05-26-2002, 01:39 AM #1
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Dr. Atkins' Diet and Polycystic Ovaries
Dr. Atkins' Diet and Polycystic Ovaries
by Marilyn Shannon
Author of Fertility, Cycles & Nutrition
Shortly after I submitted my article on Polcystic Ovarian Syndrome to Family Foundations, I received the July, 2000, issue of Dr. Atkins’ Health Revelations.. It contained an article titled "Atkins diet relieves ovarian-cyst problems." The article begins, "Some of the most profound testimonials for my diet come at book signings from women who have suffered from polycystic ovary syndrome (PCOS) and have found relief by following the Atkins diet. My own experience with patients at The Atkins Center corroborates what they’re saying: My high-protein, low-carbohydrate diet helps women get almost immediate relief from symptoms that have haunted them their whole lives." It gave anecdotes of obese women with polycystic ovaries who had return of cycles very soon after losing weight through the Atkins diet. It even mentioned that the problem of hirsutism subsides after several months on the diet.
Dr. Atkins is a maverick among nutritionally-aware physicians in that he is a vocal proponent of a low-carbohydrate diet. He has, in fact, gained considerable notoriety through his book on losing weight through restricting carbohydrates, Dr. Atkins’ New Diet Revolution. If you have not just opened Fertility, Cycles and Nutrition for the first time right now, you know that I am a proponent of a varied diet rich in complex carbohydrates. Nevertheless, I also respect the position that Dr. Atkins takes, since low carbohydrate means less pop, candy, donuts, cakes, sugar, french fries, and junk foods in general. And I think that when it comes to non-insulin dependent diabetes, his advocacy of a low-carbohydrate diet is controversial simply because it is a bit ahead of its time-- I believe that with the new research on insulin resistance, in a short while it is going to be accepted much more widely than it now is.
But back to PCOS. I am not at all surprised by Dr. Atkins’ experience with PCOS and his low carbohydrate diet, because he has repeatedly written that restriction of carbohydrates is the most effective natural way to improve the problem of insulin resistance and thereby to lower insulin levels. His weight loss diet is aimed at the relationship between high insulin and fat deposition. His thesis is that when carbohydrates are severely restricted, insulin levels will drop. When insulin levels are low, glucose cannot enter the cells and the body is forced to burn fat as its fuel. Since high insulin is at the root of PCOS, it makes sense to me that women report that the Atkins diet has helped them with PCOS.
At any rate, his article prompted me go to a bookstore and buy a copy of Dr. Atkins’ New Diet Revolution, so that I could review it for you, especially for those who believe they have PCOS. I soon had the book read, page by page; it was engagingly written, often witty, and fairly consistent with my understanding of human metabolism. I read it in hopes of answering the question, "Should I recommend this book to women with PCOS?"
Let me jump ahead and answer that question: Yes, I think you should read the book. Should you act on the book? I’d say yes, at least to some extent.
The Atkins Diet
I knew that Dr. Atkins advocated low carbohydrates for weight loss, but I was truly surprised just how low. The most restrictive part of his diet, his "14-day induction diet," allows unlimited natural fats and proteins, but only one salad a day. He claims that most people can eat unrestricted natural fats and proteins, since these will automatically suppress their appetite, and still lose weight. He does warn against the unnatural and damaging "trans-saturated" fats found in margarine, shortening, and processed peanut butter. He has developed a system to allow dieters to add carbohydrates slowly as they progress in weight loss, and shows them how to calculate just how much carbohydrate they can eat to maintain their ideal weight. The diet is certainly a carnivore’s delight; as he says, if you are a vegetarian, it’s not easy to implement.
Dr. Atkins stresses that vitamins and minerals which are known to improve insulin sensitivity (the opposite of insulin resistance) are an integral part of the diet. Chromium, vanadium, flax oil, Coenzyme Q, carnitine and other "vita-nutrients," as he calls them, are listed and suggested dosages given. He recommends exercise as well.
Is It Safe?
Dr. Atkins’ book contains plenty of pages defending the safety of the diet. I was surprised that he in fact intends to put the dieter into "ketonuria," that is, ketone bodies in the urine; ketone bodies are a byproduct excess fat breakdown. He deflects theoretical objections to this through his own experience with his own patients; I found it convincing. Instead of offering my own opinion one way or the other, though, I can only suggest that anyone interested in this approach to weight loss consult first with a physician who has read the entire book.
My real problem with Dr. Atkins’ New Diet Revolution boils down to this issue: What about your carbohydrate cravings? I do not think that craving carbohydrates is an "addiction," as Dr. Atkins states. I think it is completely normal to crave carbohydrates, as they are one of the three major foodstuffs of the human race. Did the Irish grow fat on potatoes? The Chinese on rice? The Mexicans on corn and beans? Dr. Atkins makes no distinction that I can find between the carbohydrates in cakes, pies, cookies, pop, donuts, etc., and bread, beans, rice, potatoes, corn, granola, and oatmeal.
He does admit that the diet is "unbalanced," and makes a good point that it is unbalanced in order to correct a metabolic disorder of the obese individual. I can agree that those who can’t lose weight or maintain a comfortable weight by restricting junk foods and cutting down overall calories may in fact find that his diet is the only one that works. And I thoroughly agree with Dr. Atkins that the ultra-low fat diets are unhealthy and cause blood glucose swings that lead to fatigue, "brain fog," irritability and anxiety– as well as a craving for refined carbohydrates that raise insulin levels all the more.
The Bottom Line for PCOS
If you have PCOS, whether you are obese or not, lowering your insulin is a key strategy for improving your fertility. I really do believe that when it comes to elevated insulin, Dr. Atkins’ diet and vitamin/mineral recommendations are on the right track. But I think that if you choose to follow this diet, you should do so in some modified way, right from the start. In particular, the low-calorie, low-starch vegetables are quite compatible with a low-carbohydrate approach. Cabbage, celery, Brussels sprouts, broccoli, lettuce, endive, spinach, cucumbers, tomatoes, green peppers, eggplant, green beans, asparagus, mushrooms-- these are foods which provide a wealth of health-promoting vitamins, minerals, and fiber, and even in generous amounts will not undermine a weight-loss program.
As Dr. Atkins recommends, get a medical check-up before you start. Or, as I would put it, consider the counsel of a nutritionally-aware health professional.