How we process carbohydrates is a real challenge
We hear it so often nowadays, carbohydrates are “BAD”, weight-gaining compounds, and there are many fad diets out there that severely limit or entirely eliminate carbohydrates. The truth of it is, carbohydrates are not “BAD”. As a matter of fact, our muscles use carbohydrates as a main energy source and our brains’ and red blood cells’ only energy source are carbohydrates; however, some bodies, such as our PCOS bodies, have a difficult time processing carbohydrates, and for our case, it’s referred to as insulin resistance. This is the reason why in order to keep our PCOS symptoms within a good balance, it’s necessary to eat a lower, not low or zero, carbohydrate diet richer in complex carbohydrates rather than simple carbohydrates. So, what is going on in our bodies and what is insulin resistance for us (we have a special kind)?
What are carbohydrates, and why are they important?
Carbohydrates are amazing compounds and are in the forms of saccharides, simple and complex. They are our bodies’ preferred immediate energy source and are normally very easy for the body to store and utilize. Simple carbohydrates such as glucose, fructose and galactose, are digested very rapidly in the body due to their structure being small (hence simple), and complex carbohydrates such as fructooligosaccharides, glycogen and starch, are digested much more slowly in the body due to their structure being large (hence complex).
Examples of simple carbohydrates:
- Glucose – mainly found in sugar cane, honey, maple syrup, brown sugar
- Fructose – mainly found in fruit
- Lactose – mainly found in dairy products, which is converted to galactose and glucose when digested
Examples of complex carbohydrates:
- Fructooligosaccharides – mainly found in asparagus, artichokes, soy beans
- Starch – mainly found in starchy vegetables such as potatoes, corn, sweet peas, carrots. Also found in whole grains such as oats, barley, buckwheat, amaranth, kamut, millet, brown or wild rice, quinoa (whole grains are crucial to eat due to the abundance of B-vitamins they contain. Most B-vitamins are essential for the conversion of food to energy)
- Glycogen – mainly found in animal products such as meats thus it is found in our bodies as stored energy
When foods or meals are digested rapidly in the body, such as the simple carbohydrates, it rapidly spikes our blood sugar levels leading to:
- too much sugar in our blood stream (we have a fundamental flaw in our insulin receptors’ ability to be sensitive to insulin thus not removing insulin or glucose from our blood stream- AKA insulin resistance)
- inability to control our carbohydrate cravings due to excess sugar, in which makes us crave more sugar
- difficulty with controlling our moods
- difficulty with controlling weight, commonly leading to weight-gain
- lower satiation leading commonly leading to overeating behavior
and over time, with a constant abundant intake of simple carbohydrate foods and meals, this can lead to:
- pre-diabetes and eventually, full-blown Type II Diabetes (which is 100% preventable)
- rapid weight-gain and eventually, obesity
- constant moodiness
- irreversible fatigued pancreas (development of diabetes)
- damage to your kidneys
- dark purplish-brown skin patches underneath armpits, on neck, elbows and other places of our bodies
When foods or meals are digested slowly in the body, such as complex carbohydrates, it leads to a slow increase in our blood sugar levels over time which leads to:
- well-controlled carbohydrate cravings
- ability to control your weight and control what you eat
- higher satiation leading to eating less overall
- more control over your moods
- absence of surges of blood sugar into our blood stream
- reduction of risk of development of Type II Diabetes
Due to the very obvious differences between simple and complex carbohydrates, it’s easy to see that eating a diet balanced with slow-digesting complex carbohydrates is crucial for balancing our PCOS symptoms, however, because many of us struggle with insulin resistance, we need to be intelligent about what foods we pair with carbohydrates to create the slowest digestion possible preventing a rapid blood sugar spike.
What is Insulin Resistance for PCOS bodies?
According to the authors of PubMed Health, insulin resistance is “a condition in which the body produces insulin
but does not use it effectively”. Insulin is a compound that is produced by the pancreas and is pumped out to bind
to glucose (sugars/carbohydrates), when ingested, and shuffle it into the muscles to use as energy and to the liver for storage via insulin receptors. However, most women with PCOS have a fundamental flaw in this process in which the insulin receptors are not sensitive to insulin so when insulin attempts to enter the muscles or liver via the insulin receptor, it doesn’t bind leading to a build up of insulin and glucose in the blood stream. As well as this, it was noted by
Dunaif, that due to this insensitivity of our insulin receptors, known to be caused from serine phosphorylation on the insulin receptor (unique to PCOS – different than the insulin resistance that most people get from very large doses of sugar on a daily basis), it appears to also modulate the activity of androgen biosynthesis from our ovaries; essentially, what this means is that our ovaries are excreting an excess amount of androgens in our blood stream (AKA hyperandrogegism). This fundamental flaw is the main reason why Type II Diabetes can develop from untreated PCOS as well as an excess amount of androgens, and honestly, primarily most of our PCOS symptoms.
Something else to note is a low serum level of SHBG (sex-hormone binding globulin) is commonly found in bodies that are insulin resistant, thus women with PCOS. SHBG is a protein that is synthesized in the liver and its job is to bind the following 3 sex steroids/hormones: estrogen, testosterone and dihydrotestosterone (DHT) (Bell et al., 2013). When there is a low amount of SHBG, there is an excess of all three of these hormones in our blood stream because there isn’t enough SHBG to bind and collect them. This, in turn, leaves all of the excess testosterone (and estrogen!) we are producing from our insulin resistance just floating around in our blood stream. This is WAY TOO much testosterone for a female body to handle. This is why being very attentive to our carbohydrate intake and what foods we pair with carbohydrates is crucial for PCOS balance.
Take home message-Knowledge IS Power
I understand this was a lot of information to take in, however, it is such a foundational piece to understanding and treating PCOS. We have fundamental flaw in the way we process carbohydrates and it is crucial that when you do eat carbohydrates, in which should be every day for their nutrients and energy they provide for our bodies, you choose complex carbohydrates and balance them well with protein and/or fat.
Bell, P. M., Hunter, S. J., McKinley, M. C. & Wallace, I. R. (2013). National Center for Biotechnology Information: Sex hormone binding globulin and insulin resistance. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23121642
Dunaif. A. (1997).Dunaif. A. (1997). National Center for Biotechnology Information: Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. PubMed.gov. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9408743
PubMed Health. (2016). National Center for Biotechnology Information: Insulin Resistance. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023068/