Why Intermittent Fasting Works for PCOS [Podcast] - PCOS Diva
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Why Intermittent Fasting Works for PCOS [Podcast]

PCOS Diva Podcast 137 - Intermittent Fasting“I know sometimes it feels like your willpower is weak. But your willpower is not weak, there’s absolutely nothing wrong with you as a person. Hormonally, food has a big impact. So, when you eat and what you eat has a huge impact on how you feel and what food choices you make.” – Dr. Nadia Pateguana

Intermittent fasting or time-restricted eating (TRE) is not a fad. It is a way of eating that has existed for millennia. Is it right for women with PCOS? Dr. Nadia Pateguana explains why it may be the best option for women with PCOS who wish to lose weight and/or balance their hormones. What are the benefits? What are the risks? Listen in (or read the transcript) as we discuss:

  • Intermittent fasting and PCOS
  • The optimal diet for PCOS
  • Fasting periods- why fasting longer isn’t necessarily better
  • Is it safe to fast with a history of disordered eating?
  • The role of healthy fat and how to incorporate it into our diet

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Mentioned in this podcast:

Complete Transcript:

Amy:

I get a lot of questions from PCOS Divas about intermittent fasting and PCOS, so I thought I would go to one of the experts on that subject. She’s just written a new book, The PCOS Plan, with the author of The Obesity Code. You might have heard this doctor’s name, Dr. Jason Fung. And I am going to be talking to Dr. Nadia Pateguana today about intermittent fasting and PCOS. So happy to have you on the podcast, Dr. Nadia.

Dr. Nadia Pateguana:

Thank you, Amy.

Amy:

So she is a naturopathic doctor and fasting coach for The Fasting Method Program. She’s also a speaker and the author, as I had mentioned, of The PCOS Plan book with Dr. Jason Fung. Nadia has over 15 years of experience helping clients with metabolic syndrome and specifically women with PCOS and fertility concerns through dietary modifications. So you’re really a great person to talk about this topic. Thanks for being here.

Dr. Nadia Pateguana:

Well, thank you, Amy. As I said, it’s an absolute pleasure to be on your podcast and to speak to your audience in particular.

Amy:

So, I think that your story … You start your book off with your personal story and I thought it was very powerful. And I’d love for you to share that with our listeners and how it led you to ultimately writing this book.

Dr. Nadia Pateguana:

Okay, I will. So hopefully I won’t go off for too long on a tangent. If I do, just help me along. Okay, Amy?

Amy:

Okay.

Dr. Nadia Pateguana:

All right. So as you correctly stated, I am a naturopathic doctor by training. I went to school in Canada. I was raised in Canada, that’s where the Jason Fung connection comes from. So, I was trained in Canada as a naturopath. Before that, I did an Honors biology degree. And I decided to go into naturopathic medicine even though initially I wanted to go into medical school and become a conventional medical doctor just because I was slightly dissatisfied with a few things, my own health care, and I thought that naturopathic medicine would be a better complementary medicine approach. And when I graduated from the naturopathic college in 2004, I knew that I wanted to actually work in Mozambique, which is where I’m originally from. So I’m from Mozambique, which is a country in Southeast Africa. It’s a Portuguese speaking country because it was a former Portuguese colony. So that’s where, actually, my career began.

And when I went to Mozambique, I thought I would work in the impoverished communities. I wanted to work in maternal healthcare with mothers and children and possibly nutrition and traditional medicine. And I thought somehow I would learn and bring a little bit of my naturopathic medicine into that. However, that was not available to me. I tried very hard. I was a young person, I was only 25 years old, and I tried very hard for about six months to get into the Ministry of Health and whatnot. At the very end of the road, I met with the minister of health himself who told me that was not available to me. However, he advised that I open a weight loss clinic in the capital of Mozambique, which is where I’m originally from. It’s a very busy city. It’s a city full of people, full of highly educated people. People traveled, world traveled. And he thought this is something that I would do very well at. And I was shocked because I was not prepared for helping people with weight loss but he thought I was. And he thought I should open the very first weight loss clinic in Maputo because he believed that it was a concern, and he was right.

