PCOS – What is it and how can we train/eat for it?

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As seen on one of our latest Instagram posts, PCOS affects women by causing missed or late periods, cysts in the ovaries and producing higher male hormones. Here we will go further in depth and cover some strategies for PCOS in preventing the risk of developing diabetes, which is a common occurrence when not controlled. We’ll also dive into a client story and how they benefited from working with Myofiber. 

How does PCOS develop?

Genetic factors:

•  family background of type 2 diabetes, hyperandrogenism (excess male hormones), hyperinsulinemia (too much insulin being produced), gestational diabetes (diabetes that occurs to the mother when pregnant) and obesity 
• androgen levels increase (hormone that regulates male characteristics)
•   If androgen levels stay high this can lead to diabetes 

HOW? (A quick scientific explanation)

o   androgens may produce insulin resistance. Insulin is produced by the pancreas to help the body to use sugar from foods as a fuel source

o   If there is insulin resistance the pancreas tries to produce more insulin, yet the body is unable to use it. This is done at the cellular level.

o   the additional insulin produces an excess of male hormones and it’s a back and forth effect.

• luteinizing hormone (LH) increases secretion:
•   hormone that controls menstrual cycle, if LSH is high, there is no ovulation that can occur. This can be confirmed via a blood test.
•  All these hormonal changes can cause increased hair growth, acne, hair loss (noticeable on scalp), and red itchy skin

Personal factors: 

• obesity
• sedentary way of life
• unhealthy eating habits
• oligomenorrhea (late periods each 35 days apart)

Protocols

Nutrition:

Typically, the ideal diet that is outlined includes: 50% low GI carbs, 30% fat, and 20% protein

•  low glycemic diet can help with risk of diabetes AND a lower calorie diet. What is a low glycemic diet? A diet lower in simpler sugars with an emphasis on high fiber foods. The glycemic index is on a scale (0-100) with 100 being pure sugar.
•  the glycemic index food guide suggests eating foods such as heavy mixed grain breads, peas, berries, apple, mango, frozen yoghurt, almond milk, bananas (green, unripe) lentils and much more. https://guidelines.diabetes.ca/docs/patient-resources/glycemic-index-food-guide.pdf
•  It emphasizes to try and avoid foods such as bananas (only when brown overripe), sticky rice, rice milk, bread (whole wheat and white), Rice Krispies cereal and more

Additional diets can be recommended but a low GI (glycemic index) diet is the best place to start. It is easy to get caught up in other diets and they do help but most individuals experiencing PCOS exacerbations tend to not be aware of their food intake. We usually have clients do a 3 day food log to start so that we both get an idea of how the individual is eating typically.

Exercise:

• Minimum of 150 min/wk of cardio based activity
•   Moderate to vigorous intensity (fast heartbeat & breathing heavier)
•   HIIT workouts (should be done in a progressive manner; it is NOT recommended to jump into your standard YouTube HIIT workout or a Crossfit type workout immediately), going for a run/jog, and biking are examples

• Progressive resistance training (PRT) 2 days/wk with 3-12 reps (at a minimum). It may be easy to build muscle mass for women with PCOS due to high levels of male hormones but don’t fret! The key here is that building more muscle mass helps with blood sugar balance and reducing insulin resistance. Things tend to normalize over time. Besides, you also have to eat in a caloric surplus to ‘look like a bodybuilder’
• Balancing and stretching based exercises every day for a total of 2 hours/wk (so maybe 15-20 minutes daily; does not have to be done all at once)
• Yoga would be ideal (from experience we have noticed that individuals with PCOS tend to be more stressed than others and routines like yoga are less intensive which allow for a reduced stress response versus other forms of exercise)

Our client:

With all of our clients we do the following: take an in depth history, determine what their needs are and what their current lifestyle looks like (are they training presently; how are they eating’ do they skip meals; emotional eating etc.). Next, we gather additional information through more intensive questionnaires and look at any available blood work. PCOS is commonly missed as a diagnosis and sometimes the signs and symptoms are mistaken for either being pregnant or anorexic. So a thorough workup is essential. This includes checking both male and female hormone panels and doing fasting glucose tests.

So the above is what our client did. Initially, we started off with light stretching routines mixed with strength training 2-3x a week. Unfortunately this client (we’ll call her Alexa due to privacy reasons) was working a very demanding job and had skipped meals daily, occasionally ate breakfast and when they came home, would order food and ‘junk out’. Red flags are there as you can see so tackling that with alternatives was priority. Here’s what we did: incorporated low glycemic snacks: nuts, berries, various fruits, yogurt, rice cakes etc. (we don’t make recommendations for things people don’t like or don’t have access to).

Next, we had to ensure that this individual was not ordering food daily thus introducing Alexa to meal-planning was key. We went over what meals she should eat 2-3x a day and she began preparing things at the beginning of the week via batch cooking. Unfortunately this only worked for a short while so we had to adapt. We did end up switching to intermittent fasting with an emphasis of controlling food intake within an 8hr eating window along with mostly vegetarian foods (client preference). It did help. However, we can only get so far. Alexa had a knee and hip injury from before that we were working around thus certain forms of cardio were off limits so we had to get her heart rate up through different methods: circuit training, sprints, medium intensity HIIT done on alternative days.

And lastly, sometimes certain supplements do help especially with blood sugar management. We did use a few but will not go into depth here as these supplements are not the focus of the article. It is important to remember that supplements help along with a balanced diet (unless balancing is proven to be difficult). In some cases, targets are much higher for certain nutrients and can not be attained through food. All supplement recommendations that we make are done through appropriate testing and using only evidence based research. In addition, a lot of our clientele are on medication and ensuring that no drug interactions occur is extremely important.