One of the symptoms of having insulin resistance and excess insulin production for people with PCOS is often intense hunger! This can be because insulin is a storage hormone and having more insulin in your blood triggers your body to crave more food to store. Also, a huge side effect of restricting your calories and/or your carbohydrate intake is strong, biological hunger. Since so many people with PCOS have tried a lot of diets, this kind of hunger is really common.
Here are 10 tips to help manage both the hunger that comes from dieting and restricting food AND the hunger that happens as a result of excess insulin production in PCOS. If you have questions about carbohydrates, protein, and fat, check out this link to my blog on Nutrition Basics: Macronutrients.
1. Plan to Eat 3 Times per Day
If you fuel your body at regular intervals around the same time each day, you can get into a pattern of eating when you are just starting to get hungry and stop before you are uncomfortably full. You body can learn to expect meals and snacks at certain times and you may find you get hungry around those times. Most importantly, eating frequently (without skipping meals) prevents you from becoming too hungry at later meals. Getting too hungry can lead to overeating or binge eating. See my blog Start with Eating Three Time a Day.
2. Have Protein with Carbohydrates
Carbohydrates are broken down to glucose which all of our cells use for energy and are digested relatively quickly. Protein helps our body with growth and repair and digests more slowly than carbohydrates. People feel most satisfied with meals and snacks when they combine carbohydrates with protein because you get the quick energy from the carbohydrates and feeling of fullness that protein provides.
3. Plan for Snacks
Most people feel best when they eat something every 3-5 hours they are awake. Having snacks can be a way to make sure that you don’t get too hungry before a meal. When you get too hungry, it can lead to overeating or binging. Snacks are most effective when you plan for them, so try packing them for when you are out of the house and keep healthy snack options available for when you are at home.
4. Increase your Fiber Intake
Fiber is found in plants and provides bulk to foods. This bulk can take up a lot of space in our stomach and provide feelings of fullness. Our bodies break down fiber but we do not absorb it. This can help keep your bowel movements regular, bind to fat and cholesterol which can reduce blood cholesterol levels, and promote the health of “good” gut bacteria. Good sources include fruits, vegetables, beans, seeds, and whole grains.
5. Decrease Refined Carbohydrates
Refined carbohydrates are foods or drinks made primarily from white flour or sugar without much fiber, healthy fat, or protein. These foods digest very quickly which can cause blood sugar to spike and then drop quickly. This “drop” can lead to rebound hunger soon after you eat since the increase in blood sugar causes your body to produce a lot of insulin. When you eat or drink something that is high in refined carbohydrates, you can try having a small portion, have it as part of a meal with protein, and/or go for a walk after eating to help bring blood sugar down.
6. Add Heart Healthy Fats to Meals and Snacks
Adding unsaturated fats such as avocado, olive oil, nuts, nut butter, seeds, or fish to meals and snacks can contribute to feelings of fullness and satisfaction. Unsaturated fats will not spike blood sugar or insulin the same way that carbohydrates alone can. Swapping these unsaturated fats for saturated or trans fats (like butter, fried foods, processed meats, or cheese) can help improve your cholesterol numbers too.
7. Drink Plenty of Low Sugar Fluids
When we are not properly hydrated, our body can sometimes mistake hunger for thirst. Aim to drink around 64 ounces of water, tea, coffee, milk/non-dairy milk, or sparkling water each day. If you drink non-dairy milk, choose ones with the least amount of sugar (unsweetened is best). You don’t need to drink more than 24 ounces of any milk per day. Limiting caffeine to the morning can help make sure you get enough sleep. The best way to tell if you are hydrated is if your urine is a pale yellow color.
8. Eat Slowly and Mindfully
Our brains take around 20 minutes to register fullness after we eat. Sometimes if we eat too quickly, we end up eating past the point of being comfortably full. This can sometimes happen if we let ourselves get too hungry. We also tend to eat more food if we are distracted by phones, computers, or TV. Eating slowly and without distractions is the best way to pay attention to our natural hunger and fullness cues and to tell if you have eaten the right amount of food you need at that time.
9. Get Enough Sleep
Getting at least 7 hours of sleep at night can help reduce feelings of hunger and cravings the next day. Our bodies will often crave more food when we are tired as a way to “wake up” or get that burst of energy that (especially refined carbs) foods can provide.
10. Work on Stress Management and Emotional Eating
While all people eat for emotional reasons at times, if you find that you are leaning on food to manage stress or difficult feelings often, you may want to work on other strategies for managing stress. Look for other activities you can do that can provide the same feelings of calm and wellbeing that eating does. This can be talking to a friend or family member, reading, watching TV, going for a walk, taking a bath, or writing in a journal. If you need help with managing emotions and stress, consider meeting with a therapist for more support.
