Making Sense of PCOS with Trista Chan through Science, Food, and Compassion

PCOS can feel like a maze: irregular cycles, relentless fatigue, cravings that don’t make sense, and advice that’s loud but rarely helpful. We invited Registered Dietitian and Nest and Nurture founder Trista Chan to map the terrain with clear science, practical nutrition, and a lot of compassion.

We start by decoding what PCOS actually is and how it’s diagnosed through the Rotterdam criteria—then we get honest about why care can feel inconsistent. Trista explains the nuance behind insulin resistance, why insulin isn’t the enemy, and how gentle, real-world strategies like timing your carbs and pairing them with protein and fats can steady energy and support hormones. We talk inflammation without fear, focusing on addition over restriction: more plants, more omega-3s, more variety that fits your life.

From there, we tackle the big myths: you don’t need to cut gluten or dairy unless you have a true intolerance; “hormone balance” isn’t a fixed state because healthy hormones naturally fluctuate; and carbs are not the villain—they’re your body’s primary fuel, especially if you’re active. We also zoom out to the bigger picture: genetics, stress, and the built environment shape symptoms, and acknowledging those forces helps you find your real locus of control. Expect practical starting points: which labs to request, how to track symptoms with purpose, and how to build a supportive care team that sees you as a whole person.

If you’re tired of rigid rules and ready for sustainable tools, this conversation will help you choose clarity over confusion and addition over restriction. Subscribe, share with someone who needs a kinder approach to PCOS, and leave a review to tell us which myth you want us to bust next.

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Transcript

Welcome And Guest Intro

SPEAKER_01 0:00

Hello and welcome back to the Behind the Plate podcast. We are starting out the new year strong. If you are somebody who's been wondering about PCOS, you've heard about it, you're not sure what's going on with PCOS. I have a special episode for you. Today I'm joined by Trista Chan, who is a colleague of mine and friend of mine, and we have been connected for a long time now. I've watched her career practice, everything grow for several years, and I find her so inspiring. And she is an absolute wealth of knowledge as it relates to PCOS. Trista Chan is a registered dietitian and founder of Nested Nurture, a virtual hormone platform helping people with PCOS and hormonal health take charge of their bodies. She believes periods and reproductive health deserve to be talked about openly, and that true nourishment isn't just meal planning. It's implementing sustainable integrative practices that support the body, mind, and emotions and fostering healthy relationships with food and your body. Trista has been featured in Breakfast Television, CBC Radio, The Washington Post, and numerous other publications and media outlets. So without further ado, let's get started on this episode. Hey friends, and welcome to Behind the Plate, a podcast designed to help you eat with more clarity, confidence, and compassion, especially if ADHD, binge eating, or burnout is part of your story. I'm Heather Somman, a registered dietitian and certified intuitive eating counselor. This podcast is where we ditch food guilt, question diet culture, and learn how to nourish our brains and bodies in the way that nature intended. So let's get into it. Trista, welcome again. It's so great to have you here. I always love chatting with you, and I'm so excited to pick your brain today about all things PCOS.

SPEAKER_00 2:03

Thanks, Heather. Always lovely chatting with you. I feel like we have such aligned approaches and always happy to share a little bit more about hormone health. I can't stop chatting about it.

SPEAKER_01 2:11

I love it. It's it's so important. And I know a lot of our listeners are going to get so much out of what we talk about today. So we're just gonna dive right in. I want to get everybody sort of on the same page. So for listeners who may be unfamiliar, what is PCOS and how do you explain that to people?

