PCOS Diet Book - Some Questions

by Amelie


I read your book and have some questions before starting to plan my diet:

1. Why we can't eat buckwheat? GI is about 50.
2. Is it possible to eat chia pudding?
3. Is it bad to use cacao powder (without added sugar) as a spice?
4. I'm allergic to eggs, could you please recommend something instead of it to keep my protein balanced?
5. Why tahini is not recommended while sesame seeds is ok?
6. Is it bad to eat amaranth or quinoa bread, or just cook it?

Thank you in advance and good luck! :)

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Some dietary guidelines and thoughts
by: PCOS Editor

Hi Amelie,

Thanks for your excellent questions.

The ebook is a bit out of date in several respects, and no publication is ever totally complete. Over the past year, our thinking is shifting a bit, based on the continual flow of new research.

The diet we described is still generally valid but now I'm thinking it needs more fat and maybe a bit less protein. What stays the same is the need to restrict carbohydrates.

By carbohydrates, I mean:

Total carbs minus fiber = "net carbs".

It's the net carbs that we need to keep track of. The glycemic index is one way to measure the effect of foods on the body. But the glycemic index varies a lot among different foods and thus it's a bit difficult to evaluate the effect of a mix of foods. We're finding that "net carbs" is starting to like a more accurate way to measure the effect of a mix of foods that compose your diet.

In other words, you have a single number as a goal. As an example, in the case of significant insulin resistance and overweight, a daily total of 50 grams of net carbs might be a goal to shoot for. That is, all of your food for the day would ideally total no more than 50 grams of net carbs.

50 grams of net carbohydrates per day is pretty severe. So, perhaps a goal instead would be 100 grams per day. It depends on how serious your PCOS and other diseases are, and how committed you are to following a rigorous diet.

One purpose of such severe net carbohydrate restriction is to help you normalize your insulin function, reduce inflammation, and to move your body into fat-burning mode rather than fat-building mode. This is also referred to as "ketosis", where the body's primary fuel is fat, not carbohydrates.

Let's take buckwheat for example.

Suppose you consume one-half cup of buckwheat. Although this amount of buckwheat has 9 grams of beneficial fiber, it also has 61 grams of net carbohydrates. So if you were to eat half a cup of buckwheat, you would have exceeded your daily limit of 50 grams, and theoretically at least, you would not consume any additional carbohydrates for the day.

I'm not saying buckwheat is unhealthy. Far from it. But you have to put buckwheat into the context of your entire diet for the day.

Regarding chia pudding, the question is: what is in the pudding besides chia seeds? What is the total net carbs? Chia seeds are an excellent food and are low in net carbs.

I'm a strong advocate of unsweetened cacao powder. Personally, I take a tablespoon of cacao nibs and grind them up in a seed grinder to make a powder, which I mix in with my "health breakfast".

While eggs are a very good food, I'm starting to view them a bit more cautiously. Aside from the allergy issue, I'm thinking they may have a slight inflammatory effect. This effect could be offset by other components of the diet. Inflammatory foods in general are undesirable for PCOS.

Well, what would be some substitutes?

I myself am eating fewer eggs. For protein, I generally have some combination of grass-fed beef, fish containing low amounts of mercury (sardines, wild salmon, etc.), occasional tofu, plant protein powder, free-form amino acids, and nuts and seeds. I would like to consume wild game from time to time, but it is hard to find in a typical grocery store.

Grains and legumes have protein but have other issues. One issue is that some of these foods contain "lectins", which are substances that cause an undesirable reaction in the body. A second issue is the massive application of toxic chemicals to most wheat, corn and soy, especially the herbicide RoundUp. Most rice is contaminated with arsenic. A third issue is the amount of net carbs, which can be significant.

An additional consideration is total protein intake. In general, most American consume way too much protein. Most people are sedentary and don't need as much protein as they think. So how much is the optimal amount of protein? I'm still researching that. So I don't want to give you a number just now. Some researchers say a protein serving might be about the size of a pack of cards, or maybe more for those who are physically active.

The dietary emphasis should be high in whole plant foods, high in "good" fats, very moderate protein, and extremely low net carbs.

As for tahini, it's another pretty healthy food. It's handy for dressings and all kinds of uses in the diet. However, what we're trying to do is eat mostly whole foods and minimize processed foods.

Tahini is mildly processed sesame seeds plus some added oil. Peanut butter is mildly processed peanuts. Almond butter is mildly processed almonds. The processed version is very similar to the original food, but there is at least one small distinction. When a seed is ground up and store, the surface area of the seed or nut exposed to the air is vastly increased. This greatly accelerates a process called "oxidation". Rancidity is very advanced oxidation. Oxidized food per se is not healthy.

I like tahini but rarely consume it. But I do take a tablespoon of black sesame seeds and grind them up each day and add them to my food.

If making tahini, the sooner you eat it, the better.

Amaranth and quinoa are interesting foods. Pretty good sources of protein but again, keep an eye on the net carbs.

I think bread is especially problematic for women with PCOS. For best results, I don't recommend any bread or baked goods at all. These foods are generally high in net carbs that are rapidly absorbed into the body and make it more difficult to control your insulin level.

If you feel you must have a grain, it's better to cook a whole grain than make a bread out of it.

In summary, you will have to experiment with your diet and gradually find out what works best for your body in terms of reducing symptoms of polycystic ovary syndrome. I think the biggest issue is finding a diet that is both effective and acceptable to you over the long term. I understand how challenging this can be.

I myself follow a diet very similar to one described in the e-book. In fact, in some ways I'm even more strict. But I have the same desires and weaknesses that other people have. I find that it takes a great deal of discipline and belief to stick to a truly healthy diet when it is restricted in carbs.

If I make a mistake and consume an unhealthy processed food, I don't beat myself up about it. I just try to be very mindful at all times and keep unhealthy behavior at an absolute minimum.

If you have more questions, let us know.

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