inflammation.

PCOS is actually an inflammatory condition. And there is research to show that eating an anti-inflammatory diet can actually help improve hormone levels, menstrual regularity, and glucose control. So all things, and also reduce, of course, inflammation markers. So these are all things that we really wanna be focusing on when struggling with PCOS.

And then lastly, really we wanna be focusing, of course on symptom management. We’ll talk a little bit about cravings and some of the big causes of cravings and how to navigate that, but of course, also acne, herm, and fatigue. So a lot of times if you address these first three goals, this fourth one gets resolved in the process.

And with all that said, right before we dive into some of the nutritional strategies, I do wanna talk a little bit about the dieting component and weight loss component of PCOS. Because so many individuals with PCOS are told that they need to lose weight to quote unquote fix their symptoms. But there’s a lot of research that shows that restrictive dieting often worsens stress and disordered eating patterns, and that people with PCOS.

Often have higher rates of disordered eating in the first place, and all of this can exacerbate hormonal symptoms and make things worse. So weight loss is already challenging for individuals with PCOS because of this insulin resistance. Because of this hyper insulinemia, these high insulin levels can actually lead to weight gain, and then that weight gain can also.

Worsen insulin resistance. And again, it becomes this vicious cycle and it makes weight loss that much more challenging. And also, I will just mention that people with PCOS do not necessarily need to be overweight or have a higher BMI to have insulin resistance. This can be independent and somebody with PCOS can still present relatively lean and still have these blood sugar issues.

Something else to note is that people with PCS might have underlying metabolic issues, so they may have a decreased metabolic rate, meaning that they’re not burning as much energy as somebody without PCOS, even if they end up trying to restrict calories, it might not be enough to cause any weight loss, and they would probably have to restrict so much that it would be detrimental to their health.

As I’ve talked about another podcast, your body needs to feel safe to have a regular cycle. So if you’re chronically dieting, if you’re undereating, all this does is tell your body that it is not safe to reproduce.

And so reproductive functions get shut down, which is not at all what we want. And then something else to think about is that people with PCOS might have alterations in their gut microbiome, which might influence. Certain hunger hormones like ghrelin cholecystokinin and GLP one. So these hormones are responsible for giving us these hunger signals, letting us know that it’s time to eat, that we’re feeling hungry.

So if it’s dysregulated, you might find that you have increased cravings, that it’s a lot harder to feel fall. And actually I’ll talk about in a moment, but there’s also some research to show that people with PCOS might have some leptin dysregulation as well. There’s also research to show that people with PCOS are more likely to struggle with disordered eating.

They’re a lot more likely to make weight loss attempts than people without PCOS. They’re a lot more likely to perceive themselves being overweight. Even if they’re not, and they’re a lot more likely to struggle with binge eating. And again, this might actually have something to do with this hormonal regulation piece.

Like I said before, they might actually have some leptin dysregulation, and leptin is our satiety hormone. It tells us that we are full. It tells us that we have to stop eating. So in PCOS, if you have this leptin dysregulation happening. You might be getting the message that you’re still hungry even after you’ve eaten.

And so it’s hard to say whether binge eating is a direct result of something like leptin or more because of the constant weight loss messaging that people with PCOS are often fed that tell them that they should be dieting. But we do know that there is a link. For PCOS with higher rates of binge eating, and that can lead to excess consumption of high carbohydrate or high sugar foods, which again, in turn is going to worsen this insulin resistance going to take a toll on our blood sugar and it’s going to create this cycle of PCOS.

And so thankfully it’s really nice to see that in the current updated guidelines for PCOS, there is a really strong emphasis on understanding. The role of weight stigma and how much harm that can do, how that can fuel disordered eating, and we’re glad to see it because like I said, you can have insulin resistance regardless of your BMI, regardless of your body weight.

So the goal here should really be about bouncing blood sugar. It should be about reducing inflammation. It should be getting those androgens down and weight loss. Maybe it happens, maybe it doesn’t happen. There is research to show that even a modest weight reduction can be really beneficial for PCOS, but I don’t think weight loss should be the sole goal or the primary goal with PCOS.

I think if we focus on these other things, maybe we see weight loss, and if we don’t, are we still seeing benefits elsewhere? Are we still seeing those changes in blood work, changes in symptoms, et cetera, et cetera. And thankfully there has been research to show that, a non-diet, weight inclusive approach can help improve body image.

It can lower cortisol and stress levels, and that can also be really great for blood sugar management. We’ll talk about that in a bit. It can help with symptom management. And practicing mindful eating can actually help to improve binge eating outcomes. It can help to reduce binge eating and really help you to tune into those internal hunger cues.

