by AmyPlano | Aug 5, 2016 | PCOS and metabolism, PCOS Medications, Weight Loss
If you have PCOS 
, there is a good chance you have heard of the medication metformin. However, what you may not know is why it was prescribed for you in the first place. So much of the advice I give to patients surrounding diet revolves around many of the same reasons and principles why women with PCOS are put on metformin. Therefore, I thought it would be beneficial to discuss the basics of metformin and how it can help with insulin resistance, decreasing your testosterone, improving your chances of ovulation, enhancing fertility and you guessed it – weight loss!
What the heck is metformin?
Metformin is an insulin-sensitizing agent. What this means is metformin makes your body more sensitive to the effects of the hormone insulin. But more about that later!
Metformin comes in tablet form and the dose is gradually increased until the maximum dose required is achieved. Most women with PCOS start at a dose of 500 mg and increase their dose up to 1500 – 2000 mg usually in a 4-6 week span.
Metformin does the following:
- inhibits liver production of glucose
- increases the uptake of glucose by the cells
- decreases oxidation of fatty acids
- decreases the absorption of glucose in the intestines
Note: Metformin is the most commonly prescribed drug for diabetes.
I have PCOS, NOT diabetes? So, why did my GYNO prescribe metformin for ME?!?
Around 70- 80 % of women with PCOS experience what is called Insulin Resistance (IR). If you have IR, your body produces enough insulin, but does not effectively use it. Therefore, your body is not sensitive to the effects of insulin. Your doctor prescribed metformin to help your body respond better to insulin.
Why is insulin SO dang important?
Insulin plays a critical role in metabolism—the way the body uses food for energy. When you eat, the digestive system breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, glucose gets processed into the cells where it is used for energy.
What is Insulin’s Role in Blood Glucose Control?
When blood glucose levels rise after we eat, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to the cells throughout the body.
In a healthy person, these actions help regulate blood glucose to keep insulin levels within a normal range.
But I already told you, my doc told me I am NOT healthy! I have PCOS AND Insulin Resistance SO what does that mean?
When someone has insulin resistance their muscle, fat, and liver cells do not respond properly to insulin. Their bodies cannot easily absorb glucose from the bloodstream. As a result, the body needs higher levels of insulin to help glucose enter cells. Basically the cells, despite the presence of insulin in the bloodstream, don’t function properly and don’t allow the glucose in the blood into the cells.
What Role does Insulin Resistance play in PCOS and Weight Loss ?
Insulin is considered a storage hormone. When insulin levels are high (as they are in most women when they are diagnosed with PCOS), the body goes into storage mode. This means the body stores glucose as body fat instead of using it for fuel.
And guess what? What do you think has one of the biggest affects on raising insulin levels? Carbohydrates – especially the refined types! Eating substantial amounts of processed carbohydrates creates large spikes in insulin levels. For women with PCOS – this is like pouring salt on an open wound. No bueno amiga!
As you know, many women who have PCOS are already overweight and carry a substantial amount of body fat in their belly area. Elevated weight and belly fat can further increase IR. Therefore, it no surprise that women who have PCOS have a hard time losing weight – even if their diet and exercise are “spot on.” Insulin resistance and excess weight creates a vicious cycle of weight gain in women with PCOS. And for some – without metformin – this weight is increasingly difficult to take off.
As if that was not bad enough! IR also increases testosterone levels, disrupts menstrual cycles and decreases a women chance of fertility.
How Does Metformin Benefit Women with PCOS?
Metformin is a super hero in my book for women who have PCOS and IR!
Metformin has been used off label in PCOS to prevent diabetes and increase ovulation through weight loss (1). In a recent randomized controlled trial comparing metformin, oral contraceptive pills (OCPs), and the combination of the two in patients with PCOS without T2D, metformin alone or with OCPs decreased weight and BMI. The median decrease in weight with metformin at 12 months was 3 kg (25th and 75th quartiles; -10.3, 0.6). OCP use was associated with increased weight changes of 1.2 kg (25th and 75th quartiles; -0.8, 3.0), and the combination decreased weight by 1.9 kg (25th and 75th quartiles; -4.9, 0.1). One patient in the metformin group dropped out due to nausea; no other side effects or adverse events were reported (2). Therefore, by using metformin by itself or in conjunction with OCPs, women with PCOS experienced a significant decrease in weight over the course of one year.