I opened the clinic having very little training, but I was willing to learn, I wanted to work, and I wanted to stay in Mozambique. And as I opened up this clinic, I was shocked to find out that I had a line out the door in just a few months. I became very well-known because I was the only person helping people with weight loss. So what did I know at the time? I had very good medical background, so I knew what people, what their health concerns were and now I knew that they were looking for lifestyle management.

I started working with medical doctors very, very quickly. So it did become a very nice, complementary medicine setting where I had a lot of referrals. And so I started learning, and people, as I often say, in Mozambique were wonderful quote, unquote guinea pigs. They’re very patient, they were willing to learn with me and I learned a ton with them. So I started, first and foremost, sort of trying to create and modify a real food type of dietary approach for people. People that came to see me were mostly, as I said, overweight. People with diabetes very often, and a lot of health concerns or fears like heart disease and things like that, cancer.

And so, you might wonder, how do people in Africa have such a great worry with obesity? And really I talk about this a lot because if you travel all over the world, you will see that there is an epidemic. Right? Obesity epidemic, it’s not a North American problem. It’s not a developed world kind of problem. It’s all over the world and Mozambique, unfortunately, has been hit by this as well. So, likely because a lot of processed food consumption as well as globalization. The idea of the standard American diet sort of having been inherited all over the world. People are just eating a lot of junk and very often.

So, I didn’t know this back then. There was really no connection for me back then. I just knew that people wanted help and they wanted me to help them along. So I started creating these quote, unquote detoxes and real food type of diets, which were lower in carb but eventually became much lower in carb and eventually became known as a low-carb diet.

Somewhere along the line in those very first years, I started to stumble upon the fact that people were reporting fertility improvement. Or women who had tried fertility treatments in the past or had been struggling to get pregnant were reporting to me that after starting my diet, within a couple of months their cycles were getting more regular and they were successful in getting pregnant. And this became very common and I developed this reputation for helping people with fertility concerns. And I have to be honest with you, Amy, I had no idea why this was happening. Of course, a lot of us believed the weight loss helps and the detox, elimination sort of cleansing maybe was helping. I had some very unbelievable type cases. Like people had been trying, or had fertility issues 13 years ago, had adopted a child seven years back, and all of the sudden was pregnant, did have a miscarriage, and got pregnant again within a couple of months. Things like this. Like, this was happening quite a bit and it was very evident that it had something to do with the change in lifestyle.

And so, at the time, I didn’t really know what the connection was. I had heard of PCOS, but again, it wasn’t what I was treating people for. I was treating people for obesity and diabetes mostly. And then, as life would have it, and as I say, I’m a huge believer in karma, I was diagnosed with PCOS myself at some point when I started trying to get pregnant.

My husband and I had been trying to get pregnant for over a year and I started to realize that I was expressing some hormonal concerns. I had gotten off the pill for just over a year, like I said, maybe a year and a bit, and I started to develop all of these symptoms that I had as a teenager and the reason why I got put on the pill at such an early age to begin with. So, a lot of acne, I started to get a lot of hair loss, male pattern baldness in the crown of my head, and I did start to gain weight around my midsection. Now, I was and still am a very lean individual, very thin person. I probably weighed, when I got to Mozambique at the age of 25, I probably weighed about 94, 96 pounds. I was a very, very small person and I still am. However, I started to gain and I gained an abnormal amount of weight around my midsection in those first few months that I was trying to conceive.

So anyway, at some point, I put all of this together. I did go and see a gynecologist and I was diagnosed with PCOS. I had polycystic ovaries, I had the expression of male hormones, and of course, I had the irregular cycles and I wasn’t ovulating. Unfortunately, I wasn’t given any sort of lifestyle management or treatment. I was put on Clomid, which I’m sure you know and your listeners know, is a fertility medicine. And so I went home with this information that I had and I sort of decided to put together what I had learned in the past through my clients and I decided to put myself on this strict, low-carb diet because I thought I didn’t know exactly why it was helping, I knew it had helped other women and so I thought it would help me. And of course, in a month, month and a half, I started to ovulate and I got pregnant right away with my first child.

