Practically every time I hear a health professional explain, on the Internet or in person, why a woman with PCOS has carbohydrate cravings, they blame it on insulin resistance. The rationale is, that because glucose is not getting into cells, the cells are hungry and asking for sugar.
Did you know, as rational as this explanation sounds, research does not support it?
A study published in 2004 (and one of the few I've ever even seen that acknowledged that women with PCOS crave sugar) compared several appetite hormones to appetite measures in 16 pairs of women with PCOS matched with controls. They could find no statistically significant correlation between reported appetite and insulin levels. Rather, it was testosterone levels that seemed to be the problem.
Because insulin resistance has some effect on how much free testosterone is available to affect appetite, it could be argued that the effect is still there, but more indirect. However, another study reported that it is the eating of too much sugar and the resulting change in liver function that ultimately determines free testosterone levels, not insulin. (In this particular study the diet was up to 70% sugar, to be sure the desired metabolic effect was achieved and could be studied.) The resulting fat production by the liver was correlated with reduced levels of sex hormone binding globulin, the blood protein that binds to testosterone and inactivates it.
So while the cravings are there, be sure not to blame their cause on a solution that may not help. Our philosophy at inCYST is that balancing fatty acids helps calm down the nervous system and reduce its need for sugar. It also helps the liver better process fats, thus preventing the testosterone issue described above.
I know, I know, you're getting tired of hearing about fish oil.
I won't belabor the point, today I'll just challenge you to think outside the same old test tube.: )
Hirschberg AL, Naessén S, Stridsberg M, Byström B, Holtet J. Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecol Endocrinol. 2004 Aug;19(2):79-87.
Selva DM, Hogeveen KN, Innis SM, and Hammond GL. Monosaccharide-induced lipogenesis regulates the human hepatic sex hormone–binding globulin gene. J Clin Invest. 2007 December 3; 117(12): 3979–3987.