Watch the full interview below or listen to the full episode on your iPhone HERE.
Stu: This week I’m excited to welcome Dafna Chazin to the podcast. Dafna is a PCOS dietitian based in the US and the host of The Down To Earth PCOS Nutrition Podcast, where she shares her expertise in the field of hormonal health, nutrition, and healthy lifestyle changes specifically for PCOS. In this episode, we discuss the environmental factors that can cause or aggravate PCOS and how to support it through diet and lifestyle.
Audio Version
Some questions asked during this episode:
- How is PCOS diagnosed?
- Do environmental factors cause/aggravate it?
- Is any type of diet or eating style more effective with the condition?
Get more of Dafna Chazin:
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The views expressed on this podcast are the personal views of the host and guest speakers and not the views of Bega Cheese Limited or 180 Nutrition Pty Ltd. In addition, the views expressed should not be taken or relied upon as medical advice. Listeners should speak to their doctor to obtain medical advice.
Disclaimer: The transcript below has not been proofread and some words may be mis-transcribed.
Full Transcript
Stu
(00:03)
Hey, this is Stu from 180 Nutrition, and welcome to another episode of the Health Sessions. It’s here that we connect with the world’s best experts in health, wellness, and human performance in an attempt to cut through the confusion around what it actually takes to achieve a long-lasting health. Now, I’m sure that’s something that we all strive to have. I certainly do. Before we get into the show today, you might not know that we make products too. That’s right. We’re into whole food nutrition and have a range of superfoods and natural supplements to help support your day. If you are curious, want to find out more, just jump over to our website. That is 180nutrition.com.au and take a look.
(00:42)
Okay, back to the show. This week I’m excited to welcome Dafna Chazin to the podcast. Dafna is a PCOS dietitian based in the US and the host of The Down To Earth PCOS Nutrition Podcast, where she shares her expertise in the field of hormonal health, nutrition, and healthy lifestyle changes specifically for PCOS. In this episode, we discuss the environmental factors that can cause or aggravate PCOS and how to support it through diet and lifestyle. Over to Dafna.
(01:16)
Hey guys, this is Stu from 180 Nutrition, and I am delighted to welcome Dafna Chazin into the podcast. Dafna, how are you?
Dafna
(01:22)
Good. How are you?
Stu
(01:25)
Yeah. Very, very good. Thank you. As we mentioned before just off camera, very, very excited to talk about this subject today and pick your brains a little bit because it’s a question that comes out almost daily with our audience as well and seems to be ramping up in terms of the prevalence of this particular topic. But first up, for all of our listeners that may not be familiar with you or your work, I’d love it if you could just tell us a little bit about yourself, please.
Dafna
(01:58)
Yeah. Absolutely. So my name is Dafna Chazin. I’m a registered dietitian and I help women with PCOS balance their hormones, reverse their symptoms. And I’ve been in the field of nutrition for over a decade. I’ve worked in a lot of different settings, but recently in the past five years, I’ve landed in the women’s health and hormone space, partly because I struggled with hormonal issues myself. I don’t have PCOS, but I’ve struggled with many of the symptoms that women with PCOS experience, like acne and hair growth and painful periods, anxiety, digestive issues. You name it, I’ve had it. And over the years when I was really struggling, it was a time where my stress was really high. I was in the military actually. My diet wasn’t so great, but I wasn’t making the connection between what was happening with my hormones and my symptoms and the diet and nutrition. I always thought my nutrition and food only impacts my weight, and that’s about it. And now we know that that is absolutely not true.
(03:04)
And so over time, I started looking for different treatments and options to take care of my symptoms. And I went to my doctor, and of course she immediately prescribed me with birth control pills. And she said, “Here, this is going to fix all your problems.” And I believed it and I tried it. And while some problems did get better, others started surfacing like mood swings and anxiety. And so I realized that that was not the ideal treatment for me. And as I learned more about nutrition and doing things naturally, I got so into it that I became a dietitian and I made it my career to really help other women improve their health through nutrition and find those really sustainable lifestyle factors that can help them feel better physically, mentally, emotionally. Food impacts so much.
(03:52)
I particularly like working with women with PCOS because food makes such a difference. And so this is one area where women really do have control over their health. And if they are educated and they know what to do and they do it in a way that’s easy to stick to because PCOS is a lifelong chronic condition, they can really see great results. And so that’s what I do. That’s what I help women with. And really, my job does not feel like a job most days. I get to talk about food, I get to help people eat delicious meals and really teach them the foundation of good nutrition, which no one really teaches us. When we go to school … I don’t know about you, but I never learned about nutrition in school. And what I knew about food and eating habits came from home and our parents don’t always teach us the best habits because they didn’t learn and they didn’t know better either. So it’s getting better now. I think people are more educated and there’s access to a lot more information, but at the end of the day, sometimes we have to unlearn what we’ve been doing for years and years and figure out a better way. Right?
Stu
(05:00)
Absolutely. Absolutely. Yeah. I remember learning trigonometry at school, and that’s been about as much use as use as-
Dafna
(05:07)
Yeah. And you don’t really use that every day.
Stu
(05:09)
Exactly right.