So that was nine years ago. So that’s how my story, my professional life and my personal life collided and how I probably got to where I am today.

Amy:

Oh, well yeah. So thanks for sharing that. When I was reading it, I was really surprised that you actually ended up having PCOS. I didn’t think that’s where the story was going to go and now you have these two beautiful girls. So, congratulations.

Dr. Nadia Pateguana:

Thank you.

Amy:

And you’ve done such a good job in your book about really explaining what is PCOS and you talk a lot about the optimal diet for PCOS. And maybe you could tell us a little bit more about that diet that you have refined by working with women and weight loss and fertility issues over the years.

Dr. Nadia Pateguana:

Absolutely. I’m happy that you thought we’d defined PCOS very well. In our book, we talk about not only what is PCOS, but also how PCOS is currently being treated and how PCOS should actually be treated. So the one thing that we know about PCOS … And I’m sure your listeners know what PCOS is because this is the audience that we’re speaking specifically to. But for those that don’t, PCOS is the most common endocrine condition in women in their reproductive years, so pre-menopause. Not only is it very, very common, it’s very, very serious but it is highly disregarded. Because it’s like, “Oh, you have PCOS. No big deal, billions of other women have it,” kind of thing. “You’ll be fine.” And then the treatment for PCOS, currently, the conventional treatment for PCOS is symptomatic. Meaning, you’ll be given a whole bunch of drugs depending on what you are expressing or complaining quote, unquote of.

So, if you have acne, you’re given certain medication. If you have other expressions of male hormones, you’re given one of a couple medications. If your cycles are irregular, you’re put on the pill. If you’re trying to get pregnant, then you’re given fertility treatments. And if you have any of the associated serious medical concerns, which I had, like diabetes and hypertension, then you’re given medication for that too. And there’s often a connection to anxiety and depression, so you’re given medication for that as well, just like I was. And so on and so forth. And pretty soon you’re on a million medications for a million different things, yet the root cause of PCOS is not being addressed.

So, we highly believe, and there’s scientific evidence to show, that the one thing that all PCOS women have in common is higher incidents of insulin resistance.

Amy:

I’d love for you to talk about that just for a minute. I hear from a lot of women that go and have their A1C levels done, and they’re normal. And their doctor tells them, “You don’t have insulin resistance.” But it’s been my thought, after working also with women with PCOS now for 10 years, I do think that really, every woman with PCOS, if she’s got an accurate diagnosis, has some level of insulin resistance. So that’s interesting that you are kind of leaning that way as well.

Dr. Nadia Pateguana:

Absolutely. And A1C is not a measure of insulin resistance, it’s a measure of diabetes. Right? It’s a diagnosis.

Amy:

Yeah, yeah. Or they have other markers taken and doctors say, “No, you don’t have insulin resistance. You don’t really have to worry about your diet as much.”

Dr. Nadia Pateguana:

Right.

Amy:

And I just think that if you’ve been told that, you have to maybe think about that again in a different light.

Dr. Nadia Pateguana:

I agree. I completely agree with you. And I also agree that insulin resistance … Here’s my medical disclaimer. Okay, I cannot give medical advice, Amy. Even though I was trained as a naturopath, I no longer work as a naturopath. I work as a dietary coach. So I hope to put out some information and to sort of do my best in helping your listeners to become better informed and to take more control over their health. However, I can’t say this is how you diagnose something or not. However, I completely agree with what you’re saying and I think that one of the biggest issues is that insulin resistance is not well diagnosed.