Metformin is also likely to delay diabetes onset and has a role in PCOS in those at high risk of diabetes. Boom!
While I do not think it is a miracle drug by any means, I personally have seen many of the positive outcomes I described above in my patients. However, with that being said, these same patients are also strongly adhering to my dietary and exercise advice AND are compliant with taking their metformin. You cannot have one – without the other!
Therefore for many women who have PCOS, taking metformin should be a no brainer due its profound impact on metabolic and reproductive function.
References:
- Nieuwenhuis-Ruifrok AE, Kuchenbecker WK, Hoek A, Middleton P, Norman RJ. Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis. Hum Reprod Update. 2009;15:57-68
- Glintborg D, Altinok ML, Mumm H, Hermann AP, Ravn P, Andersen M. Body composition is improved during 12 months’ treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99:2584-2591.
by AmyPlano | Aug 4, 2016 | PCOS snacks
PCOS Snacks – Parsnip Chips
Hello Y’All!
It’s Thursday and you know what that means? It means it is time to talk PCOS friendly snacks! Last week we talked about my little sweet and salty finds – Trader Joe’s Unsalted Peanut Butter Pretzels. If you missed last week’s posts and you love peanut butter half as much as I do – click here to read what you missed. Those nuggets are amazing! So onward to another PCOS Friendly Snack 🙂
This week I decided to keep the Trader Joe’s theme going. But instead, this week I wanted to share something a bit saltier – or at least tastes saltier! Trader Joe’s Parsnips Chips.
PCOS Friendly Snack – Trader Joes Parsnip Chips
If you don’t already know – I love Trader Joes. Not only is it about 1/8 of a mile from my office – but it right on the way home from Crossfit. The people who work there are also so friggin’ nice! Plus they almost always have samples which a foodie like me loves, loves, loves. I sometimes feel like it sometimes my home away from home. Every time I am in there – I am always on the hunt for different PCOS friendly foods and snacks that taste good. Most days I end up feeling accomplished and happy. Today was a good day 🙂 I found these gems:
Trader Joe’s Parsnip Chips – A great substitute for regular chips, $2.99 for about a 5 ounce bag
I have to say I was not sure what to expect when I bought them. I am generally not disappointed with anything I buy at Trader Joes and these “chips” were no exception. These chips reminded me somewhat of plantain chips – but not AS sweet. Don’t get me wrong they certainly do have a certain level of sweetness to them – but not nearly the same sweet after-flavor of plantain chips. I found the chips super crunchy and thicker than regular potato chips. But let’s see how they stack up nutritionally against their competitor — a standard serving of potato chips.
How Do Parsnip Chips compare with Regular Potato Chips? DO they live up to the PCOS Friendly Snack Hype?
Serving Size
Serving size is about 12 chips. This is pretty similar to regular potato chips in which you get around 15 potato chips per serving which is also the equivalent of 1 ounce of chips. Calorie wise they are slighter lower than the same size serving of potato chips. The parsnip chips have 120 calories per serving while potato chips have about 130 – 170 calories per serving.
Fat Content
The fat between the parsnips chip and regular potato chips is almost even. Both types of chips have about 12 grams per serving. While this is not crazy crazy crazy high – it could cut into a hefty portion of your fat grams for the day.
Carbohydrate Count
The main difference between regular chips and parsnip chips (and the reason I even wanted to talk about them!) is the carbohydrate content. The parsnip chips only have 3 grams of carbohydrates. Yes you heard me correctly – the parsnip chips have 3 grams of carbohydrates per serving while regular chips (depending upon the brand and style) have anywhere from 14 – 25 grams per servings. So in the world of PCOS – that is a BFD (Big Friggin’ Deal – if you were wondering!)
