Insulin Resistance, PCOS, and Fertility
Insulin Resistance is when your body resists the normal action of insulin—the hormone that lets glucose into your cells. Because insulin doesn’t work as efficiently as it should, the amount of glucose in your blood increases. Your body secretes even more insulin. Abnormally high levels of insulin cause inflammation and can lead to weight gain, high blood pressure, diabetes, heart disease and sometimes PCOS. Insulin resistance is more common in people of Asian descent, in Native Americans, Australian Aboriginals and Pacific Islanders. If you are sedentary and a have a diet with too many processed carbs this increases your risk of insulin resistance. Weight gain can also trigger it. (During pregnancy, some insulin resistance is normal due to hormones secreted by the placenta. However, when it becomes severe enough, it can result in gestational diabetes.)
Insulin resistance is common in women with PCOS. Too much insulin can cause growth of cells in the ovary, which can cause the ovaries to grow small cysts. Ovarian cells are in “hyper” mode, and produce excess amounts of both testosterone and estrogen. The extra testosterone causes male characteristics like excessive hair growth and acne. Insulin and hormones also affect the hypothalamus, which secretes more luteinizing hormone in the brain. This in turn, stimulates the ovaries to make even more hormones. And thus begins the vicious cycle of PCOS.
PCOS is a common cause of infertility, so managing it can help you get pregnant. To find out if you have PCOS, your health care provider may check for high levels of hormones including testosterone and luteinizing hormone.
Being overweight increases insulin resistance. That’s why weight loss, a Smart Carb diet as well as exercise, are all keys to breaking the cycle of PCOS—and increasing your chances of becoming pregnant.
What are Smart Carbs?
I talk a lot about “smart carbs” in my book Eating Expectantly! It’s a term I use to describe carbohydrate foods that are digested more slowly. Because they are whole foods or only lightly processed, they also have more nutrients and fiber. The benefits of eating smart carbs include having stable blood sugar and insulin levels, and helping you feel full so you are less likely to overeat. Examples of Smart Carbs (also called “Slow Carbs” or “Quality Carbs”) include:
- Whole grain breads, cereals and pastas: quinoa, wild rice, bulgur wheat, popcorn
- Whole fruits (including dried fruits) and vegetables
- Legumes and starchy vegetables: beans, peas, corn, pumpkin, butternut squash
- Foods containing resistant starch: beans, oatmeal, cooked and cooked pasta
Resistant starch (RS) is the new buzzword to add to your “Smart Carbs” dictionary. That’s because the more resistant starch a food contains, the lower its glycemic index, and the “smarter” it is! Resistant starch is a type of fiber and also a prebiotic. It’s “resistant” to digestion, which give it numerous health benefits—including possibly cutting the risk of colon cancer. Besides the other prebiotic health benefits listed above, foods with RS are more filling—even though they contain fewer calories. RS doesn’t affect the texture or taste like other fibers do, so it can be added to many foods and be “invisible.”
While there is no recommendation in the US or Canada about intakes of resistant starch, in Australia, 20 grams a day is recommended. So—how do you get more resistant starch? You can get more resistant starch by eating more beans, oatmeal, breads containing pieces of whole grains, and slightly unripe bananas. RS is also formed when starchy foods like rice, potatoes and pasta are cooked and then cooled, as potato or pasta salad. Yes—potatoes can be a smart carb! High-amylose corn is also very rich in resistant starch and is found in King Arthur Hi-Maize High Fiber Flour and Hi-Maize Fiber. You can replace ¼ cup (65 ml) of flour in recipes with the flour—which has 20 grams of fiber per cup (250 ml). See www.kingarthurflour.com.
See this post with a lot more information about the Glycemic Index.
Want more information about PCOS and trying to conceive? See my other related posts:
Recommended Resources for PCOS:
- Polycystic Ovary Syndrome Association: PCOSupport.org
- The PCOS Network: pcosnetwork.com
- PCOS at Northwestern University: pcos.northwestern.edu
- Project PCOS: projectPCOS.org
- The PCOS Challenge: pcoschallenge.com