So, if you Google this, if you look this up, the way to diagnose insulin resistance is very different than to diagnose diabetes. Because even though diabetes is an insulin-resistant condition, not all insulin resistant people will have diabetes. I did eventually develop diabetes and, as you know, many women with PCOS eventually develop diabetes or prediabetes and that’s because they have the same root cause. So it’s probably a good idea, and reluctantly enough within the low-carb community, there are numerous doctors that talk about insulin resistance. So I would highly encourage women with PCOS to research insulin resistance and find out what it actually is.

And then whether or not you have the opportunity to get tested for insulin resistance and get diagnosed, please note that in the medical literature … And this is something I don’t know how many of your listeners like to look this stuff up, but I do. I have actually done some reviews, one review in particular for the journal of insulin resistance, called The Contribution of Hyperinsulinemia to The Hyperandrogenism of Polycystic Ovary Syndrome. So just to make that very clear, how much does insulin play a role in the expressions of PCOS? And if you go through the review, and if you go through the studies, the actual scientific studies, the evidence is there. So what they do is, they take a whole bunch of women, some with PCOS and some without, and then they compare them for insulin resistance. And it’s shown clearly that PCOS women in comparison to what they call quote, unquote normal women if they take into account weight and everything else, PCOS women have a higher degree of insulin resistance.

Insulin resistance, again, I highly encourage people to look this up and what it means, because insulin resistance is the root cause to many concerns including PCOS, obesity, diabetes, certain types of cancer, and heart disease, and probably many other things that we’re finding out later, like Alzheimer’s, et cetera. So it’s highly important that we become more aware of what insulin resistance actually is so that we can then figure out how to treat these conditions.

Amy:

And they are treatable, that’s the good news, and intermittent fasting is one of the ways that we can do that.

Dr. Nadia Pateguana:

Absolutely. And I really hope that as somber as I sometimes might sound when I start talking about how serious PCOS is … And the only reason why I want it to be highly known that PCOS is a serious condition is because I want it to be correctly treated. I don’t want women to be disregarded that have PCOS and very often they are, just like I was. I think it’s mismanaged and highly disregarded and very often women are told things that might not actually be true about themselves or about their condition. And so I think it’s important that we become empowered and I actually hope that even though our book, I think, is very clear in explaining these things, it is a message, I think, of hope and support. It’s not somber at all, it’s actually very hopeful because, as you said, it is treatable and it is very quote, unquote simple if you know what you’re dealing with and how to deal with it.

Amy:

Yeah. So, let’s dig into the treatment. What are you, at this point, advising your … And I know everybody’s a bio-individual and everybody’s situation is different, but just some general parameters that you could give us.

Dr. Nadia Pateguana:

Absolutely, my pleasure. So now that we’ve talked about this, insulin resistance … And it’s clear that I believe and Dr. Fung believes and the science shows that PCOS is linked to insulin resistance. So now that we know that, as Dr. Fung would say … And for those of you that don’t know Jason Fung, he’s a very direct, very bright, and not afraid to speak his mind type of individual. And he’s written many books, not just the one that we wrote together. But he has one simple and clear message, if the problem is insulin, then the solution is to lower insulin and there is not medicine to lower insulin but there is a lifestyle. There are lifestyle tools to lower insulin. So there’s two in particular and really they’re not independent, they’re connected. One is to look at how you eat, and I’ll talk a little bit about that, and the other one is to look at what you eat.

So, when I talk about how you eat, I’m specifically talking about how often you eat and what time you eat. These are two important things. When I talk about how often you eat, I’m talking about what’s called time-restricted eating or in very simple terms having full, rich, satiating meals, not snacking all day long. So this, I know for many people, is going to be the complete opposite of what you’ve been hearing probably from everything that you read including treatment books and websites and things claiming to help PCOS, small meals or small snacks many times a day, low-fat type of diets. This has been conventional quote, unquote wisdom for over 50 years where people with obesity and PCOS and diabetes have been told to eat small meals many times a day. In fact, this couldn’t be further from the truth. Because if you have insulin resistance or hyperinsulinemia, which is higher levels of insulin, which again, I believe that most of these people, if not all of these people do have, then the more often you eat, regardless of what you eat, the higher your insulin levels are going to be, the more often you’re going to produce insulin. And this is ultimately what creates insulin resistance.

