Ep. 20: Understanding Nutrition for PCOS, with Tracy Mann, RD
Caitlin Estes:
Welcome to the woven well podcast. I'm your host, Caitlin Estes. I'm a certified fertility care practitioner with a master of divinity degree. Each episode will cover a topic that helps educate and empower you on your fertility while honoring the deep connection your fertility has with your faith. Let's get started!
Caitlin Estes:
Welcome back to the woven well podcast. As we continue discussing polycystic ovarian syndrome or PCOS last week, we dove into what PCOS is, what symptoms you may have if you have it, how to officially be diagnosed, and what treatment options are available. And one of the things we mentioned that can have a large effect in improvement of symptoms and the condition itself is nutrition. So it's only right that we take a closer look at nutrition this week, since it's an effective treatment option available to all of us. So to help us do that, I've invited registered dietician, Tracy Mann, to share with us today. Tracy has been a practicing registered dietician for 15 years and has dedicated the last five years of her practice, everyday nutrition, to women's hormonal health. So welcome Tracy! We're so glad you're here.
Tracy Mann:
Thank you. Thanks for having me. I'm excited.
Caitlin Estes:
Me too. So last week I shared how the exact cause of PCOS isn't known, but genetics are probably what play a huge role in it. So still PCOS is known to progress or regress over a woman's life, depending on lifestyle and treatment options. And at woven natural fertility care, we are all about increasing the quality of life through reproductive health, regardless of whether a woman is ready to have a baby. So we think it matters now. So I'm really curious to hear today: How can nutrition play a role in that?
Tracy Mann:
Well, I love talking about this topic because I think oftentimes PCOS is categorized into that reproductive segment. But actually PCOS is also an endocrine syndrome. And the endocrine system is largely responsible for how we process nutrients, but also we utilize tons of nutrients to manage a lot of our endocrine processes. And then reproductive health is kind of a bigger picture of how all of these play a role together. And so that's how we also then can get some of those reproductive symptoms, like infertility or irregular cycles.
Caitlin Estes:
So I guess when we think about the endocrine system, nutrition can play a large role in that is what you're saying.
Tracy Mann:
Yes. So probably one of the biggest endocrine processes that people would be familiar with is metabolism. So metabolism is how we get energy from the foods that we eat. And it's also, it requires certain nutrients to be at an optimal level functioning at an optimal level.
Caitlin Estes:
Okay. So how we think about what we eat and how often we eat these things, or, you know, any of the specifics that you're gonna share with us today, can have a direct effect on the endocrine system, which then will have a direct effect on how our body is adjusting the androgens in our system or the overall health as well?
Tracy Mann:
Yes!
Caitlin Estes:
Okay, great! I'm excited to learn more about it then. So what does eating for PCOS look like then, because...does it mean cutting out all sugar? Does it mean being dairy free or gluten free or keto or intermittent fasting? I feel like we've heard everything under the sun in the last couple of years. There's a little bit of everything out there, so yes. What does it look like? Are these things what we need to be doing?
Tracy Mann:
So it's kind of a complex situation, obviously. Because yeah, I always remind my clients that every body is different. And so I think for the large majority of practitioners out there and influencers, they've gotta have this, you know, neon sign of something, that's gonna be the helpful recommendation to help improve signs and symptoms of P C O S but what I've found, not only just in practice, but in all the extensive research that I've done and also my background and my training as a dietician in general, just really looking at how our bodies are designed physiologically. I don't think that any of these things are necessarily gonna help every person. So I'm just gonna kind of touch on some of the key ones that you said and kind of talk through, how it may be helpful or how it may be not helpful. <laugh>
Caitlin Estes:
Perfect.
Tracy Mann:
So let's just start with the sugar piece because, with the P C O S affecting endocrine function, and then endocrine dysfunction can also enhance symptoms of P C O S one of the big issues that my clients have is something called insulin resistance. And so I think because of that, a lot of information out there is just cut sugar and it'll be fine. The reason that is, is because when we consume sugar or any type of carb, really, we have to, our insulin has to spike to process it. And if we have insulin resistance, then that process isn't working optimally. The thing is our body still can utilize some of that sugar in set amounts and when we pair it with protein and fat, so I always tell my clients, you're welcome to try cutting sugar. But I find it a very difficult lifestyle to live with. And so I would rather educate on, you know, how much can the body tolerate at one time, and how can we make it work for you so that you don't feel like you have to completely cut out sugar.
