I’m poor and fat. Now what?? {Ep 96}

Are you struggling to make peace with food while simultaneously grappling with food scarcity? Is poverty and food insecurity contributing to feelings of deprivation? Listen now for ideas on how to navigate this food peace challenge.

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This episode is brought to you by my online course, Your Step-by-Step Guide to PCOS and Food Peace. Sign up now to get on the waitlist for the next enrollment period in January 2018, and receive my FREE road map: Your First 3 Steps Toward Food Peace with PCOS. You CAN make peace with food even with PCOS and I want to show you how.

Episode’s Key Points:

  • I just got back from BEDA! I had the honor of presenting at the conference, as well as meeting previous Love, Food guests and listeners!!
  • Lack of food access is a real food peace problem! When our body doesn’t have consistent access to food, food gains a lot of power in our lives.
  • Maslow’s Hierarchy of Needs: Only once our basic needs are met (food, shelter, oxygen, etc.) can we can reach higher levels.
  • The Hierarchy of Food Needs by Ellyn Satter: If someone doesn’t have access to food, you can’t work on changing eating patterns to support health.
  • Living in poverty causes oppression, and oppression physically harms our health.
  • PCOS is connected to many health markers that we KNOW are connected to oppression and poverty (high blood pressure, insulin issues, high triglycerides etc). Struggling with both simultaneously exacerbates the problem!
  • Poverty, living in an oppressed body, and experiencing chronic microaggressions sets us up for living in a fight or flight response. This can make conditions like PCOS MUCH worse!
  • Being pushed to diet long-term ALSO causes these negative health outcomes due to increased inflammation.
  • Most people who diet and lose weight with regain that weight in the long run, and most people who regain weight will actually regain more weight than they lost initially. This means that weight loss efforts are actually weight cycling… and weight cycling ALSO contributes to inflammation, high blood pressure, high insulin levels, high triglycerides, etc.
  • PCOS, poverty and discrimination, dieting, and weight cycling ALL contribute to inflammation, high blood pressure, high insulin levels, high triglycerides, etc. in the long term!!
  • You probably aren’t addicted to food… your body is just telling you after years of chronic dieting that you need food!! Make sure you’re eating enough, especially if you’re in a larger body and people are shaming you for your food intake, and that feeling of addiction will likely decrease.
  • Access to healthcare is also a problem here… we need equal access to health for ALL bodies!! 25% of health is determined by behaviors, and 75% of health can be attributed to genetics and the social determinants of health… this means that poor access to healthcare, food, and resources will impact your health negatively. So we need to promote health EQUITY if we want a healthy population!
  • Practice permission and cast aside shame.

Show Notes:

Do you have a complicated relationship with food? I want to help! Send your Dear Food letter to LoveFoodPodcast@gmail.com. 

Click here to leave me a review in iTunes and subscribe. This type of kindness helps the show continue!

Thank you for listening to the Love, Food series.

Inositol

Kimberly Singh, Julie’s resident nutrition grad student {{ also affected by PCOS! }} is back to blogging on PCOS topics. Enjoy!

What is inositol?

Inositol is a natural compound found in plants, animals, and humans. Inositol provides the foundation for inositol phosphates, which have many important roles in your body.

Fun fact: Inositol was once known as vitamin B8. It lost its vitamin status when scientists realized the body makes enough inositol that you do not have to worry about eating it, which is a requirement to be considered a vitamin.

How are inositol and PCOS related?

Research has found something fishy going on with inositol in women with PCOS. The exact occurrence is unknown, but there seems to be an imbalance or deficiency of inositol in women with PCOS. So, it’s no coincidence that some of inositol’s key functions overlap with PCOS symptoms. Women with PCOS are likely to have insulin resistance and ovulatory dysfunction, and inositol is important for promoting healthy insulin-response systems and ovulatory function.

Inositol supplements are insulin sensitizers, making the cells more sensitive to insulin, allowing glucose to enter the cells. This is really important for women with PCOS, who are likely to be insulin resistant and have cells that are not sensitive to insulin, preventing glucose from entering the cells (more on PCOS and insulin here, background on insulin here).

Want to find a way to treat your PCOS without dieting?

Julie can show you how! Get on the wait list here.

It seems like inositol will be a major player in the future of PCOS treatment. Research has already found inositol to also have the following benefits in women with PCOS:

  • Reduce insulin resistance
  • Reduce androgen levels (such as testosterone)
  • Decrease cardiovascular disease risk
  • Increase ovulation frequency
  • Improve oocyte and embryo quality
  • Reduce metabolic syndrome
  • Regulate menstrual cycles
  • Reduce Hemoglobin A1c

Can you get inositol from food?

