Sooo much better than Ambien!

Montmorency cherries (and walnuts) have a high melatonin content, and I just discovered they're available in dried form at Trader Joes!  I stopped by their demo table this afternoon and they had a great, simple cherry chicken salad.

Such a versatile food...on your oatmeal, in your trail mix, on your salads, or even...your Memorial Day bowl of ice cream. :)

Enjoy!



Cherry Chicken Salad

1/3 cup nonfat yogurt
1/3 cup walnuts
1/3 cup dried tart (Montmorency) cherries
1 can (or 6 oz cooked) chicken
1/3 tsp garlic powder

Your PCOS depends on healthy oceans

I am an animal lover, and it turns my stomach every time I turn on the news and see an oil-coated pelican, or a rescued baby turtle, innocently affected by the BP oil spill.  I have committed to never buy another BP brand as long as I live. 

I am very concerned about what this spill poses personally for all of the readers of this blog.  You all need omega-3 fatty acids, the kind that come from seafood, for your brain health and hormone balance.  Without healthy oceans, there simply cannot be healthy humans.  Menhaden, a huge source of fish oil, has been significantly affected.  Its season opened just as the oil spill started.  Omega Protein Corporation, the world's largest manufacturer of fish oil, fishes largely out of the Gulf.  They've stated that they'll simply move their boats and there isn't a short term issue, but as the problem persists...the long term impact of such a disaster begins to become more and more frightening.

I encourage all of you to take this issue personally.  The obvious boycott would be BP products for your car.

There's another one, a pretty big one, directly related to each and every one of us.  Cans.  Aluminum cans.  The kind we crack open when we Jones for a soda.  The primary manufacturer of these sodas is a division of BP. 

Maybe, if you haven't been able to stop drinking the sodas, even when we've blogged about the caffeine and the sugar and the high fructose corn syrup and the artificial sweeteners...you can do it if you know the company who makes the cans they come in is chipping away at the integrity of the fragile environment your hormones need to live in.

It's a smple act, but with 1 in 10 women on the planet living with PCOS, if they banded together and collectively put the cans down, imagine what message that could send.

The pelican who's watching over this post...on behalf of his endangered pals, thanks you for your consideration.

Click here for a link to a list of products and services related to BP.

Ten ways to set yourself up for success with your dietitian

Rachel Brandeis is a dietitian in our network, practicing in the Atlanta area.  She is well respected in the reproductive medicine world, and well versed in PCOS.  The other day, in a phone conversation, she mentioned that one of the aspects of her work that doesn't always allow her to be as productive and helpful to her clients, is when they come unprepared and unready to get down to work.  She sent me a great list of bullet points that you can use to prepare for working with your own dietitian.

Keep in mind, we tend to ask a lot of questions and stick to business!  It's not because we don't care about you or your story.  But since you're spending time and money to work with us, we tend to be focused on the task at hand.  We also understand that a lot is riding on our advice, so we want to be sure there is time in the appointment to get our information across.

Here is what Rachel suggests:


1..Be prepared to give an accurate diet history -- foods and beverages that you commonly consume; it may be helpful to keep a detailed food record for a week (including a weekend).

2.  Be honest when discussing what/how/when you eat -- you are paying us to help you, not to judge you!

3.  Be prepared to also give an in depth weight history and past dieting attempts (both successful and unsuccessful).

4.  Know what medications you are taking and the dosage of each medication

5.  Bring your most recent lab work with you

6.  Keep an exercise diary -- we need to know how frequently you exercise, how long and how intensely.

7.  Be prepared to answer "what would you like to get out of this consult"

8.  Understand that we don't have a "magic wand"

9.  Come back for follow-up appointments! Change does not happen with one consult!

10.  Have realistic expectations.

If you'd like to contact Rachel about an appointment, visit her website.

Should you use flax during pregnancy?

This question comes up from time to time, and since inCYST is so big on flaxseed, it's a good idea to have information at your fingertips.

Around the Internet, caution regarding the use of flax while pregnant is easy to find.  The rationale for this caution is that mothers and fetuses are especially sensitive to hormones.

The Internet is also full of advice from flaxseed manufacturers promoting its use, because it can be converted to DHA, which as this blog consistently discusses, is crucial for conception, pregnancy, and development of a healthy baby.

Neither of those assertions is totally correct.

I dove into Pub Med last night and looked for any research to support the advice against flax during pregnancy.  I couldn't find it.  What I DID find was a whole host of animal studies, primarily done on pigs and cows, with mostly positive findings.  It's always important to remember that animal studies do not always extrapolate completely to humans, but they do give us an idea of what's going on. 

