Dr. Cabeca Answers Your Questions

03/21/2011

Dr. Cabeca,

I recently heard you speak at the IFM Symposium on Advanced Women’s Health. Thank you, it was a great presentation. I am a registered dietitian in my own private practice. I see many women with PCOS. I believe I understood you to say that the PCOS patients should not follow a typical DM diet balancing carbs through out the day…with 5-6 meals.  I believe you said to have them consume only 3 meals a day????

I have a client that has PCOS, has had children successfully, has very elevated blood glucose levels. I do not believe her insulin levels were measured. She is on metformin and is following a DM diet. Her levels are  not under control yet. Do you recommend only 3 meals a day?

For the clients w/o PCOS but high levels of insulin, again do you recommend 3 meals a day and not the 5-6 in a typical DM diet?  Thank you for your input and a great presentation.

Sue

Susan T. Anthony, RD

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Dear Sue,

Thanks very much for your compliment and attending my lecture at the Integrative Healthcare Symposium in New York City on polycystic ovarian syndrome, metabolic syndrome and insulin resistance. This is a fascinating topic and understand that it goes against basic nutritional guidelines of three meals and three snacks per day, however this does not work on the insulin resistant patient. Two hours or even three hours after she has eaten her insulin levels may still be above 50 and we want them to be nice and low otherwise they are storing glucose and storing fat and it continues to propagate insulin resistance, and metabolic syndrome, as well as the sequelae of the disease such as high cholesterol, high triglycerides, hypertension, increased abdominal obesity diabetes, infertility, etc.

Therefore in my patients I recommend that they keep an alkalinizing diet with a good amount of protein at each meal at lease 25 to 35 g of protein and a low glycemic index, and at least 4 to 5 hours between meals. As you know they‘re getting healthy fats and protein. Your not going to make them hypoglycemic with this regimen whether or not their on a sulfonurea or metformin.

Additionally, I recommend the mighty Maca greens because it is alkalinizing and it has insulin sensitizing herbals and it is a very good way to bring nature back into the body. She should also be on high quality of Omega threes with a high level of EPA/DHA in addition to a diet high in cruciferous vegetables, greens and low glycemic index.

Thanks for your question, and complement and look forward to hearing from you againycystic ovarian syndrome, metabolic syndrome and insulin resistance. This is a fascinating topic and understand that it goes against basic nutritional guidelines of three meals and free snacks per day, however this does not work on the insulin resistant patient. Two hours or even three hours after she has eaten her insulin levels may still be above 50 and we want them to be nice and l low otherwise they are storing glucose and storing fat and it continues to propagate insulin resistance, and metabolic syndrome, as well as the sequelae of the disease such ashigh cholesterol, high triglycerides, hypertension, increased abdominal obesity diabetes, infertility, etc.

Therefore in my patients I recommend that they keep an alkalinizing diet with a good amount of protein at each meal at lease 25 to 35 g of protein and a low glycemic index, and at least 4 to 5 hours between meals. As you know they‘re getting healthy fats and protein. Your not going to make them hypoglycemic with this regimen whether or not their on a sulfonurea or metformin.

Additionally, I recommend the mighty Maca greens because it is alkalinizing and it has insulin sensitizing herbals and it is a very good way to bring nature back into the body. She should also be on high quality of Omega threes with a high level of EPA/DHA in addition to a diet high in cruciferous vegetables, greens and low glycemic index.

Thanks for your question, and complement and look forward to hearing from you again.

Best regards,

Anna

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