Yes, but it is difficult to get the correct dose from your food. The benefits of inositol in women with PCOS have been found with inositol supplementation. If you are still interested in foods that contain inositol, some great options are: Brazil nuts, almonds, walnuts, cantaloupe, citrus fruits, bran, oats, beans, and peas.

Are all inositol supplements the same?

NO! I don’t mean to shout, but really, they aren’t!

There are nine different forms of inositol, and two of those nine are most abundant in our bodies. These two inositol superstars are myo-inositol and D-chiro-inositol. Most supplements will contain either one of these or a combination of the two.

The benefits listed above were found with combination of the two forms of inositol in a 40:1 ratio of myo-inositol and D-chiro-inositol.

Which brand of inositol should I take?

Unfortunately, the supplement industry is not well regulated. This means that you have to be careful to use trusted brands. Julie recommends Theralogix Ovasitol inositol powder. This powder has that ideal 40:1 ratio that has been proven to help women with PCOS.

Ovasitol can be ordered in 3 month supplies here. Save $12 by using Julie’s Provider code: 127410. (In the nature of full disclosure, please know this is not an affiliate code so she is not compensated for the referral, rather just an easy way to save money.)

How do I consume inositol powder?

The inositol will be proportioned in individual packets that contain 2,050 mg inositol in the 40:1 ratio. Consume two packets per day by dissolving the powder in a hot or cold liquid. The inositol powder is tasteless and odorless (thankfully).

Are there any side effects?

Research has not found side effects to inositol supplements.

Inositol has an exciting role in the future of PCOS treatment. Inositol is a great option for people who had negative side effects with Metformin. Some research even finds it to have better ovulation and pregnancy outcomes than Metformin.

Let’s continue this conversation in the Facebook PCOS Support Group. Click here to join! Do you take an inositol supplement? What changes, if any, have you noticed?

References

Bizzarri, M., & Carlomagno, G. (2014). Inositol: history of an effective therapy for Polycystic Ovary Syndrome. European Review for Medical and Pharmacological Sciences, 18, 1896-1903.

Clements, R., Jr., & Darnell, B. (1980). Myo-inositol content of common foods: development of a high-myo- inositol diet. American Journal of Clinical Nutrition, 33(9), 1954-1967.

Colazingari, S., Treglia, M., Najjar, R., & Bevilacqua, A. (2013). The combined therapy myo-inositol plus d-chiro-inositol, rather than d-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Archives of Gynecology and Obstetrics, 288(6), 1405-1411. doi:10.1007/s00404-013-2855-3

Hamid, A., Mohamed, A., Madkour, I., & Wail, A. (2015). Inositol versus Metformin administration in polycystic ovary syndrome patients: a case-control study. Evidence Based Women’s Health Journal, 5(3), 93-98.

Kalra, S., Kalra, B., & Sharma, J. (2016). The inositols and polycystic ovary syndrome. Indian Journal of Endocrinology and Metabolism, 20(5), 720. doi:10.4103/2230-8210.189231

Minozzi, M., Nordio, M., & Pajalich, R. (2013). The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. European Review for Medical and Pharmacological Sciences, 17(4), 537-540.

Monastra, G., Unfer, V., Harrath, A. H., & Bizzarri, M. (2016). Combining treatment with myo-inositol andD-chiro-inositol (40:1) is effective in restoring ovary function and metabolic balance in PCOS patients. Gynecological Endocrinology, 33(1), 1-9. doi:10.1080/09513590.2016.1247797

Pintaudi, B., Vieste, G. D., & Bonomo, M. (2016). The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. International Journal of Endocrinology, 1-5. doi:10.1155/2016/9132052

Sortino, M. A., Salomone, S., Carruba, M. O., & Drago, F. (2017). Polycystic Ovary Syndrome: Insights into the Therapeutic Approach with Inositols. Frontiers in Pharmacology, 8. doi:10.3389/fphar.2017.00341

Unfer, V., & Porcaro, G. (2014). Updates on the myo-inositol plus D-chiro-inositol combined therapy in polycystic ovary syndrome. Expert Review of Clinical Pharmacology, 7(5), 623-631. doi:10.1586/17512433.2014.925795

Watson, R. R., & Dokken, B. B. (2015). Glucose intake and utilization in pre-diabetes and diabetes: implications for cardiovascular disease. Amsterdam: Elsevier/Academic Press.