The label for Trader Joe’s Parsnip Chips
Low Salt
The salt content of the parsnip chips are also substantially lower than regular chips. The parsnip chips only have 90 mg of sodium – while most regular chips have anywhere from 150 – 300 mg per serving depending once again on the brand and style. Flavored potato chips often have the most sodium per serving – so beware. You want to stay under 1, 800 mg of sodium for the day.
Overall verdict
The parsnip chips are solid. I would rank them an 8/10. They fit the criteria for a PCOS friendly snack. They are certainly a better choice than regular potato chips for women with PCOS due to their lower carbohydrate count. But they are still fairly high in fat and contain no protein. That does not make them a bad choice – it just means just like any other snack in your diet we must have the proper “budget” left in our daily requirements.
I felt that the serving of 12 was more than enough to fill me up. I think this was due to the high fat content of the chips. If you have more calories left in your snack budget – I might suggest eating them with a couple of tablespoons of hummus or guacamole. I did enjoy them and do feel when consumed in moderation they could be an interesting addition to your PCOS friendly snack arsenal. And remember variety is the spice of life for sure when it comes to snacking.
Have you tried this latest find? What did you think ? Yay or nay? Give us the 411 on your favorite PCOS friendly snacks. I would love to hear what you are munching on! Leave us your thoughts in the comments below.
by AmyPlano | Aug 2, 2016 | Weight Loss
Hello Cysters!
There no denying it – most women who have PCOS are overweight. While we are not entirely sure why this population tends to be more overweight than not – we cannot deny the evidence. The number one reason why people come to see me when they have PCOS is for weight loss. Therefore, I thought it would be helpful to put together my top five tips for losing weight when you have PCOS. I feel like I could go on and on about this topic – but I decided to keep it short and sweet – like me!
1. Become a carbohydrate counter
Most women with PCOS are very sensitive to carbohydrates.
For some cysters, they just look at a food containing carbohydrates and they gain weight! Therefore, rather than count calories – count the amount of carbohydrates you consume on a daily basis. For most women with PCOS a good range is about 85 – 130 grams to support weight loss.
2. Push the Protein for PCOS and Weight Loss
Women with PCOS benefit from consuming lean sources of protein throughout the day. Examples of lean sources of protein include foods such as Greek yogurt, eggs, egg whites, low-fat cheeses, chicken, lean cuts of steak, lean ground beef & turkey, as well as some cuts of pork, white fish and low-sodium deli meats. Protein takes longer to digest and allows women who have PCOS to feel full for a longer period of time. Protein also helps stabilize blood sugar levels in women with PCOS that in turn helps to curb cravings.
3. Don’t shy away from fat
I see too many women who have PCOS and are fat phobic. It drives me nuts! No pun intended. Fat shares many of the same weight loss principles as protein. It delays gastric emptying, stabilizes blood sugar and plays a key role in hormone production. Aim to consume healthy fats such as nuts, seeds, avocados, olive oil, and natural nuts butters. I like to see about 30 – 35 % total daily calories coming from healthy fats to help facilitate weight loss in women with PCOS. Depending on the calorie level you are following this comes out to around 45 – 65 grams of fat per day.
Hip-Hoo-Horray for Fats for Women with PCOS.
4. Establish regular eating patterns
Many women who have PCOS suffer from fluctuations in their blood sugar that can cause them to feel weak, tired, light-headed, and irritable. These symptoms are exacerbated when they skip meals and go long periods of time without eating. Sound like you, cysta?!?
You have likely heard the saying, “Fail to plan, plan to fail.” Do your best to consume a meal or snack every 3 hours. This helps prevents you from becoming hangry (and we don’t want that – do we?) and eating anything that is not nailed down. Take the time to establish regular eating patterns and you will be glad you did. “I am so pissed I planned and prepped my meals and snacks,” said no cyster ever.
