Protein, Blood Sugar, and PCOS: Nutrition for Fertility | Ep. 607

Episode 607

Registration is officially open for our next round of our fertility awareness mastery
mentorship certification. Whether you’ve been looking for a deeper way to support your
fertility clients, whether you’ve been looking for an opportunity to teach fertility
awareness in your practice, or whether you’re just ready to interpret complex charts
with confidence. You’ll absolutely love what we’ve put together for you in FAM. But
don’t take my word for it. Here’s what Haley had to say about her experience in
FAM. Before FAM, I was still growing my practice, but there wasn’t the structure I
have to it now. Fertility awareness method and using cycle charting in this way as
the diagnostic tools completely integrated into my practice. It is at the center of
my signature offering. And I did increase my prices. Gosh,
it’s been several years now, but I am generating the most revenue that I ever have.
Head over to fertility friday .com slash fam live to apply today. That’s fertility
friday .com slash F -A -M -M -L -I -V -E. This is the Fertility Friday podcast,
episode number 607.
Happy New year. It’s officially 2026 and I want to welcome you back to the
Fertility Friday podcast. I’m really excited for this new year. And you know what? I
thought what better way to kick off the new year than with this in -depth episode
with Lily Nichols where we dive into the importance of nutrition for fertility?
We get into a lot of really interesting data in this episode, we go into PCOS as
a case study to showcase why blood sugar balance, macronutrient balance, and
micronutrients matter for fertility. We talk about the issue of under -eating protein
because this is something that is very, very consistent. Under -eating protein
consistently is associated with unbalanced hormones and menstrual cycle irregularities.
And so we talk about what the research has to say about how higher protein
approaches do result in better outcomes for women not only with PCOS,
but overall. And that is truly only the tip of the iceberg. For those of you who
don’t know Lily, Lily Nichols is a registered dietitian nutritionist, certified
diabetes educator, researcher, and author with a passion for evidence -based nutrition.
Her work is known for being research focused, thorough, and sensible. She is the
founder of the Institute for Prenatal Nutrition, the co -founder of the Women’s Health
Nutrition Academy, and of course the author of three books, Real Food for Fertility,
which we wrote together, Real Food for Pregnancy and Real Food for Gestational
Diabetes. So without further ado, let’s go ahead and dive into today’s episode with
Lily Nichols.
And I’m excited to be back again with Lily Nichols for our part two throwdown on
Real Food for Fertility. Welcome back. Happy to be here. Let’s do this. All right.
Well, so in our first episode together, I had a ton of fun. We were able to
really talk a little bit more about the process of writing and share some behind
the scenes. But In today’s episode, we wanted to get into some of the nitty -gritty
details and especially some of the details that you went to in your sections of the
book. So, yeah, we have on the agenda today to talk a little bit about PCOS and
to talk a little bit about protein because you found some really interesting data.
So I think I’ll just ask kind of a general question to get us started. I know we
got into a little bit of this in our first episode together, but share a little
bit about what you found about the significance of protein infertility and how it
relates, especially to women with PCOS. Well, I’ve long been a proponent of people
consuming enough protein for many reasons, even outside of like the childbearing and
pre -childbearing years. Just because of its effect on our satiety and blood sugar
regulation. It just makes a very tangible difference when people get enough protein
and so many people I find are under eating. I may be a little bit naive because I
mean, I’m coming at it from the assumption that protein is important, but I don’t
know how far off the recommendations are for supporting optimal fertility compared to
what our recommended dietary allowances are. Whereas like in pregnancy,
it’s like I have like specific data to pull from where they’ve like studied pregnant
women and this is optimal and fertility like I alluded to in our last interview is
a little bit trickier to like nail down. So I went at it from a couple of
different angles looking at the like blood sugar perspective and how that affects
fertility. Obviously there’s a little bit of carryover on protein there. Looking at
it from the standpoint of like opulatory f***
amino acids and how that affects the menstrual cycle, ovulation, conception,
and early embryogenesis. So looking at it from like all of those angles, as a
whole, I can say without getting into the nitty -gritty, at least not yet, is that
optimal protein intake for supporting fertility, reproductive hormone levels like
menstrual cycle function and supporting optimal conception and supporting optimal intake
of
the protein levels I’m recommending for early pregnancy in, you know, my other book,
Real Food for Pregnancy, and for women who are more physically active and they have
higher protein turnover from muscle repair and like supporting their connective tissue
and everything, they need to aim even higher for protein. So that was like the
major takeaway on the PCOS side of things and we can get into more of the
specifics. the most successful dietary intervention trials for PCOS were in those that
modified the macronutrient ratios in a way that they were eating more protein.
