Ten PCOS-friendly actions you can take in 2010

It's 2010! It's also the time for reflection and resolutions. Don't forget to give yourself credit for the positive! Often times we try a new behavior, food, or activity, and because it didn't create a miracle or immediate change, we discontinue it and assume it didn't work. The truth was, we didn't give the new choice an opportunity to take hold and unfold.

We also tend to make the same old resolutions revolving around diet and exercise. Rather than fall into that trap here, I came up with a list of 10 other, less obvious, but equally important things you can do to help manage your PCOS.

Here's to another year of PCOS outreach. I am grateful for all of the wonderful people this blog has brought into inCYST's world, and I look forward to more good times and new friendships!

1. Prioritize yourself.

Most of my clients are highly intelligent, accomplished, passionate, and creative. But what strikes me is how easily they devote all of that energy to others...and have trouble using it to benefit themselves. Make time for healthy behaviors. They're appointments with yourself that are equally as important as any appointments you make with your doctor. Your body is trying to tell you that if you deserve anything, it's time for self-care. Make 2010 the year you agree and take action!

2. Be informed.

Over the year I've become busy with Twitter. I am disturbed at the number of tweets promising miracle supplements and cures for PCOS. Even moreso, I am disturbed to see that these tweets are the ones tending to be most often retweeted. The tweets with the most logical, evidence-based advice...sit there largely unread. If "fixing" PCOS was as easy as taking a pill, it wouldn't affect one in ten women. Don't get caught up with anyone promising a miracle or a pill. You deserve better than that. Be sure that any advice you try has research and evidence behind it to support its validity.

3. Be gentle with yourself.

I don't allow my clients to use self-deprecating language, and I confront them on self-punitive behaviors. Every single one of you is special. You deserve respect, and you deserve to celebrate the many positive things about you the rest of us see. You're not broken, and you don't need to be fixed. What you need is for the rest of us in your world to support a positive self-image and to see your goodness on days when you have a hard time with that. Expect more of that and less of the "broken speak" and see what comes into your life.

4. Take responsibility.
You can spend hours and hours on the Internet. You can participate in chat rooms and support groups and share your story. OR...you can take action. Many women I've tried to help have been more invested in sharing their story and their misfortune than they have in learning how to change their fortune. Are you suffering from what I call "PCOS Paralysis"? Is your time devoted to keeping you stuck, or are you consistently trying new things and working to be consistent with the behaviors that work? You can't see change unless you implement change. One step at a time is good enough. Those steps eventually add up to make a difference.

5. Create a support network.

inCYSTer Stacey Whittle (Santa Monica, CA) recently shared this quote on her Facebook fan page: "In 2010 CHOOSE your friends. Do the people you invest much of your time with sharpen you and amplify your happiness/productiveness? You will take on the habits, attitudes, beliefs and even mannerisms of the people you surround yourself with." Look around you. Are you surrounded by people who support healthy change and who help you to add those changes in your life? Or are you expected to be a lone wolf in the middle of people who are stuck in the lifestyle that helped make you sick to begin with? Look for people who live the way you would like to, and spend more time with them.

6. Try something healthy.

It does no good to read about it, tweet about it, debate about it. You have to live it!

7. Persist.

Remember, the days you need to take care of yourself the most...are the days you least feel like it.

8. Turn off your technology and live!

There is only so much the Internet can do for you. The life that will turn your situation around, is the one that exists off of your computer/iPhone/television screen.

9. Get some sun.

It will increase your vitamin D levels, improve your melatonin metabolism, increase your activity, improve your mood, and give you some nature-based inspiration. It really works.

10. Celebrate your beauty.

You are not broken. You do not need to be fixed. Your beauty is about who you ARE. Not about what you could be. Celebrate it. Be proud of it. Don't wait until you lose weight/conceive/resolve your acne to take care of yourself. Take care of yourself first, and see what happens to your weight/fertility/skin. Make 2010 the year you take care of the beautiful person you are, the way you deserve to be taken care of!

