Voices of PCOS: Kristin’s Story – Living by the Index

September is PCOS Awareness Month. The first story in this week’s Voices of PCOS series comes to us from Kristin, at Once A Mother. Welcome, Kristin!

Living by the Index

A few things to note before reading this post.

1. I am not a doctor. Or a nurse. Or a dietician. I can cook when I have the patience, and bake when the mood inspires, but I wouldn’t say I am any sort of wiz in the kitchen. That being said, I was still able to make this lifestyle change with relative ease.
2. While I do have PCOS, this is not what caused my fertility issues.
3. There are studies that tout the benefits of eating a low Glycemic Index diet when struggling with PCOS. There are others that don’t. You have to be the judge for yourself as to what works best for you and your body.

Now that we have that out of the way…

When I was fourteen, I collapsed while cheerleading at a football game. Severe pain in my abdomen left me hunched over. My brow grew clammy. I was nauseated. Before I knew what hit me, I passed out. I was taken to the hospital where it was discovered that my white blood cell count was way off, which indicated that my body was fighting some sort of an infection. The doctors assumed it was my appendix, and discussed surgery. At the urging of a family friend who was also a surgeon at the hospital, they did an ultrasound.

What they found was that my appendix was just fine, but, to their surprise and mine, at just fourteen years old I had developed a massive cyst on my ovary, and that cyst had just burst.

After that, a lot of things changed in my body. I began struggling with extremely heavy and irregular periods. Keeping my weight down took a lot of work – twice as much, it seemed, as it did for any of my friends. I dealt with sporadic high blood pressure. I was always thirsty, fatigued, and bloated. I would feel sluggish after eating large meals.

Doctors told me that these were symptoms of insulin resistance, and on multiple occasions over the next decade, I was tested for diabetes. In the end, the consensus was that given my history with cysts, and other symptoms, I probably had PCOS, or polycystic ovarian syndrome. I was informed that conception could be difficult in the future, given a prescription for birth control to regulate my cycles, and sent on my merry way.

I really shouldn’t have been all that surprised to get the diagnosis. My mother had irregular periods and struggled to conceive. My sister, who wasn’t diagnosed with PCOS herself until years later, also had irregular and heavier than normal periods. She would go on to suffer multiple miscarriages and struggled with infertility as well. I was too young at the time to give much thought to how any of this was going to affect my ability to have children in the future, but I did notice over the next few years that I was engaged in a constant battle with my weight.

Just to maintain it required hour-long workouts 4 to 5 times a week and constant dieting. Even though I had been told about the cysts on my ovaries, I had no idea that my irregular periods and anovulation could be related in any way to the thickening of my waistline. If I had only known then what I know now about PCOS and insulin resistance, I could have saved myself a lot of trouble, could have eaten far fewer rice cakes, and would have been a great deal happier for it.

Now for a little science from someone who isn’t all that great at explaining scientific things.

Insulin is a hormone produced by the pancreas that is essential in metabolizing carbohydrates and regulating sugar levels in the blood. It causes sugar from your blood (glucose) to be taken into the cells of your body and used for energy. When you are insulin resistant, your body doesn’t allow that glucose to enter the cells, and so rather than converting into energy, the sugar remains in your blood. This inability to properly process carbs and sugars into energy can result in weight gain.

That weight gain puts stress on the other functions of the body, such as menstruation and ovulation that in turn, can affect fertility. Most women with PCOS will tell you, just as I have, that it is twice as hard for them to lose weight and yet losing weight oftentimes is exactly what is necessary to improve the insulin resistance that is causing the weight problem in the first place. Is that discouraging? Don’t let it be.

Yes, PCOS and insulin resistance can feel like a lot to deal with but that doesn’t make them unmanageable. There are solutions. For me, and my body, the solution came in the form of a fairly simple lifestyle change – adopting a low Glycemic Index diet.

For reasons unrelated to PCOS, we had to pursue IVF to conceive after the loss of our first child. Over the course of our first failed IVF cycle, I gained roughly 10 pounds, which I attributed to all of the hormones I was taking. When we started planning out our second cycle, I expressed to the clinic my frustration with the weight gain I had experienced in the first round, and after looking over my records, they suggested that I try a low Glycemic Index diet before undergoing the next transfer. They told me that while studies have been inconclusive about the connection between insulin resistance and the success of IVF, there have been definitive studies linking obesity to poorer outcomes, and my ten-pound weight gain had bumped my BMI from healthy into the overweight range.

I told them that I had been watching what I was eating (remember – lots of rice cakes), and working out regularly and it hadn’t made a bit of difference, so why would a low GI diet be any different? Their answer – it seems to work. Good enough for me.