And specifically, usually erring towards more protein and fat and less carbohydrates,
or at the very least, like better quality, low glycemic carbohydrates. Well, so I
think a lot of our listeners are familiar with PCOS, but maybe share a little bit
about the kind of metabolic issues that arise with PCOS. Why with PCOS,
for, I would say, especially the more classic types of PCOS, why the dietary change
and the focus on protein would be so important. Yeah. Well, I mean, you and I both
teamed up on writing the PCOS chapter. So you could probably go into even more of
the specifics on some of this step, but to highlight one of the areas that I was
really focusing on is the insulin resistance component, which actually ties into the
other metabolic components that are also going on with PCOS. So like, it’s all
related, but I tend to really zero in on this one. I mean, the majority of PCOS
cases involve some level of insulin resistance, anywhere from like 50 to 70 % of
women with PCOS are insulin resistant to some degree. And depending on which of the
phenotypes, which are the four phenotypes you have, A, B, C, or D, levels of
insulin resistance can be, or different, or prevalence of insulin resistance can be
different among those phenotypes. So the reason that this matters is like you have
insulin receptors all throughout your body, including on the ovaries.
And if our bodies are exposed to high levels of insulin, day in and day out,
meal after meal for a really long time, our body starts to become insulin resistant.
It stops responding like it normally would to insulin. And then the body has to
pump out, like even more insulin to get the same metabolic effect, the same like
blood sugar a lowering effect that you see typically when insulin levels are.
levels, but we’re also lowering levels of insulin resistance. And it’s really tricky
to bring blood sugar levels down without consuming enough protein.
If you’re looking at like how different macronutrients affect your blood sugar levels
and thus also your insulin levels, because it’s like blood sugar goes up first and
then the insulin. Like they always go hand in hand. By and large carbohydrates are
the biggest macronutrient that’s going to spike your blood sugar. Protein and fat
will trigger a fairly small release of insulin, protein a little bit more than
carbohydrate, although in people who are not diabetic, the blood sugar surge and
insulin surge caused by protein is like really, really, really small. And even in
people with diabetes, it’s like nothing, like exponentially less compared to what’s
triggered by carbohydrate consumption. So if we can get the levels of insulin and
the levels of insulin resistance down, you start to see the other metabolic issues
going on with PCOS also improve. You tend to see chronic inflammation and oxidative
stress come down. You start to see androgen levels come down as well. Like, it’s
all related. So that’s why I tend to like focus from that angle first because it
is effective. It just works. Well, and when you talk about,
let’s say, eating like more protein, I think that a lot of women might think, so I
have to eat more food. Maybe what made me think of this also is that we had one
of our advanced reviewers who made a comment that one of her biggest takeaways was
the kind of plate method, the reorganizing of the macros. And It was one of those
things where it’s like, especially you’ve been talking about this in your work for
so long. I mean, you were doing this in the community and seeing such great
results. And it seems after you learn about the plate method, it seems so like, oh,
of course, you know. But I don’t know. I just thought about that review and thought
like, okay, well, wow, that was one of her biggest takeaways. So maybe share just,
I suppose, for anyone who’s like, oh, is she telling me I have to eat a whole
bunch more food? How does this work? Well, you can eat a whole bunch more food
depending on what the food is. So that depends. You might actually be able to eat
a whole bunch more food. You don’t necessarily have to, and your satiety will
probably shift a little bit as you pay attention a little more to your macronutrient
ratios. So it’s funny. I find my work is split between like this really in -depth
and detailed scientific stuff and then also like the sort of basic educational
takeaways like the plate method like the plate method has been used for decades by
lots of different practitioners I think my plate method like is a little more fine
-tuned by macronutrient groups versus like food groups from the typical like government
ones to really kind of hone it in a little more detail but It’s really quite
simple. When we shift the ratios of our macronutrients are fats, carbohydrates, and
protein toward a type of plate that is not so heavy in carbohydrates,
we’re going to improve our blood sugar and insulin levels. So typical way that a
lot of, at least Americans will eat, is a very like carb -centric meal.
