The PCOS Dietitian

When it comes to nutrition for PCOS, I bet many of you think more about macros (carbs, fat, protein) rather than the little guys like micronutrients. I doubt you’ve ever said I need to increase my intake of polyphenols (unless you’re in the mood to drink red wine) But you should start to think about polyphenols because they can play a role in helping you manage your PCOS!. What are polyphenols?... They are naturally occurring compounds found in plants that offer a wide range of health benefits to the body. Studies have shown they can play a role in: 1Improving Insulin resistance 2Decreasing inflammation 3Improving gut health 4Enhancing Immunity, 5Improving cardiovascular health. Polyphenols can improve 3 MAJOR DRIVERS of PCOS! Stay tuned for my post tomorrow on foods and beverages rich in polyphenols. Hint: I bet some of them might surprise you Do you know of any polyphenol rich foods?

Let’s talk mental health and PCOS. May is mental health awareness month. Women with PCOS have an increased incidence of mental health issues, including: Depression Anxiety Binge-eating disorders... Disordered eating So why the increased incidence of mental health disorders? 1The symptoms of PCOS (and feeling like on one is listening or understands you) can obviously cause distress depression and anxiety. 2Being constantly told to restrict foods in your diet and/or weight gain for no reason can cause disordered eating (Not a shocker here) But did you know that having PCOS in itself can actually cause mental health issues? Examples: 3Blood sugar imbalances 4Lower levels of certain neurotransmitters (ie. Serotonin) 5High DHEAS6High insulin levels (there is a link between insulin resistance and anxiety & depression) So it’s not all in your head! It doesn’t mean you are doomed for a life time of mental health issues. There are many things you can do to deal with them. Check out one of my fav books called the PCOS Mood Cure by Dr. Gretchen Kubacky. Stay tuned for a book give away and IG live with her. Don't suffer in silence if you have mental health issues!

Feeling anxious or depressed? Binge eating? It's not all in your head. There is link between PCOS and mental health issues. It’s estimated that up to 60 percent of women with PCOS have at least one mental health concern. May is #MentalHealthAwarenessMonth .... so let's chat about it! The physical symptoms and health risks with PCOS are commonly discussed. However, the psychological ones often remain silent, even though these issues may have a more profound effect on someone’s... life. PCOS comes with an increased prevalence of: Depression: 4x more likely to have Anxiety: 6x more likely to have Binge eat: up to 58% Binge/eating disorders. 15% Disordered eating: 12% This isn’t surprising, as PCOS is a hormone condition, and hormones affect every system in the body, including the brain, which controls mood. In addition, PCOS can generate a tremendous amount of anxiety about appearance, as well as health concerns and overall frustrations with the condition. Stay tuned for another post this week when I talk about PHYSIOLOGICAL reasons why these mental health issues can be occurring. Do this post hit home for you?

Insulin resistance is a hot topic in PCOS. However it can be a little confusing! People often get insulin resistance confused with blood sugar, thinking if your blood sugar is in the normal range, this means you are NOT inulin resistant. If you have normal blood sugar, you can still have insulin resistance (however having elevated blood sugar makes it more likely you’ll have it) Maybe your doctor even checked your fasting insulin levels. But here is where it can get ...more confusing, you can still be insulin resistant EVEN if you have NORMAL insulin levels. . Insulin resistance affects the majority of women with PCOS to varying degrees and is believed to be at the root of PCOS (along with other factors). The exact cause is not known, however there is believed to be an intrinsic insulin resistance unique to PCOS. This is likely compounded by issues including weight gain, inactivity, poor diet, stress, inadequate sleep, etc. It’s hard to know exactly what percentage of women with PCOS are insulin resistant (because there aren’t many good tests for it) and the stats vary from 70 to 95% And there are varying degrees of insulin resistance. A woman who is very overweight - especially with weight in belly area, has great difficulty losing weight and experiences many symptoms of PCOS likely is much more insulin resistant than a lean woman with PCOS who stores a little extra fat in the abdominal area, has irregular periods and some acne. *But lean women can have insulin resistance as well which proves the point that there is an intrinsic insulin resistance in PCOS. In general, the more insulin resistant you are, the greater risk you have for diabetes and heart disease. But the good news is that diet and lifestyle can play a huge role in decreasing insulin resistance Have you been told you are insulin resistant? See more

You’re probably tired of reading about the foods you should supposedly avoid if you have PCOS. But I prefer to take a different approach . think about the foods you should ADD to your diet. Foods that can decrease inflammation, insulin resistant and improve gut health. Insulin resistance is a biggie in PCOS. Studies estimate 75-95% of women with PCOS are insulin resistant. The good news is that following the PCOS plate method (1/2 plate veggies, 1/4 protein, 1/4 high fib...er carb) and some fat ALONG with adding in certain foods can decrease insulin resistance. Some of my favs include: blueberriescinnamon avocado flaxseedslegumes apple cider vinegar fenugreek green tea Which are your favs?

