Episode #151: The Evolution of PCOS Care: Survey of Nutrition History

Welcome back to the PCOS Repair Podcast, where today we’re going to take a little walk through the history of nutrition. One of the things that is very evident with PCOS is that the numbers have been on the rise. When I was first diagnosed with PCOS just over 10 years ago, the numbers were about one in 10. Then over the next five years, people started saying maybe one in eight. Now, the recent research I reviewed a few weeks ago on the podcast was saying 18% of women of reproductive age have PCOS.

So those numbers have just skyrocketed over the last 10 years. There are multiple reasons why that is. As awareness grows, more women go and get tested. As awareness grows, more practitioners are looking for it. But even if we just look at the general population, we can see that health has changed.

If you’re somewhere in your 30s or 40s, when you were a child, the average child size was smaller. Now, it’s not uncommon to see children maintaining that so-called “baby weight” into their growth spurts and then regaining that baby weight. If we think back and look at pictures of kids in the ’90s and early 2000s, most of the kids had little toothpick legs and a very different body composition. So, when we look at the general population and see that obesity is on the rise—and that PCOS, a metabolic disorder that affects younger women, is also on the rise—it’s important to look at what’s going on and what has changed.

That’s why today’s episode is so important. Hopefully, it will give you some great insights into what’s been changing in nutrition and how we eat as a community. This can help us understand where we could make some changes to improve our health, improve our PCOS, and not just improve our body composition, but also our hormone health.

I’m not saying there’s a correct body size—that’s not what I’m trying to get at here. But when we start to see that body sizes are shifting, and we think about the fact that we didn’t necessarily have a strong emphasis on health or nutrition in our country in the past, something has clearly changed. People were just going about their lives, and now something is no longer working for our bodies.

That’s what we want to take a look at today. All right, let’s get started.

So first of all, how has dietary intake changed over the last several years?

The basic changes are that fast food serving sizes and packaged convenient options have increased exponentially. Just from my own personal standpoint—and let me know on Instagram if this was the same for your family—but growing up, we ate out maybe once a week. I remember there were times where we had something once a week, and that one time we could each order one item at Taco Bell. Then we would go home, and my mom would add it to whatever fruits and vegetables we had—kind of like Taco Bell was the main dish, and that was a special treat. We could each choose one item. That was for a couple of years of my childhood.

But for the most part, we didn’t eat snacks. I remember every once in a while we would have some fruit snacks or a cup of cereal or something like that. But generally, we ate breakfast, lunch, and dinner. We might have an apple or some crackers here and there, but unless we were on a car trip or couldn’t have a meal at the regular time, we didn’t eat a lot of snacks.

Now, my mom was a health nut. She was very conscientious about eating lots of vegetables. She wasn’t great about getting enough protein in for us, but for the most part—and especially for the time—she was conscious about health. She may not have been super up-to-date on the latest nutrition science, but she focused on whole foods, healthy foods, organic foods, and things like that. And honestly, that was pretty similar to my friends. They had more junk food than we did. I know they had more interesting snacks than we did, but still, there wasn’t a lot of eating out. Eating out was special.

The amount of convenient food was also a lot less. You just didn’t have as much at your disposal in terms of packaged foods. Now, we can get almost anything delivered. With the start of things like Grubhub and DoorDash, we can have any food delivered to us at any time.

I remember when I was in high school, there was news coverage about how big portions had gotten. It was in the news because fast food restaurants and other places had to start providing calorie counts on their menus. And it blew people away because they hadn’t realized how many calories they were consuming in a typical restaurant meal. One of the chains that got called out was The Cheesecake Factory. Some of the rolls and appetizers had more calories than what we should eat in an entire meal, if you’re trying to base your day around 2,000 calories. Then people would order an entrée and dessert—eating three or four days’ worth of calories in one sitting.

That really stood out to me.

Now, raising children myself, I watch them and their friends. I see what’s put in their lunches and notice that kids are going days without being required to eat a vegetable. I’ll send a sandwich, some fruit, and various things in my kids’ lunches, and if I’m not paying attention to what’s coming back at the end of the day, I won’t realize that, oh—they didn’t eat the cucumbers I packed, or they didn’t eat the carrots.

It’s really easy for kids to just pick and choose what they want to eat because there’s so much food around. They’re getting candy at school for good grades or good behavior. There’s always something going on at school. Just recently, they had a jog-a-thon, and for raising the money they were aiming for, the reward was a Kona Ice day.

There’s always something being offered as food or a treat. And with that, kids can kind of navigate around the less appetizing, plain whole foods and instead eat more of the treats and processed, packaged foods. That’s something that has drastically changed over the last 20 to 30 years, and it’s something we’re going to take a closer look at.