What PCOS Is And Why It’s Complex

SPEAKER_00 2:28

Yeah, great question. Right, so polycystic ovary syndrome, short PCOS is basically a condition that impacts how your ovaries function. Probably has been diagnosed or knows somebody's been diagnosed because it's so, so, so uh prevalent. So up to 10% of people with ovaries of reproductive age is diagnosed with PCOS. So if you go online, you'll probably see a ton of media around it. And finally, there's coverage, finally, there's understanding, there's conferences, right? But there is still such a big gap in how we know and treat PCOS, and it comes with a lot of struggles. So if you're listening, then it's things like maybe, maybe you're living with it and you know these struggles. It's constant fatigue. Maybe you're sleeping eight to hours, 10 hours, you wake up, you you still don't feel rested, and by the end of the day, you're like wired but tired, right? Maybe you're missing periods and there's fertility challenges, maybe there's intensive cravings and it feels so primal, right? It's almost like out of control, right? Maybe there's facial hair growth, hormonal acne. So, so we know that with PCLS, it there is, yes, it increases the risk of diabetes, heart disease, endometrial cancer, and also the day-to-day quality of life can be very challenging as well. So, so there's a wide, wide features when it comes to psychological, metabolic, dermatological, um, and and it's it can be quite an um uncomfortable condition, right? So, oh, you know, my goal as a practitioner and a clinic founder is really to create a space where people with PCOS or suspected PCOS who are navigating challenges in any honestly age and stage of life can find a little bit of healing and a little bit of clarity through the power of good food and tailored healthcare managements.

Diagnostic Criteria And Care Gaps

SPEAKER_01 4:18

Wow, it sounds like there's such a need for that because as you were just explaining what PCOS is, it's sounds like it's so systemic. It impacts so many different parts of our body, right? Like it's not just one thing. And yes, it's all rooted back to the endocrine system, but it sounds like it impacts so many other parts of us. And I think it's really great that you're taking this sort of like holistic approach to things. I think that's wonderful. Um, I'm wondering, do you find because PCOS seems like a relatively new thing, although we know it's not new, but more and more people are getting diagnosed? And my understanding is that a lot of people struggle to get these diagnoses. Is PCOS misunderstood within our healthcare system right now and amongst healthcare professionals? And if it is, why do you think it is misunderstood?

SPEAKER_00 5:06

Oh my goodness, such a good question, Heather. Yes, yes, yes, yes. It is so widely misunderstood, and that's because there's no one size fits all. Right. So there is a national guideline, right, for treatment, diagnosis of PCOS. But even within that, if you go through, you know, I presented on these guidelines and the barriers to care, there are so many um barriers when it comes to identifying and treating PCOS. So when we look at the diagnostic criteria, we want to meet two out of three of the Rotterdam criteria. One is an ovulation, right? So long cycles, lacking of ovulation for certain um amounts um per year. Two is signs of hyperanrogenism. So that could be the facial hair growth. That could be things like either clinical, like things you can see, like the facial hair growth, the acne, or it's showing in your blood work. And three is an AMH level, right? Or um ultrasound showing um excess follicles and ovaries. So when we look at this criteria though, like some of it is subjective and is based on clinical assessment, right? So for example, facial hair growth, what is your true, what is your baseline? That could differ based on ethnicity, right? And we know that when it comes to research for PCOs, it's mainly done in Caucasian bodies, right? What about patients who, due to just genetics separate from PCOS, may just have a little bit more hair on their bodies? How do we find that differentiation, right? If it's the first one, there's no period. How do we rule out other causes of inovulation? For example, hypothalamic amenorrhea, if there's something going on with the pituitary glands, right? Is it a medication side effect? There's so many reasons. And because it is a little bit more complex, um, that, and and it can manifest and show so differently in people, there truly is a wide spectrum. It is so misunderstood. It is um suggested in data that it is underdiagnosed, and even when it is diagnosed, it is suggested and widely reported. Actually, globally, when you look at the data and the survey respondents of people with PCOS, is that they are just really like really dissatisfied with their care, right? Um, and I think that goes to okay, we don't know so much about PCOS. We know it's prevalent, but it actually receives very, very little funding, although that is changing, which is great, right? Um, so so I think it's so important to have spaces where, yes, we're looking at the data and the research we're working on that we have, but we're also using our clinical expertise working with patients. We're also meeting patients where they're at. Because someone next to me, like a patient, literally like last week, was like, actually, I have really regular periods, right? But I'm just like very, very stressed and I'm more concerned with insulin resistance. And I'm like, okay, great. The patient next to them is very like, maybe they're they're they don't necessarily like their blood sugars are fine, but their periods are missing, right? And they may actually be looking for ways to like up their muscle mass and like increase their weight, right? And support with the meal planning while regulating their menstrual cycle. So so it can look so, so differently. And it's it's so nuanced, right? Like everything in nutrition. I'm sure you just think the same, Heather.