I get emails and DM’s every day from women who are confused, frustrated and overwhelmed from their PCOS. And the conflicting info on the internet makes it worse! After specializing in PCOS for over 15 years, I want to help more of you learn what you can do NOW to manage your PCOS. Nutrition and lifestyle make a huge impact on improving your PCOS. My online course - The PCOS Nutrition & Lifestyle Blueprint is open for enrollment. It’s packed with science-based evidence ...and step by step guidelines on helping you manage your PCOS with nutrition and lifestyle. Participants from my last launch said: You’ve given me a wonderful gift and I’m so grateful I feel empowered for the first time in a long time, feel like I have the knowledge I need to manage my PCOS Why is my program different? In addition to science-based education and practical step by step guidelines --> Small groups where you get all your questions answered. You won’t get lost amongst 100’s of women in a course. And I added something HUGE - a PCOS trainer! You’ll get an 8 week exercise program and exercise coach to keep you on track! (This is an optional bonus) This is my 4th course launch and I keep adding in MORE material for the same price! Learn what your PCOS drivers are and find out exactly what do about them zoom calls where I answer YOUR personal questions access to my private Facebook group where I your questions daily lifetime access to the course. It’s self paced so take your time! Get an 8 week exercise program tailored for YOU from PCOS exercise coach @be.fit_with_Ginny AND weekly check-ins Weight Loss Bonus module Over 200 ideas for PCOS-friendly meals and snacks (including recipes) Over 25 videos, downloads, cheat sheets for lab tests and supplements, and much more! I’d love to have you join me! The link to enroll is below. DM me if you have any questions! EARLY BIRD Pricing ends soon

Are you a little confused about what kind of exercise you should be doing with PCOS? You’re not alone! The internet is filled with conflicting (and often inaccurate info!) Almost as many myths as with nutrition Some of the myths that really drive me nuts are: 1If you have this type of PCOS, do/avoid this type of exercise. First of all, I don’t believe in types and second, you can’t generalize like that... 2Cardio is bad for PCOS. 3HIIT is bad for PCOS. It can be for SOME people, but great for others. Studies show it can have many benefits, especially for insulin resistance 4Heavy weight lifting is bad for PCOS. I’ve seen some of the best results with clients who have increased their weights, but again, it’s not good for everyone. The bottom line is that you need to listen to what works best for YOU. The one thing I will say is that overexercising is not good for anyone especially if you have stress as your main driver. Want more info? Check out the IG live I did with @be.fit_with_PCOS yesterday. Coach Ginny is a certified exercise trainer (who has PCOS) and specializes in training people with PCOS Read the articles I wrote on exercise for PCOS on my blog (link in bio) Saving the best for last - enroll in my 7 week online course: PCOS Nutrition & Lifestyle Blueprint. You can tons of info on exercise (like tons!) AND can get an add on to the program to work with @be.fit_with_pcos as YOUR exercise coach for 8 weeks. Any exercise questions for me or @be.fit_with_pcos

How often have you been told you had to lose weight to manage your PCOS? This puts a tremendous amount of pressure on you. The good news is that exercise - by itself - WITHOUT weight loss can have huge health benefits for PCOS. And this includes all kinds of exercise: walking, weight training, cardio, and yoga. The benefits occur through improving the HPA axis and well as insulin resistance. Benefits include: 1Lowering androgens... 2Improving insulin resistance 3Decreasing stress 4Improving body composition 5Decreasing dangerous visceral belly fat 6Improving mood 7Improving ovulation What is your fav exercise?