The Nurtured Mama Podcast

Hello there! I was recently on the Nurtured Mama Podcast sharing my story of becoming a mother, growing my family and fielding comments about my body throughout the journey to motherhood.

As an expert in PCOS, food behavior and body image, I also share how I came to specialize in PCOS, why dieting is harmful to women with PCOS and how they can manage their symptoms WITHOUT dieting. Listen here now!

Which PCOS type are you?

Women with PCOS share many similar experiences, yet there is quite a bit of variation among the PCOS experience.

Why do women with PCOS have different symptoms? 

Why is there body diversity among the PCOS community if we all have the same condition? 

Will the same medications help everyone? 

The questions are endless!

Research has demonstrated women with PCOS can be separated in four different categories depending on three basic PCOS symptoms:

  • inconsistent and/or lack of ovulation (oligo/anovulation),
  • increased male sex hormones (hyperandrogenism),
  • and the presence of cysts on ovaries (polycystic ovaries).

Yes, you read that correctly, having cysts on your ovaries is not a requirement to having PCOS. One study identified the following four types of PCOS, and these four types have built the foundation for understanding the general differences between women with PCOS:

Oligo/

anovulation

Hyper-

androgenism

Polycystic

ovaries

Classic polycystic ovary PCOS                X                X              X
Classic non-polycystic ovary PCOS                X                X
Non-classic ovulatory PCOS                X              X
Non-classic mild PCOS                X              X

Since these types of PCOS were identified many researchers examined what other symptoms vary between the types.

Want to find a way to treat your PCOS without dieting?

Get Julie’s FREE PCOS Video Training!

The classic polycystic ovary PCOS is the most prevalent type of PCOS, and, unfortunately, it is associated with the most negative health outcomes. People with this type of PCOS are more likely to experience more severe insulin resistance (more on that here). They are also at an increased risk of having unhealthy lipid panels.

All three types of PCOS that have hyperandrogenism are at an increased risk for developing cardiovascular disease.

There are also hormonal differences between the types. One study found that women with classic polycystic ovary PCOS have higher testosterone levels than the other types.

There have been some studies that compared the body sizes and shapes between the types of women with PCOS. Most studies find that women with the Classic polycystic ovary PCOS are most likely to have larger bodies and carry more weight around the midsection.

Although the research on body diversity and PCOS is super scarce, this is such a great indicator that women with PCOS should not be expected to have a particular body type. I have heard so many people suggest that if there are thin women with PCOS then all women with PCOS should and can be thin. This is false for any population- especially for women with PCOS.

Differentiating between types of PCOS gives me hope for the future of PCOS research. So many people with PCOS feel disappointed with the quality of healthcare of treatment options available.

I hope that by better understanding different PCOS experiences, future treatment options will be more individualized.

Let’s continue this conversation in the Facebook PCOS Support Group. Click here to join! Which type are you? Did that keep you from getting accurately diagnosed?

References

Aziz, M., Sidelmann, J. J., Faber, J., Wissing, M. M., Naver, K. V., Mikkelsen, A., . . .

Skouby, S. O. (2015). Polycystic ovary syndrome: cardiovascular risk factors according to specific phenotypes. Acta Obstetricia et Gynecologica Scandinavica, 94, 1082-1089. doi:10.1111/aogs.12706

Clark, N. M., Podolski, A. J., Brooks, E. D., Chizen, D. R., Pierson, R. A., Lehotay, D. C., &

Lujan, M. E. (2014). Prevalence of Polycystic Ovary Syndrome Phenotypes Using Updated Criteria for Polycystic Ovarian Morphology. Reproductive Sciences, 21(8), 1034-1043. doi:10.1177/1933719114522525

Hayek, S. E., Bitar, L., Hamdar, L. H., Mirza, F. G., & Daoud, G. (2016). Poly Cystic

Ovarian Syndrome: An Updated Overview. Frontiers in Physiology, 7. doi:10.3389/fphys.2016.00124

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). A case–control

observational study of insulin resistance and metabolic syndrome among the

four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. Reproductive Health, 12(1). doi:10.1186/1742-4755-12-7

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2015). Comparison of clinical

and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Archives of Gynecology and Obstetrics, 293(2), 447-456. doi:10.1007/s00404-015-3889-5

Pehlivanov, B., & Orbetzova, M. (2007). Characteristics of different phenotypes of

polycystic ovary syndrome in a Bulgarian population. Gynecological Endocrinology, 23(10), 604-609. doi:10.1080/09513590701536246

Sahmay, S., Atakul, N., Oncul, M., Tuten, A., Aydogan, B., & Seyisoglu, H. (2013).