Are you vegetarian with PCOS? Take note of this important potential deficiency

One of the more frequent searches bringing readers to our blog is "vegetarian" and "fertility"...and "vegetarian" and "pcos". I've also noticed when doing Fertility Friendly Food Tours at Whole Foods, that a disproportionate percentage of women attending these classes, are vegetarian. And, in my individual counseling, it's not uncommon to learn during an assessment that if a client is not currently vegetarian, she was at some point in her life.

So I wasn't surprised to find this study reporting that women with PCOS tend to be deficient in vitamin B12.

I often teach that PCOS is a counterintuitive illness. By that, I mean that what often needs to be done is the opposite of what you might think. In this case, rather than immediately assuming that the most important strategy is to restrict food choices because your appearance suggests overnutrition, it may actually be to add foods back into your diet to correct underlying deficiencies.

This B vitamin is found almost exclusively in animal products, including fish, meat, poultry, eggs, milk, and milk products. It is also found in some fortified breakfast cereals, but if you're avoiding carbohydrates as well as trying to be vegetarian, you're likely not getting enough vitamin B12 in your diet.

Some fermented soy products, namely tofu, tempeh, miso, and tamari, may contain vitamin B12, if the bacteria, molds, and fungi used to produce them were vitamin B12 producing. This is a project I'll look into and blog about in a later post.

Finally, some nutritional yeast products also contain vitamin B12. Lucky for you Aussies reading this blog, that means Vegemite and Marmite, made from yeast extracts, can be excellent choices to include in your diet!

It is possible to obtain vitamin B12 by taking a vitamin supplement, but the amount of the vitamin that is actually absorbed through the digestive tract may be very low. For this reason, physicians who note a low vitamin B12 level may recommend an injection, to bypass the digestive tract.

Women over 14 years of age, if not pregnant, should be consuming 2.4 mcg of vitamin B12 per day. They should aim for 2.6 mcg per day when pregnant, and 2.6 mcg per day when breastfeeding.

It's clear, if you don't do vegetarian eating in a thoughtful, proactive way, it carries considerable health risks. As you've seen before in this blog, inCYST believes that healthy vegetarian eating is about what you DO choose to eat, more than what you DON'T choose to eat.

It is a good idea, if you're vegetarian, or ever have been, to ask your physician to check your vitamin B12 levels. A low status is easy to correct and that can be part of your strong foundation for managing your PCOS and improving your mood, insulin function, and fertility.

Kaya C, Cengiz SD, Satiroğlu H. Obesity and insulin resistance associated with lower plasma vitamin B12 in PCOS. Reprod Biomed Online. 2009 Nov;19(5):721-6.

Food of the week: Greek yogurt (maybe it's not the best yogurt if you have PCOS)

Greek yogurt is all the rage these days. Are you missing something by not eating it?

Yes...and no.

This dairy treat is popular with consumers because it's thicker and creamier than regular yogurt. Nutrition experts like it because it is higher in protein. That, for PCOS is something to look for in foods.

Before you jump on the bandwagon, however, consider a couple of things.

Greek yogurt is made by straining out the water to make it thicker. In the process of straining, calcium leaches out into the water that is strained and discarded. This means that its calcium content tends to be lower.

Greek yogurt also doesn't contain vitamin D, a vitamin that is increasingly being found to be deficient in women with PCOS. I personally checked all major brand labels (Fage, Oikos, Chobani, and several other lesser known options) in the store to verify this, and unfortunately, not a single one is fortified with vitamin D.

So if you're using Greek yogurt as your dairy choice for the day, and you're assuming it's a good source of calcium and vitamin D, you're selling yourself short.

Fortunately, if you love Greek yogurt and you have a few minutes of time, the problem can easily be solved. It turns out, it's fairly easy to make Greek-style yogurt from regular, vitamin-D fortified yogurt! All you need to do is strain the regular yogurt with a cheesecloth. Here are the directions, with pictures.

Here is a list of yogurts that DO contain vitamin D. My recommendation is to stick with plain in order to keep the sugar content low. Also, to consider a low-fat rather than a non-fat version. Researchers have found that if only one of your dairy choices a day contains fat, you tend to increase your fertility.