What type of PCOS do you have? Maybe you took a quiz and were given some rules for your type of PCOS. Spoiler: I don’t love the word TYPE. It implies your PCOS fits into a neat little box. And I dislike the rules that are associated with your type (the one I hate the most is if you have the inflammatory type, you need to avoid gluten and dairy!) We don’t know exactly what causes PCOS, but we do know their are drivers that can worsen it. Like what’s going on under h...ood of your car And these drivers can change depending on what stage of life you are in or even month to month! I can’t tell you how many women I’ve met who are focusing on the WRONG things to manage their PCOS based on what they read on social media. Like eating too few carbs which causes more stress to their body. Or cutting out food groups unnecessarily. Or being too strict with intermittent fasting. Or exercising too much (or too little in part due to confusion on what to do). Or becoming overly focused on macros and neglecting the "little guys" (micronutrients). But I can help you with this!! The doors to my online course: The PCOS Nutrition & Lifestyle Blueprint open Tues 1/19. You’ll learn about YOUR drivers and find out what to do about it! Find out about my course LINK IN BIO. Drop an emoji with your PCOS drivers (likely more then one!) -Insulin resistance: -Inflammation: -Stress: -Gut microbiome:

Acne, hair loss, hair growth, irregular periods, mood swings? All these PCOS symptoms are due to high levels of androgens. The good news is that decreasing androgens will decrease your symptoms. Here are some sneaky tips to lower androgens with diet and lifestyle. 1All kinds of exercise, but especially weight training, lower androgens. Yup yoga too!... 2Stress mgt is great for lowering adrenal androgens 3Omega 3’s from fatty fish or supplements lower androgens (Source: PMC3941370) 4Almonds & walnuts increase SHBG and decrease testosterone in PCOS (source: Kalgaonkar, et al.) 5Spearmint tea 6Flaxseeds 7Balanced meals to prevent insulin spikes 8Eating more food earlier in the day vs later Now of course everyone has different drivers of PCOS so there is no one size fits all approach and treatment plans needs to be tailored to YOU. I can tailor a plan for you and am now offering mini coaching packages (contact me in link in bio) Which of these do you do?

Having PCOS can be confusing and it can also be confusing to know if your treatment plan is doing anything! Let’s say you working really hard making changes in your nutrition and exercise regimen and taking your supplements diligently. And maybe you’ve also started taking a medication. How do you know if your treatment plan is working? Getting some kind of positive feedback can help keep you motivated. Here are some areas to check (see graphic for details) ... Lab tests Symptoms Health indices Fitness Body fat/lean mass More regular periods/ovulation >How long does it take to see results? It's normal to want QUICK results (like when it comes to weight loss, stopping hair growth/loss or getting regular cycles). But it can actually take 3-6 months for you to notice a difference in these areas. It can also take 3 months to notice a difference in your HbA1c or cholesterol levels. But you see changes in other areas (like mood, energy levels, fasting blood sugar) in a soon as a few days once you've made changes in diet/exercise/sleep/stress mgt. The trick will be to look for small changes occurring in your body. One of the biggest ones I see is less carb cravings and more energy. As your blood sugar starts to get balanced, other hormones balances and more changes occur. And if you don’t notice any changes after a few months then maybe it’s time to try something else. I’m a huge proponent of keeping a journal recording what you eat, sleep, exercise, your energy levels and how you feel (and of course tracking your cycle as well).This helps you get really in tune with your body. Learn how to get improvements in all these areas in my 7 week online course: PCOS Nutrition & Lifestyle Blueprint launching next week. How do you judge your progress?

Tired of the same old snacks? Be bored no more with these snacks packed with ingredients that ADD nutritional benefits for PCOS. 1Kale chips: add protein and Vit B12 with the nutritional yeast 2Roasted chick peas: This high fiber snacks packs in more antioxidants with black pepper and turmeric... 3Protein balls: High fiber, healthy fats and chocolate! 4Chips and dip: Bean chips are fiber rich and have a lower glycemic effect .. and add more healthy fats and fiber with avocado 5Crackers and Spread: These flaxseeds crackers are low carb and high fiber Which is your fav snack?

Last minute PCOS holiday wish list! I wrote today’s post based on two different conversations I had with my clients this week. 1One client could not get her doctor to order simple labs she wanted (like full thyroid profile and DHEAS)... 2And another client was having trouble losing weight and talked to her doctor about it. She told her doctor she worked out 5x/wk (she actually owns a gym!!) and ate very healthy. She was told to put in a little more effort. WTF??? Not doctor bashing as there are some amazing docs out there but please: 1. Don’t make someone’s weight the focus of their treatment plan 2. Take the time to ask someone what their diet and exercise program is like don’t assume it’s not enough without asking. (And too much isn’t good either) Refer to a knowledgable dietitian to help the client if they are interested 3. Order the labs the patient wants 4. I know most docs discuss pros and cons of medications (but not all do) Discuss in detail and give the patient other options if they want. Be open minded to supplements too :) That’s it! Merry Christmas (to those who celebrate it) What do you have on your wish list?