It’s based around pasta or potatoes or rice or bread.
It’s just really heavy on the carbohydrates. And then the other components of the
meal are just kind of like extras. You have like, oh, a little bit of protein in
there, like a few meatballs on the pasta. And maybe there’s like a few vegetables
mixed into the pasta sauce. But really at the end of the day, you have a huge
plate of carbs. And if we can shift that towards like a,
I’ll just use the pasta example, because that’s one I came up with, a small portion
of pasta the taking up maybe a quarter of the plate, a larger portion of meatballs.
So you actually get a substantial filling portion of protein for most women that’s
probably going to be, well, it depends on your size and your activity levels, but
like three ounces at minimum, maybe four or five, even six ounces of protein for
somebody who’s more active. And then like a large salad or a large portion of like
cooked broccoli or green beans or something on the side. Or maybe you get real
fancy and you do like zucchini noodles or something in place of part of the pasta
and kind of work it into the meal itself. The effect of that on your blood sugar
and insulin levels is like a completely different animal from the plate that was
really
satisfied for longer, but without the crazy blood sugar roller coaster that would
follow a typical carbohydrate -rich meal. And for women with PCOS, especially,
I would say uncontrolled PCOS, you know, when we’re still seeing the effect on the
menstrual cycle, which is primarily delayed ovulation leading to a really long cycle.
I’ve worked with a number of clients who, when they’re in that season, where before
they’re able to get the insulin resistance under control and have the cycle
normalized.
like super low carb like ketogenic style diets to modifying the carbohydrate quality
and like shifting the protein up. So I can go into a couple of those. I will say
that as a whole, even in studies where you just modestly reduce the carbohydrate
intake, even like 10, 15%, you see significant improvement in a lot of different
parameters that we’re worried about with PCOS. Here’s one example that I think is
worth mentioning women with PCOS were given.
diet had 78 grams of protein per day and 265 grams of carbohydrates.
And in the women in the high protein group, they experienced greater weight loss of
17 pounds versus 7 pounds. They had a reduction in body fat and they had
significantly improved blood sugar levels after six months on the diet. And other
trials that have done more strictly low carb like some of the ones that have done
a ketogenic diet have seen, I would say, even greater improvement. So there’s one
study where they did a moderate protein ketogenic diet. So they kept carbs at 20
grams of carbohydrates per day. That’s quite strict, but that’s at ketogenic levels.
And this diet was followed for 12 weeks. And at the end of that time, clients lost
an average of 21 pounds, 18 pounds of which was body fat.
And that’s important because sometimes you put people on dietary interventions and
they lose weight, but they’re losing muscle mass. 18 out of 21 pounds was body fat.
So that’s showing significantly improved metabolic health. It helped normalize their
sex hormone profiles. It significantly improved blood sugar and insulin levels, markers
of insulin resistance, and blood lipids. So I could go into more.
There are plenty more dietary intervention trials at different levels of carbs or
protein or whatever. But as a whole, I think the takeaway is sort of shifting the
balance to slightly less carbohydrates and better quality carbohydrates, so less
process, less refined carbohydrates, more protein, and fearing fat less than is the
standard. The degree to which you’re going to
But in some cases that are more severe or more resistant to treatment or ones where
like, say your insulin resistance levels are at levels where your doctor wants to
put you on medication like metformin or something, you might want to err on the
even lower carb, even higher protein route if avoiding medication is one of your
goals. Well, you know, interestingly, I was actually talking to my husband yesterday.
Because of what I do, he always finds himself in conversations with women. And he
mentioned a friend of his has PCOS. And like a lot of women with PCOS, she was
just told to lose weight. And so what’s really helpful, even about what you just
shared with us, is that in the second study you mentioned, the participants did lose
weight as an effect of the diet, but it’s more nuance that. We’re not just saying
flat, like, oh, as the only solution just to lose weight. We’re actually going a
little bit deeper into what is the root of this issue, the insulin resistance, and
talking about how to control the blood sugar. And then as a byproduct of that, as
you improve metabolic health, you’re seeing these benefits. I could just imagine for
his friend to hear this information, it’s so much more helpful because then she
actually has an understanding of what the problem is. And to kind of put it out
there as well, I mean, in our PCOS chapter, we talk
we didn’t jump in and say you should restrict your calories to lose weight. Right.