SPEAKER_01 8:23

Yeah, I absolutely do. And as I'm listening to you talk about this, I mean, wow, it's really just opening my eyes to how it is so important to get individualized care. One thing I'm wondering here, you mentioned insulin resistance a couple of times and blood sugar. And you said, you know, some people will have regular blood sugar levels, like when we look at it from a blood work standpoint. Is insulin resistance something that everyone with PCOS has? And um, if not, sort of what else are we looking at from a nutrition standpoint? I know you also mentioned inflammation, so like some foods come to mind for me there, but I guess when we put our like dietitian hats on here, like what are we sort of looking at from a nutrition standpoint?

Insulin Resistance Demystified

Nutrition By Addition, Not Restriction

SPEAKER_00 9:05

Yeah, such a great question. So insulin resistance, the data suggests that it is found in about 70% of people with PCLS, right? So a high amount. And if we're looking at things like just blood sugars on its own without looking at the relationship with fasting insulin, right, we're not necessarily be able to assess like how responsive your insulin is to your sugars, right? So so there may be signs of insulin resistance. We do have to do more thorough panel to see if there's early signs or current signs of that. That said, it's 70% of people. Um, and I think, you know, insulin is so misunderstood too. Like it's not a villain, guys. Like it's actually on its own, just like inflammation. It is, you're just laughing on because I'm sure you've had these discussions. It's it's um, you know, at its core, it's a hormone that's necessary for survival, right? It helps us convert the food we eat into um energy used by ourselves. That said, when it becomes resistant, that's not necessarily working as well. And I always, when I'm talking to patients about the importance of stabilizing blood sugars, it's not that we don't want, you know, any carbs to spike any of the insulin. It's more, are we looking at timing? Are we looking at type? Are we looking at how we are pairing it with different foods? So I like to explain insulin resistance. Like, imagine you have a new coworker and they're playing an essential function on your team, right? And they're that sad, they're super, super, super, super eager, right? And then they end up really showing up in places they really shouldn't be. And they're working on the overtime and they're like putting their hands in places they don't need to, and it ends up disrupting the whole system, and you become less efficient, your team, right? So that's like insulin, it stops working as well, but instead of you know, but it ends up just putting out more. It's like, okay, I just need to work a little harder, I need more insulin being released from my pancreas, and that is what worsens that resistance causes, and that's what leads to, you know, elevated risk for diabetes, gestational diabetes. So this may be found in 70% of bodies with PCOS. That said, for the 30%, right? Maybe we're doing a full panel. There's a fasting insulin, there's a fasting sugar, maybe they've even done like an oral glucose tolerance test and there's no signs of insulin resistance. Great, like, you know, just because insulin is a huge buzzword, like yes, it's present in many bodies, no need to fear it, right? That said, it is still important, I'd say, in general, to have dietary strategies to stabilize blood sugar for anyone. And maybe there's no signs of insulin resistance, right? But there is that heightened risk later on in life, right? So that's when we're looking at we're spreading the meals out. That often goes hand in hand with dietary strategies that reduce inflammation over time, right? Another thing that's actually a protective mechanism for whoever is listening, inflammation helps you survive. We're here today because we have those responses, right? But when it becomes, you know, too much for a long period of time, that's when it could start impairing your body's function and your immunity. Um, so that's where we're okay. Now we're looking at meal timing. We're eating carbs, we're spreading it out throughout the day. So we're stabilizing the insulin response, right? We're not overloading that coworker who's super eager and then causing a little bit of a shit show. Um, and we're adding protein, we're adding fats. Now, how do we add a little bit more anti-inflammatory eating? So that's things like, okay, how do we just add a little bit more plants here and there? How do we add some more fatty fish? How do we add some nuts and seeds, right? Oh, if you're starting with a beagle for breakfast, let's add some eggs, let's add some berries on the side, right? If you're having like a uh lentil stew, let's throw some spinach in there, right? So it's really through that nutrition by addition approach. Um, I find so much of nutrition information online is like take this away, take that away. Like these are high inflammatory foods, right? But like let's, you know, the best way to maximize your your health is to maximize like variety within your tolerated limits, right? So, so how do we add more? And I'm huge on that. It's like the abundance, we're not being scarce with our foods, that's self-limiting, right? It's adding more of those, those delicious, nourishing things into the day.