So that’s where something like intuitive eating can be a really beneficial tool in your tool about if that’s something you’re curious about, I highly recommend the book Intuitive Eating. It’s written by two dieticians and it’s just a really helpful resource for unpacking diet, culture and weight stigma and learning to get in tune with your body’s own cues.

I also really love the book anti-D Diet by Chrissy Harrelson, another dietician. It goes into just how dieting really is BS and how can be more. How can be more harmful to our health than we realize. So those are some great resources if that’s something that’s of interest to you. Something else that’s really interesting to note is that there is a connection between PCOS and gut health, and I think that’s really fascinating.

I think it’s still really unclear, which. One is the chicken and what’s the egg? Is gut, is poor gut health contributing to PCOS or is PCOS contributing to gut health? And it seems like it’s probably doing a little bit of both. So research has shown that women with PCOS have significantly lower microbial diversity and altered composition of microbes and that.

Their gut tends to favor these more bad bacteria over beneficial ones compared to women without PCS. So for example, there’s a decrease in lactobacillus in the vaginal microbiome. And this bacteria is a healthy bacteria and a lack of this bacteria is associated with infertility and issues with implantation and some other adverse pregnancy outcomes.

Studies have also found that there’s a decreased abundance of Akkermansia in the gut, and Akkermansia is so interesting. It can help to reduce inflammation, it can help to improve blood sugar and strengthen the gut lining. So really important if we do think that there might be this leaky gut, this intestinal permeability going on, Akkermansia could be really key for that.

Studies have also shown that people with PCOS have higher levels of bactes, and what’s interesting is that this bacteria might actually cause the dysregulation in some of those hunger hormones, like ghrelin that we talked about earlier. Studies also show that this lower microbial diversity of PCOS can also negatively impact testosterone levels, especially if there’s any kind of dysbiosis going on.

That can negatively impact beta glucuronidase levels. So this is an enzyme that when you have too much of it, it can get in the way of clearing excessive hormones. Essentially, it de conjugates them so it can de conjugate estrogen. It can de conjugate testosterone. And what ends up happening is these de conjugated hormones end up circulating back into your bloodstream, and so you can end up with higher levels of androgens.

And then on the flip side, having too little beta glucuronidase. Also isn’t great because it can cause low levels of hormones like estrogen, and that in and of itself can cause hormonal issues with PCOS. So when it comes to gut health, this could be something where maybe a stool test could be helpful to see the gut microbiome composition to see what’s going on.

However, I don’t think this should always be the first step. I feel like a lot of people are always so willing to go into tests. And if that’s you, if you like that data, if you like that information, amazing. But I think a lot of the times we can start with the basics. Start by really incorporating lots of fiber rich foods, lots of, really gut supportive foods.

And I think that will get us pretty far. And then if it seems that there is some ongoing issues, maybe it’s time to dig a little deeper. But sometimes I think just showing our gut a little extra support. Probiotics where it’s needed prebiotics. So you know the foods that feed the gut. It can definitely make a huge difference.

So with all of that said, let’s dive into some of the nutrition and lifestyle strategies for PCOS. Before we dive in, I do wanna say that currently there is no evidence-based diet, like one diet that is ideally suited for PCOS. There has been research on diets like low carb diets, ketogenic diet, Mediterranean diet, and all of them have shown benefits of PCOS

I say this because, so often if you go online, you hear that there’s one specific way, one ideal way to eat. And I know it’s really popular to consider going really low carb when it comes to balanced blood sugar, and I’ve talked about this in other podcasts, that the problem with that is yes, it does work.

If you, in the sense that if you were cutting out carbohydrates, you are no longer getting that glucose that is causing that insulin to spike. Yes, that’s true. But there is also research to show that it does affect your insulin sensitivity over the long haul, and also you end up missing out on some of these really important foods, specifically fiber, because fiber is found in plant foods

those are the foods that feed the gut. And so as we talked about, we really wanna be supporting our gut health when it comes to PCOS. So I’m not a huge fan of just arbitrarily cutting out anything. I think we could maybe be mindful of certain foods, like of course some of those processed high carbohydrate, high sugar foods.

We do really wanna be mindful of our intake of that. But on the whole, I do wanna say that. There is no one specific diet and I don’t think there’s any need to, especially when we know the link between eating disorders and people with PCOS. I think the last thing we really wanna be doing is restricting out entire food groups unnecessarily.