Yeah, we don’t. I was actually at a conference recently the Metabolic Health Summit
and Dr. Ben Bickman was speaking. Many people know him.
He’s like a metabolic health researcher often specifically looking at fat and insulin.
And one of his comments that I found really poignant because I had never thought of
it in this way is that one of the confounding very
means. So with an energy deficit, low calorie,
you’re going to lower insulin levels. With a low carbohydrate diet, even if it’s
higher calorie or sufficient calories, you’re going to lower insulin levels. Now
still, oftentimes the low carbohydrate diet outperforms the low calorie diet in these
interventions, depending on how much they restricted The calories, right? They often
do outperform them, though, because they’re more effective at lowering insulin levels.
You also have a higher metabolic rate when you eat fewer carbohydrates. So actually
talk about this in Chapter 2. There’s been some really interesting data showing that
people who follow a low carbohydrate diet have an increased metabolic rate.
So how many calories your body burns per day? And this can be, depends on the
study. Some of them are quite a bit. but on average about 100.
you’re going to default to overeating. And then you’re not metabolically as efficient
as you are in low carb. So even in the low carb diets and they’re not restricting
the calories, oftentimes people do end up eating a little bit less because they are
more satisfied and you’re not fighting this like blood sugar roller coaster day in
and day out. I would also say one of the tricky things about just any weight loss
promoting diet is you have to be careful.
your ovulatory function, your reproductive hormone levels, we really do want to be
shifting to like a healthier body composition, not just like wasting away and losing
our muscle. Yeah, that’s such a good point. And as you were talking,
I mean, what’s interesting is that I’m of quite the strong opinion that when a
woman is trying to optimize her cycles for conception. So when she’s actively
planning to try for a baby or she’s currently trying for a baby, I haven’t seen,
and it is my opinion, but it’s not just because I think it’s interesting. When I’m
working with women and looking at their menstrual cycles, women who restrict calories
who are under -eating overall, they are not able to maintain optimal hormone balance,
and we’re not able to keep the menstrual cycle balanced when we’re under -eating
calories, especially when you add exercise into the mix. It’s just not a
would also be beneficial for their hormones and their fertility. Right. So maybe
share with us why we were so intentional and in terms of our recommendations. I
guess why, at least from my perspective, these two competing goals don’t work.
Like weight loss specifically is the goal through caloric restriction and optimizing
your cycle in overall nutritional stores and everything for fertility. Yeah,
Yeah, kind of overlaps into our considerations about hyposalamic amenorrhea, right?
Like, if you restrict calories too much, you will disrupt the menstrual cycle and
you’ll disrupt hormone production. So with energy intake,
pretty sure we have multiple studies, but one off the top of my head, if you start
restricting calories, and you get around or about 25 % of calories as an energy
deficit. So say your body, I’m just going to throw out a random number, not saying
this is representative of all of women, but let’s say you need 2 ,000 calories per
day for weight maintenance, and you’re now eating 1 ,500 calories per day.
You’ve reduced your calories by 25%. That reduction in and of itself,
eating 25 % less food than your body requires for weight maintenance is associated
with significant reductions in estrogen and progesterone levels. Depends on the study
that you’re looking at, but they can go down quite substantially. And also, if
you’re eating low fat, you can throw that off as well, even in the presence of
sufficient calories, because you need fat to build your steroid sex hormones.
So you don’t eat fat, we got problems. So you start putting people on this low
fat, low calorie diet, it’s like a double whammy to the cycle. Now,
when somebody who’s in a bigger body and has a higher percent body fat, conceivably
you have fat stores that you can tap into for a period of time to maybe maintain
some hormone production, but not everybody with PCOS is overweight, and that’s
another, like, myth that we go into in the book. And it’s also just not necessary
to deprive yourself and be miserable as a means to achieve weight loss.