Dafna
(05:10)
But you do have to eat every day.
Stu
(05:11)
That’s exactly right. So PCOS, it’s got to be one of the biggest buzzwords, at least on social media at the moment. I’m seeing more and more daily posts and videos and information and deep dives into that. But tell us a little bit about PCOS. What does it stand for, what is it, and what issues does it bring with it?
Dafna
(05:34)
Yeah. That’s a great starting point. PCOS stands for polycystic ovary syndrome, and it’s a condition that affects five to 10% of women or people in general. And while it’s the leading cause of infertility in the world, it’s so much more than a reproductive condition. PCOS can impact our mental health, our metabolic health. So there’s a huge connection with heart disease risk, with insulin resistance. PCOS can also impact of course hormones. So women with PCOS tend to struggle with high androgen levels, high male hormones. And like I said, mental health is a huge issue as well. So we know that 30% of women with PCOS struggle with depression, and 40% of women struggle with anxiety. And so it is a condition that impacts the entire body. And because it’s a syndrome, everyone’s PCOS looks a little bit different.
(06:33)
So everyone has their own set of symptoms that they’re struggling with, and some people may be of higher weight and struggle more with blood sugar control issues, while others may be lean and have period problems or have excess facial hair. And so we can’t really look at someone and know if they have PCOS or not. And that’s one misconception that comes up a lot where I hear women tell me, “Well, my doctor said I don’t look like I have PCOS.” Well, there’s really no way to tell because everyone’s symptoms are really different. It can manifest in many different ways, and it can also change over time depending on what’s going on in the life cycle. So women who are during puberty or in their early 20s may experience PCOS in a very different way than a woman in her 50s. So it’s really important to know that things can evolve, hormones change. And unlike men who have the same level of hormones 365 days a year, every day is more or less the same, women’s hormones really fluctuate throughout the month and over the course of the lifespan. And so many times women think that once they are no longer in their reproductive years, they don’t have PCOS anymore. That’s actually not true. It’s a lifelong condition.
Stu
(07:56)
With so many different symptoms, much like a thyroid issue, it could be anything. It could be weight, it could be sleep, it could be skin, energy, all of the above. How would we go about diagnosing that?
Dafna
(08:13)
Yeah. That’s a great question. So recently there’s more consensus around the diagnostic criteria and what’s most commonly used is called the Rotterdam Criteria. And what the Rotterdam Criteria says is that a person needs to have two of the following three things in order to be diagnosed with PCOS. They need to have menstrual cycles that are longer than 35 days apart. And that may mean less than 10 cycles per year. They need to have high androgen levels. So that may mean upon blood work. So when someone goes to get their blood work done, they come back with high androgen levels like testosterone, so higher testosterone than what the norm suggests. Or they can just have symptoms of high androgen. So hair loss, hair growth where women wouldn’t necessarily get hair, like facial hair or chest hair or back hair. That is common with PCOS. So that is a sign of high androgen levels, missing periods again, or acne. So those can all be thrown into the mix as a sign of high androgen levels.
(09:17)
And then the third criteria is ovarian cysts. They’re called cysts, but they’re really fluid filled sacs that can be seen upon ultrasound. So we can’t know if a woman has them or not just by looking at her. We need to do an ultrasound and see if she has what’s sometimes called a string of pearls on her ovaries. That means that the body’s trying to ovulate but none of the follicles are actually releasing an egg. And so they look like little cysts, but they’re really fluid filled sacs. The follicles that are filled with fluid. So if someone has any two of these three things, high androgens, ovarian cysts, or long cycles, they can be diagnosed with PCOS.
Stu
(10:01)
Okay. And mentioned previously that it just seems to be becoming way more popular. It’s the talking point on a lot of the social channels. I’m keen to understand, is this a modern day issue?
Dafna
(10:21)
That’s a really interesting question. We don’t really know what causes PCOS. There’s certainly an uptick in diagnosis, and you’re right, it seems to be becoming more common and women are talking about it more. I think part of the reason that it’s more common now is that we have better criteria for diagnosis. So what used to previously be dismissed as, oh, you didn’t get a period this month, you’ll get it next month, whatever, it’s not that anymore. When we look at the whole slew of symptoms and issues that someone may have and we put it together, we can see, okay, maybe there’s a chronic issue here. So I think the better diagnostic criteria is helping diagnose this better. And there are still a lot of women who get undiagnosed with PCOS for years and years, and they struggle for many years with symptoms. And their doctor says, “Well, why would you even need a period if you’re not trying to conceive?” And they would say, “Well, because I just want to have a healthy body and a healthy cycle.” Women are concerned, but oftentimes they’re gaslit a little bit, their symptoms are minimized, and these issues are dismissed by a lot of doctors, and so they go undiagnosed for years.
(11:34)
So I think it’s a good thing that we have better diagnostic criteria, and doctors are more aware of the fact that these combinations of symptoms are a PCOS diagnosis. But the other thing I think is happening is we see more insulin resistance and inflammation and partly because of the way we live and what we’re exposed to and habits. But we definitely know that insulin resistance is a huge driver of PCOS. And so if someone’s lifestyle is causing insulin resistance over time or they have the family history of genetic predisposition to having blood sugar dysregulation or higher insulin levels, they are going to experience more PCOS symptoms.