SPEAKER_01 13:35

So no, this is so important because anyone who's listening who has heard anything that I've ever said aligns with that so well in terms of like the nutrition by addition approach. And I think it's so important to like as you were talking, I'm visualizing almost like a pyramid of your priorities, right? It's like, are we eating enough? Are we getting the timing? How do we add more nutrient density? And that's very similar to the work that I do in folks with ADHD, disordered eating, and stuff like that. So it seems like there's such an important foundation here that I think all of us really try to set across the board. And I know one thing I hear a lot in my practice is a lot of people feel as though their health condition or uh the way they're reacting to food is almost like their fault. And I could imagine in PCOS, there's there's probably a little bit of that too. Like if somebody hears that they have insulin resistance or inflammation, whatever it might be, I could see how someone might see that as a personal failure, like they're not doing enough from a nutrition or exercise standpoint. I'm wondering if you could maybe speak to why a condition like PCOS isn't a personal failure and it's not somebody's responsibility and sort of what your thoughts are there.

PCOS Is Not A Personal Failure

Environment And Social Determinants

SPEAKER_00 14:48

Yes, totally, because it's like there are so well, well, first, you know, at its core for whoever's listening, like you can't eat or not move your way into PCOS, period, or stress your way into it, or do anything, right, to cause PCOS, right? And it's like disease is so complex, like it's never due to one risk factor. If it were that simple, then it would be really easy to quote unquote correct for a lack of a better term, right? Like, if it were that simple, then no, none of us would be sick. Like, mm-hmm. So I always say that, like, okay, let's break down the science first. Like, I'm validating those concerns, of course, because so much of what we see online, especially now, where I feel like wellness is commodified, and I know Heather and I have had so many discussions about this, about like wellness, self-care is commodified as another form of diet culture, right? Where you think that you know you can micromanage your control and there's like a purity to it, that there's like that old school work ethic, right? Morality attached to being really free with your diet, and that it can send the message that if you're not doing things perfectly, then you are at fault. Right? Like pull yourself up by the bootstraps, let's go. What actually happens with PCOS is that it is a genetic and environmental condition, right? So there's that hereditary component. What even research suggests that even endocrine exposure in uterine, right, may increase your risk of PCOS, which is pretty cool. We also know that if you have a family member, particularly a mother, an aunt, or sister or grandma who has a history of type 2 diabetes or even PCOS, maybe they maybe they had it and it wasn't diagnosed, right? I hear I hear these stories all the time from patients. I'm like, is there a family history? And they're like, well, my mom always, you know, struggled with this, this, this, but who knows? Like she wasn't really assessed for that, right? Um, then there's that higher risk. Sometimes when there's that predisposition, there might be an external factor, like a severe period of like burnout, high stress, right? That activates it per se, or an environmental change that activates it, right? Or a trauma. So it's really that perfect storm. That said, it is 100% and it is a metabolic condition, right? It is an endocrine condition, right? We can do what we can within our locus of control and within our environment to support ourselves. Know that it's also not all doom and gloom. I know I'm just like talking about all the, you know, the the the uncomfortable side effects, but many, so many people I see it every day with PCOS can thrive, right? It's it's also not a death sentence. I don't want anyone to walk in and be like, oh my god, like I can't do anything because I have PCOS, right? There are so many, yes, there's the barriers, but also you can live a very full, happy, thriving life with PCOS. Um, there's so many dimensions of your health, right? Take care of your mental health, your physical health. There's no such thing as perfect hormone health in that same vein, too, right? It's about you going back to you and saying, okay, what do you really value given how you're feeling now? What does health mean to you? And how do we actually get there? You are you are the driver, I'm just holding a map, you decide the destination, you can take a pause, right? And know that also there are so many systems around us that is like a multi-million dollar industry that wants us to think that you know, to sell shame, to sell self-blame, low self-worth, so they can sell us a product, right? That that is that quick fix, right? So it's just also reminding them of what how we got here, what is around us that's maybe those forces working against us, and how do we shield ourselves from that?

