Beat Your PCOS Carb Cravings

One of the biggest complaints I hear from my patients with PCOS is their uncontrollable carb cravings! If bread, pasta or chocolate calls your name, you’re not alone. And once you start in on these foods, it may be hard to stop. There are many reasons for these cravings. Insulin, inadequate sleep, altered appetite hormones, stress are just a few of the causes. The good news is that there are ways to beat your PCOS carb cravings!

Here are some causes of PCOS carb cravings

1. Going too long without eating.This will lead to low blood sugar which will increase the urge to eat carbs. I doubt many of you crave broccoli when you haven’t eaten for 8 hours! My guess is that you would be looking for something starchy or sugary.
2. Consuming too many processed low fiber carbs. Foods such as white rice, white bread, sweets and other sugary foods are low in fiber and have a high glycemic index. Eating high glycemic foods (especially larger portions) can cause a quick spike in blood sugar, followed by a quick drop. This stimulates a spike of insulin, followed by increased hunger and can cause the urge to eat more carbohydrates.
3. Not eating adequate protein at meals. Eating meals that contain only carbohydrate (i.e. a jumbo bagel, big bowl of pasta or frozen yogurt with granola) will cause a rapid rise of blood sugar, followed by a spike of insulin, then a crash of blood sugar. This can exacerbate cravings. Protein helps to slow digestion a bit and keep you feeling full long.
4. Not eating adequate fat at meals.Many of my clients are fat phobic and will go out of their way to avoid eating fat. This isn’t a great idea especially if you have PCOS.  Fat takes a long time to digest, helps to prevent rapid peaks and drops of blood sugar and helps keep you full longer. Keep in mind that fat is high in calories, so be careful not to overindulge if you are watching your weight.
5. Taking your caloric intake too low.When your consume too few calories, your hypothalamus produces extra NPY (neuropeptide Y),  a chemical messenger that encourages you to eat more carbohydrates. In addition, the hypothalamus secretes another chemical called galanin which increases cravings for foods rich in fat and carbs. Take home message: eating too few calories = cravings for high carb foods.
6. Having sweets in your environment can give you “sugar brain”. I call foods that set off more cravings “trigger” foods.  It’s been shown that in certain people, high sugar, high fat foods activate a center in your brain what will cause you to want more of them. Trying to fight this by “being more disciplined” often doesn’t work. You’ll only end up beating yourself up … which can lead to even more eating.    Reference
7. Getting inadequate sleep. Sleep affects hormones that regulate satiety, hunger and how efficiently you burn calories. Too little sleep can lower levels of leptin and raise levels of ghrelin, which can increase hunger for sweet and/or starchy foods.
8. Consuming inadequate carbs,especially if you are an active person. I commonly see my patients with PCOS follow very low carb diets. While it may work out for some people, others feel exhausted. Exercising on a regular basis and not consuming adequate carbs can cause you to have powerful carb cravings as well as low energy levels. This is because carbs are the major fuel used by exercising muscles. Your body likes to keep your energy stores full of energy (called glycogen). If you exercise on a regular basis and don’t eat enough carbs, your body may go into “carb seeking mode” as it tries to replete its glycogen stores. In addition, you will likely find your energy levels plummet.
9. Having high stress levels.High levels of stress can cause chemical imbalances in your body.  Cortisol is produced by the adrenal glands in your body when you are under stress. Cortisol will increase production of a neurotransmitter called neuropeptide Y, which as I previously discussed, can increase cravings for sweet or starchy foods.
10. Triggers: emotions, people, places or certain foods. Some may be obvious (the candy on your co-workers desk, your husbands pint of ice cream) but others may be more subtle. And even certain foods can trigger more carb cravings.
11. Altered hunger hormones. Women with PCOS are often leptin resistant. Leptin resistance can cause hunger and reduced the number of calories you burn. More on this at a later post! But in the meantime, most of the tips I’ve discussed in this blog post may help.
12. Nutritional deficiencies. This one is not “proven” in studies that I’m aware of. Yet, deficiencies of certain nutrients have been shown to be associated with insulin resistance and elevated blood sugar. So it’s possible there is a connection to cravings.

