Why Don't the Typical Low-Fat Weight-Loss Diets Work?
Approximately 50 to 60 percent of women with PCOS are obese. It has been shown that losing even five percent of their body weight can lead to an improvement in skin, regularity of menstrual cycles, and
decreased insulin levels. However many women with PCOS experience difficulty losing weight, possibly due to high insulin levels, which promotes fat storage. The standard low-fat, high-carbohydrate, weight-loss diet may not be the best approach for women with PCOS. High intakes of carbohydrates, especially refined carbohydrates (e.g., sweets, white bread, white rice, etc.) will quickly turn to sugar and cause elevated levels of insulin. Since high levels of insulin can cause a multitude of problems for women with PCOS, a better diet would be a low-glycemic index diet. This is a diet that includes foods or combinations of foods that do not cause a rapid rise in blood sugar. The low-glycemic diet will be discussed more in detail later in this article.
How Many Carbohydrates Should You Eat a Day?
At this point in time, I am not aware of any studies that provide data as to the recommended level of carbohydrates for a woman with PCOS. Some diets include The Food Pyramid-based diet (55 percent of calories from carbohydrates—but select mainly from whole grains), a diet which is 40 percent carbohydrates (The Zone), or a very strict diet that allows only 20 percent of calories from carbohydrates (Atkins or Protein Power). In my experience, there is no one level that will work for all women. Dr. Walter Futterweit, clinical professor of the Division of Endocrinology of the Mount Sinai School of Medicine, has been working with women with PCOS for 25 years. He suggests that nonobese women with PCOS who get regular periods eat a balanced diet, moderate—not excessive intakes of carbohydrates (approximately 50 percent of calories), and select complex unrefined carbohydrates over refined carbohydrates. An obese insulin-resistant woman should consume a diet that is 40 percent carbohydrates or less, depending upon the degree of insulin resistance. These are only guidelines—the diet should be tailored to fit the individual person. I would suggest starting with a diet that is 40 percent carbohydrates and work your way downward if need be. Some subjective indicators that the diet is "working" are: decreased cravings and increased energy levels. Some objective measures that the diet may be working are: weight loss, decreased insulin levels, regular periods. Clearly, this is an area that needs to be researched.