Caitlin Estes:
That's great. Yeah, I like that. You said too, it's about making a realistic plan for each person because cutting out sugar sounds great in theory, but that's very difficult to do. <Laugh> So I like that making it approachable.
Tracy Mann:
Yes. And that's where, you know, some people that I work with, they, they haven't had sugar in years. They just, that's not a lifestyle that they live. But then I have other people who consume lots of sugar. And so rather than completely cut that, we try to figure out an amount that's appropriate. And I would never tell somebody who isn't already consuming a lot of sugar to start doing it, you know? But the other important side of that too, is, there are different types of sugars. It's not all just white sugar and corn syrup and those types of things. And so, I really think it's helpful when women start learning what are the different sources, and knowing how the body processes different types of sugars differently.
Caitlin Estes:
That's great. Okay. I didn't mean to interrupt. You keep, keep going down your list.
Tracy Mann:
The good news is you don't have to cut it.
Caitlin Estes:
Yes!
Tracy Mann:
Gluten free and dairy free are huge. I have always tons of clients come to me say, I tried it and it didn't work, or I've read that I need to do it. And it's so hard to do. So here's my big things with these two items. There are about 30% of women who do have a negative reaction to dairy. And we aren't always sure exactly the reason it could be an issue with, the proteins in dairy, or it could be the lactose, but 30% of women. That's a pretty good number of women. And so the big signs and symptoms I see that cutting dairy could be helpful with specifically skin issues like cystic acne, which can be problematic with P C O S. Part of that is due to the elevated androgens and sometimes it's due to estrogen.
Tracy Mann:
So, sometimes with that, it's just seeing how you feel. Another one is just chronic allergy, like symptoms like post nasal drip, or maybe kind of a stuffy, almost feeling like your sinuses are kind of swollen. That's another symptom of a dairy sensitivity with gluten. It's going to be things like digestive problems, also, sleep difficulties and brain fog. Yeah. Okay. So if you just feel like you're chronically groggy or just have trouble focusing, or if, you know, some clients also have issues with their thyroid, which is part of that endocrine functioning. If you have thyroid issues, cutting gluten can be helpful with those as well.
Caitlin Estes:
Okay. So only if your body is giving you those signs that dairy or gluten specifically may be giving you an issue, should you maybe try to reduce those things? It's not just, if you think you have P C O S you need to be gluten for your dairy free.
Tracy Mann:
Correct. Yep. It's looking at what are your specific signs and symptoms, and then, if anyone is listening and is curious, maybe you just don't even know. What I have you do is just try to eliminate gluten and dairy for 30 days. And then at the end of that 30 days, add one of them back then, wait a week and add the other one back. So you can kind of see sometimes we don't notice that we're feeling better until we add them and then notice those things. And that's something I hope clients do too. Cause it can be overwhelming and difficult to stick to without a little bit of guidance and accountability.
Caitlin Estes:
Absolutely. So it's definitely not a one size fit all, but I'm sure there are some things that anyone who suspects they have P C O S could, you know, do, so what should we be focusing on nutritionally?
Tracy Mann:
So I like to talk about a nutritional foundation. So there's all these little nit-picky things that we can do, trying to figure out if there's foods we react to or, or these types of things. But when we look at the foundation of nutrition, what we are trying to do is manage our blood sugar and our insulin, and also manage our stress responses in the body. So, I actually, if anyone wants to visualize this, I like to make it into a graphic of a triangle. So your foundation is the bottom of your triangle and that's insulin and cortisol. Those are two hormones in the body that sometimes we don't think about, we just usually think about our sex hormones. The middle of the triangle is our adrenal glands and our thyroid, and the top of our triangle is our sex hormones.
Tracy Mann:
And so if we have dysfunction at the foundation, we're also going to start experiencing dysfunction at the other two levels. And when we realize this, it actually starts to become a lot easier to use nutrition to manage our symptoms because we want to manage that insulin response through, just not eating too much of any types of foods at one time. And then we also wanna manage the stress response in the body. And there are stressors obviously that are harder to control, but the one that we can control is fueling our body properly. And that actually can go back to how intermittent fasting can affect our signs and symptoms of P C O S because the body is designed to be fueled every four to five hours throughout the day when we're awake. And if we're going too long, then that puts stress on the body. And so really, I work foundationally on the timing of eating just to start with.
