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Low GI/GL diet, PCOS and Core

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I went to see the gyn this past week and talked to him about the fact that in the 18 months since I went off BCP, my weight has gone up 40 pounds. I haven't been pigging out (although I wasn't sticking to WW either), but certainly wasn't eating enough calories to put on that weight without something else being a contributing factor.

 

I was diagnosed with PCOS when I was 14 and kept it under control through BCP. Then I took a break from the pill and ended up with a huge weight loss and rarely got a period.

 

The gyn said I really should be doing a low glycemic index diet - he even mentioned Atkins, although he said he didn't recommend Atkins per se. I've done Core before and lost 18 pounds, so I know Core can work - it just works very, very slowly for me. The gyn said I likely have insulin resistance, which is why it is harder to lose in general doing the typical WW diet.

 

From what I've read, Core and GI can work well together, but there are a few things that fit the GI that aren't core - the non-fat SF yogurt is fine for GI, but isn't core. White pasta is fine on GI b/c of the low glycemic load, but it's not core. And a lot of the frozen meals that are a meat serving and a veggie serving would be considered low GI, but not core. And there are some things that are core but not low-GI - potatoes are allowed on core (within limits) but aren't low-GI. So I would really need to take a good look at the core list and find out what should be added or taken away in order to be consistent with the dr's recommendations.

 

I have an appt with the general physician this Friday to discuss the fact that my blood pressure is also up recently. This is also something that happens with the PCOS.

 

Has anyone managed to mesh the two? What sort of adaptations need to be made to the Core list to stay within the bounds of a low GI diet?


SW:233.0 CW:233.0 GW:160

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I have PCOS, but I've only had it for about 3.5 years. I think Core alone is probably fine and that there's no benefit to trying to add more restrictions to your diet. If you work the plan, you probably will see results - and possibly restore ovulation, thus eliminating the need for the Pill unless you're using it for BC.

 

Has your doctor mentioned the possibility of prescribing metformin? I've heard that metformin can restore ovulation and encourage weight loss. It certainly did the former for me, if not the latter.

 

Personally, I think Core+metformin could probably be a winning combination for you. If you wanted, you could exclude the really obviously high-GI foods like potatoes while doing Core. Since Core is moderate/good carb, hopefully you'll lose belly fat that way, and as you know belly fat is a huge contributor to insulin resistance and PCOS. I think for PCOS, Core is probably a better choice than Flex, and that was part of my rationale for choosing it. You might want to ask over at Soulcysters.net if you haven't already. They might know more about potentially mixing GI and Core diets and if it works for PCOS.

 

Also, watch the whole blood pressure thing. You might not actually have high BP; it could be white coat hypertension, in which case you might get pushed into taking meds for no reason. Try monitoring your BP at home and see if it's still high. Also, make sure the doctor's office is using the right size cuff. I don't really know anything about your weight, but I know when my husband goes to the doctor, they sometimes use a cuff that is too small for his arm, and his BP reading is inaccurately high. He has a lot of muscle in his upper arms due to his job. When they switch to the bigger-sized cuff, all of the sudden he has normal BP. Anyway, just a heads-up that sometimes doctors will prescribe meds without taking stuff into account. I know my personal doctor's office is really bad because they are so in it with the drug reps, but I know not all doctors are like that.


Started Core 8/19/08

10% - 11/08/08

Restart 1/1/10 at 177.6

 

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1 Cor. 6:12-20:

All things are lawful for me, but I will not be mastered by ANYTHING! I am bought with a price, and I will start acting like it.

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In some ways the GI thing would be less restrictive (like being able to eat the Yoplait rather than mixing plain yogurt with the jam), in some ways more restrictive (potatoes). I'm going to ask the dr on Friday what he thinks would be best - and I'm definitely going to ask about the metformin. That might just be the boost I need. I know that flex was NOT working for me at all!

 

The BP thing was discovered at my dentist's office, by chance. I had a filling fall out and just happened to be in the same shopping center as the dentist. They took my BP (they do that regularly, I think) and found it to be high. Then at the gyn it was high as well. I work in a school, so I can see the nurse any time and check it when I'm not under the "white coat" stress possibility - but I know my mom has had high BP for several years, so it won't be a huge surprise if I do have it.