If you want to, you can even save the liquid you've drained off and include it in smoothies--thus recapturing the calcium and the whey protein that's been drained off in the straining process.

Bottom line--don't assume that because yogurt is a dairy product that it is the exact nutritional equivalent of milk. And don't get caught up in the hype, and assume that Greek yogurt is automatically your superior choice.

Why are you taking metformin? Do you really need it?

One of the main reasons women with PCOS are encouraged to take metformin is because it is widely believed that it can help to improve fertility and reduce the incidence of miscarriage.

A 2009 study challenges this belief. It comes from the Cochrane Collaboration, a not-for-profit organization that evaluates groupings of research independent of for-profit (read "drug company") funding. I like their studies because their sample sizes are large and their findings are evidence-based. It takes them a long time to adopt new ideas, but it is because they so heavily scrutinize the available information rather than jumping on any bandwagons.

In this study, authors searched several comprehensive medical databases for studies evaluating metformin used during in-vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI). They specifically looked at randomized, controlled trials containing a "no treatment" or placebo group to compare to a group receiving metformin. They evaluated several types of outcomes that metformin may have an opportunity to influence: live birth rate, pregnancy rate, miscarriage rate, incidence of ovarian hyperstimulation syndrome, patient-reported side effects, and several hormone levels (estradiol, androgen, fasting insulin and glucose).

This exhaustive review, under rigorous statistical analysis...

"found no evidence that metformin treatment before or during assisted reproductive technique (ART) cycles improved live birth or clinical pregnancy rates."

The one benefit of metformin appeared to be a reduced risk of OHSS in women with PCOS and undergoing IVF or ICSI cycles.

I'm not a physician and therefore, I am not able to prescribe metformin. And I am ABSOLUTELY NOT ENCOURAGING ANYONE READING THIS TO DISCONTINUE USING MEDICATION THAT THEY HAVE BEEN PRESCRIBED. I do, however, see a tendency to hand this medication out without evaluating whether or not it is appropriate. It's important to discuss such issues with your physician and to be sure they are aware of the research supporting (or not supporting) their recommendation.

Here is the reference for anyone who wishes to share it with their personal provider.

Tso LO, Costello MF, Albuquerque LE, Andriolo RB, Freitas V. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD006105.

Omega-3's are great for mental health--and >80% of women with PCOS are struggling with mental health issues

From inCYSTER Karen Siegel...contact information for her Houston clinic is listed below.

"Yes. Another reason to keep encouraging the fish oil supplementation."

Public release date: 16-Dec-2009

Contact: Public Affairs Office
public.affairs@apa.org
202-336-5700 202-336-5700
American Psychological Association

New study links DHA type of omega-3 to better nervous-system function
Deficiencies may factor into mental illnesses
WASHINGTON — The omega-3 essential fatty acids commonly found in fatty fish and algae help animals avoid sensory overload, according to research published by the American Psychological Association. The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington's disease; and other afflictions of the nervous system.

The study, reported in the journal Behavioral Neuroscience, provides more evidence that fish is brain food. The key finding was that two omega-3 fatty acids – docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) – appear to be most useful in the nervous system, maybe by maintaining nerve-cell membranes.

"It is an uphill battle now to reverse the message that 'fats are bad,' and to increase omega-3 fats in our diet," said Norman Salem Jr., PhD, who led this study at the Laboratory of Membrane Biochemistry and Biophysics at the National Institute on Alcohol Abuse and Alcoholism.

The body cannot make these essential nutrients from scratch. It gets them by metabolizing their precursor, α-linolenic acid (LNA), or from foods or dietary supplements with DHA and EPA in a readily usable form. "Humans can convert less than one percent of the precursor into DHA, making DHA an essential nutrient in the human diet," added Irina Fedorova, PhD, one of the paper's co-authors. EPA is already known for its anti-inflammatory and cardiovascular effects, but DHA makes up more than 90 percent of the omega-3s in the brain (which has no EPA), retina and nervous system in general.