Caitlin Estes:
Well, I love that you're talking about cortisol because I talk a lot with my clients about how stress can affect the reproductive system. So it is important to think about cortisol plays a very important function in our bodies, but it's supposed to be used in a very specific way. And so I love that you're talking about eating to respect that and working within that healthy range of that stress hormone, which is really important. Well, I'm really curious too about the timing of eating. Is there a time, first thing in the morning or last thing at night, that's sort of too early or too late, or, you know, I'm just kind of throwing this out there, but I'm curious about that.
Tracy Mann:
Yes. So foundationally, I recommend that you eat within an hour of waking because once we kind of wake up, start using our brains, start using our bodies, our cells need energy coming in. And if we go about an hour after waking without eating, we're gonna spike that cortisol and that whole stress response. So eating within an hour of waking is a great way to reduce stress on the body at the cellular level. And then after you eat that first meal or snack, and, you know, that's individual based on the person, after you eat that first time, then try not to go longer than four or five hours without eating again, and then try to be done eating around 7:00 or 8:00 PM so that your body can go through a natural overnight fast, which is how the body was designed. It's okay to fast when it's overnight because, we're sleeping and we're resting and we don't need that coming in.
Caitlin Estes:
Okay. Very helpful. And obviously through everything you've said today, it is best to work with someone to provide you with very specific guidance on your situation, your goals, whatever they are, but could all of these things be helpful for someone to begin even before they seek out some sort of medicinal support, if they do have P C O S and maybe they need to take Metformin for insulin resistance, or they're considering trying Femara or Clomid or something for ovulation induction, would all of this be helpful first?
Tracy Mann:
Like I said, this is foundational nutrition. And I think honestly, every woman could benefit from it, whether they have P C O S or not. And so, even if you're waiting on an appointment, you could start incorporating these, or I have a lot of clients who are trying to avoid starting medication. And so they're just trying a few more things before they get to that point. And I've had a lot of clients reduce the need or even eliminate the need for medications over time.
Caitlin Estes:
Wow. Wow. So for someone who is listening, who suspects that they have P C O S or maybe they've already been diagnosed, it can feel a little bit overwhelming to hear, "okay, I've gotta do all this stuff at once." Whether they're hearing about medicine or they're hearing about the dietary changes they need to make. So from your perspective, what would you recommend as the best baby step to begin with?
Tracy Mann:
The first baby step that I have clients do is just work on that timing of eating. I'd say it doesn't matter what you eat when you eat, but if we can work on that timing, so eating within the first hour of waking, and then not going more than four or five hours between meals and snacks. And if you feel like, you know what, actually I do pretty good job, cause some people already that is kind of natural for them. The next thing you could start working on is just focusing on one meal of the day and just focus on how can I get the most nutrients in at this meal.
Caitlin Estes:
That's great. That is very realistic and very doable. Because even if someone doesn't know the difference between carbohydrates and protein and fat, they can put a timer on their phone. <laugh> So that's very realistic. I love that. So we may have some people listening who are ready to take that step and they may be interested in working with you. So how would be the best way for them to contact you?
Tracy Mann:
The best way is through our website. It's everydaynutritionllc.com. There's a contact form on there and it sends it to our email. So that's probably the easiest in it gives a little bit more information about what we do and answers some questions before ever even reaching out.
Caitlin Estes:
Okay. Well, wonderful. Everydaynutritionllc.com. That's great. And for anyone listening, Tracy and I are also going to host a webinar workshop together next month in June, 2022 on the benefits of charting and dietary choices for women with P C O S. So if you like today's episode, and you'd like to hear more from Tracy and I on this subject and how to get a real picture of your reproductive health while addressing P C O S in your body from a nutritional focus, we invite you to email me caitlin@wovenfertility.com and I'll be sure to give you some additional details there. So Tracy, thank you so much for joining and being on today.
Tracy Mann:
It was fun. Thanks so much.
Caitlin Estes:
I agree. Very fun. And thank you all for listening. As we continue to explore together what it means to be woven well.