Another thing that’s changed is how much busier we’ve become. Think about how social media has shaped our world, the rise in competitiveness. On the academic front, it used to be that you went to school, did your best, took the SATs or PSATs, applied to whatever you wanted to do after high school, and moved on.

Now, a lot of people are paying for prep programs. This started to become a thing when I was in high school—taking classes for the PSATs because scoring high could mean getting scholarships. And now the scores are higher across the board, so it almost feels necessary to take a prep class. That takes time—time after school, multiple nights a week. So now, after school, you’re going to your prep course.

Sports have changed, too. I’m watching this with my own kids. A lot of my friends didn’t even start playing sports until middle school. But now, in some circles, if you haven’t played a sport like basketball or soccer by fifth grade, you’re already behind—because some kids have been doing it since kindergarten. Their footwork, dribbling, and strategy skills are more advanced—not because they went to elite camps, but because they’ve just played every season, building that experience.

And then they move on to the next sport and the next. By fifth grade, they’re well-rounded little athletes. They may not go on to play in college, but they’re good at what they do. So it becomes difficult for someone new to join when everyone else has been doing it for years.

Of course, that doesn’t mean you shouldn’t try, but it can be discouraging. I coach my second-grade basketball team, and even at that level, I see kids who have been playing since kindergarten, while others are just starting in third grade—and there’s a big gap. The new kids struggle and sometimes feel like they don’t like it, because they’re behind. Their peers get frustrated, too, when the newer kids fumble the ball.

Even by third grade, kids can feel left out or behind. Again, this isn’t a judgment—just an observation of how our society has changed.

So, instead of kids going to school, coming home, and playing—riding bikes, running around, playing in the street—we now have an after-school culture filled with extracurriculars. Gymnastics, sports, music lessons, tutoring… families are spending their evenings in the car, running from one thing to the next. Dinner becomes something picked up on the way home. There’s less time to cook, less time to sit together for meals, and less time for kids to just play freely outside.

We used to come home from school, eat dinner around 5 or 5:30, do some homework, maybe help with chores or get ready for the next day. Now, it’s about getting everyone to their activities, eating late, and staying up late to finish homework. Adults are more sedentary, too. Jobs have become more sedentary. We commute longer distances, or we work remotely, sitting at desks all day. The digital age has made our lives even less active.

We’re not moving as much. We’re not walking and talking in community spaces as we once did. We’re on Zoom, Skype, or phone calls. And all of this change has taken place gradually over the last 25 to 30 years. It may not seem dramatic in the moment, but it adds up.

So, when we think about how different our lifestyles are today compared to a couple of decades ago, it’s clear just how much things have shifted. I encourage you to reflect on your own experience—how your parents did things, how your household ran growing up, what meals looked like, and how all of that compares to how things look today.

Now, how has the diet industry changed?

This one is huge—and it seeps in under the radar. There are so many supplements and recommendations out there. They’re numerous, and often they contradict each other. This creates overwhelm, confusion, and that shiny object syndrome where we’re constantly chasing the next new thing. We think, “Oh, that must be what I need to do,” or “That must be what I’m doing wrong.”

If we think back to how nutrition advice used to be, it was very simple: eat less, move more, lose weight. But now we understand there are nuances. And a lot of those nuances come from preservatives and packaged foods.

The nutrition industry has evolved to cater to convenience, to flavor, and to shelf life. Restaurants want their food to taste good, and even convenience foods from places like Costco can be tricky. I recently picked up some chicken enchiladas from Costco. On the one hand, they were packed with chicken—great protein content. But when I read the nutrition label, I saw a long list of preservatives and added ingredients that I’d never use if I made enchiladas at home.

So, while the macros looked good, the inflammatory components of the meal were high. That’s the trade-off we often make when choosing convenience—less time and effort, but more processed ingredients. And then we see influencers showing what they buy at Costco, and we think, “Oh, they’re thin, they look how I want to look. Maybe if I eat that, I’ll look like that too.”

So we try it. Then it doesn’t work. So we follow someone else. Then that person recommends a supplement, so we think, “Okay, I just need to track my macros and take this supplement, and then I’ll look like them.” But it doesn’t work like that.

The truth is, the solution is actually quite simple. And it’s not your fault. It’s not that you’re doing anything wrong. But without the education to understand what your body needs and how nutrition really works, it’s easy to fall into the trap of copying what seems to work for someone else.

We do this with everything—outfits, paint colors, makeup. We see something we like, and we copy it. And sometimes it works. But with nutrition, exercise, and health, it’s never that simple… and it’s also not that complicated either.