SW:233.0 CW:233.0 GW:160

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I can't answer your question, but wanted to let you know that I've been looking into the exact same low GI/Core combination. I was diagnosed with PCOS 9.5 years ago and was initially treated with met, but stopped taking it after just a few months because it was too hard on my tummy. I've had 2 more children since then and gained *ahem* a few more pounds and am now wanting to give met and low GI foods another try. Like you, Core works for me - but it is a painfully slow process. I am getting closer to 40 though and really want to dump the weight before it gets even harder to do so. I'll be making an appt with an endocrinologist in the next week, but I'm sure it'll take awhile before I can actually get in to see him.

 

Anyway, I'd love to hear how you are progressing and what your dr has to say about it all.


~ Pam ~

homeschooling mom to 3 girls

"It's not that some people have willpower and some don't. It's that some people are ready to change and others are not." James Gordon, M.D.

 

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when looking at the Low GI diet, it is really not that different then the Core plan.


Lori

SW 252/CW 217/ GW 150

Short term goal: below 200 lbs

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I have insulin resistance and PCOS. I'm taking Metformin and it does take a little while for your tummy to get used to it. My dr. started me with 1/2 a pill twice/day for a couple of weeks and gradually worked me up to 2 pills/ day (500 mg tablets). When you get ready to start taking those, do NOT eat a salad several hours before or after taking the meds...you'll regret it...believe me! Even after taking it for about 3 years now, sometimes a salad will upset my tummy if I take my meds too close to eating the salad.

 

Core works great along with the Met to help you lose weight. I think you could just work in a little low GI if you want, but I don't think it is really necessary. I originally lost 35 lbs on Core + Met, then went off program and gained it all plus some back. Now I'm at it again and you can see my losses so far.


Penny

 

SW 213.8

CW 186.0 (Total Core loss = -27.8)

GW 150

 

Wife to Eugene :buddysmoo

Mom to Joseph and Jake

 

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Metformin by itself can be very upsetting to your stomach, but if you combine metformin with a controlled carb/GI/Core diet, you will probably not see the level of upset that you would see if you continued to eat high-fat, high-sugar meals.

 

I know this is true for me. If I take metformin with a starchy or high-GI meal, the metformin "punishes" me for this choice, particularly if I don't balance it with protein. For instance, drinking a regular Coke by itself is more likely to result in stomach upset than drinking the same amount of Coke as part of a meal that includes lower-GI choices like chicken and ww pasta.

 

Metformin is (or should be) the first line of therapy for PCOS, along with a change in diet. In the world of PCOS treatment, BCPs are like fad diets and metformin is like WWs, in my opinion. Birth control pills "regulate" your periods, but they only mask the symptoms instead of treating the causes. If the met bothers you, consider trying metformin XR. The extended release version has a much lower symptom profile, restores ovulation better, and I think controls insulin better (thus more weight loss). Both are available in generic form, and in my opinion it is rarely worth the price difference to get the name brand.


Started Core 8/19/08

10% - 11/08/08

Restart 1/1/10 at 177.6

 

weight.png

ttc.png

 

1 Cor. 6:12-20:

All things are lawful for me, but I will not be mastered by ANYTHING! I am bought with a price, and I will start acting like it.

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I saw the GP yesterday and he mentioned Metformin but wanted to run the tests first. So I did thyroid, insulin resistance and cholesterol testing yesterday morning. He also mentioned Atkins as being more in line with PCOS friendly. I asked him about WW and he said that works as well, but limit the amount of carbs you get - rice, potatoes, pasta and I forget the fourth one he said.

 

I really don't like Atkins with the no/low carb thing, so I will try Core again with a couple of modifications per his suggestions. I guess once he gets the test results I'll find out about the metformin. In the meantime, the BCP is being used to regulate things and cut down cancer risk.


SW:233.0 CW:233.0 GW:160

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Your doctor is wise to run labs before he prescribes metformin for you. If your fasting insulin or insulin:glucose ratio is high, then you have IR and metformin will probably help. Also, if you can restore relatively early ovulation with metformin (CD21 at the latest), the medical research suggests that birth control pills don't provide any additional cancer protection. It is the unchecked estrogen of a woman who rarely or never ovulates (thus not producing progesterone cyclically) that puts Cysters at such high risk of certain cancers. But if you're not TTC, I don't really see how BCP could hurt, other than making it harder to lose weight potentially.