It’s also usually not sustainable. So, like, you might lose weight for a little
while. I mean, we know plenty of people who go on yo -yo diets, right? You lose
weight for a little while, and then it becomes so unbearable to be starving all the
time that you eat again and you gain weight,
disruptions to the menstrual cycle. So in somebody who’s already experiencing a
disrupted menstrual cycle, why would we make it worse, or maybe throw in like a
disruption from another angle, like another mechanism to disrupt your cycle? Like
that’s not fair? Well, I think this is something that really stands out to me
because of my work when you’re looking at the menstrual cycle. Because Instead of
looking at the woman and being really obsessed and hyper -focused on her side,
because I think this is something that happens to a lot of women, too, when they
present with PCOS, where they’re looking for help with something that the doctor
can’t see past whatever their weight is. And so then they’re sitting there trying to
get help for something, and the doctor is just focus on the weight. Like, you need
to lose weight. But like the woman has issues. So one of the great things about
looking at the menstrual cycle as vital sign and actually paying attention to the
cycle itself is that it helps you. It’s not to say that weight is not an issue at
all, because obviously we know that it plays a role in overall health and fertility
and insulin. Like, we know this. But when we’re looking at the menstrual cycle, then
we can have that more objective marker. If we focus on supporting this woman to
achieve optimal hormone balance, and we can get the menstrual cycle back in line
through reducing insulin resistance and balancing blood sugar.
cycle where we’re not just then making it all. Because I mean, this is just yet
another thing that’s frustrating to me that women aren’t being cared for. So if you
want to comment on that, but I also wanted to ask you about the nutrient stores as
well, because I do see it to be problematic when you are restricting overall
calories. I mean, our goal, when you were talking also,
when we’re thinking about how we’re supporting women to achieve optimal fertility, is
to give them a way
well. Well, I think you’re exactly right in that the conventional approach is
focusing so much on the weight versus seeing the weight as a symptom of something
being metabolically out of balance in the body. So we don’t really focus on weight
very much in the book at all. It’s just naturally that as you improve your
metabolic health and you improve like when you eat more protein, your metabolic rate
goes up. When you choose better quality carbohydrates, your total carbohydrate intake
usually goes down a little bit, which again, is improving your metabolic rate, how
many calories your body’s burning per day. We’re improving your micronutrient intake
because we’re focusing on diet quality, not just macro ratios or calories or
whatever. So you need all these different micronutrients for your mitochondria to like
work properly, which is also important for your egg quality too, like once you get
pregnant.
Like, no education around diet quality, like you’re just looking at it from this one
angle, this one possible intervention instead of you can actually achieve a lot of
the same things from a different angle that’s more supportive of like female
physiology as a whole and better prepares your body for conception,
which is often the goal, at least for people who are picking up our book, usually
the goal is they want to conceive and have a baby. So the last thing we want you
to do is come into pregnancy, feeling depleted. That is just not a good scenario to
aim for many, many, many different reasons. We want your nutrient stores at their
peak before conception. So, yeah, we don’t have to, like,
is that a method that sometimes works? Yes. Do you have to do that? No. Is it
less miserable to do it another
of issues. One of the things that you argue, though, is that blood sugar regulation
is not only important for individuals who have an overt issue with metabolism,
like in the case of PCOS. So maybe share why this whole concept of blood sugar
balance and macro ratio is important for everybody, regardless of whether they have
PCS or not. Yeah. Well, I mean, I’ve been in like the conversation around blood
sugar space for most of my career since I’m also a diabetes educator. So I
personally just see this rippling out to just about every possible health issue.
When your blood sugar levels are out of whack, it naturally leads to a state of
inflammation in your body, which disrupts, I mean, you name it,
just about everything, like health of your cardiovascular system, hormone balance,
muscle repair, liver function. Like, it is an emergency.