So that’s my TED talk. Let’s dive in. So again, as I mentioned, one of the core strategies we wanna start off with is balancing blood sugar, because insulin resistance really is such a key component of most people with PCOS, it affects up to 70% of people, again, regardless of weight. Okay. As I mentioned earlier, elevated insulin can increase androgen production and disrupt ovulation.

So really important when we’re thinking about fertility. But it, these elevated androgens can also cause some of these side effects that we talked about. And it’s also a driver of inflammation. And since PCOS is an inflammatory condition, we really want to. Decrease that inflammation as much as possible.

And one of the key ways to do that really is to balance blood sugar. There are definitely a couple strategies to do that. The glycemic index can be a really useful tool if you’re looking at balanced blood sugar. If you’ve never heard of it, you can Google it. And it essentially just ranks foods based on how likely it is to have an effect on your blood sugar.

And I will say it’s not perfect because there are some people that you know. Like a food might not impact their blood sugar, but somebody else might have a huge impact in blood sugar with the same food. But generally it is pretty accurate and. We wanna be trying to eat as low glycemic as possible.

So typically it’s gonna look like consuming whole grains and legumes and non-starchy vegetables. So we really wanna be prioritizing foods that are higher in fiber, and that’s gonna help slow down how quickly that sugar is entering the bloodstream. And then, like I said, these foods are high in fiber, which are really good for supporting overall gut health.

And then the second key thing to do is to never eat. Naked carbs, and what I mean by this are if you are eating carbohydrates, you wanna pair it with something like protein. And fiber to make sure, again, we’re slowing that release of sugar into the bloodstream. One of the easiest ways to do this is with the plate method.

This is now part of Candace Food Guide. I’m pretty sure it’s also part of the US Food Guide, but if you’ve never heard of it. You can look it up, but it’s essentially, if you take a plate and imagine that a quarter of that plate is protein, a quarter of that plate is going to be your complex carbohydrates, those high fiber foods, and then half of the plate is going to be your vegetables, preferably non-starchy vegetables.

So thinking of those greens, peppers, zucchini, broccoli, things like that. And that is guaranteeing that you’re essentially pairing. Food with your carbohydrates. Do you have a balanced, protein packed meal that is going to support overall blood sugar levels, which we love. But I think this is something you can also utilize if you are preparing a snack.

And if you are craving, you want something like potato chips, maybe we could think about what can you pair with those potato chips. To help balance your blood sugar and also keep you fuller for longer. Really help with that satiety piece and really eating these balanced meals is gonna be so beneficial, like I said, for satiety, for balancing blood sugar, but it can also help with cravings and really help with binge eating because a lot of times what’s happening with binge eating, especially when it’s happening late at night, is that.

You’re not eating enough during the day or you’re not eating enough of the right foods during the day, or not spacing out those meals enough. And so you’re actually just starving. And so by the time evening comes rolling around, you haven’t actually eaten enough. And that’s where it can be really easy to go into your pantry and just eat whatever is readily available to you.

And often that is going to look like more. Processed high carb, high sugar foods because your brain is gonna be like yes. Get that into me stat. And if you’re like me and you’re basic and you’re like, I don’t know, like what to eat for snack, I honestly go with the classics. Pair it with a hard boiled egg, maybe some cheese, maybe a yogurt, for thinking protein and I’m just thinking of the chips as an example, but it could really be anything.

It could be apples and peanut butter, it could be hummus with veggie sticks. There’s so many options. You can definitely Google. Healthy snacks or healthy meals, but in general, we wanna be thinking about, okay, if I want a cookie. And have a cookie. Live your life, enjoy your cookie. But is there something we can add to that to make it a little bit more satiating and to really bump up the fiber and bump up the protein?

And lastly, I think it’s really important to space it our meals and eat relatively frequently for blood sugar. But I will talk about that a little bit more once we talk about some more supporting hormonal health. But I’ll say it now, just to really reiterate it, that you don’t wanna be going too long without eating because like I said, it’s gonna mess with your blood sugar, but it can also increase some of those binge eating patterns that we wanna avoid.

The second goal we wanna think about, so we talked first about bouncing blood sugar. Second, we really wanna focus on reducing inflammation. And really eating anti-inflammatory foods is gonna be the best way to do that. So this will go by quick. Just some things to think about adding into your diet include colorful fruits and vegetables.