If you would like more help dealing with PCOS hunger or other PCOS related symptoms, click here to contact me about nutrition counseling.
The terms “clean eating” or “eating clean” have gotten very popular in recent years, even though these words might mean different things to different people. You may be interested in clean eating if you have PCOS and are looking to improve your symptoms with nutrition. But what does clean eating mean?
While there is no clear definition, it usually means avoiding or limiting processed foods, eating mostly organic foods, and avoiding GMOs. Let’s take a closer look at these topics.
Most foods you eat are processed to some degree. Any kind of washing, chopping, freezing, fortifying, preserving or drying is a type of processing. Foods that are considered minimally processed are: fruits, vegetables, eggs, nuts, beans, milk, and meat.
Foods may be further processed by milling, grinding, extracting, combining ingredients, heating, canning, pickling, and fermenting. A lot of these foods can be very healthy choices for everyone, including those with PCOS. Some options include: whole grains such as brown rice, oatmeal, or quinoa, whole grain flours, whole grain products such as bread or pasta, oils, yogurt, canned tomatoes or beans, soy milk, edamame, peanut or other nut butters, tofu, or tempeh.
Highly processed foods often have a lot of added sugar, salt, and fat and these tend to be the ones that give processed food a bad name. Here are a few: sweetened drinks like soda, iced tea, juices, or energy drinks, chips, shelf stable cookies or cakes, sausages, hot dogs, candy, ramen noodles, and some frozen prepared meals.
Bottom line: Processing foods doesn’t automatically make them unhealthy. However, eating foods with a lot of sugar, salt, and saturated or trans fat (whether you add them or someone else does) can negatively affect your health and make your PCOS symptoms worse if you eat them often.
In order for foods to be labeled as organic, they must meet the standards that the USDA have set in place. This standard can be expensive and difficult for farmers to achieve, but ultimately the foods are produced without banned chemicals including synthetic fertilizers, pesticides, hormones, or antibiotics.
While there are definite environmental benefits to organic farm practices, there is limited evidence that organic foods make people healthier. The nutritional benefit of organic foods depends on the food itself. Eating foods with skins or peels that are exposed to pesticides can increase the levels of these chemicals in our bodies, but more evidence is needed to see how this affects us. Organic dairy and meats may have higher levels of omega 3s and some organic produce may have higher antioxidant levels than conventional produce.
Bottom line: Eating foods made with organic practices can be beneficial for the environment and may help you to avoid some exposure to excess chemicals. However, don’t avoid eating foods like fruits and vegetables if you feel like you can’t afford the organic version. There is plenty of evidence that eating a lot of fruits and vegetables is one of the best things you can do to reduce your risk for heart disease, diabetes, and cancer. Click here to learn more about the organic label from the USDA site.
Genetically modified organisms (GMOs) are foods where the genes have been manipulated with bioengineering so that they have some traits that are considered beneficial. Usually it is done so that foods can hold up better when shipped, have a higher yield, and increased resistance to disease. There are environmental concerns about how these new plants affect other organisms and the amount and type of fertilizer these plants need.
We don’t have evidence that suggests that nutrition quality is worse with GMOs compared to non-GMO foods or that people who eat GMOs have worse health than those who don’t. The technology is still pretty new so this could change in time.
Bottom line: Just like organic foods, you may want to limit your exposure to GMOs for environmental reasons, but there isn’t any reason to avoid GMOs for health reasons at this time. Click here to learn more about GMOs from the Genetic Literacy Project site.
Final thoughts about the word “clean”
The labeling of foods as “good”, “bad”, or “clean” can have some consequences for you. If you eat something “good” or “clean”, then you may feel like you are being good or are a good person. And on the other side if eat something “bad” or processed, you may feel like you are a bad person and your self esteem and health may suffer.
Your thoughts are powerful and will drive your behavior. Having a healthy relationship with food includes making room for all foods without judgement. Ultimately I don’t like the term “clean eating” because in addition to being vague, it may cause you to judge how you eat which is more likely to make you feel badly about yourself than improve your health.
If you want to make changes to your diet to improve your PCOS symptoms, cooking more at home and adding in more fruits, vegetables, healthy fats, and whole grains can make a big difference. But let’s not call it “clean”. Check out my post on the best diet for PCOS in this link.
Interested in learning about nutrition counseling for PCOS? Contact me for a discovery call!