There are delays in conception observed in women who have blood sugar levels,
even on the higher end of the so -called normal range. So, in other words, even
blood sugar elevations that are below a diagnostic threshold for pre -diabetes or
diabetes can actually be problematic. So we don’t know for sure why all these things
are happening. I mean, I know from my work in pregnancy, that high blood sugar
levels can actually be teratogenic, so they can cause birth defects, particularly
early in pregnancy when the organs are forming. That’s all in the first eight weeks
of pregnancy. And again, like half of that period of time, you don’t even know
you’re pregnant yet. But we don’t know what exact time points, like the elevated
blood sugar is causing issues, is that at the time of fertilization, is at the time
of implantation, we know that there is a disruption there and we know a
studies and like outcomes from assisted reproductive technology interventions and you
see poorer outcomes as you see blood sugar levels rise to higher levels. So I’m a
proponent of everybody for their own well -being, physical, mental, and otherwise
aiming for blood sugar balance, at least having some awareness. It just makes you
feel better on like a day -to -day basis, but from the standpoint of fertility can
greatly improve your chances of conception. And then as you get into pregnancy, we
can reduce your risk of developing gestational diabetes or having a difficult to
control case, for example, or even reducing your risk of preeclampsia,
like blood sugar and blood pressure, go hand in hand. It’s like it’s related to
everything, really.
Registration is officially open for our next round of our fertility awareness mastery
mentorship certification. Whether you’ve been looking for a deeper way to support your
fertility clients, whether you’ve been looking for an opportunity to teach fertility
awareness in your practice, or whether you’re just ready to interpret complex charts
with confidence. You’ll absolutely love what we’ve put together for you in FAM. But
don’t
It sounds like such an amazing opportunity, and it has been better than I
anticipated. Every certification that I’ve done up until this point, and I’ve done
many, and I just love how much in -person contact there is, how we actually get to
know each other, and that has been the most wonderful part about the program. Other
things that I’ve done, it’s very kind of screens off. If there is an in -person
element, screens off, nobody talks. And I love that that’s not the case here. Like,
you can ask as many questions as you want. It’s been probably the best part about
this year for me. And I definitely did not have time for it. So if you,
if you think that’s you, you’ll figure it out. Head over to fertility friday .com
slash fam live to apply today. That’s fertility friday .com slash F -A -M -L -I -E.
practitioners that would suggest that there’s a minimum amount required and that we
shouldn’t go too low. And you mentioned a little bit of this with respect to PCOS
already, but maybe share a little bit about what you found when you were researching
for this book and where we essentially came to in terms of our recommendations.
Hopefully this question was clear for the listeners, but just to kind of wrap it
up, we tend to to recommend more of a lower carb, but not like a ridiculously low
carb, but like a lower carb type of approach as a way of balancing blood sugar to
support overall hormonal health. And also part of the recommendation, though, is that
you’re getting sufficient protein and fat, which naturally crowds out the excess
carbohydrates so that you’re getting enough food overall to clarify that. But like
this is different to some of the recommendations all because many practitioners kind
of recommend more of like a you shouldn’t eat less than this many carbohydrates type
of thing so I’ll leave it over to you yeah so I mean I’m not new to the
controversy surrounding carbohydrate recommendations and I feel like it was actually
hard to like condense and keep the carbohydrate section like under control because
there was so many qualifying statements necessary to clarify exactly
to like unpack that. And this one felt very similar. So in the women’s health
space, some people have talked about there being a minimum threshold of carbohydrates
required to induce a lutenizing hormone spike,
which triggers ovulation. And so if you go below this theoretical minimum level, they
say you won’t produce enough lutenizing hormone to trigger ovulation and your
ovulation is messed up. So the number that is commonly given is 130 grams per day.
I was like, okay. So I looked into this. I spent months actually looking into this
question because I wanted to see if there was more than the study that people cite
about this. And in fact, there is not. So the only evidence really that’s in to
back this claim is a study that tested not a low carbohydrate diet,
but a low calorie diet on menstrual cycle disturbances. It was a well -done trial,
like controlled feeding trial, love controlled feeding trials. They’re not real world
at all, but you can test the mechanisms and the specifics of things. So they look
at it. And the control feeding trial for anyone who doesn’t know is like when they
tell you exactly how, like you’re eating a specific amount? Usually most of them,
all the food is provided or you’re actually in an inpatient setting where you’re
like admitted to a hospital and like the metabolic kitchen, the research kitchen
prepares all of your foods. Everything is like precisely, calorically measured. They
might measure your like metabolic rate and like how many calories you’re burning and
then like match your diet exactly to that amount of calories or percent deficit.
It’s very controlled. So in
Carbohydrates made up 57 % of energy intake. That is not a low carbohydrate diet.
Carbohydrate recommendations in our dietary guidelines are 45 to 60 % of calories.
