Circadian Rhythms, Insulin Resistance, and FOOD

By Dr. Gretchen KubackyChronic Illness, PCOS

A recent article over on CNN offers some excellent insights about one of my favorite topics. Yup, you guessed it: FOOD.

As many of you who, like me, deal with polycystic ovary syndrome (PCOS) have probably experienced, the relationship with food can become…tense. Food becomes less a source of joy and nourishment and more like a threatening opponent we must wrestle into submission in order to control our weight.

Interestingly, according to the research and interviews cited in the aforementioned article, eating in tune with our natural circadian rhythms might actually help us control our weight. So, in other words, it’s not just what you eat, but also when you eat it! The article is a great source of information and I highly recommend that you read it and come back. It’s ok, I’ll wait.

Welcome back! So, in addition to all the nuggets (mmmm, nuggets) of information in the article about weight loss, there was something else very relevant to PCOS hidden in there. Did you catch it? The article mentioned that insulin sensitivity also operates according to circadian rhythms! Why is that important?

Well, our level of insulin sensitivity controls how our body processes and stores glucose, which has a ton of important downstream effects on our health and weight. Unfortunately, more than half of women with PCOS display insulin resistance. This is bad because insulin resistance is a prime factor in developing Type II diabetes, a serious health condition that, if left unchecked, can lead to a runaway breakdown in how your body processes sugar and lead to severe health complications such as cardiovascular disease.

Insulin resistance is also a prime contributor to weight gain, as the lower our insulin sensitivity is, the more likely our food is to be stored in fat cells rather than burned for energy. Controlling weight is a huge component of proper PCOS self-care for a number of reasons. Not the least of which is that even just a 7% reduction in weight is associated with increased fertility among women with PCOS! In addition, weight gain is yet another pathway through which diabetes and cardiovascular disease can occur.

Finally, insulin resistance is also linked with sleep-disordered breathing, such as sleep apnea. This is important because sleep-disordered breathing leads to poorer metabolic function, which leads to weight gain, which worsens sleep-disordered breathing and so on, creating a negative spiral in which weight gain, insulin resistance, and poor sleep are all exacerbated, all of which then increase the risk for developing or worsening (say it with me now) diabetes and cardiovascular disease. Yikes!

So what to do about all of this? Well, as CNN’s article suggests, in order to eat according to our circadian rhythms, it’s important to eat breakfast, make a healthy balanced lunch your biggest meal of the day, and to avoid carbs at dinner. This will help synchronize your food intake when your metabolism in order to maximize energy and feelings of satiety, as well as reduce the tendency to store the food as fat. Your body will thank you for it!

References:
Drayer, L. (May 19, 2017). Weight loss can be tied to when, not just what, you eat. CNN. Retrieved 5/25/17 from: http://www.cnn.com/2017/05/19/health/weight-loss-circadian-rhythms-drayer/index.html
Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: Mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774–800. http://doi.org/10.1210/er.18.6.774
Punjabi, N. M., Shahar, E., Redline, S., Gottlieb, D. J., Givelber, R., & Resnick, H. E. (2004). Sleep-disordered breathing, glucose intolerance, and insulin resistance: The sleep heart health study. American Journal of Epidemiology, 160(6), 521–530. http://doi.org/10.1093/aje/kwh261