So think of things like crucifers, veggies, onions, berries, grapes, cherries, citrus fruits, tomatoes, pomegranates. Something I really like to think about too is getting a lot of diversity in the kinds of foods you’re eating. So if you typically. Eat white onions. If you switch to red onions, you’re getting a little diversity, which is great for your gut microbiome, but also those red onions are high in that red pigment in those anthocyanins, which also offer additional antioxidants.

Same thing if you’re choosing red cabbage over green cabbage. That red cabbage is going to have these additional polyphenols, these antioxidants, which are going to help reduce inflammation, so when we can, trying to switch it up and get a lot of diversity and getting lots of color. Then I think this is also true when we’re getting apples, switch it up, get a lot of diversity.

It’s really just the more diversity you get your gut is going to love that. So also thinking about including lots of herbs and spices. So especially things like turmeric and ginger, oregano, rosemary, cinnamon, all of those spices and herbs. Offer anti-inflammatory properties. And so just throwing those into everyday cooking is amazing.

As I mentioned before, you know when possible opting for those low glycemic carbohydrates, that’s looking like whole un processed grains and that can just be whole grain bread whole grain pasta when you can choosing fresh fruit rather than dried fruit or juice. ’cause we want that fiber.

We also want that water content that’s gonna add volume that’s gonna keep us full. Sweet potatoes, pumpkin squash, and then lots of beans and lentils. I love if you can throw beans and lentils into things. I think that’s great. One of my favorite things to do, especially in this economy, is whenever I cook up a pound of ground beef, I will usually throw in a can of lentils because it’s just gonna extend the meal a little further.

You get a little bit more bang for your buck, you can’t taste it, and you’re getting some additional fiber in there, which we love. Some other anti-inflammatory foods include nuts and seeds like pumpkin seeds, sunflower seeds. Almonds, cashews, et cetera, and Omega-3 fats. So typically that looks like fatty fish.

And of course people always think of walnuts, flax, hemp, and chia seeds. And those are great. I love them. But it is worth noting that those are a different kind of Omega-3 fat. So it’s actually a LA and that is a fatty acid found primarily in plant-based foods. Like walnuts and hemp seeds and it’s still good for you.

It’s like we still love these foods, but it’s not as great as EPA and DHA, which is found in fatty fish, and we do convert a LA to these other fatty acids. But the conversion rate isn’t great, especially if you have any kind of compromised gut issues. It’s still great. We still love our chia pudding, but also thinking about potentially taking an Omega-3 if you don’t love fish and you have a hard time getting in fish regularly.

Also, including monounsaturated fats, so things like olive oil, avocados canola oil is also high in monounsaturated fats. I know it gets a bad rap and people really hate on it, and believe me, I used to be part of that bandwagon. But it actually does have a really good nutrition profile. The only reason I would say to if you’re, if you don’t consume it, you’re like, should I consume it?

It depends. It’s a cheaper oil, which is great, but we do consume it in a lot of other capacities. So like sometimes, like maybe we switch it to olive oil just for a little bit of variety in our diet, but if you’re worried about consuming canola oil, I wouldn’t be the really big issues about seed oils.

But this is true of any oil is just that constant. Re frying reheating. So when you’re thinking about going to a restaurant and you’re getting, french fries and that oil that’s been reheated multiple times, it’s, that’s when we start to get this oxidization, this oxidation happening, and that’s when we tend to think of it as being more inflammatory.

Also, other seed oils do have a higher omega six, two, Omega-3 ratio. And while that’s not necessarily a bad thing because we often already consume a lot of omega sixes in our diet, especially if you eat a lot of processed foods, you’re typically exposed to more omega sixes. The worry then is that your ratio, your balance gets thrown off.

You’re not eating enough omega threes to omega sixes, and that’s where you start to see a rise in things like inflammation. That being said, canola oil actually has higher omega threes than omega sixes. So I know it gets lumped in a lot with can with seed oils and probably because a lot of times it’s a blend of oils.

When you buy vegetable oil, you don’t really, you don’t really know what that makeup is. But on the whole, especially if you’re looking to save money, and I know olive oil is expensive these days. I would not be afraid of using canola oil. And of course, adding in lots of fermented and prebiotic foods is going to be great for the gut.

So we’re thinking about fermented foods. I’m talking about sauerkraut, kimchi, Tempe kafi, if you like it. Honestly, I don’t. But if you can tolerate fermented foods like that, amazing meso paste. All of these are great and as some final thoughts to reducing inflammation. We also wanna make sure we’re really addressing the stress and sleep component.

And these are actually huge for inflammation. There’s a lot of good research to show that. High stress drives cortisol, which causes inflammation in the body. And even not getting enough sleep has been shown to be more detrimental to blood sugar than a poor diet. So we really wanna be emphasizing quality sleep.