Stu
(12:21)
Right. Okay. So in terms then of effective treatments … So very keen to dive into, and I would imagine there would be a whole number of different strategies that you could utilize when wanting to address this. Quick question before we dive into that. Conventional medicine versus integrative medicine. Do they differ? Because I know that obviously integrative medicine is a more holistic approach and very dietary focused as well, whereas perhaps conventional medicine may be more pharmacological in its approach.
Dafna
(13:11)
Yeah. You’re absolutely right. I think the biggest thing to understand in terms of the difference between more holistic approach and natural approach and integrative approach and traditional western medicine is western medicine addresses the symptom. We look at what’s happening on the surface and we give a medication, or if I’m having acne, I’ll give you a cream for it, or if you’re having hair loss, I’ll give you a shampoo for it. So it’s very surface level solutions usually that only take care of what we see, what the symptom is. They don’t really address the problem that’s causing it to begin with. And so when we work on more natural approaches and more holistic treatments, we really go deeper and we go to the root of what’s going on. And that may be inflammation, gut issues, insulin resistance, maybe adrenal problems caused by stress or poorly managed … Could be sleep. Could be other things that are triggering your body to throw the hormones off balance.
(14:19)
The first thing we need to understand is that there’s no cure for PCOS, but women can manage the condition to the point that it’s unnoticeable and it’s almost reversed. And usually the best way to do that … It may take a little longer, but the best way to do that is through lifestyle changes. We do have studies that show that even though there are great medications to help with PCOS, things like Metformin, which is also known as Glucophage and medications like Spironolactone that can help reduce androgens. And of course, birth control pills. Those are the three most commonly prescribed medications for PCOS and they can help. There’s absolutely nothing wrong with using them, but they have to be combined with lifestyle changes otherwise we’re just addressing the surface. We’re not really taking care of the problem.
(15:08)
So what I usually recommend … And I’m not against medications, but what I usually recommend is if you need to be on a medication and you feel like you really need your symptoms to get better controlled now … Maybe you’re not feeling well, maybe you’re at risk of developing diabetes, by all means a medication can help, but let’s work on the other things as well while you’re on the medication so that hopefully you can wean off of the medication and just continue living a healthy lifestyle and managing it more naturally on your own. But what we do know from studies is that, and this is really interesting, medications have been shown to be less effective than lifestyle changes for PCOS. So really the first line approach for treating the condition is nutrition, movement, supplementation, stress management, sleep, all of those great things that we all have to do pretty much every day. We have to sleep every day, we have to eat every day. But again, we’re not taught how to do that. And when we do learn how to do it, it can be extremely powerful, more so than a prescribed medication.
(16:10)
So I think that’s great news for everyone listening, if they’re struggling with PCOS and if they’ve been through the wringer as far as trying different things, diets, medications. This is really great news because a lot of that is in your control. And so it should be empowering to know that you really do have the ability to manage your PCOS without having to rely on a medication in a way that feels natural, it feels doable, and it really can fit into your day-to-day life. As far as the most effective treatment, it’s not the most exciting. I wish I had a magic wand that I can wave over everyone and PCOS would go away, and maybe that’s in the future when more research is done, but right now we don’t have that and so the best thing to do is really commit to working on lifestyle changes and the results are really astonishing.
(17:09)
I can tell you that I’ve had clients who weren’t getting a period for years and were trying to conceive and were already considering IVF and other interventions. And when they have committed to making the lifestyle changes and being patient with their body and really thinking about what’s going to work best for them, they were able to get a period and ovulate and get pregnant naturally. And so it really is very transformative to think about what can be done with simple things like food and movement and some supplements maybe. But at the end of the day, it’s not complicated.
Stu
(17:45)
Yeah. It’s exciting as well because I think it’s almost a move back to our ancestors in terms of slowing down, having more time to cook and prepare your own foods, working on quality sleep. No gadgets before we go to bed that mess our sleep and moving our bodies and things like that. So I’m keen then before we get into that, to talk about perhaps the antagonists. What factors do you think most negatively affect this particular condition?
Dafna
(18:23)
I would say that first and foremost, the foundation is sleep and stress. I think these are two things that are very overlooked, very much overlooked in today’s society where we’re constantly being pushed to do more and multitask and achieve more. I think oftentimes it comes at the expense of sleep and it causes tremendous amounts of stress that maybe we’re used to them and they’re common, but they’re not normal. Our body still responds to that stress in ways that are not good for our health. And so I think that probably one of the factors that can worsen PCOS and hormones in general the most is lack of sleep and high stress. That can increase cortisol levels and that can increase inflammation in the body. Our body is also less likely to process food properly when we’re stressed. And everyone who’s probably listening knows that when you don’t sleep well, you also crave sugary foods and you’re constantly hungry and you’re irritable and you don’t want to move. And so it’s a really slippery slope. So when we don’t sleep, we don’t want to do anything that’s great for our health because … It’s not that we’re lazy or we don’t have discipline. Our brain actually releases chemicals and hormones that trigger us to want more sugar, to look for very available energy sources in terms of food.