SPEAKER_01 18:40

Oh, that's so important. Thank you for speaking to all of that. That's that's huge. One question I have just I know some of the listeners might need some clarification. When you said that PCOS can, it sounds like it can sometimes be exacerbated by things like our environmental exposures, things like that. What do you mean by environment? Is it like the world we live in? Is it like outside the climate? Like, what do you mean by environment?

SPEAKER_00 19:04

That's a great question. So it could be the built environment, right? So I'm mainly talking through like the social determinants of health as well, right? So it's the built environment. Is it that you live in a food desert, thus you're eating a diet high in hyperpalatable, you know, ultra-processed foods, and that over time it worsens the pre-existing insulin resistance, right? Because of that access challenge. Is it the built environment in terms of we live in a neighborhood that's very low walkability and very, very high stress, right? Maybe there's like a high violence at crime rates that's causing sedentary behaviors and a lot of mental stress, hypervigilance. You're all you know, you're you're in fight or flight, right? That does a ton of harm on your body too, right? It could be actual, you know, um, in terms of the in utero exposure, right? To um certain, now I don't want to open up a whole can of worms, but like um energy. Receptors like plastics that are, you know, not to be reheated and reused, right? So if we're not following the proper protocol, right, are we now exposing ourselves to um things that may increase the risk of PCOS? Right. So there's the social environment, there's the build environment, the physical environment, um, so many of things impact disease risk, and these are all non-modifiable or or non-medical factors and modifiable factors.

SPEAKER_01 20:30

Yeah, and I was just thinking about how you were talking about the locust of control. Like there's some of those things that you just listed that a lot of people don't necessarily have control over, which might be where, like where they grew up, for example, if it was a high stress environment. So that's really helpful. Thank you for for defining that for us.

Top Myths: Gluten, Dairy, And Hormone “Balance”

SPEAKER_00 20:48

And then I also want to say that like sometimes when I talk about social determinants of health, like actually most mostly it's really well received, which is great because it's very validating. But sometimes people are like, well, are you saying that, like, you know, I can't change, like, you know, I can't, you know, control my health at all, or like I shouldn't, like, I worked so hard, right? And it's not meant to dismiss all the hard work you do and can and may put into your health behaviors. It's just validating all those things that you can't hard work your way out of in the short term per se. If that makes sense. Absolutely.

SPEAKER_01 21:22

So it makes so much sense.

SPEAKER_00 21:24

Yeah, yeah. It's just contextualizing it. And I feel like it gives people more power to say, this is the broader spectrum, this is what's in my control. So let's focus on that. Like, let's add those tools. Like, it's super cool when you when you see the bigger picture and what's immediately in front of you.

SPEAKER_01 21:39

Absolutely. I I think that's a really important part to bring up because I have these conversations with people often of like, yeah, sure, nutrition and exercise, we can do a lot to control that, but we can't control our genetics per se. And like you said, a lot of PCOS is genetics. So when we think about again, the social determinants of health, like genetics is one of those and can't change that, but we can, you know, work on a few other things. And I feel like sort of like the nutrition by addition mindset of when we can focus on things that we can control, sometimes that leaves a lot of our clients feeling empowered rather than feeling kind of scared and like this like scarcity a little bit around what they can and can't do. Totally, totally, yeah. Awesome. I I have a question for you, and this may be putting you on the spot a little bit, but I'm wondering about just in the world you work in, I know there's a lot of misinformation, and I'm wondering what the top three, in your perspective, what the top three biggest nutrition myths are as it relates to PCOS.