In the study, the researchers fed four different diets with no or varying types and amounts of omega-3s to four groups of pregnant mice and then their offspring. They measured how the offspring, once grown, responded to a classic test of nervous-system function in which healthy animals are exposed to a sudden loud noise. Normally, animals flinch. However, when they hear a softer tone in advance, they flinch much less. It appears that normal nervous systems use that gentle warning to prepare instinctively for future stimuli, an adaptive process called sensorimotor gating.

Only the mice raised on DHA and EPA, but not their precursor of LNA, showed normal, adaptive sensorimotor gating by responding in a significantly calmer way to the loud noises that followed soft tones. The mice in all other groups, when warned, were startled nearly as much by the loud sound. When DHA was deficient, the nervous system most obviously did not downshift. That resulted in an abnormal state that could leave animals perpetually startled and easily overwhelmed by sensory stimuli.

The authors concluded that not enough DHA in the diet may reduce the ability to handle sensory input. "It only takes a small decrement in brain DHA to produce losses in brain function," said Salem.

In humans, weak sensorimotor gating is a hallmark of many nervous-system disorders such as schizophrenia or ADHD. Given mounting evidence of the role omega-3s play in the nervous system, there is intense interest in their therapeutic potential, perhaps as a supplement to medicines. For example, people with schizophrenia have lower levels of essential fatty acids, possibly from a genetic variation that results in poor metabolism of these nutrients.

More broadly, the typical American diet is much lower in all types of omega-3 than in omega-6 essential fatty acids, according to Salem. High intake of omega-6, or linoleic acid, reduces the body's ability to incorporate omega-3s. As a result, "we have the double whammy of low omega-3 intake and high omega-6 intake," he said.


###
Article: "Deficit in Prepulse Inhibition in Mice Caused by Dietary n-3 Fatty Acid Deficiency"; Irina Fedorova, PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Anita R. Alvheim, PhD candidate, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, and National Institute of Nutrition and Seafood Research, Bergen, Norway; and Nahed Hussein, PhD and Norman Salem Jr., PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Behavioral Neuroscience, Vol. 123, No. 6.

(Full text of the article is available from the APA Public Affairs Office)

Norman Salem Jr. can be reached at nsalem@martek.com or at (443) 542-2370 (443) 542-2370 . He was with the National Institutes of Health until 2008, when he became the chief scientific officer and vice president of Martek Biosciences Corp. in Columbia, Md., an ingredient supplier of DHA. He states that he and his co-authors conducted this research while with the NIH.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.
--
Karen Siegel, MPH, MS, RD, LD, LAc
Acupuncture & Nutrition Clinic
9660 Hillcroft, Suite 202
Houston, TX 77096
713/721-7755 713/721-7755
www.AcupunctureandNutritionClinic.com
or
www.Karensclinic.com

With PCOS, it's what's under the hood that counts

If you're trying to conceive, you likely know that it's important to be getting enough folate in your diet in order to prevent neural tube defects.

Even if you're NOT trying to get pregnant, folate is important for women with PCOS.

Homocysteine is a compound found in the blood, which, in elevated amounts, indicates increased cardiovascular risk and inflammation. It tends to be elevated in women with PCOS.

Fifty patients with PCOS, were divided into two groups receiving two different treatments. The first group received 1700 mg of metformin per day, along with 400 mug folate. The second group received metformin without folate.

Homocysteine levels were significantly increased in both groups, but to a lesser degree when they also supplemented with folate.

I was heartened to see this study, since so much research on PCOS focuses on the part of PCOS we can SEE (i.e., weight), and seems to ignore that biochemistry can be altered regardless of weight. In fact, another study I ran across while looking for a blog topic this morning, focused on the fact that metformin improved biochemistry even without diet or exercise modifications. Yes, you can make a study say anything you wish if you correctly design it, but it is not fair to women with PCOS to do that and falsely lead them to believe that medication is the only answer. And, you've got to understand that even if your weight is normal with PCOS, you still have to pay attention to what is happening metabolically.

You've got to care about what's under the hood, not just how pretty the paint job is.

