A lot of PCOS blogs, advice books and experts are exponents of the Low GI diet. Whilst it does work for some, it doesn't work for all - it certainly didn't work for me. Here's why:
Background
PCOS is basically a disease of hormone imbalance. Controlling the endocrine system and helping it back to balance is key in the reduction of all symptoms, across the board and not just weight management, whether issues surrounding fertility, male pattern issues such as hirsuitism, alopecia, oestrogen dominance issues such as acne or mental health issues such as anxiety, insomnia, depression.
Controlling the endocrine system is of course, partially down to control of oestrogen, testosterone, progesterone, thyroxine, Vitamin D etc, and controlling adrenaline and cortisol through stress management, but it's also about control of insulin.
Insulin is one of the master hormones and is key to any treatment plan, whether weight is a problem or not - it's also the most reactive on a minute-by-minute basis and affected most directly by our intake (food, drink etc). Furthermore, insulin doesn't work alone and has a direct effect on the levels of other hormones. Keeping insulin in check should absolutely be a cornerstone of any plan.
In my case, if I don't keep insulin in check I go right back to suffering a range of symptoms, including insomnia, anxiety, sweating, gastro problems (normally diarrhea for me). It's an immediate cause and effect: symptoms will come on within a matter of minutes in some cases. What I eat will definitely affect the quality of sleep I'll experience that coming night.
In my case, if I don't keep insulin in check I go right back to suffering a range of symptoms, including insomnia, anxiety, sweating, gastro problems (normally diarrhea for me). It's an immediate cause and effect: symptoms will come on within a matter of minutes in some cases. What I eat will definitely affect the quality of sleep I'll experience that coming night.
Why Paleo is the Best Choice - Keeping Insulin in Check
The best way to keep insulin balanced is to avoid anything which causes an insulin spike. Whilst all foods trigger some response, fats and proteins do not cause a significant reaction. Carbohydrates cause an insulin response and this can be significant (in my case, disproportionate), compared to either the quantity of food eaten or compared to the response of a healthy person.
As a result, avoiding insulin-trigger foods is key to keeping my insulin levels balanced and the paleo diet does exactly that. It also has the benefit of meaning that I don't need to count calories, restrict my eating or stick to any kind of plan as long as I stay within the boundaries of paleo.
Insulin control is a major factor of any paleo diet - it's just co-incidental that it works in our case - look up Loren Cordain's The Paleo Diet or Mark Sisson's The Primal Blueprint for the details.
Please note this also means what I call "true paleo", following the guidelines, rather than the myriad of blogs and recipe sites which seek to turn just about any food into a "paleo" version. Creating chocolate brownies full of honey may be slightly better for you than their sucrose counterparts, but will just as surely cause an insulin spike and therefore, in my view, don't count as true paleo and certainly don't help to control insulin levels. Seeking out these "cheats" is just shooting yourself in the foot: if you really want a chocolate brownie, have a real one (occasionally), enjoy every bite, make sure it's made with real butter and put full fat double cream on it to mitigate the sugar hit. Trying to get a free pass with honey or palm sugar is, in my view, worse than going for the authentic version.
This is also why metformin works so well for some sufferers: it artificially holds down insulin and keeps it in check, but diet also plays a major part in this - metformin won't be able to keep insulin level if the sufferer is overloading on sugar and other foods which create an insulin response. In the same way that most diabetics need to avoid sugar and other carbs in order to keep their levels constant, so the same applies for PCOS sufferers. I'll write more on metformin in another post.
As a result, avoiding insulin-trigger foods is key to keeping my insulin levels balanced and the paleo diet does exactly that. It also has the benefit of meaning that I don't need to count calories, restrict my eating or stick to any kind of plan as long as I stay within the boundaries of paleo.
Insulin control is a major factor of any paleo diet - it's just co-incidental that it works in our case - look up Loren Cordain's The Paleo Diet or Mark Sisson's The Primal Blueprint for the details.
Please note this also means what I call "true paleo", following the guidelines, rather than the myriad of blogs and recipe sites which seek to turn just about any food into a "paleo" version. Creating chocolate brownies full of honey may be slightly better for you than their sucrose counterparts, but will just as surely cause an insulin spike and therefore, in my view, don't count as true paleo and certainly don't help to control insulin levels. Seeking out these "cheats" is just shooting yourself in the foot: if you really want a chocolate brownie, have a real one (occasionally), enjoy every bite, make sure it's made with real butter and put full fat double cream on it to mitigate the sugar hit. Trying to get a free pass with honey or palm sugar is, in my view, worse than going for the authentic version.
This is also why metformin works so well for some sufferers: it artificially holds down insulin and keeps it in check, but diet also plays a major part in this - metformin won't be able to keep insulin level if the sufferer is overloading on sugar and other foods which create an insulin response. In the same way that most diabetics need to avoid sugar and other carbs in order to keep their levels constant, so the same applies for PCOS sufferers. I'll write more on metformin in another post.
In that Case Why Does Low-GI Work for Some?
Low-GI diets may well work for some sufferers - I think it depends on the severity of the symptoms and what your diet has been until the point you decide to start.
It's all relative, switching from a typical modern western diet to Low-GI might be enough, but it comes with problems. If it's enough for you and you lose weight on this plan, I'm thrilled, but I think there is a better way which has more chance of success in a greater range of sufferers.
It's all relative, switching from a typical modern western diet to Low-GI might be enough, but it comes with problems. If it's enough for you and you lose weight on this plan, I'm thrilled, but I think there is a better way which has more chance of success in a greater range of sufferers.
Going from a relatively typical "modern western diet" including all the processed foods which are available in your typical supermarket, with a heavy reliance on carbs (wheat, grain, sugar), even those which purport to be "diet" or worse "low fat" to a Low-GI diet will, undoubtedly, help to control insulin spikes relative to the levels experienced previously. Switching from processed white bread to granary will certainly help in some quarters (as the granary bread takes longer to process through the digestive system, and therefore longer for the sugars contained to be released).
However
The body is designed to follow a plan which goes as follows:
Food is eaten, insulin is released to help process, causing a spike, which then falls back to a resting level ready to be activated again at our next meal.
With Low-GI, foods are chosen for their relatively higher fibre level which means that they take longer to break down and the sugars within them are released more slowly. Great because the initial spike is not as high, but not so great because the levels stays elevated for much longer e.g. a Low-GI breakfast will keep our insulin elevated all morning until our next meal. Far too long.
Keeping insulin levels raised encourages contributes to a whole range of problems, but chief amongst them is that it causes other hormone levels to rise along with it. Our hormones are part of an endocrine system, they are not just single agents working to their own plan. As a result, a rise in one hormone will cause a reaction (rise or fall) in the others, and it's this which causes the real problem for PCOS sufferers, and the reason why Low-GI is not the best choice for our group.
Low-GI is certainly a less radical change from "normal" than the change to a Paleo diet might be, but if you are following a Low-GI plan and still have insomnia, mood swings, anxiety, you might want to give Paleo a go. For me, these symptoms either stopped or drastically reduced within a week, so the switch was worth it and three years later I've not looked back.
What do you think? Have you tried Low-GI? Did it work for you? Have you tried Paleo. I'd love to hear your views.
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