Insulin resistance (IR) is a major driver for most people with PCOS, yet it may be the most confusing one! Here is the problem: *There is NO one accurate test to tell you if you have insulin resistance* This is because your insulin levels vary from hour to hour and day to day. There are some tests and signs/symptoms that suggest you have it though. ... Here are some myths: 1Having normal blood sugar does not mean you are not insulin resistant. They are two different things. High blood sugar (especially HbA1c) suggests IR. But you can have normal blood sugar and still have IR 2While IR tends to occur more in people who are overweight, lean people with PCOS can also have IR. There is something about PCOS that just causes IR regardless of body weight. The statistic range from anywhere 30% to 75% of lean people with PCOS may have some insulin resistance. 3Gaining weight does not cause IR. Even lean people can have it. But weight gain can worsen IR - so losing even 5-10% of your body weight can improve IR 4While a high fasting insulin is highly suggestive of IR, a low fasting insulin does not mean you definitely don't have it. 5You don't need to be on a very low carb diet if you have IR. Some carbs like berries and whole grains actually improve IR..But you should still eat carbs in moderation and combine with protein/fat when possible (and choose healthy types of carbs) 6Metformin is often prescribed for people who have informed resistance. Well it definitely can help with insulin resistance, you do not need to be on this medication. Healthy diet and lifestyle can work wonders for decreasing insulin resistance. And supplements like a inositol is great as well. My online course, The PCOS Nutrition & Lifestyle Blueprint takes a really deep dive into finding our YOUR PCOS drivers, including insulin resistance. You'll learn how to know if you have it and what to do about it. (and a ton more) Make sure you get on the waiting list to learn of early bird pricing. It's launching soon! Any questions for me?

As 2020 comes to an end, I’d like to give a HUGE shoutout to my nutrition interns! You have helped me tremendously and have dealt with my manic behavior of throwing last minute projects at you. You all worked SO well independently in view of the pandemic curve ball. Best of luck to you in your future careers as RDs!! 2020 Nutrition Interns of 2020 at Martha McKittrick Nutrition....... Tedi Nikova @tedinikova wins at the award for recipes, meal graphics, helping a lot with my 30 day PCOS online challenge, recipes for my upcoming PCOS book Nikki Kim wins the award for her canva graphics (rockstar graphics!) google slides, research, and blog posts. Amber Narcisse @ambs_ann wins the award for google slides! She did the majority of slides for my PCOS online course last winter. Wrote some great blog posts and did research Lydia Chen @lydia_h_y wins the award for jack of all trades - canva graphics, lots of research, blog post. Maggie Ozcan wins the award for helping me edit my book, formatting references, doing research and writing a blog post.

Teas are the healthiest beverage for PCOS. The main health-promoting substances in tea are polyphenols, in particular catechins and epicatechins. Numerous studies have shown a variety of teas can fight inflammation, may help decrease risk of heart disease, boost the immune system, have a positive effect on gut microbiome and more. In addition, PCOS is associated with higher levels of oxidative stress. Tea is rich an antioxidants, which help to neutralize free radicals that... come with oxidative stress. Here are some of my fav teas for PCOS along with the health benefits: Green tea: Rich in anti-inflammatory antioxidants and may increase calorie expenditure and reduce body fat. Spearmint tea: Has anti-androgen effects in PCOS and can help reduce hirsutism. Turmeric tea: Turmeric contains curcumin, an active ingredient that has anti-inflammatory properties Cinnamon tea: Cinnamon may reduce insulin resistance. It also is rich in antioxidants. Chamomile tea: Contains an antioxidant called apigenin, which has a calming effect, helping you sleep. Ginger tea: Fights against morning sickness, can be used to treat chronic indigestion and helps to relieve joint pain caused by osteoarthritis. Which are your favorite teas?

The gut microbiome is one of my fav areas of research. We are only at the tip of the iceberg on what we know! Studies are suggesting there is a major connection between the gut microbiome and PCOS. What is the gut microbiome? ... We all have 2-5 pounds of bacteria living in us and on us. These trillions of microorganisms - bacteria, viruses, fungi and other life forms are collectively known as the microbiome. They function as an organ and play a role in many areas of health, including immune system, metabolism and body weight, mental health/mood, heart health, risk of diabetes and metabolic syndrome, allergies nutrient & mineral absorption, and more PCOS & Gut Microbiome Altered gut microbiome in PCOS Less diversity Increased incidence of IBS Alterations in gut permeability Gut microbiome can cause insulin resistance, hyperandrogenism, chronic inflammation, obesity, diabetes and may contribute to the development of PCOS Stay tuned for more posts on the gut microbiome! We need more research in this area