Serum anti-mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 170(1), 157-161. doi:10.1016/j.ejogrb.2013.05.019

Mental Illness + PCOS

Stigma surrounds mental illness. It prevents people from speaking openly about their mental health, seeking treatment and living their full lives.

This stigma falsely tells the world that mental illness is a secret that should be shamefully swept under the rug. 

In response to society’s stigma around mental health, I would like to quote the great Dr. Brene Brown:

“If you put shame in a Petri dish, it needs three things to grow exponentially: secrecy, silence and judgment. If you put the same amount of shame in a Petri dish and douse it with empathy, it can’t survive.”

There are many parallels between PCOS and mental illness. There’s shame and secrecy around both PCOS and mental illnesses. Both cause people to feel the need to defend the legitimacy of their experiences. So much effort is spent trying to explain your experience you may even begin the question the validity of your own perception. This may also be the case for the many women that experience PCOS and a mental illness.

You may be surprised to learn that mood disorders are very common in people with PCOS. Women with PCOS are likely to experience:

  • Higher likelihood of having anxiety and depression
  • High rates of bipolar disorder
  • Increase likelihood of binge eating and having food cravings
  • Increased rates of disordered eating
  • Problems related to compulsivity, somatization, obsessive compulsiveness, interpersonal sensitivity, and hostility
  • Overlooked diagnosis for depression

Want to find a way to treat your PCOS without dieting? Get Julie’s FREE Road Map: Your First 3 Steps Toward Food Peace with PCOS.

Why do women with PCOS experience increased rates of mood disorders and other mental illnesses? 

The cause is unknown. Many researchers suggest the causes are actual PCOS symptoms. They argue that facing infertility, menstrual irregularities, and other PCOS symptoms may cause psychological disturbances. Other research suggests that the problem is in the hypothalamus-a part of your brain that regulates moods and has a central role in PCOS.

Although the exact cause is unknown, research suggests women with PCOS are more likely to experience some sort of mental illness.

If you have PCOS and suspect you may also experience a mental illness, don’t let the stigma around mental health stop you from getting help. Keep in mind your relationship with food and body may need extra attention.

To help manage my mental health, I try to avoid content that promotes unhealthy relationships with food. I manage my anxiety with meditation, somatic experiencing, guided imageries, listening to music, and lots of self-compassion.

By seeking treatment, voicing our concerns, and openly discussing mental illness, we are fighting back against the stigma.

Let’s continue this conversation in the Facebook PCOS Support Group. Click here to join! Do you experience mental illness? How do you manage it? What’s the toughest part? Connect with others going through the same in our support group.

References

Balen, A. (n.d.). Polycystic Ovary Versus Polycystic Ovary Syndrome. Contemporary 

Endocrinology Polycystic Ovary Syndrome, 37-49. doi:10.1007/978-1-59745-108-6_4

Blay, S. L., Aguiar, J., & Passos, I. C. (2016). Polycystic ovary syndrome and mental

disorders: a systematic review and exploratory meta-analysis. Neuropsychiatric Disease and Treatment, Volume 12, 2895-2903. doi:10.2147/ndt.s91700

Dokras, A. (2012). Mood and anxiety disorders in women with PCOS. Steroids, 77(4),

338-341. doi:10.1016/j.steroids.2011.12.008

Mccook, J. G., Bailey, B. A., Williams, S. L., Anand, S., & Reame, N. E. (2014).

Differential Contributions of Polycystic Ovary Syndrome (PCOS) Manifestations to Psychological Symptoms. The Journal of Behavioral Health Services & Research, 42(3), 383-394. doi:10.1007/s11414-013-9382-7

Morosi, A., & Jeanes, Y. (2017). Food cravings, binge eating and emotional eating

behaviours in overweight and obese women with polycystic ovary syndrome. Proceedings of the Nutrition Society,76(OCE1). doi:10.1017/s0029665117000155

Podfigurna-Stopa, A., Luisi, S., Regini, C., Katulski, K., Centini, G., Meczekalski, B., &

Petraglia, F. (2015). Mood disorders and quality of life in polycystic ovary syndrome. Gynecological Endocrinology, 31(6). doi:10.3109/09513590.2015.1009437

Rassi, A., Veras, A. B., Reis, M. D., Pastore, D. L., Bruno, L. M., Bruno, R. V., . . . Nardi, A.

E. (2010). Prevalence of psychiatric disorders in patients with polycystic ovary syndrome. Comprehensive Psychiatry,51(6), 599-602. doi:10.1016/j.comppsych.2010.02.009