Palomba S, Falbo A, Giallauria F, Russo T, Tolino A, Zullo F, Colao A, Orio F. Effects of metformin with or without supplementation with folate on homocysteine levels and vascular endothelium of women with polycystic ovary syndrome. Diabetes Care. 2009 Nov 23. [Epub ahead of print]

Oppelt PG, Mueller A, Jentsch K, Kronawitter D, Reissmann C, Dittrich R, Beckmann MW, Cupisti S. The Effect of Metformin Treatment for 2 Years without Caloric Restriction on Endocrine and Metabolic Parameters in Women with Polycystic Ovary Syndrome. Exp Clin Endocrinol Diabetes. 2009 Dec 8. [Epub ahead of print]

Food of the week: chili peppers

A few weeks ago I was visiting my parents in Tucson. You could tell the holidays were coming, because the corner lots were all occupied by chili ristra vendors. These chilis, popular in the Southwest, are crafted into artistic wreaths and strands that hang on doors, gates, and walls, everywhere you look. Traditional wisdom says that a house with a ristra hanging out front is a happy household.

I thought this would make a fun food for a holiday greeting, and perhaps if we hung a ristra on this blog, we'd radiate electronic happiness and goodwill.

What is so great about chilis? Well...what isn't?

They are a great anti-inflammatory. Capsaicin, a compound in chilis, has been found to delay the onset of arthritis, and to be therapeutic for diabetic neuropathy. Both of these conditions are more likely to be issues in people prone to inflammatory disorders.

Chilis can reduce cholesterol and heart attack risk. They can reduce the risk of diabetes.

From a practical standpoint, chilis make food interesting. It's easy to eat healthfully if you like what you're eating!

Here is a recipe for Mexican Red Chile Sauce, a staple in New Mexico and excellent on pork...or leftover turkey.

Whether you like Mexican, Szechuan, Indian, or Thai food, don't forget the chilis.

New feature: 10 PCOS-friendly foods you can order online

The other day it was brought to my attention that amazon.com had a pretty extensive grocery section on their website.

I liked a lot of the items they were selling and it occurred to me that highlighting some of them from time to time would be a way to provide a virtual grocery store tour for those of you who do not have the ability to attend one of our live classes or counseling options.

I also wanted to create options for the many people reading this blog who live outside of the United States who do not have access to many of the shopping options we have here in our own country.

I did, in the process, become an Amazon associate, but truthfully, I have done an equally good job of providing this new service if you only click through to look at the photo and don't buy. It's about becoming more confident in your food choices, and this seemed like a fun way to promote that.

I do, as a small business, have more of a desire to promote other small businesses, so the emphasis will be on products created by companies who have put as much of themselves into what they do as I have with inCYST.

From time to time I'll post some suggestions for your consideration. There are some great options out there, and I hope you enjoy learning about them!

Bergin Nut Company Almonds Whole Raw, 16-Ounce Bags (Pack of 2)
All nuts are great, and you'll get the best benefit if you vary the types that you eat.

KIND Bar Fruit & Nut Delight, 1.4-Ounce Bars (Pack of 8)
Kind Bars are one kind that are as bare and natural as you'll be able to find.

Amish Country Baby White Popcorn - 2lb.
Be sure to pop this in olive or canola oil.

Traverse Bay Dried Cherries, 4-Pound Box
Tart cherries contain melatonin, which you'll read about a lot on this blog. Great to throw into your oatmeal or trail mix.

Traverse Bay Dried Cranberries, 4-Pound Box
Another high antioxidant option for snacking!

KIND Bar Macadamia & Apricot, 1.4-Ounce Bars (Pack of 8)
Of the kind bars, this is the one with our favorite nut--very high in monounsaturated fats and very high on the "healthy" scale.

Just Tomatoes Just Strawberries, 4-Ounce Tubs (Pack of 2)
I love these snacks! Again, use for trail mix or keep in your desk to eat right out of the container.

Mary's Gone Crackers, Original, 6.5-Ounce Boxes (Pack of 12)
Crackers are the hardest category to find PCOS-friendly options in. Here is one of my favorite brands.

Bare Fruit 100% Organic Bake-Dried Apples, Fuji, 1 Pound Bags (Pack of 2)
If you like dried fruit, take advantage of it!