If you haven’t already listened to my podcast episode on stress and burnout, I highly recommend you go back and give it a listen. There is so much good information there on really focusing on. Circadian health on sleep, on stress reduction strategies. I also have an entire masterclass called Beat the Burnout, and that’s exactly what we dive into because stress is such an important factor when it comes to health.

And I know she’s not cute. I know we don’t like to talk about her. We wanna do the, sexy supplement route first. But I promise you, addressing sleep as stress is going to be a huge game changer, always.

So I think I’m actually gonna wrap up here and we’ll have to do a part two series. So in part two we’ll talk a little bit more about how you can support hormone health, how you can decrease androgens. We’ll also talk a little bit about nutrient deficiencies and nutrients of concern when it comes to PCOS.

We’ll talk about the importance of movement and what that. Exercise might look like. We will probably talk about sleep and stress a little bit more. And then we’ll also talk about supplements ’cause I know there’s a lot of questions about what kind of supplements to use. So we can dive into more about that in our next podcast episode.

So I think that’s a wrap on today. Thank you so much for tuning in. I’ll be back real quick with the next episode, I promise. And in the meantime, if you’re looking to connect, definitely follow me on Instagram at Nourish with tis. You can also check out Nourish with tisch.com. That’s where I share lots of blog posts and nutrition tips.

I share recipes there. So lots of good stuff there. And if you have a second, I would love if you take a few minutes to leave me a review, that is probably the best way you can help to support this podcast. Thank you so much. Enjoy the rest of your day.

References

Journal Articles:

Alesi, S., Ee, C., Moran, L. J., Rao, V., & Mousa, A. (2021). Nutritional supplements and complementary therapies in polycystic ovary syndrome. Advances in Nutrition, 13(4), 1243–1266. https://doi.org/10.1093/advances/nmab141

Cooney, L. G., Gyorfi, K., Sanneh, A., Bui, L. M., Mousa, A., Tay, C. T., Teede, H., Stener-Victorin, E., & Brennan, L. (2024). Increased prevalence of binge eating disorder and bulimia nervosa in women with polycystic ovary syndrome: A systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 109(12), 3293–3305. https://doi.org/10.1210/clinem/dgae462

Gu, Y., Zhou, G., Zhou, F., Li, Y., Wu, Q., He, H., Zhang, Y., Ma, C., Ding, J., & Hua, K. (2022). Gut and vaginal microbiomes in PCOS: Implications for women’s health. Frontiers in Endocrinology, 13, 808508. https://doi.org/10.3389/fendo.2022.808508

Mohan, A., Haider, R., Fakhor, H., Hina, F., Kumar, V., Jawed, A., Majumder, K., Ayaz, A., Lal, P. M., Tejwaney, U., Ram, N., & Kazeem, S. (2023). Vitamin D and polycystic ovary syndrome (PCOS): A review. Annals of Medicine and Surgery, 85(7), 3506–3511. https://doi.org/10.1097/MS9.0000000000000879

Moran, L. J., Tassone, E. C., Boyle, J., Brennan, L., Harrison, C. L., Hirschberg, A. L., Lim, S., Marsh, K., Misso, M. L., Redman, L., Thondan, M., Wijeyaratne, C., Garad, R., Stepto, N. K., & Teede, H. J. (2020). Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: Lifestyle management. Obesity Reviews, 21(10), e13046. https://doi.org/10.1111/obr.13046

Shele, G., Genkil, J., & Speelman, D. (2020). A systematic review of the effects of exercise on hormones in women with polycystic ovary syndrome. Journal of Functional Morphology and Kinesiology, 5(2), 35. https://doi.org/10.3390/jfmk5020035

Teede, H. J., Tay, C. T., Laven, J. J. E., Dokras, A., Moran, L. J., Piltonen, T. T., Costello, M. F., Boivin, J., Redman, L. M., Boyle, J. A., Norman, R. J., Mousa, A., Joham, A. E., & on behalf of the International PCOS Network. (2023). Recommendations from the 2023 International evidence-based guideline for the assessment and management of polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, 108(10), 2447–2469. https://doi.org/10.1210/clinem/dgad463

Web Sources:

Romm, A. (n.d.). PCOS: A natural prescription. Aviva Romm. https://avivaromm.com/pcos-natural-prescription/

Romm, A. (n.d.). PCOS and the gut connection. Aviva Romm. https://avivaromm.com/pcos-gut-connection/