(19:54)
So when I’m sleep-deprived, I’m not going to be craving a kale salad and salmon. I’m going to be craving chocolate chip cookies and chips. And so that’s very much biological. And so I think that when we’re stressed, it’s so much more than our mental health. It can actually impact hormones and the choices that we make around food and the choices that we make around movement. And so I think focusing on that as the foundation is really important. And then we also have other factors that can impact. So we’re going to talk about nutrition I’m assuming in a minute, but in terms of environmental factors like pollution and toxins in the environment like plastics and xenoestrogens, which are chemicals that are found in a lot of different beauty products and other common household products that can be toxic to our hormones. And the reason that they are toxic is that they can really mimic the effects of estrogen in the body and cause disruption of our hormones.
Stu
(21:01)
Interesting.
Dafna
(21:02)
And so those are some things that … They’re not the most important thing to address. I would say that the others, food, nutrition, sleep, stress, movement, those definitely come first. But when we look at a pyramid of what’s impacting PCOS, they’re in there somewhere. Sometimes those are the ones that we can’t really control. If someone lives in an area where there’s a lot of air pollution or maybe you’re working with someone who’s a smoker and they smoke next to you and you may not have control over that all the time. That’s why I usually say those are things that we can worry about later. Let’s start with what we can control but those environmental factors are definitely there in the mix.
Stu
(21:46)
Okay. No, that’s fantastic. We always allude to sleep being the most important pillar in the framework of overall health because as you mentioned, everything else crumbles. Bad food choices, more insulin resistant, less likely to want to move, less cognizant. And I just think that it impacts every other pillar so profoundly. And oftentimes people really, really struggle because mentally as well, it can be a little bit of a mind game. If you think you are not going to sleep, then you can ruminate on that and you can disrupt your sleep. I am fascinated by sleep, obsessed by sleep. Had issues sleeping a long time ago when my wife gave birth to twins, and we had a youngster already, so three girls in the house. My sleep just went. But I got it back and I’ve continued to work on it and track it with technology literally from that point and now I sleep really well. So I’m interested to hear then from your perspective, what are the quick wins for sleep? Just the things that are no-brainer and maybe things that people may not even consider that could have the biggest effect when wanting to really shift that lever in the right direction?
Dafna
(23:10)
Yeah. I’d love to talk about that because it is so important. So a lot of people don’t realize that sleeping at night and the quality of your sleep and how easy you go to sleep really starts in the morning. And so when you wake up in the morning, a lot of us go into our home office or another place and we don’t get natural light. We actually never go outside. I know I sometimes forget to go outside because I work from home and certainly after covid, that’s the case for many people. And so getting natural light exposure, even if it’s for 15 or 20 minutes, ideally as early as possible, so that light goes through your eyes and into your brain, that helps to reset your circadian rhythm system. That’s your body’s biological clock and everything is happening according to that biological clock. And so we want to make sure that we get natural light early in the day, even for a few minutes.
(24:02)
And then routines are very important as well. So keeping things as consistent as possible as far as waking up and going to bedtimes, that’s really helpful. Keeping your meal schedule regular. Not eating heavy meals later in the day. We used to think that it doesn’t matter when people eat. Now we know that there is something to that. And even though I don’t recommend intermittent fasting in a very strict way, I do recommend that people contain their eating within a 10 to 12 hour window. That allows your body enough time to rest and digest and really get that food where it needs to go. And you’re much more likely to fall asleep and stay asleep when there’s not a lot of food in your system and your body needs to work hard to break down a high fat meal or a high carbohydrate meal at nine or 10:00 PM. That’s usually something that can disrupt sleep as well.
(24:54)
And then of course, avoiding screens as best as you can because the blue light from screens like our phones and our iPads can interfere with our melatonin production and with the circadian rhythm system. And so sometimes when people can’t sleep at night, the first thing they reach for is their phone, right? We start scrolling. And that I think is so harmful on so many levels first because of the blue light, but then also you’re not really in control of what contents you’re exposed to and what you see in your feed, and that may trigger you or cause some thoughts. And so I would recommend that instead of keeping your phone by your bed, keep a notepad, keep something that’s going to help you maybe … If you’re having anxiety or you can’t sleep because of racing thoughts, put those thoughts onto paper and get them out of your system.
(25:46)
Or if you can, go to another room, read a book, dim the lights, keep the environment in your home as close as possible to what’s happening outside. Meaning when it’s light outside, yes, you can have your lights on and have full daylight inside your home as well. But as the day goes by and it’s becoming evening, I would say dim the lights, create an atmosphere that’s conducive to going to bed, signal to your body that it’s time to wind down. And it is really helpful to also set up your bedroom in that way. So keep the bedroom a little bit colder. Maybe you need to get shades that block light. A lot of my clients like to use a dawn simulator. It’s a machine that helps them gradually wake up in the morning. It creates the sensation of sunrise in your home. And so there’s a machine that can help with that.