Most people I talk to who have PCOS are interested in losing weight. That is why they are looking to talk to a dietitian. They may have been told by a doctor to lose weight. They probably have tried many different diets to lose weight.
I understand the desire to lose weight. We live in a culture where dieting and being a certain size or weight is seen as the answer to all of our mental and physical problems. People with PCOS are particularly vulnerable to these messages since weight is blamed as a root cause for PCOS and losing weight is seen as a solution. Many women in larger bodies who have trouble with fertility, even beyond PCOS, are told to lose weight.
What’s the problem with dieting to lose weight? It doesn’t work 80-95% of the time. The biggest predictor of weight gain over time is dieting. You may say that a certain diet “worked” for you, but if you ended up gaining the weight back and more, how did this diet work for you?
We also know that weight cycling or “yo-yo dieting” puts you at greater risk for heart disease and diabetes than if you had never lost the initial weight. Stress from body dissatisfaction, food restriction, overexercise, and weight stigma can also increase your risk for these metabolic conditions.
So if dieting is not the answer to improving PCOS symptoms, what is the answer?
The answer is learning how to be an intuitive eater. The 10 principles of Intuitive Eating, by Evelyn Tribole and Elyse Resch, have been around since 1995 and can help improve your health by learning how to listen to your body’s messages about what to eat and how much to eat. It is the answer to ending the diet cycle and making peace with food. Over 60 research studies have shown that Intuitive Eating helps people have lower rates of disordered eating including binge eating, increased well-being, improved blood sugar and cholesterol, reduced stress, and higher self esteem. Click here for a link to Evelyn Tribole and Elyse Resch’s website devoted to Intuitive eating.
With PCOS, you can learn how to eat intuitively, give yourself permission to eat all foods, and still work in some food strategies (gentle nutrition) to improve the metabolic and physical symptoms of PCOS.
Learning to become an intuitive eater can take some time, especially if you have been dieting for a long time. Getting support can be crucial as you take this journey since you will still be bombarded by diet culture in your everyday life. However, the rewards to making peace with food are immense. You will learn to truly enjoy food, notice how your body adjusts your intake based on what it needs, and feel like you don’t have to spend so much time being worried about what to eat. And this huge reduction in stress alone can help your symptoms of PCOS.
What are the Intuitive Eating Principles?
- Reject the Diet Mentality
- Honor Your Hunger
- Make Peace with Food
- Challenge the Food Police
- Feel Your Fullness
- Discover the Satisfaction Factor
- Cope with Your Feelings Without Using Food
- Respect Your Body
- Exercise: Feel the Difference
- Honor Your Health: Gentle Nutrition
Will I lose weight if I eat intuitively?
When you start to eat intuitively, you will either lose weight, have no weight change, or you may even gain weight. You have to fully nourish your body on a consistent basis before seeing if and how weight is impacted. Your body has a set point that it likes to be at and it is hard to know what your natural weight is before you let your body adjust with intuitive eating. The goal for learning to eat intuitively is not weight loss. The goal is to learn to trust your body to make food decisions without judgement. When you let your body be your guide, you will likely enjoy a large variety of foods and eat enough to satisfy your hunger without letting yourself get too uncomfortably hungry or full.
That sounds great, but what if I still want to lose weight?
It’s okay that you still want to lose weight. Most people can not undo a lifetime of negative thoughts about weight with the “flip of a switch”.
You can still start working on becoming an intuitive eater, even if you haven’t fully embraced it. This is a process, and for many people it’s a long process. Starting to work through the principles will likely benefit you. It’s not another diet where you have follow a set a rules. You can and probably should take baby steps.
As you know, PCOS can impact your whole body including mental health. It affects you throughout your entire life, not just when you are trying to get pregnant. It’s best to think about improving your physical and mental health for the long term. Quick fixes (diets for weight loss) will not serve you in the long run if they are leaving you hungry, tired, bored, and stressed.
As you search online about what you can do to improve your diet and manage your PCOS symptoms, you are likely to encounter the term “nutrition counseling”. Since this is a term that dietitians use to describe our services, I thought I would explain a little more about what nutrition counseling and why you may want to consider it.
A lot of people are understandably nervous to make an appointment with a dietitian. You may think that you will be judged or “yelled at” for what you are doing or not doing. This could be because you’ve had another health professional judge or scold you in the past. You may also think that a dietitian will tell you to give up all of your favorite foods, eat a really low calorie diet, cook all of your foods from scratch, and work out 5 times a week. You also may think that dietitians eat a “perfect diet” with no chips or sugar, that we work out all the time, and/or we’ve never had any health problems before. (This is not true.)