So again, TRE, time-restricted feeding, or intermittent fasting, whatever you want to call it, really just means eat full meals and avoid snacks. So in order for you to eat full meals and avoid eating snacks, as I said, you’re going to have to have very rich, nourishing, satiating type of meals that don’t leave you grazing and craving and snacking and that’s where what you eat comes in. So what you eat, in other words diet, we advocate a real food dietary approach and this is what our book is about. We talk very clearly about this. We have food lists, we have shopping lists, we have recipes. There’s 50 recipes in our book just to make it really clear. And these recipes were made by me and I’m not a chef and I’m definitely not a complicated person. I’m a very simple person, I want things to be simple for you. I know we’re all very busy individuals.

But a real food diet, in very general terms, means that you are avoiding sugar, grains, and processed foods. Of course, within that umbrella you have all the low-carb diets; the Keto Diet, the Paleo Diet, there’s so many different names. But really I don’t even know that it is absolutely necessary that you get down into the details of this so long as you can eat a meal and walk away. Now, that’s where the trouble begins for many, many people because there are people, like me and many other women with PCOS, that when they eat, within an hour or two, they feel the need to eat again. One, out of habit; two, because they’ve been told to do that; and three, because they might have something that’s called rebound hypoglycemia. I had that.

Amy:

Oh, I had that too. It’s really difficult.

Dr. Nadia Pateguana:

And you know, Amy, how much do you want to bet that most women with PCOS have rebound hypoglycemia?

Amy:

Yeah, definitely.

Dr. Nadia Pateguana:

You know why that is?

Amy:

Yeah, tell us.

Dr. Nadia Pateguana:

It’s because we produce too much insulin no matter what we eat. And so insulin’s main job is to take blood sugar out of the blood. It does many other things. Now, we know it’s a hormone with reproductive functions and tumor growth, cancer functions, unfortunately, and many other things. But one thing it is for sure is it’s a hormone that takes the blood sugar out of the blood. So, if you produce too much insulin every time that you eat, you’re going to have this rebound, meaning after effect. The after effect hypoglycemia, low blood sugar, after you eat. So then, of course, you need to eat again and guess what you’re going to do? You’re going to go and search for sugary foods because that’s what you crave and you’re shaking.

And so, if you follow this pattern all day long, you’re never going to have a full meal. You’re never going to want to eat real food because all you do is crave sugar and you’re just stuck in this vicious cycle. Because every time that you eat, you produce more insulin and every time you produce more insulin, you become more insulin-resistant. So the next time you’re going to produce more insulin for everything that you eat and that’s how insulin resistance develops. And that’s how PCOS goes further and further up on the spectrum. And that’s how people either produce more male hormones or they actually reduce the production of another hormone in the liver called SHBG, which is sex hormone-binding globulin. And because as PCOS women we have lower production of this hormone in the liver, we have more expressions of male hormones.

You may not necessarily have higher testosterone levels, but you have less of this hormone that binds it. So it’s more free to express its male expressions all over your body because it’s not bound to this hormone that’s supposed to take it where it’s supposed to go. And this is what then causes those physical expressions of male hormones. This is what eventually, one of the reasons, why your menstruation becomes more irregular and you stop ovulating. Insulin, in and of itself though, does have a direct impact on the ovaries as well.

Amy:

So, thank you for that explanation. You know, I guess I never even realized that I was practicing like a form of fasting. But I noticed that my body felt the best and I was able to maintain my weight when I stopped eating after dinner and didn’t snack at nighttime and didn’t eat again until the morning. And I know that is one, I think, very easy way to practice this idea of fasting.

You mentioned another one about avoiding snacks and eating your meals, a good, healthy meal. I wanted you to kind of get into the other sort of fasting scenarios that you talk about in your book. But I wanted you to kind of … Are there any women listening that there should be some caution before they start a fasting routine?