We don’t need as many supplements as social media suggests. We don’t need 15 different gummies for sleep, muscle gain, cravings, and focus. We just don’t need that much.

Think back to when people were, on average, thinner—not necessarily healthier in terms of lifespan, but their bodies often functioned better, had more energy, and just looked more vibrant. Of course, every generation has its issues, and pictures from the past don’t tell the whole story, but we can see that over time, we’ve overcomplicated nutrition.

We now have more supplements, more dietary trends, more influencers telling us what to do—and yet, we’re making less progress. So what if we simplified things? What if we looked at what started to go wrong in the first place?

Back when we first started talking about PCOS, say 10 to 15 years ago, the blame was often placed on the patient. Doctors would say things like, “Your excess weight is the problem,” because they knew that excess weight was tied to metabolic issues. But no one stopped to ask what was causing the weight gain in the first place. No one looked at the root causes or how our environment and lifestyle were contributing to PCOS symptoms.

That lack of insight led to shame. Women with PCOS felt like they were doing something wrong, and that created a trauma response. So we started seeing message boards and forums and programs all trying to figure out how to lose weight, and in that pursuit, we lost sight of understanding what was actually going on inside the body.

That’s one of the reasons I started the PCOS Repair Podcast—to help bring clarity and education, so you can actually understand what’s going on in your body and work with it instead of constantly feeling like you’re doing something wrong.

So when we talk about the evolution of PCOS, it’s not just about identifying your root cause, taking a quiz, and following some steps. It’s about understanding how your body functions, what it needs, and how your environment has shifted—often in ways you didn’t choose or even notice.

These changes aren’t necessarily things you did. They’re changes that happened all around us. But once we become aware of them and understand how they relate to our root causes, we can start to respond differently. When we think historically—about how our genetics evolved, how our ancestors lived and ate—they were used to whole foods. They weren’t exposed to preservatives, dyes, and inflammatory ingredients made in manufacturing plants.

Now, with those things so prevalent in our diet, we’re seeing a rise in gut health issues, inflammation, blood sugar problems, and insulin resistance—all of which are major contributors to PCOS symptoms.

When we recognize how these things connect to the root causes of PCOS, it becomes clear that this is about more than just nutrition. It’s about the entire food environment we’ve created over the last 30 years. It’s not just the nutrition industry changing—it’s how we use it. It’s how we shop at places like Costco, loading our carts with processed, packaged foods, and maybe throwing in a few vegetables to feel better about it.

Ideally, our carts would be filled with meat, fresh produce, eggs, and simple staples like rice or beans. But instead, we often end up buying food that’s quick, convenient, and heavily preserved.

We’ve been sold solutions like “just lose weight and your PCOS will go away,” or “cut out carbs and you’ll be fine,” or “keto is the answer.” But that’s not enough. We have to look at why our body is struggling—whether it’s insulin resistance, inflammation, or a chronic stress response. We need to ask what’s going on in our environment and lifestyle so we can make individualized changes that actually work.

And we need to shift our mindset. You didn’t do this to yourself. It’s like we’re all floating in the same river. Once you realize where the current is taking you, you can start to paddle, redirect your course, even jump out and choose a different river entirely.

But it starts with awareness, not blame.

We’re beginning to wake up to this. There’s more awareness now. People are starting to look for cleaner ingredients and better options. But even that can be confusing because marketing grabs onto those terms, too. As soon as people start looking for “cleaner” foods, companies begin labeling things as “clean protein” or “high-protein snacks”—even if the item only has 7 grams of protein. Compared to another muffin, maybe that’s high-protein, but in reality, it’s not enough to be considered a true protein source. You’d have to eat so many that your calories would go through the roof.

Sure, it might be better than the alternative, but is it really good nutrition—or is it just a marketing tactic? These buzzwords lure us into thinking we’re making a healthy choice, but they often distract us from what our body actually needs.

So as we become aware of these patterns, the shift starts with asking, “What can I do better today?” If you want a full plan—what to eat, how to eat, understanding your root causes—that’s exactly what I walk you through in the PCOS Root Cause Bootcamp. Inside the Bootcamp, I provide step-by-step guidance, meal suggestions, recipes, examples, and tools to help you individualize your approach and build your personal PCOS path to health.

But even without all of that, the mindset piece is crucial. What’s one thing you can do today? One step you can take in a better direction? What area can you improve just a little? That’s where it starts—awareness. Awareness of what’s changed over the last 25 to 30 years. Awareness of what’s changed since you were a kid. Awareness of how those changes have impacted your habits, your nutrition, and your PCOS.