At first I assumed that eating a low GI diet was equivalent to eating low carb. I quickly learned that this was not the case. The Glycemic Index measures the effects of carbs on blood sugar levels. Certain carbs, like those found in whole wheat spaghetti for example, have a lower Glycemic Index, meaning they are digested more slowly and spend more time in your digestive tract than do things other carbs – like those infamous rice cakes – which, as it turns out, have a high Glycemic Index, and are digested more rapidly, causing spikes to your blood sugar. Over time, those spikes in your blood sugar can result in insulin resistance which can cause obesity.

Eating a low GI diet keeps your blood sugar balanced and reduces that risk. Maybe your eyes are glazing over at all the talk of carbs, and GI, and spikes and blood sugar and you just want to know what this means for you, and how it works. Fair enough.

In simplest terms, if a low GI food is taking longer for your body to digest, that means you feel fuller longer, eat less, and lose weight. When you take excess weight off of your body (many doctor’s suggest to aim for 10%), it alleviates the stress that extra weight was placing on the other functions of your body. When you eat a high GI food, your body burns through it quickly so you feel hungry sooner, eat more, and gain weight. That added weight negatively impacts the other functions of your body.

Unlike other diets requiring you to count carbs and calories, once you become familiar with where your favorite foods fall on the Glycemic Index, living within those boundaries is fairly easy. Low GI foods have a score of 0-54. These should comprise the majority of what you are eating. Medium GI foods (55-70) should only be enjoyed from time to time, and High GI foods (70+) are your danger zone, and should be eaten only on occasion as a special treat. I should mention, however, that eating low GI is not as simple as just eating “healthy.” There are plenty of foods that one would consider “healthy,” such as watermelon and rice cakes, which are actually some of the worst offenders on the GI Index list.

Once I understood what the Glycemic Index was, and how it worked (or at least the basics of how it worked), I found it extremely easy to stay within the foods ranked as having a low or medium Glycemic Index rating. I also learned the importance of label reading (you wouldn’t believe how many seemingly healthy processed foods contain high fructose corn syrup) and being open to new recipes. When I craved something that would be high GI, I would just look for a way to alter the ingredients, like using almond flour rather than white flour in baked goods, and make them at home.

One of the best resources on the web for delicious low GI foods is the website KalynsKitchen.com. Kalyn is the go-to expert when it comes to South Beach Diet friendly recipes and South Beach is a low GI diet. Her recipe for cheese crackers made with almond flour was the first I tried when I was craving something salty and crunchy, and once I whipped them up (with relative ease I might add) I was hooked. () That is what I mean about making this a change in lifestyle, rather than a diet. You can still have the things you want, like cheese crackers, just in a way that doesn’t contribute to insulin resistance.

Just becoming familiar with where foods fall on the Index is more than half the battle. Once you have done that, making food choices comes with ease. For example, I know that if I want a sandwich, I can choose a low GI bread, like dark rye, rather than a high GI bread, like a white Kaiser roll, and not cause my blood sugar to spike. When I crave baked goods and don’t feel like doing the baking myself, I can indulge in a treat of pound cake, which has a low GI, rather than a donut, which has a high GI. Of course it goes without saying that just because something like pound cake has a lower GI than something like a baked potato, you shouldn’t eat pound cake with every meal. As with any diet, you should keep things in moderation and use your brain.

In the 5 weeks leading up to my second IVF transfer I lost twenty pounds. The cycle was a success and the two medium grade embryos that we transferred are now happy, healthy, babbling six-month old twins. Not only that, but it feels as if my change in diet has reset my metabolism altogether. Even when I occasionally indulge in a high GI food, I am able to keep my blood sugar steady. Additionally, the 25 pounds I gained over the course of my twin pregnancy, plus an extra twenty pounds, came off with relative ease in the first month after their birth.

When your body is insulin resistant, it takes a toll on your entire system. Thanks to adopting a low GI lifestyle, I have been able to lose unwanted weight, get my insulin resistance back in check, avoid becoming pre-diabetic, bring my BMI back into the healthy range, and most importantly, increase my chances for IVF success – not to mention avoiding that crash that comes with eating the carbs that my body is just no good at processing.

I would say that was a lifestyle change worth making.

Thank you, Kristin, for this informative, detailed post about managing diet and PCOS. For more information about managing diet and weight while living with PCOS, check out The PCOS Diet Plan.

Stay tuned tomorrow as we hear from Mandie from To Love a Rose and her naturopath approach to managing her PCOS!