Dr. Nadia Pateguana:

That’s a great question. So first off, Amy, the first and most important thing is this idea of TRE, in my opinion, time-restricted eating. No matter how long you can do a fast, because at this point I’m sure you know and I know many people that have tried many, many different fasting schedules and people become very, very good at them. Because fasting, like Dr. Fung says, is like exercise. You exercise that muscle and it becomes easier and easier and easier, and especially if you learn how to do it properly, and if you’re very aware of hydration, water, and salts, and sort of how to get into that ketogenic, that fat-burning mode. People can fast for long periods of time very successfully and they have very good results including muscle building and all these other things. However, it’s just as important how you eat on your eating days as it is too fast a little longer for healing or therapeutic benefits. And like everything else, and again, this is mentioned everywhere in our resources, fasting is a very powerful tool but all tools, all weapons, have some risks.

So again, fasting longer also comes with a few risks, bigger potentially. I mean, it’s not a very riskful thing, to be totally honest, but it does come with potentially bigger risks. So fasting longer isn’t necessarily better. This is why I put so much focus and so much emphasis on this. The other, Amy, is if we can’t get women to sort of deal and control this rebound hypoglycemia that I was just talking about because it is so common. I work with so many women who want to fast but they can’t even go more than two hours without eating. How are they going to fast? So we have to address that first and the only way to address that is to address how they eat.

They will have to eliminate certain things out of their diet in order to be able to do what you were just saying. Better to be able to have dinner and then not snack after because we all know how much of a habit it is to snack especially in the evening. And the reason being is because we produce a lot more insulin in the evening. So the more you eat in the evening and the later that you eat, the more you’re going to want to eat. Again, that vicious cycle, that nonstop sort of thing. So, all of this takes practice. All of this takes a little bit of knowledge and information. So learning to eat a little bit earlier. Learning to eat less of certain foods and more of others. So very, very clearly and particularly learning to eat a lower carb, more moderate protein, and higher healthy fat diet is very key in this initial component to create these solid, rich, satiating meals.

As far as other fasting schedules, there are many, as you said. Our probably most known intermittent fasting schedule is probably the 16/8 or the 18/6 and this is the schedule people eat. Two solid meals in a six to eight hour period and then fast for 16 to 18 hours overnight, which is probably something similar to what you’re doing. Right, Amy?

Amy:

Yeah. And what you mentioned, like as my diet improved, the longer I was able to fast in the morning. So some mornings, and I don’t do this every morning, but maybe three mornings a week, I might even wait until 9:00 to eat. I’ll have my warm water and lemon or a cup of tea and then I’ll wait until about 9:00, 10:00 to eat breakfast about three days a week to try to get into that longer fast. But I don’t do that, it doesn’t really work for me every single day. And I think that’s part of it, is you have to figure out what works best for our body.

Dr. Nadia Pateguana:

Right. So a very common intermittent fasting schedule is one where people eat at 12:00 and 6:00. So they eat at 12:00 and they eat at 6:00 and they work towards that where they actually don’t eat in the morning. A lot of people are not hungry in the morning so it’s pretty easy to fast in the morning. And the other thing is, morning food choices are not always the best, they’re often carb-laden, sugar-laden. So again, you start your day with sugar, the rest of your day is probably not going to work out very well. And so that’s the most common schedule, the 16/8, where most often people are having lunch and dinner.

So, of course, there’s some fasting aids that people use sometimes to get started and to get their body into that. But for some people, that’s just very, very easy. For PCOS women, not necessarily easy. I speak from experience. That was something I had to work on because often PCOS women wake up hungry because they’re craving sugar. That has to do with the insulin resistance and that has to do with that cycle that I was talking about. So we can work on that.

And so the other schedules often talked about and very well-known are the alternate day fasts. So you may have heard of these, where you eat one day, fast the next. Again, this has to come with some information, some knowledge, proper electrolyte consumption. That’s a very common schedule. That’s a very common schedule as well for weight loss, alternate-day fasts. So that’s well documented in our resources in our book.