5. Rock your veggies
Veggies are chock full of vitamins, minerals, phytonutrients and fiber. There are so many awesome properties of fiber. Fiber helps keep you full, optimizes cholesterol levels and helps control large rises insulin when you eat. Sounds like the trifecta of weight loss!
Aim for about 30 grams of fiber per day. You can consume unlimited amounts of non-starchy vegetables to help meet these requirements. The only vegetables you need to count towards your carbohydrate count are peas, corn, potatoes and the winter squashes. Any other vegetables you can consume in unlimited quantities. So rock those veggies and reap the weight loss benefits of fiber.
I was really struggling to keep it at five key points for you cysters. The tips for women who have PCOS seems infinite in my mind – but I had to choose the one I felt were the most important. I hope you learned something about where to focus your attention when it comes to weight loss and PCOS. While I know it is not easy – I am confident with the right resources you can AND will lose weight. And always remember — you are so much stronger than you think.
Gosh, I know YOU must be chock-full of tips for weight loss. I would love to know what tips you have found helpful for weight loss and PCOS. Please share them with our community in the comments below.
by AmyPlano | Jul 29, 2016 | PCOS Medications, Weight Loss
New PCOS Drug on the Horizon
Wow cysters this is HUGE! Finally some promise on the horizon for treating women with PCOS. A new PCOS drug has just completed a phase 2 clinical trial. And the results seem quite promising! Yay – Hooray!
Will this drug help “cure” PCOS?
While there is no solid consensus for what causes PCOS, we do know there are several trends that exist in this population. One of these trends is that women with PCOS tend to present with higher than normal levels of Luteinizing Hormone (LH) and elevated testosterone levels. It is the “pulse” of these two hormones that is speculated to be responsible for both the absence and abnormalities seen in the menstrual cycles of women with PCOS. This new PCOS drug has the potential to correct these hormonal abnormalities. However, the data is preliminary and much more extensive testing is required. Also due to the fact that PCOS is a syndrome, it is unlikely any single drug would resolve the myriad of symptoms many women with PCOS experience.
When should we expect to see the new PCOS drug on the market?
It is important to note this PCOS drug has just completed the second of three phases of rigorous testing. In the third and final phase, the drug will be tested in a much larger, diverse population of women with PCOS. Currently the stage 2 phase only examined the effects of the drug after 7 days. In order to successfully reach the market, the new PCOS drug will need to under go much more clinical testing. We can likely assume that the investigators will be interested in the long-term effects of this drug as well as whether or not it can be used side-side with the administration of fertility drugs. But it is likely several more years before these studies are complete.
So until then we will continue to know what works best – diet – exercise – sprinkled with a little metformin and ♥
Fingers crossed — 🙂
Here is a link to the article. You can click on the actual trial within the press release to examine the various treatment protocols and study demographics.
by AmyPlano | Jul 28, 2016 | PCOS snacks
PCOS friendly snack of the Week
Happy Thursday Y’All! Today I wanted to share with you my favorite PCOS friendly snack of the week.
So I have been thinking lately — and one of the questions I often get from women who have PCOS is, “What can I snack on?” I thought it would be helpful to provide you with a PCOS friendly snack that checks all the boxes. These might be snacks that I am already recommending – or they might be new finds (you know I heart grocery stores!) I want to introduce to the PCOS community. So onward to the method to my madness!
If you have already worked with me you know that I look at all foods in context of the allowable carbohydrates for the whole day. What that means is – everything works around your daily carbohydrate budget.
So if you have a carbohydrate budget of 120 grams per day (think about it like I am giving you $120 to spend on carbs!) – and you spend 30 grams on each breakfast, lunch and dinner you have used 90 grams of your allowable carbohydrates. This leaves you with 30 grams of carbohydrates to spend on snacks! Yay – hooray! So what count as a PCOS friendly snack? I thought you would never ask!
What is a PCOS Friendly Snack?
