PCOS ebook - How on earth am I supposed to eat cabbage for breakfast???

Hi there, I have just finished my first skim read of your book. It was all sounding ok until I reached the meal plans, and then it spun out of my reach.

I am vegetarian - I just do not see how I could cope only eating vegetables nuts and eggs. I was so hoping this would help me.

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Editor's comments: The PCOS diet e-book has a brief chapter called Advice for Vegetarians (chapter 11.7). The chapter doesn't exactly tell you what to do if you are a vegetarian. But it does raise a few important issues.

A rhetorical question might be: Has a vegetarian diet been effective in controlling your symptoms of PCOS? If not, then we have to examine why not.

A high percentage of women who have PCOS have an exaggerated insulin response to ingestion of carbohydrates. In other words, when the carbohydrate in a meal is consumed, blood sugar rises, which in turn causes insulin production to increase to levels that may be quite high. The insulin gradually returns to normal…or maybe you have another meal before it has a chance to return to normal…and the insulin never or rarely drops back to an optimal level.

The presence of chronically high insulin not only exhausts the pancreas gland (leading to diabetes), it leads to a condition called "insulin resistance". Insulin resistance is thought to be the #1 driver of PCOS. Insulin resistance is discussed in the back of the ebook.

If you are a vegetarian and don't eat meat, fowl, fish, or eggs, what's left? Milk? Soy? The ebook reviews a few problems with milk and soy.

If you don't consume adequate protein with a good balance of all the essential amino acids, the body will get its protein or missing essential amino acids from your muscle mass and other tissues. Not desirable.

Secondly, if you don't consume enough protein, by default you must either consume more fat and/or more carbohydrate. It's not uncommon to see vegetarians eating a lot of cereal grain products and soy products. Not only are they refined foods, they are also laden with carbohydrates.

If you have insulin resistance, consumption of additional carbohydrate is likely to increase weight, increase insulin resistance, reduce fertility, exacerbate other symptoms of PCOS, and possibly make you a "carbohydrate addict".

A carbohydrate addict will unconsciously reach for any food that has a substantial amount of refined carbohydrate, because it will increase blood sugar and temporarily make the person feel better and more energized. Especially favored are those foods with a high "glycemic load" (glycemic load is also reviewed in the e-book). Unfortunately, this is like trying to put out a fire with gasoline.

Vegetables are high in carbohydrates. But an addict does not gravitate towards vegetables because they do not contain refined carbohydrates and thus are not very satisfying.

Is there a solution?

You can explore alternative sources of dietary protein. Protein helps to control appetite and control insulin.

Insects are an excellent source but are not consumed in "advanced" cultures, unfortunately.

Eggs are an excellent source of balanced protein.

Other possibilities are protein powders such as whey or rice protein. There are many other plant-based protein powders as well.

Occasional yogurt is another possibility.

Small fish like sardines are an outstanding source of protein and essential fatty acids. Possibly you could be flexible with your vegetarian principles and consume small fish.

Modest amounts of whole legumes and whole grains would be permissible. However, it's wise to check the glycemic index of the food first. The lower the glycemic index, the better. For example, millet has a relatively high glycemic index and is not recommended.

The recommended diet in the e-book is not intended for vegetarians, but for the average person. You can take the ideas, meal plans and recipes and change them to fit your personal requirements.

The diet is a set of "recommendations", not "commands", based on the best science available. You will have to modify and experiment in order to find out what works best for you. As pointed out in the e-book, there is no "one size fits all" diet for PCOS.

Does anyone else have some ideas?