Advice / others experiences

[Ohdeer]

Hi all

An insulin resistance question. When modifying the LE diet for insulin resistance/pcos should wholemeal always be substituted for white in terms of flour, pasta etc?

I also wondered about alcohol. White wine for example. Is this ok? I am feeling a bit overwhelmed by how complicated the diet is generally and then when you add insulin resistance or PCOS it all becomes very contradictory. I’m a bit lost.

at the moment I’m eating homemade 50:50 whole meal and white (sodium free) bread made with corn oil and eating it with jam or Nutella for brunch. Following that with rice (white) and green beans/ sweet potato. And then a chicken/paneer/based dinner. And wine. And coffee. And tea. Sometimes an occasional Splenda-based hot chocolate with skim milk. Felt quite confident with this but am now second guessing all the things I’ve read.

Hope somebody else has been in this position and can help! I’m generally quite relaxed about the swaying aspect but want to at least be on the right track.

[atomic sagebrush]

For reasons we do not understand, most PCOS/IR people tolerate white rice and potatoes much better than white flour so while you should always/usually sub out whole wheat flour when you can, you don't necessarily need to extrapolate this to rice OR skip potatoes either (as long as they are not processed).

So YES with whole wheat (if you tolerate it ok, and I will often make exceptions for pasta because I know whole grain pasta is not super yummy, so if you eat it only once in a while on a day you're already fairly low in carbs, I will turn a blind eye )

NO to rice and potato, if you tolerate them ok and do not have severe PCO you do NOT need to cut out potatoes and can still have white rice instead of brown. You can HAVE brown instead/too but you don't ahve to.

Alcohol is fine on the alternate diet. I can go into a big explanation about why this is if you'd like me to.

The diet is actually not that complicated, the nutshell version is simply slightly higher protein and fat intake with same number of calories (in effect cutting carbs without even thinking about it) and then getting your carbs from healthier options - whole wheat, white rice, potato, fruit and veg.

No more skim dairy. For reasons we do not understand skim dairy is really bad for blood sugar so I'd go to full fat only.

Your diet is pretty good to me, the sugar in the jam and Nutella is actually more of an issue than some of the other things but many, many people with mild to moderate PCO can tolerate some sugar here and there just fine as long as you're not carbing it up all day every day.

[Ohdeer]

Thank you so so much for your response. It’s so informative and I’m really glad I asked as there is a lot I didn’t know mentioned here. Could I ask a couple more questions based on what you’ve said?

Milk
I’m super grateful for the information about skim milk and blood sugar because I didn’t know that and it will be useful in my day to day life aside from the swaying. I have been having so much skim milk!

1. Does this apply to yoghurt too? I have been having fat free greek-style yoghurt but should I be avoiding fat free dairy completely or is it just skim milk that I should avoid?
2. I have a dash of skim milk in tea in the morning because I don’t like fattier versions. Can I continue this or should I substitute with oat milk cos skim is a no no whatever?

PCOS and sweetners
1. The fat free yoghurts use sweeteners. Should PCOSers avoid sweetners used in these products and Diet Coke etc?

I’ll swap out the jam and Nutella for peanut butter. And I’ll swap my skim hot chocolate for a camomile tea. So grateful for your advice and impressed by how much research you’ve done. I thought that PCOS would mean I’d struggle to understand but you’ve really helped me get a sense of how to manage this.

[atomic sagebrush]

Of course!

1)Yes applies to yogurt, cheese, etc. Full fat everything.

2)Both skim and oat milk are not great for those with PCOS but if you need one or the other I'd go with skim.

1)If you mean artificial sweeteners you can have those in moderation on alternate diet.

Just let me know if you need anything! It's what I'm here for.

[Ohdeer]

Thank you, it’s appreciated. I think I understand but it’s hard to recalibrate the way I’m thinking about the LE diet because I thought it was almost the opposite. Do you mind checking if this diet looks ok?

No breakfast, just black coffee and one black tea with a dash of skim milk

10/11am Corn tortilla wrap with full fat cream cheese

12pm Rice with green beans and full fat yoghurt OR homemade salt-free bread (with corn oil) and peanut butter. Strawberries and raspberries

Dinner: chicken-based with rice or potato

Drinks: white wine, a Diet Coke, tonic water

Snacks: wholegrain rice cake with FF cream cheese if necessary

If skim and oat milk isn’t recommended are there any other non dairy milks that would work e.g. rice or almond milk?

Am very grateful for all your advice, thank you

As I understand it the limits for LE Pcos are 50-60g protein and fat? So most cals from (good) carbs, then fat, then protein.