(26:48)
And so those are some of the things. But I would say for sure routines and getting yourself to a point where you’re doing a sequence of activities in the evening that help that now it’s time to shut off devices, it’s time to unwind. Maybe you do a short breath work session, maybe you do a meditation, maybe you listen to a sleep story so you don’t go on your phone, but you can put in your earbuds and listen to a sleep story. I really like the Calm app. They have great sleep stories. And so it’s almost like when you put a child to bed, they have a routine. They eat their dinner, they take their bath, they read the story, they brush your teeth. So you want to do some sort of a routine like that that will help soothe you and help you get to bed and really create that sequence of events that signals to your body that it’s time to go to bed.
Stu
(27:41)
Yeah. No. That’s great advice.
Dafna
(27:44)
Yeah. Thank you. I recently had someone on my podcast, she was a sleep doctor, and her name is Audrey Wells. And that’s actually a recent episode on my podcast where she really talked about also the habits of sleep and the mindset around it. And so she really dove deeper into a lot of these tips there. So maybe we can link to that in the show notes or I’ll give you some more information about that.
Stu
(28:11)
Absolutely. Yeah. The more we can do to raise awareness of what we need to do to improve sleep quality, the better, because just as we mentioned, it impacts everything. So no. Fantastic. You’re just ticking all of the things that I have in my mind about the most important things to be aware of. And when you said that good quality sleep starts when you wake up, absolutely right. You’ve got to get outside and get into our natural environment and reset the clock for sure. Fantastic. So let’s then say that we’ve mastered our sleep. That’s a big tick for us. We’ve got good quality sleep. We’re not waking up during the night. We’re actually opening our eyes in the morning and feel well rested. Then how might we apply that mindset then to nutrition in terms of just creating the right habits that we need to in order to cover that area as well?
Dafna
(29:09)
Yeah. One of the things that’s really important for PCOS is blood sugar balance. It’s important for everyone, but with PCOS, because insulin resistance is so common … Up to 90% of women with PCOS have some degree of insulin resistance, we really need to focus on eating in a way that keeps blood sugar stable. And what that means is that when we eat a meal, we’re not getting a huge surge of insulin to cover our meal. So insulin is the hormone that helps our body process carbohydrates and get sugar from our digestive tract and from our bloodstream into our cells and really energize the cells and get them the essential nutrition that they need. Our cells feed on glucose, on sugar.
(29:56)
And so one of the important ways that we can do that … Well, there are a few things that I want to mention. The first one as we just talked about is consistent meal timing. When you eat in consistent intervals throughout the day … And I know it’s hard. I know we’re all busy. I know skipping lunch or skipping breakfast is a common thing to do, but our body doesn’t like that because when we skip meals, we tend to get hungrier. Our body tends to burn less calories so our metabolism can slow down, and then we end up overeating because we’re so hungry that a lot of insulin is being secreted, and there could be a blood sugar spike and then a dip. And so when we get a blood sugar spike, we get a lot of insulin in order to keep blood sugar in the right ranges. And when someone is insulin resistant, their body is not responding well to that insulin. So what ends up happening is they have a lot of insulin being released and much of it is not working right so blood sugar stays high and insulin stays high.
(31:04)
And so one of the signs that this is happening is you get extremely fatigued after meals. You get a lot of sugar cravings, you get hungry soon after you eat. Maybe you have bloating and brain fog. Maybe you’re feeling really irritable. Those are all signs of blood sugar fluctuations that can be related to insulin resistance. And so we want to eat in regular intervals so that we don’t get into this situation and we want to make sure that each meal contains the following three things. A source of protein, a good source of fiber, and a lot of produce. All three of these things are going to help stabilize our blood sugar. They’re going to help prevent those peaks and valleys, and they’re going to make sure that you’re getting good nutrition and that your body’s not secreting too much insulin or causing your blood sugar to be like a rollercoaster. And it’s-
Stu
(32:00)
So-
Dafna
(32:00)
Yeah. Go ahead.
Stu
(32:00)
Sorry. Just to interject there, you didn’t mention fat. I’m really intrigued as to where that falls into this conversation.
Dafna
(32:09)
Yes. I think that for the most part, the way most people cook and the way that we eat, a lot of times fat is already included in our meals. So if I were to cook my vegetables or I were to cook my protein, I usually include olive oil in that. Or if I eat a salad, I usually include salad dressing with that. And the way that I teach people to put their meals together, the fat is part of the preparation. But you are right. If someone is not eating a meal that would contain a fat naturally, they absolutely need a few servings of fat in that meal because that really helps with blood sugar control as well. And generally speaking, I like plant-based sources for the most part. So things like nuts and seeds, avocado, olive oil, as well as fatty fish. So things like salmon and trout, those are really good sources of healthy fats. Of course, fish also provides protein. But those combinations tend to be the most blood sugar friendly.
(33:08)
And the reason that we focus so much on produce as well … And that could be fruits or non-starchy vegetables. Both fall under that umbrella of produce. Is that specifically with vegetables, they help volumize our meals. And when we volumize our meals, we tend to feel fuller. Of course, we’re getting a lot more nutrition through the vegetables, a lot more fiber, but we get to eat a little bit more. And I don’t know about you, but I like to eat more whenever I can.