Ways to beat your  PCOS carb cravings

1. Keep a journal to help identify eating triggers. I  find a journal is the most important thing you can do to help you become aware of your triggers. See my previous blog post on journals so you’ll know exactly how to keep it. And once you know what they are, you can come up with a plan.
2. Eat meals at regular intervals. Plan a healthy snack for in between meals. Carry this snack with you if you’ll be on the road.
3. Include a protein source at meals and snacks. Protein sources include: meat, fish, poultry, eggs, nut and nut butters, non GMO soy and dairy products. Note: not all women with PCOS choose to consume dairy – but if you do, the best choices would be organic and fermented like yogurt – especially plain Greek yogurt. And stick to full fat or at least 2%.
4. Don’t be fat phobic. Adding fat to meals can go a long way to keep you feeling full and warding off cravings. Add  olive oil and avocado to your salad, natural peanut butter (which contains protein as well) on your morning toast instead of just jelly and a small handful of nuts with your afternoon snack of fruit.
5. Stick to whole grains and high fiber foods as much as possible. Limit/avoid sugary foods and refined “white” carbs.
6. Don’t take your calories too low! This will only backfire. If you want to have some lower calorie days interspersed in between days that are a bit higher, that’s ok. But going too low on a regular basis can set you up for trouble.
7. Rather than trying to “improve your self-control”, focus more on “reengineering your food environment.” Avoid keeping these tempting foods in your home or office.  Ask your family or significant(s) other to keep them out of the house or buy a flavor you don’t like. If they must be in the house, at least hide them. Avoid the candy on your co-workers desk …. don’t even start!
8. Get adequate sleep! Turn off the computer and tv at least an hour before bed. Ideally try to read before going to sleep. This helps to “shut you down”. Stay tuned for more sleep tips in an upcoming post.
9. Find your personal carb tolerance. This is not a mathematical formula! It means you’ll need to find what works for you. Eating too few carbs may trigger more cravings … yet eating inadequate carbs can also trigger cravings! I don’t recommend going below  2-4 servings of carb rich foods a day (includes fruit and grains) for the majority of women (many women need more). And of course, very active people would need significantly more than this.
   On the other hand, a some women (not many in my opinion!) feel better following a ketogenic diet. While this is not my first choice for PCOS, it works for some women! Just make sure you do it in a healthy way. Read my blog post on how many carbs a day should you eat with PCOS?
10. Find an activity to do that relaxes you or at least takes your mind off stressful thoughts. Try getting a massage, taking a bath, reading a book, taking a walk or going to the gym, taking a yoga class, practicing meditation – or any other pleasurable activity that doesn’t have anything to do with food.
11. Delay the urge. Often times if you distract yourself for even 10 minutes, the urge to eat something sweet can go away. Call a friend (who does not stress you out), go for a quick walk, do a 10 minute meditation exercise.
12. Supplements. I always take a food first approach (as well as behavior/lifestyle!) but supplements may be worth a try if you still can’t tame your PCOS carb cravings. Keep in mind these are only general recommendations. You should always check with your doctor before taking any supplements.
    – Inositol .May have many benefits for PCOS, including improves insulin sensitivity, regulates menstrual cycles, boosts fertility, improves metabolic syndrome and more. Some women report it helps with carb cravings. Read my blog post on Benefits of Inositol for PCOS-Magnesium at bedtime has been reported to significantly improve fasting blood glucose, insulin levels, and insulin resistance. Additionally, magnesium regulates dopamine, a hormone which signals reward and may stimulate action toward a reward. Magnesium may play a role in regulating reward pathways and reducing carb cravings. The majority of people are deficient in magnesium  References: #1
    – Chromium enhances the function of insulin to work more effectively. It has been found to reduce blood glucose and insulin levels. May be helpful for older adults as age-related deficiencies have been reported. A supplement dosage would be 400 mcg or a multivitamin. References: #1       #2
    – Omega-3 fatty acids can help cells better utilize insulin. It also helps reduce leptin levels which are linked to insulin resistance. Leptin is a hormone that signals satiety, but the body can become leptin resistance, leading to energy conservation and weight gain. Supplementation of 1-2 grams per day may help reduce carb cravings. However, supplementation is not necessary if you eat fish 4 or more times a week. Reference 
    – Glucomannan is a soluble fiber extract that can slow down carb absorption and decrease insulin response after a meal by up to 50%. It may help reduce appetite and may therefore help reduce carb cravings. This could be added to smoothies, oatmeal, or mixed with a liquid. Read my blog post on Health Benefits of Glucomannan.

Bottom line

If you experience frequent carb cravings, I’d recommend you play detective! Keep a food journal for at least a week. Record what you eat, the time, how much sleep you got, what you did for exercise along with any emotion you felt before you had the craving.You’ll likely be able to figure out what caused the craving and come up with a solution! 

I’d love to hear about your carb cravings and help you brainstorm ways to beat them!