Phew! Thanks for helping me get it straight in my head

[atomic sagebrush]

No, the opposite is eating 2000-2500 calories a day, 90-120 g protein a day, lots of animal fat, protein and carbs at every meal and snack, eating 5-7 times a day, fortified foods, and 9-11 servings of nutrient dense fruit and veg a day in ADDITION to eating a nutrient dense diet. The foods themselves are not so much of the equation, it's the nutrient content as a whole that matters. So PCOSers need to stick in pink range for nutrients but then tweak their diet so as not to be aggravating their PCOS with lots of white carbs.

No non dairy milks. They are all extremely carby and not great for those with PCOS.

Do you have totals for that day's meals? I can't sign off on any diet without the totals. Right kinds of foods, but I'd like to check to be sure we're in range on the cals, pro, and fat.

Don't be afraid to add in some veggies with that. Vegetables, all the low carb ones anyway, are free and unlimited. I would like to see you eating at least some veg daily to help with food fatigue and be sure you're getting enough micronutrients to keep yourself going healthfully.

I think we're on the same page with your understanding of the diet (that you will end up getting majority of cals from your good carbs) but I want you to understand there is not a "first carbs, then fat, then protein" progression. I want you to be sure you are getting that 50-60 g protein and fat every day without exception and then treat the carbs as the "gap filler" to be sure you're getting enough calories overall if that makes sense. The way you've worded that it sounds like you are prioriziting carbs but they are all of equal priority, this is meant to keep you ovulating and allow you to get and stay pregnant without aggravating your PCO tendencies.

[Ohdeer]

Hi Atomic,

Thank you again. You’re spot on - I’m working it out as you describe (as a progression) so not the right way.

So my last two days have been like this (I know it’s not great ie too low cal but I’m very petite and am more in need of the 1200 calorie range - I don’t lose weight otherwise)

Day 1:
Carbs 87g (46%)
Fat 32g (30%)
Protein 28g (15%)
Total cals 1074

Day 2:
Carbs 80g (39%)
Fat 42g (47%)
Protein 28g (14%)
Total cals 1217

This looks really bad now I’ve written it down! I guess I need to up my fat and protein foods quite substantially. I struggle finding non-meat sources of protein and also good fats that aren’t high in sodium. I’ve used MyFItnessPal for this so not sure how good it is.

Thank you for the info on non dairy milk - I had no idea. Will try full fat milk as my dash in tea or go black.

I’ll add some veg too (green beans, asparagus, spinach peppers). Will also add pine nuts to the wrap. That should up the fat and protein?

You are so clear in your instructions: thank you. My basic takeaway is I have to be hitting 50-60g in fat AND protein but remaining low sodium? Carbs will just come after that. Hope this sounds like I’ve got it right and thanks again. I’m so glad I came on here because I didn’t have a real grasp of how to factor in my PCOS until now.

[atomic sagebrush]

That's why we have the exception - a very petite person will simply need fewer calories than a very tall person and the middle of the road people will be in between. fine as long as we are not dropping below 1200 and that you add cals as needed if weight flies off.

You probably ought to let the sodium restriction go. The mineral diets have not worked for us and virtually all of us (myself included) gave up the sodium restriction and our results have only gone UP since we did. So I would have you let that go and it is MUCH MUCH MUCH easier to stick with the diet. I got my girl eating scads of sodium after limiting it and getting my 4th boy.

That having been said oil is no sodium and you can always use that for cooking if you NEED to. MFP is not reliable at all for sodium either, it has foods like asparagus that have little sodium listed with quite a high amount because people entered the data for salted asparagus for some reason. So take that with a grain of salt (haha)

adding pine nuts if you like them. But you can have some meat on the alt. diet in small quantities. That is fine and it's a good way to add some protein while still keeping pretty low cal since you need that. That is what I have anyone who needs 1200 cals but 50-60 g protein do is meat because it's the best way to get a lot of protein without a lot of calories.

Glad to be of help! Let me know if I missed anything.

[Ohdeer]

Thank you for explaining it all. I’m so happy to hear the words ‘let the sodium restriction go’! Can I just clarify one thing? Given that I’m limiting myself to 1200 cals should I still be aiming for 50-60g fat and protein? I’m struggling to get to those levels, especially the protein. But if so the meat is how I’ll do it.

I’m not planning to be super strict with minerals etc, I just want to make sure I have the limits right for fat and protein. I’m basically doing that and delaying breakfast and hoping for the best. Talking to you has shown me that I had some things really wrong and I think that’s the main thing - I just want to go forward knowing I’m somewhere in the right ballpark. Sorry if it’s taken me a while to understand! Thanks again, you’ve been great.

[atomic sagebrush]

If you have PCOS then yes you should aim high on the protein. You can fudge if you need to (and of course never ever drop below 40 g since that is the necessary amount for healthy pre-pregnancy diet) but the point is you need to be getting a certain % of your calories from non carb sources. So lets say you get to 48 g, that's still likely going to be good enough for 1200 cals.