Stu
(33:36)
Absolutely. I agree.
Dafna
(33:38)
So we get to eat bigger amounts, have the meals fill us up for longer. And for a lot of my clients, that is really a game changer because it helps them with satiety. That feeling of fullness and not having to think about food within 30 minutes of eating. So produce is a really important component here. Not to mention it also helps with inflammation. When we eat a variety of fruits and vegetables, a mix of colors and textures and types, it really helps with increasing the amount of antioxidants that we eat and that’s important for reducing inflammation, which is an issue with PCOS as well.
Stu
(34:16)
Brilliant. Brilliant. So a bit of a curveball question. We mentioned social media and the prevalence that PCOS is currently undergoing. We see it everywhere. It’s often linked to radical diets. Almost the extreme. And I’m not so much seeing the extreme plant-based. I’m seeing it in the extreme carnivore subset where people are going eliminate everything apart from meat. The proponents of these diets might look at their evolutionary ancestors and say, well, this is all we’ve eaten. But we don’t really have any hard and fast data and rigorous clinical long-term studies to support the use of that as an intervention. And I just wonder what your thoughts are on that, because I do see that the two … Oftentimes, at least on social media, which is a crazy place to want to get medical information anyway, they’re often linked.
Dafna
(35:24)
Yes. Keto is really popular in terms of PCOS, and I see a lot of people who are pushing keto. Usually those are people with not much of a medical background or any real knowledge as far as nutrition. And the reason that I personally do not recommend it and I actually think it’s dangerous, is partly the connection between PCOS and heart disease. When we eat a very protein-based diet and we eliminate fiber, we eliminate things like beans and legumes, we eliminate a lot of things that are actually very healthy and have been eaten for thousands of years in regions like the Mediterranean and other blue zones … If anyone listening right now has heard of blue Zones, those are areas of the world where people eat gluten and they eat a lot of carbohydrates, and they are the healthiest people on earth.
(36:16)
And so really with PCOS, it’s no different. When we’re eating a diet that’s very high in animal protein, chances are we’re taking in a lot of saturated fat and we’re not eating enough gut healthy foods like plant-based foods and fiber and that can really be detrimental for health. Not just because it can raise cholesterol and heart disease risk, but also because it reduces gut health. And we know gut health is tightly linked to inflammation. So if our gut is not thriving, our bacteria in our gut is not getting the fiber and nutrition that they need … And they do not feed on protein, they feed on plants mostly. Our immune system is going to be impacted negatively. Our digestion is going to be impacted negatively and inflammation is likely to rise.
(37:03)
And so the way I see it, and from my experience and knowledge, keto is not a suitable approach for PCOS. Not to mention very few people can live on keto for the rest of their lives. It’s not really a sustainable diet. You may be able to do it for four, six weeks or a few months, but at the end of the day, do you really see yourself not eating carbohydrates or eating cream cheese, steak and bacon for the rest of your life? For my clients and women that I interact with every day, the answer is no. I don’t want to live like that. It’s a really good litmus test for a diet or a plan that you see online to ask yourself, I think this could work for me, but can I actually see myself eating this way five years from now, 15 years from now, 20 years from now?
(37:55)
Okay. So with PCOS, again, it’s a chronic, lifelong condition. What you do today has to be doable in 10 years from now still. And so I think this is a really thought-provoking question for anyone listening right now who has PCOS or is having a hard time managing their PCOS and maybe have struggled through keto and intermittent fasting and gluten-free dairy-free diets, which are also very much recommended for PCOS, and that is a complete myth. There is no reason to eliminate gluten and dairy for PCOS. But unfortunately online the loudest voices are the ones that end up being perceived as the most credible, and that is absolutely not the case. And so if anyone listening right now has been through keto or gluten-free diets or has eliminated many different foods in order to manage their PCOS and their symptoms didn’t get better, which is very likely, I want you to really reconsider and think about following a less strict approach that is more balanced and is actually sustainable long term.
Stu
(39:01)
Yeah. No. That’s solid advice. You mentioned gluten-free, dairy free. There is such a sliding scale on gluten, wheat and grains and dairy. And yes, we could grab a cake from the bakery with icing and sweet treats and everything like that. Yes, that will behave quite differently to perhaps a slice of sourdough. And similarly with dairy, we could get a chocolate milk from the service station as opposed to Greek yogurt, for instance.
Dafna
(39:46)
Exactly. That’s exactly. It’s all about quality. We need to consider quality. This is why we don’t want to eliminate complete food groups, entire food groups and label them as bad. There’s such nuance and variability, and we really have to consider the quality, the level of processing of the food and how you personally respond to that food. And just to piggyback off of what you said, I could go to the bakery by my house, and also buy a gluten-free and dairy-free cupcake, and that’s no health food.
Stu
(40:19)
It’s still a cupcake, right?