Carbs, Performance, And Practical Fueling

SPEAKER_00 22:42

Oh my goodness. Oh, this is not putting me a spot on all. Thank you for asking. Okay, one is gluten-free and dairy-free. And I hear this actually, yeah, I hear this a lot in the past few months. Maybe it's the algorithms changing a little less, a little less clients have been asking on the 101, a little bit less on the TikTok, but um, a lot of information online about like cutting out gluten, cutting out dairy to support PCUS because they the the line of thought is that it's pro-inflammatory, right? And there is, you know, very rarely will I say like a hard no or a hard yes to things because we know nutrition is so nuanced, right? But there is truly zero research. It's one of the few things where I'm like, truly, like please, if there is a study I'm missing, send it to me and I will retract the statement. Also, this is 2025, you know, I'm just dating this year, right? Um, there's truly not one study of any quality, not even low or high, that suggests that gluten and dairy result in poor health outcomes with PCUS. That said, hey, sometimes if you're reducing ultra, let's say processed foods, you might feel a little bit better. Sometimes those foods have the protein gluten. So sometimes if a patient will come to me and be like, oh, I want gluten-free and I started feeling so good. And I'm like, okay, what changed? And they're like, well, I stopped eating, you know, XYZ, I stopped eating, you know, fried, let's say, for example, like pizza every single day and nothing else. Right. So it's like, okay, so maybe it's that and not so much the gluten, right? That said, there is celiac disease, there is lactose intolerance, there may be people who are sensitive to that. That is very different, and that that that's very individualized, right? So what I encourage is rather than think like, okay, I'm just gonna do a blanket, if there's any suspected intolerances, working one-on-one with a dietitian to say, okay, what are the other factors that may be exacerbating some of the digestive discomfort, for example? Is it the is it the gluten-containing food or is it the fructons, another indigestible, hard to digest carbohydrate? Is it a buildup of gut triggers? Is it that we're lacking in fiber, right? Is it the meal hygiene? Is it that we're always in a state of anxious fight or flight when we're eating, let's say, said food, so that's making us indigest, right? So, you know, my approach is never anything that says yes or no, hard, like take a little bit of nuance. Same with the dairy. If you don't have lactose intolerance or a milk protein allergy, like it's not gonna be inflammatory, it's a great source of protein and calcium. That's that it's not the only source. So you also don't have to eat something just because you know it's it's uh there too, like there's so many different journeys. So that is one, one big one.

SPEAKER_01 25:29

Okay, so that was myth number one, Trista. What is the second one?

SPEAKER_00 25:33

Yes, the second, okay. So the second myth, this is a little bit of a broader scope, is um, it's kind of ironic, but like the the the actual concept of hormone balance in itself, which is so interesting to me because like you there there's hormone support, there's hormone balance, and yes, sometimes it's you know, it's I'm glad that we're paying so much attention to our hormones, but there's no such thing as true hormone balance because guess what? They are meant to be in flux, right? Just as your blood sugars are meant to have a low and slow rise and fall for sustained energy, your hormones are meant to change, and they are responsible for so much of your body. There's sexual function, mental, you know, energy production, right? For for immunity, right, growth and developments. And in order for all those processes in your body to work, they need to be changing your hormones. So there's no such thing as true balance, but what there is your hormones is okay if they are out of range, or if, for example, the hormone insulin is really, really high, right? That's not necessarily quote unquote an imbalance per se, but maybe it's higher than what we'd want it to be for better metabolic health. How do we include strategies to reduce that? So it does increase a little bit throughout the day, but it's not so high all the time. Same with cortisol, another hormone that gets a little bit of misunderstanding. Cortisol is a stress hormone, it helps us manage stressors. Now, what we want is ideally your cortisol levels to be highest in the morning so it wakes you up and then it gradually declines throughout the day. So then you can sleep. Sometimes, and I wouldn't call this hormone balance per se, but it's more cortisol dysregulation, it stays high, right? So then you're a little bit more wired and tired, you can't necessarily sleep very well. So, so my point is that I love, you know, it's so important. And this is yes, I'm I run a hormone health clinic, right? It's so important that we're paying attention to these and knowledge is power. And I love that we're learning about estrogen, you know, progesterone have the rises and dips, and that's what causes the PMS, right? In the luteal phase, and we're learning about cortisol, but also know that like data is powerful, but let's not ascribe this perfectionist-driven and myth-driven expectation of having perfect hormone balance because that doesn't necessarily exist. And I don't want us to feel like we have to pathologize or that everything needs fixing, or if our values don't come back perfectly, it's like, okay, what can I do to tackle this right away? Right? They're they're meant to be in flux. If there's any abnormalities, work with your clinician one-on-one to address that, right? The why, the how, the what next, but also know that like it's it's also okay to have hormones that change.