Seapoint Farms Dry Roasted Edamame, Lightly Salted, 4-Ounce Units (Pack of 12)
Edamame is one of four kinds of soy that is best for PCOS. It's a great, high protein snack or salad topping.

For those of you looking to buy shirataki noodles

Awhile back, I wrote about shirataki noodles as a food of the week. I learned from that, that there are quite a few people looking for these noodles!

I just learned they are available through Amazon.com. To make it easy for those of you looking for these low-carb noodles, I've set up a link where you can directly order them from Amazon. Click here to order shirataki noodles online

Disclosure: inCYST does have an associate agreement with amazon.com.

Ahhh...those evil body fat machines, part 2

I recently wrote about my experience with a personal trainer at a local gym, and the interaction we had about my doubt about the body fat number he measure for me.

Yesterday I was at another location of the same gym, waiting for yoga class to start. Another personal trainer walked by with the same apparatus, and asked if anyone wanted to have their measurement taken.

I volunteered, and I got the same inflated measurement they gave me before. Again...I told him I had two degrees in nutrition and fitness-related fields, that I'd managed an exercise testing laboratory during graduate school, and the numbers simply were not consistent with what I knew about my exercise level and my body type.

Again, he backed off and gave me a lower estimate that was almost exactly what the other trainer had given when I put pressure on him.

It's not about vanity. I actually went shopping for jeans right after yoga class and discovered that with all of my exercise over the past year I've DROPPED a size.

It's about what looks to be a scam on the part of gyms--to give you an inflated body fat measurement in an attempt to sell you personal training sessions.

Don't fall for it.

If you MUST have your body fat measurement taken, have it done by someone who has no financial gain to derive from overestimating your actual number. And/or...have it performed by two different people employed by two different organizations.

Talking your PCOS down out of a tree

Last month I had the opportunity to spend a week with 5 women with PCOS at Green Mountain at Fox Run's first ever PCOS week. I learned a tremendous amount from them, maybe even more than I went to teach to them, about the syndrome.

One of the most important insights I gained, was why it can be so difficult to lose weight once you've decided to change your eating and exercise habits.

Insulin has a lot to do with it.

Your body is constantly taking in data, recording the temperature, the light level, energy levels, etc., and adjusting itself to be able to meet the demands of the situations it's recording. When it comes to hormones, it often records and hangs on to information from weeks before. It's as if it wants to be sure it's ready to handle the worst case scenario it's going to have to be asked to deal with. So...if you've been binge eating, and you've changed your habits, information it's taken in about that binge, if it occurred in your recent past, is still in the database. Your body is likely to want to make more insulin than it currently needs, just in case it's asked to have to handle a binge session like one it remembers you engaged in.

If you continue your new eating habits, consistently, that will register positively, your body will trust that it needs to make less insulin, and your lab values will improve.

The challenging part is being patient with your body while the new data has a chance to be recorded and acted on.

If you've got high insulin levels and all of a sudden you decide to go on a diet, or exercise at high levels, the insulin levels won't automatically adjust. It can be very easy to create a hypoglycemic state if you take on too much too soon. And, as your blood sugar levels drop, your hunger and carbohydrate cravings are likely going to be triggered to correct the situation.

Hypoglycemia is a stressful situation for the body, so when this scenario kicks in, it also triggers the release of stress hormones. Cortisol, one of the major stress hormones, is made with cholesterol. As are estrogen, testosterone, and progesterone. If choices you are making are demanding of the body that it makes more cortisol, it's going to be hard for it to make the other three hormones in the proper proportions.

The other thing that is common with PCOS is an intelligent, driven, all-or-nothing tending personality. When you decide to take on diet and exercise, it can be in an extreme fashion. When weight doesn't come off as planned, you can be very hard on yourself, raising your stress levels, possibly bingeing out of frustration.

And thus the cycle starts, all over again.

Hence the title of this post. How do you back yourself out of such a situation?

Ohhhh...you all are going to hate this, but the key word is "moderation". Be gentle with yourself. Rather than taking on an extreme exercise plan and a rigid diet, focus on small simple changes and working to turn them into habits. Be patient. Understand that the changes you're implementing on the outside take time to be registered by your internal hormone control systems.