Dafna
(40:21)
Exactly. It’s still a cupcake. And so just by something being labeled a certain way or having a health halo or being gluten-free, dairy free, soy free, it does not give it a stamp of approval as far as your health. You really have to understand what are the factors that really matter? And quality is a big one. Making sure that things don’t contain a lot of added sugar. So whether it’s gluten-free or dairy-free, it could still have a ton of sugar added to it, and that’s not good for PCOS or anyone in general. So with that, we also have to find balance to include those treats and to include those foods that we love. And so if I’m celebrating my birthday or anniversary and I have PCOS, I want to be able to enjoy cake or a glass of wine or whatever it may be without feeling like I’m doing something wrong for my hormones. And so we really have to unlearn those strict rules. We really have to stop thinking in black in white, good and bad when it comes to food. Let’s consider quality first and then start sprinkling in those foods that we know are not the best for us, but we still want to enjoy them. That is the definition of a balanced lifestyle. You’re not on either extreme, right?
Stu
(41:33)
No. I completely agree. And if every day looks like a birthday party, then you’ve got problems.
Dafna
(41:40)
Yes. Yes. It sounds lovely, but it’s really not great for our health.
Stu
(41:45)
No. That’s right.
Dafna
(41:46)
It’s so funny that you say that because I have a lot of women in my programs who say, “Well, I’m good all week, but then on the weekends I like to eat out and I like to have a few drinks.” And what I say to that is if you look at Saturday and Sunday, two days out of seven days, that’s a pretty high percentage of the time, and that happens every week. So a birthday may happen once a year, but if every weekend you’re checking out and you’re eating whatever, it’s going to be really hard to face Monday every single week. And so we don’t want to be in that, again, all or nothing mentality. It’s good to live in the gray when it comes to eating and find that, again, balance. Health with a teaspoon of fun and enjoying your food. And that’s not to say that healthy food can’t be enjoyable. I have a library of delicious recipes inside all of my programs, and women are pleasantly surprised to find out that they actually like this healthy food and their whole family and husbands and kids are eating it as well. But again, I understand that sometimes we just want to have a chocolate cake, a basket of fries and a cheeseburger, and there is room for that.
Stu
(42:59)
I think so. We use the phrase ultra processed foods, refined carbohydrates and industrial seed oils. And if you can try and minimize those best you can, then you’re going to be naturally gravitating towards whole foods, real foods. And oftentimes it’s hard to overeat when you have an abundance of nutrient dense foods. Because all of the signals work in your body and there’s no craziness that has been engineered in a laboratory for that perfect bliss point to make you want more.
Dafna
(43:36)
Exactly.
Stu
(43:37)
Yeah. It’s a bit of a journey to rewind, eat like our grandparents used to eat. Get a wide variety. Let’s not go too crazy and just eat one particular food group and think that we’re going to live until we’re 150. It doesn’t really make sense. But no, I think we are definitely in alignment. So let’s just say then that we’ve ticked sleep, we’ve ticked nutrition. What other lifestyle factors then could possibly support PCOS?
Dafna
(44:05)
Movement. Movement is a huge part of blood sugar control. And it doesn’t have to be any specific type of movement. Part of the noise on social media is about the best type of workout for PCOS, and there’s really no such thing. Everyone’s body is so different. Some women do really well with higher intensity workouts. Some people like yoga and leisurely walking. Whatever type of movement feels good and is doable for you, you can actually do it consistently multiple times a week. That is the best workout for you. I usually recommend starting with … If someone’s not working out right now, they can start very easily with just taking a 15, 20 minute walk after dinner or after lunch. Timing your walking and movement after meals really help increase insulin sensitivity. So when we start moving, it’s a wake-up call for ourselves to start taking up glucose and use up the insulin in our system. And so that’s one really easy way that someone could get started.
(45:07)
There are many studies that show that resistance training, so weightlifting strength training can also improve insulin sensitivity, so that’s great as well. And then yoga. Especially for those trying to conceive, yoga is a great type of movement that’s linked to increased fertility, and that can help with ovulation, regulating your cycle and increases the chances of conception. A mix of all of those is likely a good place to start if possible. If not, just pick one. Try to do it maybe two, three times a week to start. See how you feel. You can always build from there. But some form of movement is highly, highly recommended as tolerated.
Stu
(45:53)
Okay. Fantastic. So much like the subset of people out there that perhaps really just hone in on one element and just do it to death. I guess the same would apply to exercise. If you are getting up at 5:00 in the morning and smashing yourself on a bootcamp seven days a week, probably not the best approach to take from a healing perspective.
Dafna
(46:18)
That’s really going to be tough on your system as far as cortisol levels and recovery and a lot of times people don’t allow proper recovery. They get into this mode, like you said, of I’m going to do a bootcamp, or I’m doing a 30-day challenge where I’m going to the gym every single day and I’m lifting the heaviest I can and I’m exerting myself to the max, and then I’m not sleeping well, I’m not eating properly to fuel after those workouts, and I don’t stretch and I don’t take a day off. And so that’s a recipe for really creating a hormone storm, if you will, in your body that’s going to leave you feeling rundown, maybe more prone to illness, more prone to things like colds and definitely feeling aches and pains, joint pain and not sleeping well. And so if you have hormonal issues, and if you are listening right now and have PCOS or suspect that you have it, that is definitely not the way to go.
