PCOS and Insulin Resistance: How Diet Plays a Key Role by Alice Yang

PCOS and Insulin Resistance: How Diet Plays a Key Role by Alice Yang

It seems that we’re always battling against time. Whether it’s the daily morning rush out the door to work, last minute exam cram, pivotal moments where we wished we had more time with a dying loved one or the ticking of our biological clock to create new life, it can make us feel at the mercy of time. 

The feeling of time passing almost feels the same as a chronic disease that passes by daily. Occasionally we notice its presence just like when the seasons change, or when the sun rises or sets. The symptoms which crop up tells us the disease exists, and what we do about the disease is how we “pass the time” with that condition.

The parallels between time and disease could be applied to most chronic illnesses, but when it comes to Polycystic Ovary Syndrome (PCOS), timing really might be everything.

PCOS Insulin Resistance: Why Does it Happen?

How long PCOS has existed in humans, we’re not sure. Nor are we certain how, why or when it occurs. To be honest, no one has the exact answers, but there are millions of women around the world affected by it. The negative effects on the body ranges from increased risk of diabetes and related cardiovascular diseases, infertility, weight gain or difficulty losing weight, acne, and possibly even facial hair growth, all of which can affect the mental and emotional wellbeing of the woman.

From what we currently know, PCOS seems to have a strong link with insulin resistance, but why is something seemingly isolated to the ovaries linked to insulin which runs throughout the whole body?

Because of the link between insulin and PCOS, metformin, normally used in diabetes (also an insulin related disease), is the first choice when it comes to medication management of the condition. How metformin works exactly, is a bit of a mystery just like PCOS, but we know it works in diabetes where there is an apparent increase of insulin, or lack of sensitivity by the receptors on cells to the effects of insulin.

This apparent increase or lack of sensitivity to insulin also seems to be at play in PCOS. So why is there an excess of insulin? Insulin is normally released in response to glucose (a sugar) which is one of the net products from the food we eat and is required by the body for energy.

The diagram below helps to outline how this process works.

pcos insulin

Just as time in reality is not against us, our bodies are not against us. In fact the body and all the wonderful daily processes that seem to go on in the background are all an incredible effort to keep us alive and functioning. The human body has evolved over time to ensure we have adequate energy stores to survive varying environmental conditions, and thus the invention of fat stores.

PCOS and Diet: How Insulin Contributes to Weight Gain

But these days basic survival is much more accessible to everyone. There are hundreds of apps, websites, or the old school phone to bring freshly cooked food to our door, attaining a source of energy for survival requires much less physical effort.

The body is smart, it knows it can’t predict the future, it can only prepare for the future, even if you’re comfortably relaxing on the couch in a state of “Netflix chill” after a long stressful day, the body’s processes continue and it assesses the environment. It was a stressful day, had very little sleep the night before, no time for lunch today, no time for breakfast this morning, but now there’s time to have a late pizza dinner to make up for the rest of the day.

The pizza has gone in, and the delicious doughy pizza base made from refined flour is easy for our digestive system, no fibrous vegetation to sort through, the glucose is efficiently extracted and sent into the bloodstream to be further processed. Because the refined flour was easily digested, there is suddenly an increased amount of glucose in the body especially considering there was very little food conversion to glucose earlier in the day, other than maybe some glucose from that cup of coffee and a few biscuits.

pcos weight gain

Insulin is called upon and like a manager it starts dictating to different cells to pick up their workload, glucose; this is done in accordance with the orders of the big boss, the brain. But like any work setting, management is often a difficult job.

After a while the cells don’t really care about what insulin has to say. Sometimes the cells haven’t much work to do – when we go through “starvation”, when we don’t have the time to eat, and sometimes there is a sudden spike in the work load, where a lot of glucose needs to be put away. The worker cells eventually get tired and fed up of the extreme up and down, they become insulin resistant.

Meanwhile, the big boss sees that there is still plenty of glucose lying around waiting to be put away, so the big boss increases middle management, more insulin is sent out, but the root of the problem isn’t necessarily the cells, or insulin, but the timing and quantity of glucose coming into the body.

Fat Cells versus Muscle Cells: Why They Matter In PCOS

There are different types of workers – fat cells and muscle cells. All the cells in the body have insulin receptors, as every cell requires energy to function.

Insulin receptors can be thought of as a cell’s work desk. Fat cells can be thought of as having a larger desk compared to muscle cells, so fat cells in general are more receptive to insulin, and therefore can take on more of the glucose workload and store it in the fat department.

This continues to be the case even when muscle cells become less able to receive as much glucose, because their work desks tend to be smaller than that of the fat cells, and is only able to process so much glucose, no matter how much insulin is sent its way to enforce a deadline.

To bring this all back to PCOS, we know insulin resistance is involved in the disease, and other than medication management with metformin or contraceptive hormone pills, there are perhaps lifestyle choices we can make to help us live with PCOS differently, and hopefully in an improved way.

Lifestyle Changes Can Make a Big Difference With PCOS

We can retrain our worker cells to listen to insulin again, and make it an easier job for insulin. Eating foods low in glucose is a start. Consuming foods which slow down the digestive process reducing the chance of having sudden dumps of sugar on our cells. It also provides a steady paced work load for our cells instead, which requires putting food in at regular intervals rather than an all or nothing approach.

Many popular health diets today include the essential element to retraining insulin cells, such as the low glycaemic index diet or paleo diet. Regardless of the labels and abundance of recipes to accompany either diet, ultimately, it’s all about eating more plants and less refined and processed foods.

pcos and diet

Increased vegetable intake, and I don’t mean comforting ones like creamy or crispy potatoes, starchy rice, or sweet corn, but a rainbow of leafy and crisp vegetables. In fact, vegetables need to become a large portion of the daily food intake, with good sources of protein and fats. Vegetables, protein and fat all work together to provide nutrients, while keeping us feeling satiated and give the cells a stable level of sugar to process and use as energy.

It doesn’t have to be a complicated list of what we can and can’t eat. Of course, the portion and proportion is still important, but a simplified concept of simply eating more vegetables, a healthy portion of good protein and fats and little to no sugary foods is crucial if we want to make it a life-long change to our relationship with PCOS.

The Grain Free and Fiber Rich Pizza Base

This is an easy recipe to make even with a busy schedule. It is also an excellent way to hide vegetables in one of children’s favourite dishes. It doesn’t need to be an elimination of your favourite foods just a different way to preparing them.

 grain free pizza

Ingredients: (2 x A4 size pizzas)

5 cups or about ½ of a large cauliflower minced into a fine meal but not a mesh.
4 eggs
1 cup of almond meal
2 tablespoon of nutritional yeast (vegan option) or cheese of choice


Mix all ingredients in a large bowl.
Spread and press mixture onto a baking sheet lined with baking paper, roughly 5mm thick (depends on personal preference).
Bake at 170oC for roughly 10 minutes each sides (depending on the oven) or until slightly golden brown.

This can be made in advance and stored in the freezer.

Hope you enjoy the recipe.

All the best,