Probably key? Remember this: THE DAYS YOU FEEL THE LEAST LIKE STICKING WITH YOUR NEW HABITS ARE THE DAYS IT IS MOST IMPORTANT TO DO JUST THAT. It's tempting to blame a bad day on something you've done, to take it personally, rather than let your body do what it does best when it's not interfered with. By bingeing and not exercising on a day you feel badly, you prolong the time it's going to take to get things back into balance.

Food of the week: calamari

I am on a mission to encourage my colleagues to stop recommending so much salmon! Why? Because (1) salmon is not the only omega-3 containing seafood,(2) there is not enough salmon in the world to meet everyone's omega-3 needs,(3)salmon tends to be a seasonal fish, (4) salmon is not affordable to many, and (5) for some cultures, there are other seafoods that can provide DHA that just fit better.

It's not that salmon is BAD...it's just not the best choice for everyone, every time.

Today I wanted to talk about calamari. It's not a scaled fish, it's not even a cold water resident. But...it still contains omega-3's. It's ok to eat if you are trying to eat more of those. Nutritionally, it's a great source of selenium, vitamin B12, and riboflavin. For anyone who likes Greek, Italian, Spanish, or Mexican food, it's a natural!

If you eat calamari in a restaurant, be sure it's not breaded, and if it is fried, that olive oil is the agent.

If you cook it at home, here are some healthy ideas:

Grilled Calamari with Parsley

If breaded is the only way you like calamari, try this recipe at home: Healthy Breaded Calamari (the breading contains flax!)

The way my Mexican clients and neighbors like to eat it, in a seafood stew called Sopa/Zarzuela de Mariscos. A side note: I received a call from a Mexican client one night, she was at a restaurant, and craving this soup, but was afraid to have it because her friends had told her it could cause her to miscarry. I told her to enjoy it. She didn't miscarry, and she and her husband have a healthy baby to enjoy Christmas with this year. She, of all my clients, was the most diligent about omega-3 intake during her pregnancy, and I believe it was important to her overall success story.

So if you're not sold on salmon...but like other seafood, take heart...you're still on the right track. Enjoy!

Does grapefruit cause breast cancer?

I engaged in a Facebook discussion about grapefruit recently. Ruby Reds are currently cheap at Trader Joe's, a fact which made one friend very happy. One of HER friends cautioned that grapefruits have been associated with breast cancer.

I promised to look into it and blog, which is what you're reading now!

In a survey of 50,000 women, researchers found that grapefruit may increase estrogen levels, a known breast cancer risk. It is thought that this relationship may be related to the fact that grapefruits alter a metabolic pathway involved in estrogen metabolism, called "cytochrome p450".

The cytochrome P450 pathway is also important for the metabolism of many medications commonly used with PCOS. Grapefruit and grapefruit juice may alter the metabolism of this pathway in the following ways:
--may induce excessive sedation with benzodiazepenes
--may induce rhabdomyolysis with statins
--may cause hypotension with calcium antagonists
--may alter electrocardiograms with astemizole, cisapride, pimozide, and terfenadine
--may induce overdose with SSRI medications such as Paxil

Wow...sounds like grapefruit could be the kiss of death, doesn't it? Well, those studies certainly sell newspapers and drive up advertising rates on websites who post them, but that's not the whole story.

First of all...when it comes to your medications, if you eat grapefruit regularly, tell your physician. She can calibrate the dose of the medication to reduce the risk of these side effects. Since grapefruits are a winter fruit, you may need to communicate with your physician to account for seasonal changes in your diet.

With regard to breast cancer, even though a couple of years ago the grapefruit/breast cancer link got lots of press time...a recent study reported no association between the two. None of the studies looked specifically at this issue with PCOS, but I suspect with the already present tendency toward high estrogen, there may be an altered metabolic system that could be grapefruit sensitive....and could be problematic...IF YOUR RELATIONSHIP WITH GRAPEFRUIT IS NOT ONE OF MODERATION.