(47:19)
Low and slow wins the race with PCOS. Let’s not go all out, especially if you’re not used to that level of activity. And many women with PCOS are athletes. They play sport at a high level. And because of this slight increase in androgens, they’re very muscular and they’re strong. And so if you’re used to that kind of movement and that level of exercise, there’s nothing wrong with it. But if you’re finding that you’re having a hard time recovering from your workouts, I would say let’s tone it down. Let’s take the intensity and frequency down. Try something that’s a little bit less aggressive, and I think that can work better.
Stu
(48:05)
Yeah. Brilliant. No, that’s fantastic. In a nutshell, really it’s the basics. Nourish yourself appropriately, move every day, get natural light and sleep well and oftentimes you’re going to be in a far better place than where you’ve come from. So really good advice.
(48:26)
Dafna, we’re coming up on time. I’ve got a few questions that just wanted to ask more so from perhaps your own perspective as well. If we wanted the big hitters, if you could give us perhaps three tips say that you think could make the biggest impact on our overall health, that irrespective of where you are on your health journey, if you adhere to these things, they’re never going to fail, what do you think they might be?
Dafna
(48:54)
Okay. That’s a big question.
Stu
(48:55)
Yeah, it is.
Dafna
(48:56)
I’m going try my best here, okay?
Stu
(48:57)
Yeah.
Dafna
(48:58)
And I’m going to give you my top tips from my angle, which is nutrition. I like to focus on the diet. I think it’s super important. I would say the first one is eat enough, don’t under eat, and don’t skip meals. Keep a regular consistent schedule as much as possible. And let’s open a little parentheses here and say, keep a consistent schedule as far as your sleep as well. Set boundaries around your time. A lot of boundaries have been blurred during covid as far as work and personal time. I would say it’s time now to reevaluate whether you have enough leisure time for self-care and taking care of your needs versus when you’re working and stressed and focusing on other things. And so with that umbrella of consistent meal timing also comes consistent sleep schedule, consistent self-care schedule. So that’s really important as well.
(49:52)
Include produce, protein and fiber in every meal and a source of fat if it’s not included already. Okay. That’s really important. Move in a way that feels good, like we just said. And then overall, try to do something that will take care of your mental health every single day. Whether that’s journaling, meditation, listening to sleep stories or calling someone that you love and you haven’t spoken to in a while. Make it a point to call them today. Make sure that you’re spending time in nature. And then also, take time off. I think that’s one of the most underrated health habits is alone time. Take time off. Be with yourself if you like that. I know I do. And unplug a little bit. Put the phone down, put the devices down, maybe read a book, do something that you used to love doing and you don’t do anymore. I think that’s so important just for your own mental health and for keeping yourself in a good head space.
Stu
(50:49)
Brilliant. Yeah. Fantastic. Lots and lots and lots of great information there. And I think that if people can listen and adhere to that and start building it into each and every day and creating healthy habits, then they’re going to be going in the right direction. So what’s next for you over in the next six to 12 months? What have you gotten in the pipeline?
Dafna
(51:08)
I have some exciting stuff. Yeah. Thanks for asking. I have a lot of exciting things coming up. I am launching a program of mine called Reset Your PCOS that has been going on for several years. It’s a group coaching program that I really love and enjoy working with women inside. I have my podcast, so it’s called The Down to Earth PCOS Nutrition Podcast. That’s where I share weekly different topics and information, guest speakers regarding PCOS, nutrition and health in general. Then I hang out on social media. I hang out on Instagram most days. I’m @PCOS.nutritionist.dafna, so people can find me there and connect in DMs. And other than that, I plan on enjoying some time in my home. We’re coming up on hopefully fall soon. I’m in New Jersey, so I’m looking forward to some cooler weather and just continuing to cook and travel and hang out with my kids, all of that good stuff.
Stu
(52:09)
Brilliant. Fantastic. And so for all of our listeners then that want to get more of you, dive into the podcasts, explore the program, and essentially just follow you and stalk you and reach out as they can, where can I send them? Where would be the best place?
Dafna
(52:24)
The best place would be social media, so Instagram. And they can just search PCOS nutritionist Dafna and I’m going to come up. My podcast again is Down To Earth PCOS Nutrition. And then I also want to mention that if anyone is confused or not sure where to go after listening to today’s conversation, they want to get started with managing their PCOS, they can take my free quiz. It’s called What’s Driving Your PCOS Symptoms Right Now. It’s where I dive deeper and help them understand what is the root cause of their PCOS and what they should do next. So it’s a free five minute or less quiz. And at the end they’ll go to a results page that will tell them what’s driving their PCOS and how they can manage it and how they can get started with addressing that driver. And so that can be found at dafnachazin.com/quiz.
Stu
(53:17)
Fantastic. That is fantastic. We’ll put all of the links that we’ve spoken about today in the show notes and then look forward to launching this to our community because I think there’s huge value in everything that we’ve spoken about today. Dafna really, really appreciative of your time and look forward to sending some traffic your way, and hopefully people can uncover the mystery of PCOS once and for all.
Dafna
(53:41)
Sounds good. Thanks so much for having me.
Stu
(53:43)
Thank you. Bye-bye.