If you’re in your early twenties and listening to this, you may not even remember a time before all of this convenience. You were born into it. Into a world where highly processed foods are the norm—foods that look like food, taste like food, but are far removed from how food is actually grown or found in its natural form.

So now, the question becomes: how can I nourish my body better today? How can I move more today? How can I start to bring in those habits that align with how our bodies were designed to thrive?

I used to think I was a fairly healthy person. I bought whole wheat bread, I bought vegetables—that seemed healthy. But when I really looked at what I was eating in a day, I realized I wasn’t eating that many vegetables. And I was eating a lot more pure carbohydrates than I realized. So while trends like cutting carbs might seem extreme, they’ve at least helped us become more aware of how much of a certain macronutrient we’re actually consuming.

That said, just tracking macros doesn’t tell the whole story. It doesn’t account for food quality. It doesn’t always help you see your overall intake clearly, especially when your focus is on hitting protein numbers. Until you understand how to meet those needs in a sustainable way, you might miss the full picture.

So the takeaway I want you to have from all of this—because yes, today’s episode is kind of a survey of big shifts—is just to start noticing. Start becoming aware.

What do you eat in a typical day? Is it coffee for breakfast, a sandwich for lunch, takeout for dinner? Where is the real nutrition coming from? How many servings of vegetables did you have? Not just a tomato slice and a piece of lettuce on a sandwich—that barely counts as a cup.

Think about it: where did the nutrition in your day come from?

This is why it’s so important to become aware of what we’re actually consuming. The same goes for movement. Maybe you don’t wear a smartwatch, but your phone likely tracks your steps. If you don’t have a wearable step tracker, even using your phone as a rough estimate can be eye-opening. People often throw out the 10,000-step recommendation—it’s a good benchmark. But it’s hard to reach unless you’re intentionally building movement into your day.

I move around a lot, and even with that, I have to go out of my way to get those extra steps in. So chances are, unless you’re actively trying, you’re probably getting closer to half of that. That’s something to consider—just how sedentary most of our lives have become, how much time we spend sitting, commuting, or standing in one place without much real activity.

This episode isn’t about giving you one specific action step—it’s more about building awareness. Think about how things were in the 1950s. Not that we want to go back there, but just to ask: what was different?

My mom was born in 1957, so she grew up in the 60s. She remembers that dinner was always some kind of meat or fish, a vegetable, and you had to eat your protein and your veggies. That was a fairly typical meal.

Now, meals tend to be fancier, but often with less real nutrition. So ask the people around you—your parents, or anyone a bit older—what meals looked like when they were growing up. Reflect on your own childhood. What did you do all day? How much did you move? What did meals look like? How often did you snack?

Did you live on granola bars or what we now call “protein bars”? These have become convenient staples but often lead us astray. Sure, they might have the right macros, but they’re full of inflammatory ingredients. They can make us bloated, mess with our cravings, and include an over-sweetened flavor profile that leaves our bodies confused.

So, as we wrap up today, I want you to think about your root cause. When you take the PCOS Root Cause Quiz and identify your primary root cause, also think about how your environment has shifted—how our society as a whole has changed.

What would it look like to start shifting your lifestyle back to something more natural? A way of eating that’s whole-food-based, that includes more daily movement, less sitting around, and more time outdoors. Something that supports your body from the inside out.

Take time to ground yourself. Go outside, breathe in fresh air, get some sunshine. As we head into summer, ask yourself: what can I do to help my body feel more nourished, more present, more alive? Maybe it’s drinking more water. Maybe it’s swapping just one convenience food for something more nutrient-dense. It doesn’t have to be perfect—it just has to be intentional.

Coffee isn’t bad. Protein bars aren’t evil. But when they crowd out whole, nourishing meals, it’s worth questioning the norm. Are you hydrating enough? Are you eating in a way that aligns with how your body actually functions best?

So with that, I hope you found this episode helpful. The goal wasn’t to overwhelm or to make you feel like you have to change everything overnight. It was to open your mind—to start questioning what’s become “normal” in our society, and whether it’s really serving your health.

Some of it might be great. Some of it might just be autopilot. And some of it might be tripping you up without you even realizing it.

If you found this episode helpful, be sure to hit the subscribe button so you get notified each and every week as a new episode becomes available. And if you’re ready to go deeper—if you want the full plan for what to eat, how to support your root causes, and how to make it all work for your life—the PCOS Root Cause Bootcamp is where I walk you through every step. Meal ideas, recipes, guidance—it’s all in there.

But even without that, the first step is awareness. What’s one small shift you can make today?

Until next time, bye for now.