Getting Started: Labs, Team, And Next Steps

SPEAKER_01 28:15

I love that so much, and I think that's so important. I'm just thinking about like, I think I was maybe like 28 when I first saw a diagram of how female hormones fluctuate throughout a month, and that completely blew my mind, and like knowing that that's normal to have these different hormones go up and down. So I think you paint a really important picture here that there really isn't like a balancing of that per se. Like it's normal for things to go up and down, and we're just talking reproductive hormones here. I'm also thinking as somebody who lives with insomnia, and I know this is a common thing for folks with ADHD, for example, who get cortisol rises in the middle of the night, and that can impact their sleep. Like that might be something else to work on as well. And yet, cortisol is supposed to go up and down throughout the day. So it's it's just I think a really important point that you bring up. So thank you for debunking that one for us.

SPEAKER_00 29:06

Wow, my pleasure. And so, and so common, right? You're right. What we just talked about was just the reproductive and the sleep and then the stress management. Like, there's there's dozens and dozens and dozens. Great. So knowledge is power, but let's not like we also don't have to go like micromanage it. Exactly. That's it. Okay, what's the third one? Okay, so the third one is that carbs are bad. I'm sure it's nodding a lot. I'm sure you were expecting this one. Yes, I was hoping you'd talk about it. Yeah, so many patients walk through our doors and they're like, they've tried keto, they've tried keto, and there was a little bit, you know, they're like, oh my A1C dropped, or they you know, they had weight loss, and then it was the regain and it shoots back up and they're feeling like so so um low carb is not necessary for PCUS outcomes, right? Now we want to make sure that we're eating balanced meals, right? But let's not vilify one macronutrient which provides our body's primary fuel source. So oftentimes, yeah. Amen. Yes, exactly. It is our body's primary fuel source. The way I describe carbs is it's our body's fuel, it gives us quick fuel. If you want extended fuel, then let's add the protein, add the fats, and this is like the holy trinity. Um, and even if we look at the literature around macronutrient intake and different suggesting different dietary approaches for PCOS, I think there's such an emphasis on what we see online on like macros, macros, macros, right? Let's like let's perfect the macros. Truly, if we're looking at the literature and there's a systematic literature review that looks at all the different dietary interventions of what's most effective for PCOS, is that they find that the ranges of carbs can vary greatly. It's more the quality of food, right? That is associated with improved metabolic outcomes, improved hormone profiles, right? So it's okay, how do we make swaps and adding a little bit more nutrition through minimally processed foods, nutrition by addition, once again, rather than like taking away that carb, right? And then it's it's so funny too that like this is so vilified now. Like we have to remember, like, so many of my patients with PCS are also sometimes they're very active. Like, I literally was just working a few months ago with the patient long-term who who runs a triathlon, right? And like, if you're a triathlon athlete, you need to carb low, right? Like, yeah, that's gonna help with performance, that's gonna help with recovery, preventing fracture, risk, great, is gonna help just have that really solid foundation going into your performance and recovery. Um, but when we first started working together, like she was so concerned and like she wasn't feeling properly, she wasn't feeling energized because she thought that she couldn't have any carbs at all, right? Because that would be fierce by your sugars. And I was like, no, but how do we um find the right kind of um amounts for you? How do we spread it out the timing-wise, right? So so carbs aren't off limits, it's understanding how they impact your body and based on your goals, where you're at, how do we adjust it and pair it with other nutrients and foods, right, to support your well-being?

SPEAKER_01 32:14

Oh, so well said. I think that's so important. I love it. I sometimes joke that like 60% of my job is talking about carbs. I'm sure you feel that way too. It's a lot of carb talk, and and I'm totally fine with it. I think it's the narrative that gets pushed a lot in the world that we live in. Yeah, it's so funny as well.