 

I think you should give Core a try, but I also think that you should consider following the plan as written IF your doctor is okay with it. If you follow the Core guidelines, you're doing Core. If you don't, you're doing something else that hasn't been tested. I think it will work better if you allow it to work the way it was designed to work - but hey, I'm no doctor, so take me with two aspirin and a grain of salt.

 

In the end, the best weight management plan for you is one you can stick with. No matter what diet you do, if you are losing weight you will probably be improving your PCOS, and that's a good thing. :bcb_up

 

It's tough being a Cyster sometimes, but with hard work, we can overcome it!


Started Core 8/19/08

10% - 11/08/08

Restart 1/1/10 at 177.6

 

weight.png

ttc.png

 

1 Cor. 6:12-20:

All things are lawful for me, but I will not be mastered by ANYTHING! I am bought with a price, and I will start acting like it.

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The nurse called back yesterday but they closed early and I didn't get a chance to talk to him before then. So I'm thinking they got the tests back.

 

The only modification he really sounded like he would suggest was the starch thing. He said to avoid potatoes and rice and pasta and didn't really make allowances for one potato per day, or brown rice or whole wheat pasta. So while Core may allow these things, he may say they aren't really that good if I have IR. Then again...he may say it's OK but not to eat more than XX servings per day/week.


SW:233.0 CW:233.0 GW:160

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He may or may not. It is probably a good idea to avoid potatoes, because they are high GI (almost as high as pure sugar at 96, where glucose/sugar is 100). Or at least eat them at a meal with lots of protein.

 

But an apple (at 38) has roughly the same GI as whole wheat pasta (at 37), and regular white pasta is not much worse (at about 42). Watermelon, by contrast, is at 103! Many fruits are high-GI, but presumably your doctor isn't going to restrict fruits on Core - is he? The fiber and protein content of food mitigates the glycemic impact that foods have on you. Fruits have lots of fiber, and a cup of whole wheat spaghetti has 6g of fiber and 7g of protein.

 

All I'm saying is that I have insulin resistance too (fasting glucose 92, fasting insulin 27, G/I ratio 3.4). I've sort of been there, done that. I've been taking metformin for two and a half years. It normalizes my hormones and makes me ovulate and get a period, regardless of the diet I eat.

 

However, I know that diet is helpful to PCOS. In particular, studies have found that losing weight by any diet helps people with PCOS regulate their hormones. SoulCysters is the premier site online for people with PCOS. Here are some of their research articles about the relation between PCOS and diet.

 

http://www.soulcysters.net/pcos-weightloss-composition-diet-really-might-not-matter-129459/

http://www.soulcysters.net/cutting-calories-via-any-diet-regulates-hormones-women-pcos-29474/

http://www.soulcysters.net/dietary-composition-restoring-reproductive-physiology-overweight-cysters-48856/

http://www.soulcysters.net/first-approach-restore-periods-obese-pcos-patients-may-diet-123257/

 

The best diet for PCOS is a diet you can stick to and lose weight on. If you know you can stick to your modified Core plan as dictated by your doctor, well, you know yourself best. For me, a diet like that would not be sustainable for the long haul, but if it is for you, go for it.

 

Good luck!


Started Core 8/19/08

10% - 11/08/08

Restart 1/1/10 at 177.6

 

weight.png

ttc.png

 

1 Cor. 6:12-20:

All things are lawful for me, but I will not be mastered by ANYTHING! I am bought with a price, and I will start acting like it.

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From what I've heard, you should look at both the GI and the GL of foods - watermelon does indeed have a high GI, but a low GL.

 

His concern was definitely with the carbs. He said people eat way too many carbs, largely because they overestimate their caloric needs and the amount of calories in the portion they are eating. He didn't say anything about fruits at all - just the "big four" - bagels, bread, potatoes and rice.

 

I don't eat a lot of potatoes, even on core maybe 2-3 times per week at most. I like being able to drink skim milk and eat fruits as much as I want. It was the "little rules" that I didn't like about core that made it difficult for me at times - the Yoplait light yogurt counting as 2 points, but FF yogurt mixed with SF jam was odd to me, since yogurt is definitely not a trigger food for me. I never saw why 100 calories of SF/FF yogurt was 2 points, but 100 calories of FF yogurt with SF jam was core. According to the dr, things like yogurt aren't my problem - it's the things like rice and potatoes and pasta that ARE core that make it difficult to lose weight.

 

I guess I can't really do too much until I get back to him so he can tell me what the tests showed.


SW:233.0 CW:233.0 GW:160

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