This was 57 % of calories. They were not testing a low carb diet. They were testing
a low calorie diet. That said, that study did have some really confusing sentences
in their, it was either just the discussion or the results section where I can see
how somebody just scanning for the literature for proof that low carb is harmful
would like pull out a sentence and say, oh, it’s 130 grams of carbs as minimum.
But no, this wasn’t a low carbohydrate diet. It was a low calorie diet. I was
actually not able to find any evidence in the literature to support the idea that a
low carb diet, specifically in the context of a diet that is providing enough
calories, so a non -energy -restricted diet, is harmful to hormone balance or
fertility. And I think the PCOS studies are a perfect example where we often see
improvements in ovulatory function when carbohydrates are restricted. But those,
again, are in the context of a diet that has enough energy. So can a low
-carbohydrate diet screw up your cycle and screw up ovulation? Yes, it could.
If your interpretation of a low -carb diet is low -calorie,
or I think we originally had it, like, low -food, low -card does not mean low food.
I think we had to edit it because our editor was like, uh -uh, I don’t like the
way that this sounds. But that is a common misconception. And I would also say if
you were the type of person where when you eat low card,
up your carbs or up your calories because you might be accidentally under -eating.
It’s just so satiating, particularly when you get the protein up. It’s so filling
that oftentimes calorie intake can spontaneously decrease. But there is not a study
showing low -carb messes up your leutinizing hormone spike.
It was a low -calorie study, And it’s unfortunate that that has been perpetuated
everywhere as fact. It’s just not the case. I think people misinterpreted the study.
And I think one of the challenges is that to clarify, like, we’re not suggesting
you eat in a really restricted way. Like, you know what I mean? Like, we’re not
suggesting, like, to have this, like, math equation on the wall with, like, you
know, you can only eat this many cars. Like, it’s not like that. It’s more, I
think the problem is that when you are confusing this information and making it seem
like we need to have a certain amount of, like, focusing on the carbs part, I
think what can happen is that the part about getting enough protein and fat is lost
discussion. Right. What I’ve found is that most of my clients, I don’t have to tell
them to eat more carbs. It can happen because there are some people that might take
it to the other level where they’re really restricting carbs and working out a lot.
But what’s happening is not a carb problem. What’s happening is a low food problem
for these individuals. And because they’re severely restricting carbs and you can see
that that’s happening, then we’re blaming the carbs. But really, in those types of
situations, it’s a low food problem. So I think, again, when we bring it back to
the menstrual cycle and we actually see what’s happening real time with women in
terms of luteal phase length, there are signs of potentially low progesterone, because
the second half of the cycle, the luteal phase from ovulation to your period, the
whole cycle is sensitive, but I feel like that is often where it’s easier to see
the issues first. So when we’re paying attention to the menstrual cycle, we can
really hone in on what the actual problem is. And if it really was carbs and not
food, we would see that, but that’s not what we see. So I’m really glad that you
clarified that, Lily, because that was certainly a topic that we talked about last.
again
them. Can it work? Yes, I know athletes who follow a ketogenic diet. Is it
necessary? Usually not, unless they like really, really want to do that,
but then they have to be super diligent about getting enough calories in, right? So
you have to like look at the clinical scenario and like decide, but this whole
concept that if like 130 grams is like this magical minimum number doesn’t even make
sense in the context of global diets because you go to latitude extremes like the
Arctic. Even if you tried, you can’t eat 130 grams of carbohydrates per day for a
very large portion of the year because nothing is growing. The ground is frozen over
and you’re eating animals. I can say this because I’ve lived in Alaska. Even in the
summer, the sweetest thing that you can get is like not very sweet berries. As a
whole, their diets are they default to ketogenic diets.