And then there’s what people call extended fasting. Extending fasting is something that can be used as a very powerful tool for people that have a lot of weight to lose if done properly. It’s not something we talk a whole lot in our book, it’s also not something I use a whole lot in my former practice and today with my online clients, but it is something when used properly, can be very powerful with proper guidance.

Amy:

So I know you know that women with PCOS, we are at higher risk of disordered eating patterns. What do you say to somebody who has struggled with some type of disordered eating? Should they consider doing fasting or could that just trigger old behaviors?

Dr. Nadia Pateguana:

Well, I think that’s an excellent question. It’s probably a very common question. I have to tell you that in my experience that hasn’t been that big of an issue as people might think that it is. Disordered eating, if we’re talking about anorexia and things like bulimia, these are not necessarily associated to PCOS, these are psychological concerns.

Amy:

I think it’s more of the binge eating.

Dr. Nadia Pateguana:

Exactly. I’m so glad that you said that because binge eating, in my experience, more often than not can maybe be confused with this whole pattern that we’re talking about, sugar addiction and rebound hypoglycemia and this need to eat constantly. And so if that’s what the problem is and you address it by lowering insulin, it actually doesn’t trigger binge eating or this type of binge eating, it actually reduces it. So again, I’m not here to diagnose anything much less a serious psychological disorder. All right?

But people that have the feeling of rebound hypoglycemia and sugar addiction can often address that by eating real food and partaking in some TRE or time-restricted eating and intermittent fasting. All of the sudden, quote, unquote it magically gets taken away. So I actually don’t see that becoming more of a problem. I don’t see people eating more often or binging more when they eat real food, lower carb, and when they do intermittent fasting, it’s the opposite. However, it actually takes some time. Like any addiction, like any habit, it takes time to create new habits.

Amy:

Yeah. I mean, I know that I was one that I could not understand why I was having these uncontrollable cravings. This is way back in my early PCOS journey. And I felt like I could control so many areas of my life but I can’t control eating three Snickers bars on my way home from the grocery store. But I can attest that once you start eating real food like you talk about in your book. I often think that women with PCOS, we’re overfed, we’re eating too much empty calories. I mean, I don’t even like the word calories.

Dr. Nadia Pateguana:

Absolutely.

Amy:

Food that has no nutrient value. And once we start nourishing our body with nutrition, then you do become satiated. And I think that, like right now, I can really manage my insulin and so that I don’t crave Snickers bars anymore.

Dr. Nadia Pateguana:

For me, it was Twix. So for you, it’s Snickers. For me, it’s Twix.

Amy:

Oh, same thing.

Dr. Nadia Pateguana:

It’s like my kryptonite. But here’s the thing, information is key here. Like, I know that if I eat a Twix bar, I’m going to want two or three. Right? But I also know, and I’m not advocating that people do this because I am an advocate for real food diet, but I also know that if I were to eat a full meal and then have a Twix bar, I wouldn’t need to have two or three. And again, not advocating this, but it’s information.

How you eat and what you eat makes a difference in your hormonal responses. I don’t produce as much insulin to sugar and carbohydrates if I eat it within a full, rich, satiating meal. But if I were to eat a Twix bar on its own, my reaction is still very similar to what it was a few years ago.

Amy:

Yeah, exactly. And I think one of those keys to a full, rich, satiated meal is fat. So why don’t you talk to us a little bit about fat and healthy fat and how to incorporate that into our diet?

Dr. Nadia Pateguana:

Absolutely. And I think for years, again, we’ve been fed all these myths. We’ve been fed all these, I say myths because I don’t want to say any other word, that fat is bad for you. Quote, unquote fat is bad for you and it causes obesity or it causes heart disease and there are some great, great resources out there. Great authors, great doctors in the low-carb community and journalists and all these other pioneers that have come out and said, “Hey, it’s not fat that’s the problem, it’s sugar.” And so we also have to look at fat and what kind of choices we’re making because there’s a big difference between healthy, natural fats and processed, polyunsaturated vegetable and seed oils. And unfortunately, that was not only what we told not to eat the natural fats that our ancestors had been eating for thousands of years, but we were told to eat the polyunsaturated vegetable and seed oils instead. So that’s caused a lot of havoc in our system, a lot of inflammation as well.