SPEAKER_00 32:33

Um, sorry, just like a ticket. No, that's okay. Like a reel. That's a probably someone on my team in Maine. She was like, when you go to school for six years to defend a banana every day. I saw that too. It's so good. It's so good.

unknown 32:46

Okay.

SPEAKER_00 32:47

Which once again, love doing it's just very interesting to have it.

SPEAKER_01 32:52

Yeah, just didn't think that's what it was gonna be going through it. Um, the last thing I wanted to ask you. So if people are listening and they're sort of thinking, like, hmm, I'm if they're curious about PCOS, if they think maybe they have it or they've been diagnosed and they feel like really lost as to where to go, what what do you suggest? Where do you suggest people get started? What kind of care should they add um to their care team?

Resources And Where To Find Trista

SPEAKER_00 33:18

Oh, such a great question. So, so if you suspect, right, um and you haven't been diagnosed, I'd say speak to your your your primary care provider, right? You know, track your symptoms, right? Get that data, track, you know, how your periods have been, your mood, your inadjustant. You can actually present it and be like, hey, like this is not okay, right? And hopefully you have a provider that's responsive and provides that patient-centered care. Regardless, I do highly recommend running lab work, right? Because that's gonna help identify, okay, is there what's the level of testosterone of DHEAS? Right? What is, if there's concerns with blood sugars, what is your A1C, your fasting sugar, your fasting insulin? If there's is that let's say you're diagnosed, run a lipid panel, liver enzymes, because it does increase the risk for things like um, you know, colloquially known as you know, fatty liver and like and like reduce increasing your lipid profile. Um, but also one of the most important pieces of PSOS management is nutrition therapy. And it is shown to be a very effective first-inline treatment done in the vein of compassionate care, of gentle nutrition, of sustainable nutrition, right? Because I also know we don't live in labs, we live in the real world, humans are complex, food is complex. So, what we work at Nesta Nurture to support patients is in equipping them with the tools to learn how to one maximize their nutrient intake to potentially restore their regular your menstrual cycles, right? To correct nutrient deficiencies, to stabilize blood sugars, increase insulin sensitivity to nutrition by addition to help with reducing inflammation and also improve their relationship with food because so many people we we know with PCOS there isn't that increased prevalence of eating disorders, especially since so much of PCOS care is weight-centered and kind of slap on this, okay, lose weight and come back when you're gonna get pregnant kind of approach, right? So, you know, it's so unfortunate we live in that world, but I am really a big believer in advocating for yourself, and then while you are that our team is also here, and so many wonderful organizations and and clinics, right, are also taking that person-centered approach. So definitely, you know, get the lab work if you can. I also have a PCOS hormone lab work um checklist that I can share um with you. It's free. You can download it and you can actually bring this and request this from your physician. You can also, if you live in Ontario, we also have a uh nurse practitioner in our clinic, right? Who can also um conduct lab screenings um and then work with work with a dietitian who also understands you and who can see as a whole person and support you because nutrition is so powerful and that it really can help across the board, right? It's so interesting. Sometimes patients come in and they're like, oh, I have pre-diabetes and PCOS. So we tackle that, they're seeing improvements, but they're like, oh, you know what? I actually mentally just feel so much better because I'm not second guessing everything. There's so much mental clarity. Oh, my digestion feels good. I've been sleeping a little bit better. So it's so, so powerful in so many aspects.

SPEAKER_01 36:22

Oh my gosh, that's that's amazing. Thank you, Trista. And I know as somebody who's watched you and your clinic grow for time, that you have helped so many people and you're just an absolute wealth of knowledge. So thank you so much for taking the time to be here with us today. Where can our listeners find you?

SPEAKER_00 36:40

Yes, so you can find me on Instagram. We are quite active there. Our handle is nestandurture.health, and then I'll be hopefully linking it below. And you can also find us at our website at nestandurturehealth.com where you can access our free toolkits, our hormone and gut health toolkits, um, and then learn a little bit more about our one on one nutrition and nurse practitioner services. Amazing. Thank you so much, Trista. Thanks, Heather.