Where women with PCOS might go wrong is if they cycle in and out of diets with limited variety and which focus on grapefruit...um...THE GRAPEFRUIT DIET. If you have PCOS, you may already have a tendency to be hyperestrogenemic. You may be on at least one of the medications mentioned above. And your relationship with food may be more one of feast/famine than one of moderation and variety.

Also, if you have a family history of breast cancer, eating too much grapefruit, all the time, may not be a good idea. Enjoying a seasonal box of Ruby Reds once a year...probably isn't going to be the worst thing you could do to yourself. Even if you have PCOS.

If you moderate the diet, so that grapefruit is one of many fruits you enjoy, and you practice moderation instead of yo-yo dieting, you should be ok with grapefruit.

And you might even get yourself off of some of the medications that were of concern in the first place. :)

http://www.globalrph.com/gfruit.htm

Monroe KR, Murphy SP, Kolonel LN, Pike MC. Prospective study of grapefruit intake and risk of breast cancer in postmenopausal women: the Multiethnic Cohort Study. Br J Cancer. 2007 Aug 6;97(3):440-5. Epub 2007 Jul 10.

Spencer EA, Key TJ, Appleby PN, van Gils CH, Olsen A, Tjønneland A, Clavel-Chapelon F, Boutron-Ruault MC, Touillaud M, Sánchez MJ, Bingham S, Khaw KT, Slimani N, Kaaks R, Riboli E. Prospective study of the association between grapefruit intake and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control. 2009 Aug;20(6):803-9. Epub 2009 Feb 18.

Green Mountain at Fox Run Resort Announces its 2010 PCOS Week Dates

I wanted to be sure you had the dates for these events in case you are interested. We had so much fun the first time around we decided to schedule some encores!

I have been told that during the March event there's still plenty of opportunity for outdoor activity...in fact, I've been promised I will be learning snowshoeing!

Click here for more information.

Hope to see you there!

Food of the week: Brussels sprouts

I am willing to bet you wrinkled your nose when you saw this week's choice. Most people will. That's unfortunate, since this kissin' cabbage cousin is a nutritional powerhouse. It's especially high in vitamin C and vitamin K, it's got folate (which all of you ladies need as much as you can get of), and it contains that anti-Alzheimer's compound I've been writing about a lot lately....choline. It's one of those vegetables like cabbage and broccoli that has some powerful anticancer properties as well. They're low glycemic, and each one only contains 10 calories!

Most people have never eaten a properly cooked Brussels sprout, which is why they think they don't like them. They can taste sulfurous if cooked too long. It's best to cook them until they just turn a bright green. Here's a video on cooking them that may be helpful.

If you're really adventurous, and willing to reconsider, here are some interesting ways to cook them:

Roasted brussels sprouts

Caramelized brussels sprouts (You will need some sugar to do the caramelizing, but you can experiment with how little you really need.)

Brussels sprout stir fry

Browned Brussels sprouts with orange and walnuts

Brussels sprouts with grapes

Grilled Brussels sprouts

And my personal favorite, pictured above, Brussels sprout salad

Bon Appetit!

Top Ten PCOS-friendly (and Martha Stewart-worthy) Ways to Include Food in Your Holiday Celebrations

If you allow it to happen, holiday festivities can leave you feeling left out of the fun. It doesn't have to be that way if you think creatively. Here are some fun, PCOS-friendly ways to include food in your holidays.

Now go make Martha proud!!!

1. A high percentage of my clients love to decorate cakes. If it's the decorating part you love....why not make salt dough Christmas ornaments?






2. Make cranberry/popcorn garlands for your tree.






3. Make orange clove pomander balls for gifts and ornaments.






4. Donate food to or volunteer your time at a food bank or homeless shelter. It is a powerful way to gain perspective on food and your own relationship with it.






5. Decorate your home with rosemary garlands for a fresh, clean holiday aroma.





6. Make olive-oil based vinaigrette dressings placed in pretty bottles for holiday gifts.





7. Decorate your holiday table with cranberry ice candles.




8. Hang a nut/seed wreath in your backyard for the birds you enjoy watching.







9. Decorate your front door with chili pepper wreath.







10. Invest in a decorative nutcracker and set it near a pretty bowl of mixed nuts.