Fertility Diet, part 4, Keto is the best for PCOS
I Love Keto too!
My great grandfather’s last name is DeCiantis. It is derived from the Italian word “ciancia” meaning “plump”, “round”, or “rotund”. As a surname, it was likely used as a nickname for someone who was round or plump in stature (at least according to the internet). The region in Italy where the DeCiantis hail from is incredibly poor. Some people’s bodies have adapted over time to store more fat as a survival mechanism. Part of my lineage developed this ability. My mother always struggled with her weight. She did not consume a lot of food or large portions of food but she was always struggling. One thing we did eat A LOT of growing up was carbs. When I was young low fat diets were the rage. We can now see how low fat/high carb diets are actually terrible for some people.
It has been highly researched women with PCOS have a metabolic disorder. No one can explain why this is but it’s known that women with this disorder have issues with obesity and insulin resistance. It’s easy for a thin physician to tell a patient to ‘just lose weight’ and point to a study that shows losing weight helps regulate the ovary and the menstrual cycle. Lots of things are easier said than done. Based on my extensive clinical experience, the best and easiest diet for women with any metabolic disorder or PCOS is keto. You will be able to lose weight without trying if that is an issue for you.
Keto is a special type of low carb diet. Carbs just don’t work for your body if you have PCOS. I used to race my motorcycle when I was younger (I know crazy). When I was racing, I would use a different fuel since that makes the engine perform better and faster. Formula 1, NASCAR, etc, doesn’t use the same gas as what you get at your local gas station. If you have PCOS, you are almost like a high performance car and can’t put just anything in your engine. You can power your body from either glucose or ketones. There’s a lot of books out there that go deeper into the science of this. One I recommend by a fertility doctor is this.
Your carbs need to be less than 10% in order for your body to generate ketones and burn fats vs burning glucose. We want our cells to get energy from ketones vs glucose when we have a metabolic issue. For keto, fats need to be 70-80% of your diet with protein being 20-25%. The typical American diet is 65% carbs, so this is a radical adjustment. Most people at first freak out about eating more foods that have cholesterol in them. Cholesterol is not bad for fertility. The precursor to your hormones is cholesterol, which means your body cannot make estrogen, progesterone or testosterone if you don’t have enough cholesterol. If you want to grow 30 eggs during IVF, you need more cholesterol. If you are struggling with infertility, forget about heart disease or cancer at this moment. 100% focus on fertility. Don’t think about how heart disease runs in your family, etc. That’s not your problem now. I always tell patients that someone training for a marathon is eating a radically different diet than someone training for a weightlifting competition. Eat for what your end goal is now, which is fertility, not heart disease. This doesn’t have to be your forever diet (even though there’s a lot of info out there how keto is a heart friendly diet, but I won’t argue that point now).
It’s very difficult to get started with keto since it’s not something most people grew up with. There aren’t restaurants that are well known that are keto focused in NYC. This is the one time I recommend for a few months doing a meal delivery to get familiar with the diet. One company I like that has keto meals is Factor 75. Their portions I find to be a bit small if you are a very active athlete but it’s a great way to see how to get more fat in your diet. Eating keto is also very hard to do all the time. Some people do keto cycling, which is eating keto for 5-6 days, then taking a day or two off but still eating low carb on your break days. I’ve actually seen great results with keto cycling. A cookbook my patients have recommended to me written by a fertility doctor is this.
I wish I could tell you why life is not fair and why some people need to be more vigilant about their diet. It’s not fair that some people can eat crap all day, be surrounded by toxins, not exercise, consume copious amounts of alcohol, and have no health problems. We just have to deal with the cards we’ve been dealt.