So what does happen in an appointment with a dietitian?
In the first visit we ask a lot of questions and really try to get to know you. We want to know what you eat, but also how you sleep, what your schedule is like, who cooks and shops at home, what is your medical history, what medicines and supplements do you take, and what “diets” have you been on before. We ask about emotions and food, any symptoms or intolerances you feel with food, cravings, how hungry and satisfied you are with food, and what health goals you have. We need to find out a lot about you before we can begin to work on goals to change things. A lot of people say that it feels like they are going to a therapist when they talk to a dietitian, since we really do dive into a lot of aspects of your life when we talk about food.
Follow up appointments for PCOS
After gathering information about you, we can map out a plan for feeling better depending on where are at. I like to do some education about what PCOS is and why you have the symptoms that you do, depending on what your knowledge is. We will talk about strategies that may include modifying what you eat, modifying how you eat, adding in more movement, taking supplements, stopping to take some supplements, improving your sleep, and reducing your stress. We may talk about adding in more food since you are not eating enough. Which strategies we do depends on what your goals are and where you are starting from. We typically will meet every week or every other week for around 5-6 sessions depending on how things are going. It works best to make a few small changes each visit instead of a lot of unsustainable changes from the beginning.
My goal for all clients
No matter what other goals you have for your health, my goal is for you to enjoy eating and eat the foods you love. You may not think this is something you need to work on, but if you are someone who has been on a lot of restrictive diets in the past you may not find much joy from food. Eating and thinking of what to eat may make you feel stressed or guilty. You can have a positive relationship with food again, and making peace with food will make your health improve.
Dietitians are people
Finding the right fit with the right person for you will help you to get the best care. This also goes for therapists and maybe even doctors. Nutrition counseling works when both the client and dietitian are fully engaged and communicate well with each other. We all have different personalities so sometimes you need to find the right person who works best with your personality and is aligned with your health goals.
So if you are a woman with PCOS who wants to decrease your symptoms, end diet cycling, improve fertility, increase your energy levels, and learn to trust your body with food, I may be the dietitian you are looking for. Click on nutrition counseling to contact me to set up a discovery call.
Vitamin D deficiency is relatively common in this country, and some studies suggest that over 60% of people with PCOS could be Vitamin D deficient. Vitamin D is best known for helping your body absorb calcium from food, which is important for keeping bones strong. Vitamin D could also benefit your immune system, keep muscles working well, and may possibly help prevent certain types of cancer, heart disease, and diabetes.
We make vitamin D when our skin is exposed to sunlight during certain times of the year and hours of the day. The problem is that we don’t have much exposure if we live in a northern climate in the winter, if we spend a lot of time indoors, if we have darker skin, and if we use sunscreen. And of course too much exposure to UV light can cause skin cancer. So some of the reasons are vitamin D levels are low could be because we don’t have as much sun exposure as previous generations did.
Vitamin D in Food
Food sources of vitamin D include egg yolks, fatty fish, and fortified milk/dairy, and fortified cereal. The RDA for most people is between 400-800 IU per day, which is hard for most people to get from foods.
Symptoms of Vitamin D Deficiency
Symptoms of deficiency include fatigue, hair loss, bone or muscle pain, depression, and/or frequently getting sick.
What role does vitamin D have in PCOS?
- Supplementing with vitamin D may improve insulin resistance. This is important since insulin resistance and high levels of insulin make PCOS symptoms worse.
- Supplementing with vitamin D may decrease inflammation. Inflammation can increase insulin resistance and increase your risk for heart disease.
- Several studies suggest that supplementing with vitamin D can help improve fertility for women with PCOS.
- Supplementing with vitamin D may help mood, which is important since people with PCOS have a greater risk of depression than the general population.
*** Since people with PCOS are at greater risk for vitamin D deficiency, symptoms for deficiency can be vague, we don’t have a lot of good sources of vitamin D, and there are a lot of potential benefits to getting your vitamin D levels up if you PCOS, you may want to consider supplementing.
If you suspect you have vitamin D deficiency, ask you doctor to test your levels since you may need a prescription strength supplement.
Most people can safely supplement with 1000-2000 IUs per day, though you can talk with your doctor about supplementing in even higher doses if they suspect deficiency. Some multivitamins have 1000 IUs of vitamin D you may want to consider taking (though the pill is big!). Here is the multivitamin I take.
Let me know if you have any other questions about vitamin D and click PCOS nutrition to contact me to talk about nutrition counseling for PCOS.