Increasingly, insulin resistance is being called out as a contributor to or underlying cause of PCOS and/or hormone imbalance. Insulin resistance is defined as a state where the cells in muscles, fat, and liver don't respond well to insulin and can't easily take up glucose from the bloodstream. When the body struggles to incorporate glucose from the blood into the cells where it is needed, glucose stays in the blood, where it can cause serious problems. In addition, the cells don’t receive the energy they need to function properly.
Identifying that our metabolic hormones and reproductive hormones are connected is a powerful step in connecting that what we eat has a major impact on menstruation and ovulation. They are indeed inextricably linked. In some ways, this is an important connection to draw.
However, it is important to respond mindfully to this information. Often, when “insulin resistance” is mentioned, “treatments” that may have worked for other individuals who also experience insulin resistance are pursued. The conversation might turn to weight loss, intermittent fasting, and food restrictions, which may work for some (often male) bodies. These practices can actually make it more challenging to balance blood sugar and rebuild healthy insulin sensitivity (which is the positive inverse of insulin resistance) in female bodies.
Let’s examine the ways in which focusing on weight loss and food restrictions can be counterproductive:
It can lead to nutrient deficiencies: when we remove entire food groups from our diets (like carbohydrates) without focusing on what we will include, this can lead to nutrient deficiencies. Micronutrients are absolutely essential for hormone balance (including insulin production and sensitivity!) and in addressing PCOS.
It can trigger or re-trigger disordered eating: creating a strict set of rules creates conditions for guilt and shame if and when these “rules” are “broken.” Those emotions have a real biological and physiological toll. Counterproductively, the stress felt in these circumstances can hinder nutrient absorption, cause cortisol to spike, and contribute to hormone imbalance.
It can further imbalance reproductive hormones: extended fasts (exceeding 12-14 hours, depending on the individual) can likewise trigger stress hormones and “starve” certain gut microbes that are helpful and important for digestion and absorption of nutrients. This can also create challenges for the whole endocrine system.
It can distract us from other healing practices that support insulin sensitivity: if we focus only on the insulin resistant component of a bodily imbalance, because of the most common current cultural approach to address this (i.e. blood sugar “control”), we can overlook other more integrated, subtle yet effective approaches to support the body in returning to balance.
It is also important to remember that not everyone who experiences symptoms of PCOS is experiencing insulin resistance either as a root cause or complication.
If insulin resistance is occurring and does need to be addressed, here are five areas to focus on that will support the pancreas and the ovaries, and all of the other organs and systems that are connected to digestion and menstruation and ovulation.
Focus on adding nutrition to each meal: instead of focusing on what to avoid, focus on how to fill your plate with the most nutrient-dense foods possible. This can mean sourcing fruits and veggies that are locally grown and in season. These will generally contain more nutrients because they didn’t have to travel as far to get to your plate (a process that causes nutrient degradation) and are more likely to be grown on farms with more biodiversity. It also means preparing foods in ways that make them easily digestible (e.g.. cooked, but see our what to eat to support digestion post for more information). Seeds, legumes, and whole cooked grains can also be a great source of nutrients. Ensuring you are getting enough nutrients means that the body will naturally feel more satisfied and satiated, and is less likely to send you constant hunger cues asking you to seek out and provide nutrients!
Incorporate herbs and spices into your life: herbs and spices are incredible nutrient powerhouses and many also support digestion and blood sugar regulation. Cinnamon, fenugreek seeds, turmeric, black pepper, and ginger are used traditionally and validated by modern research to support blood sugar and are fantastic to incorporate.
Follow kapha-pacifying food recommendations: Ayurveda recognizes insulin resistance as a kapha imbalance. As a result, they have specific recommendations about what foods are great to pacify kapha and ultimately support insulin resistance:
Find movement that you love: movement is a fantastic natural way to support blood sugar balance. It does not need to be high intensity competitive exercise — yoga, a walk, gardening, playing with kids on a playground, any of these will support your cells in absorbing blood glucose.
- Favor foods with a bitter, astringent, or pungent taste. Minimize foods with a sweet, sour, or salty flavor.
- Favor fruits such as apples, pears, pomegranates, cranberries, and apricots. Reduce fruits like bananas, pineapples, and figs.
- Grains: Favor barley, corn, millet, buckwheat, and rye. Reduce intake of oats, rice, and wheat.
- All spices except salt are pacifying to Kapha.
- Reduce intake of dairy, which tends to increase Kapha. Small amounts of ghee, milk, and yogurt (ideally homemade) are OK.
Support your sleep: deep, restful sleep is incredible for hormone balance. The total amount of time someone sleeps as well as the time of day that person sleeps impact insulin resistance and blood glucose. All of the tips above will support your body in being able to fall and stay asleep, which is great news.
All of these activities support one another and the ultimate goal of blood sugar and hormone balance, without any of the drawbacks of severe carbohydrate restriction, extended fasts, or stressing too much over nourishment.