So, when we’re talking about eating a healthy fat diet, we’re talking about eating good sources of animal or vegetable fats like butter, ghee, coconut oil, avocado oil, and avocados themselves, and olive oil, which I think all over the world has been sort of recognized as a healthy fat. We have stayed away from things like pork fat and beef fat, which is lard and tallow, but I think more and more people are beginning to realize that these are probably better for you than we think. I personally cook with them. My grandmother used to cook with them and all the grandmothers before her. And I’m very comfortable cooking in and eating these very natural fats. Of course, everybody has their own food preferences and can make their own selection. But this is what we’re talking about when we’re talking about natural, healthy fats.

So, what you probably want to avoid is the, as I said, polyunsaturated, highly-processed vegetable and seed oils because those are highly modified and have nothing to do with anything-

Amy:

And very inflammatory too.

Dr. Nadia Pateguana:

Very inflammatory. So I’m not going to say any specific names but again, if you were to look this up, it would be very easy to … and it’s something that in human history … well, it was only able to be produced after industrialization first of all. So it’s obviously something very, very recent. And I think, hopefully, most people are aware that they should be staying away from these polyunsaturated fats.

Amy:

Right. Well, to bring us to a close, do you have any other words of wisdom for women with PCOS that you’d like to share?

Dr. Nadia Pateguana:

Wow. I have lots. I think that for me, this is an important topic because I can relate. I was that woman who, like you mentioned, Amy, who just couldn’t stop eating sugar, and I just want people to know that it does take a little bit of information. I know sometimes it feels like your willpower is weak. But your willpower is not weak, there’s absolutely nothing wrong with you as a person. Hormonally, food has a big impact. So how you eat and what you eat has a huge impact on how you feel and what food choices you make.

So, information is power, we all know this. The problem is we’re getting a lot of conflicting information. I get it. I get it. I fully know this. So you have to sort of take control, take some … I don’t want to even say a risk. But look into what we have been talking about today as a possible big help in your particular situation, whether you’re trying to conceive or you’re just trying to regulate your cycles or you’re just trying to make yourself feel better.

Amy:

Yeah, and give it a shot. One of my clients said to me once, “Having PCOS, it’s just like one big scientific experiment trying to figure out what works for me.” And you know what? Yeah, it is.

And thank you for writing this book, The PCOS Plan, because it gives you another experiment. And again, you did a great job laying out the different types of fasting. You put together a whole diet and some really great recipes. I’m going to be trying some of those for sure.

Dr. Nadia Pateguana:

Thank you, Amy. Appreciate it.

Amy:

And your book is available on Amazon, really anywhere books are sold. And tell us more about how we can follow you on social media, get more information about your work.

Dr. Nadia Pateguana:

Awesome. So I am a dietary coach and have been for the past, almost, four years for thefastingmethod.com by IDM. So I work alongside Dr. Jason Fung and Megan Ramos as well as many other coaches. It’s a great, wonderful team. Our focus is on intermittent fasting and real food dietary approaches for people in general. I don’t just work with women with PCOS, I work with people in general that have different expressions of metabolic syndrome like obesity, diabetes, all the things we talked about today. And so you can find me there for sure, that’s where I work, thefastingmethod.com. And on social media my handle, my Twitter and Instagram handle is @nadia_pateguana. I also have a YouTube channel where I sometimes post some videos if I’m inspired. Yeah, I’m out there as much as I can because I’m really passionate about this.

Amy:

Well, thank you for your passion. We all need these resources to kind of get through the PCOS healing journey. So thank you so much for being with us today, Nadia. And thank you, everyone, for listening. I look forward to being with you again soon. Bye-bye.

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