Typically I like to see 2-3 snacks per day for women with PCOS. These snacks can range anywhere from 0 – 20 grams of carbohydrates and from 50 – 150 calories. I set the upper limit at around 20 grams of carbohydrates as I want to minimize any excessive spikes in insulin.
So now that you the know the “why” now let me tell you the PCOS friendly snack I am enjoying this week.
Just like everyone I get bored with snacks. So this week when I was in Traders I on the hunt for something different. The Trader Joes Unsalted Peanut Butter Filled Pretzels caught my eye for numerous reasons and of course ended up in my cart! But you may be asking ….
What Makes Trader Joes Peanut Butter Filled Pretzels a PCOS friendly snack ?
Serving Size
First check out the serving size! You get 11 pretzels for 140 calories. That’s not too shabby. Calorie wise this fits my criteria of being > 150 calories. Score!
Baby got fat! And that is a GOOD Thing!
Next – I love the fact that this snack has a decent amount of fat – 8 grams to be exact. I like snacks that have fat (and protein, too!) in them as I find they provide a certain level of fullness many women with PCOS need. When people eat foods that are low in fats – they tend to not be very filling. What this means is that in no time – their stomachs are growling and they are prowling for the next snack. Remember – the goal of snacking is to stabilize blood sugar and help curve hunger. The 8 grams of fat in these little nuggets should definitely help with that!
Low in Carbohydrates
Carbohydrate- wise these pretzels are a score – they only have 14 grams of carbs per 11 pretzels. They also have 2 grams of fiber in them as they are made from wheat flour. This should add to the fat content and contribute to your feeling of fullness when you eat this little suckers.
Push the Protein
While they are not what I would consider a high protein snack (I consider foods with > 8 grams of protein per serving a higher protein snack) – they do have 5 grams of protein. It is no surprise that high-protein snacks, as well as balanced meals, have been linked to increased satiety.
In fact, several studies have suggested that protein-containing snacking have the potential to boost satiety and facilitate weight loss. In a longitudinal study, researchers gave 17 men and women with type 2 diabetes moderately high-protein morning and afternoon snacks (5 g to 12 g of protein) for four weeks, and compared the results with their normal eating habits for four weeks. The subjects who ate the two high-protein snacks lost a modest but significant amount of weight (1 kg) during the four-week period. Researchers noted that the subjects’ weight reduction occurred without making any changes in total energy intake (1).
Therefore, not only are these pretzels delicious – they can help promote weight loss. Did someone say winner-winner chicken dinner!?!
Low in Sodium
Sodium wise – they this PCOS friendly snack is a home run. They only have 80 mg of sodium per serving. I like to keep snacks < 300 mg of sodium whenever possible. We know that many women who have PCOS are pre-disposed to heart disease and hypertension. So in light of that information there is no need to “sodium bomb” anyone! Of note – Trader Joe’s does sell a salted version of these pretzels – but they have about 200 mg more of salt per serving.
Magic in your Mouth
It goes without saying that these pretzels taste amazing. They have just the right amount of peanut butter – not too much and definitely not too little. I have tried both the salted and the non-salted version and I actually prefer this version to the former. Most pretzels all you taste is the salt – not these guys. All you taste is the crunchy goodness – and for only 14 grams of carbs these are a true winner in the PCOS snack bag. They are just SO good!
So I would love to know what YOU are snacking on. Have you tried Trader Joe’s Peanut Butter filled pretzels? If SO what ya’ think? Love or hate? What’s in your snack cabinet? Let us know in the comments below. As you know we can never have too many awesome snacks that are PCOS friendly!
Need other suggestions for PCOS friendly snacks? Check out one of my other blog posts that sure to delight your sweet tooth!
References:
1. Navas-Carretero S, Abete I, Zulet MA, Martinez JA. Chronologically scheduled snacking with high-protein products within the habitual diet in type-2 diabetes patients leads to a fat mass loss: a longitudinal study. Nutr J. 2011;10:74.