bring this too close. I mean, we could just keep talking, but we have to wrap up
soon here. So I’m going to throw this to you, and I’ll let you, because it could
take longer, but we’ll see. For the listener, I mean, like I said, today we focused
a lot on PCOS. I’m really excited to share this episode with my audience and
everything. But if you would take a moment to kind of summarize some of
So for the listener who’s like, well, what are the foods? And also maybe just share
a little bit, just kind of summarize what some of our recommendations were globally,
like overall, what listeners can expect when they grab a copy of the book. And then
I’ll let you kind of share where they can get it and all that. So general, outside
of the context of PCOS. So, I mean, if you’re listening and you already kind of
know my work, I mean, obviously from the title, Real food, essentially we’re talking
about a whole food diet that includes some specific nutrient -rich foods to make sure
you have enough micronutrients, vitamins, and minerals to optimize your hormone levels,
reproductive function, prepare your body for pregnancy, and your partner as well. So
as for foods, we’re talking about animal and plant foods. So for the animal foods,
meat, poultry, fish, seafood, dairy products, for plant foods, really the whole gamut,
vegetables, fruit, nuts, seeds, legumes, whole grains, in moderation,
at least with the whole grains. But, you know, an array of foods. We do have a
chapter that specifically focuses on some nutrient -dense foods that you may want to
emphasize even more of because of their nutrient density. So organ meats are one,
eggs with the yolks, certain types of seafood can be really beneficial. Certain types
of dairy products can be beneficial fermented foods. They have a lot of probiotics,
improve your microbiome. Certain types of produce are particularly nutrient rich and
full of antioxidants. So we have sections that like emphasize those. And then
throughout the book, we’re kind of weaving in the nutrition component into everything.
So the first part of the book is very heavily nutrient focused. It’s like, this is
the dietary, like, structure we’re talking about. And then we get into more the
specifics on how those things play into potential like menstrual cycle issues,
egg quality, sperm quality, PCOS, hyposlamic ameneria, a variety of like reproductive
challenges and fertility challenges. And then we do tie it together as I do in my
other books with sample meal plans and recipes. And yes, they’re all different
recipes than from either of my other books. I intentionally did not want to overlap
on those. So I did have to throw on liver patte in there. But we have variations
to liver patte. So it’s not exactly the same as the ones in the other book. So
still kind of like brand new and fresh, even if you’re already kind of familiar
with this way of eating. I think some of the major takeaways we had from our
advanced review team, and I even got this from some dietitians, like, wow, I thought
I was well versed in this, but I learned quite a bit about the macronutrients.
Like, I had no idea how that affects the menstrual cycle, and I didn’t know this
research on carnitine or taurine or how that affects ovulation. And So that was
reassuring. There is a lot of information in this book that just has not been
written about before. I think we can conclusively say. And hasn’t been put together
because a lot of your audience knows something about the menstrual cycle,
but like we know it’s like a whole thing. They don’t really know Lisa level
menstrual cycle information. Yeah, for sure. Yeah. So we’re really thrilled about the
book and how it turned out. We’re super thrilled about its release this week. We
invite you to head over to Real Food for Fertility .com, and all the links will be
there for you to grab your copy. You can also search for it on Amazon. And Lily,
thank you so much for coming to the show again. Thank you. The guest I’ve had the
most times, you’re my most repeated guess. Now I’m really getting up there,
right? This is what, eight or something so yes or somewhere in there and i’ll link
all your previous episodes for the listeners who want to hear more from you so yeah
thanks so much for being on the show and i’ll talk to you soon talk to you soon
thank you for listening if you enjoyed today’s show please share it with a friend
you’ll find the show notes page over at fertility friday dot com slash 607 i hope
that you enjoyed today’s episode with lily it is always a treat to have her on the
show
importance of evidence -based nutrition to optimize fertility, to support sperm and egg
quality, and to really support women who are wanting to conceive. This is an area
that is underserved, and I’m sure all of you listening know that. And I’m reminded
every single time I kind of go out into the world in my personal life. So in my
personal life, I don’t go around talking about what I do all the time. If somebody
asks me what I do, I tell them. But what always strikes me is that whenever I’m
in a personal setting out and about, if I go to a Christmas party or whatever’s
going on, inevitably someone will ask me what I do. And as soon as I share a
little bit about my work, I get so many stories. Fertility challenges in fertility
are so common and they’re becoming more common. The stats, say 15%, which is one
out of every six couples. And every time I’m out there in the world just in the
wild. I only have to say two words and I’m the
about it because people definitely need this information. If you haven’t had a chance
to grab your copy, you can download the first chapter for free, real food for
fertility .com. And with that said, I wish you a wonderful and prosperous 2026.
Let’s make this year amazing. And so as always, until next time, be well and happy
charting.
And that’s a wrap. If you’ve been loving the podcast and you’ve been thinking about
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