Effects of flaxseed consumption during pregnancy (again, in pigs and cows) included:
--healthier immune systems in babies
--better growth in babies
--after having one baby, a shorter time to ovulation (restored fertility)
--breast milk with a higher omega-3 fatty acid content and a lower omega-6 to omega-3 fatty acid ratio
--higher brain omega-3 content in babies
--increased levels of EPA, another omega-3 important for prostaglandin function and healthy blood clotting
--higher pregnancy rates
--larger follicle size
--higher conception rates
--lower miscarriage rates
--higher progesterone levels

IMPORTANT DISCLAIMERS
While I'm always excited to report positive links between nutrition and fertility, you all should know when I look through the research I am actually searching hard for the BAD news.  This is such a high-risk specialty!  The very last thing I would want to do is encourage our readers to make choices leading to frustration, disappointment, heartache, and loss of our own credibility.  So I want to make it clear, the benefits of flax can be achieved only if it's used with respect.

Flax cannot replace fish oil.  Some flax supplement manufacturers promote its use because it is converted into DHA and therefore can be used as a supplement for flax.  Not true!  The studies I perused found different effects for both, meaning you need both in your diet. 

If your diet is imbalanced, flax won't make up for it.  One study I found showed that when protein intake was low, flax supplementation was not beneficial.  This would be a scenario not uncommon with our vegetarian readers, if their definition of vegetarian eating focuses more on what to eliminate rather than what to include, or is the remnant of an eating disorder.  As always, supplements work best in a well-nourished environment; they cannot replace balanced, nourished eating.

Finally, if you choose to use flax...IT MUST BE GROUND.  In other words, the flaxseed tortilla chips at Trader Joe's were not what made these studies work. :)

I've heavily referenced this post to save the skeptics the work. 

I hope you find this helpful!

Rao SS, Kale AA, Joshi SR, Mahadik SP.  Sensitivity of fetus and pups to excess levels of maternal intakes of alpha linolenic acid at marginal protein levels in Wistar rats.  Reprod Toxicol. 2007 Nov-Dec;24(3-4):333-42. Epub 2007 Jul 28.
Yu B, Khan G, Foxworth A, Huang K, Hilakivi-Clarke L.  Maternal dietary exposure to fiber during pregnancy and mammary tumorigenesis among rat offspring.  Int J Cancer. 2006 Nov 15;119(10):2279-86.
Ambrose DJ, Kastelic JP, Corbett R, Pitney PA, Petit HV, Small JA, Zalkovic P.  Lower pregnancy losses in lactating dairy cows fed a diet enriched in alpha-linolenic acid.  J Dairy Sci. 2006 Aug;89(8):3066-74.

Petit HV, Twagiramungu H.  Conception rate and reproductive function of dairy cows fed different fat sources.  Theriogenology. 2006 Sep 15;66(5):1316-24. Epub 2006 Jun 2.
Farmer C, Giguère A, Lessard M.  Dietary supplementation with different forms of flax in late gestation and lactation: Effects on sow and litter performances, endocrinology, and immune response.  J Anim Sci. 2010 Jan;88(1):225-37. Epub 2009 Sep 25.

Colazo MG, Hayirli A, Doepel L, Ambrose DJ.  Reproductive performance of dairy cows is influenced by prepartum feed restriction and dietary fatty acid source.  J Dairy Sci. 2009 Jun;92(6):2562-71.
Farmer C, Petit HV.  Effects of dietary supplementation with different forms of flax in late-gestation and lactation on fatty acid profiles in sows and their piglets.  J Anim Sci. 2009 Aug;87(8):2600-13. Epub 2009 Apr 24.
Brazle AE, Johnson BJ, Webel SK, Rathbun TJ, Davis DL.  Omega-3 fatty acids in the gravid pig uterus as affected by maternal supplementation with omega-3 fatty acids. J Anim Sci. 2009 Mar;87(3):994-1002. Epub 2008 Nov 7.


Galbreath CW, Scholljegerdes EJ, Lardy GP, Odde KG, Wilson ME, Schroeder JW, Vonnahme KA.  Effect of feeding flax or linseed meal on progesterone clearance rate in ovariectomized ewes. 
Domest Anim Endocrinol. 2008 Aug;35(2):164-9. Epub 2008 Jun 5.

New! Couples Full Moon Infertility Getaways in Phoenix

If you're looking for a way to step off of the infertility treadmill, gain perspective about the process, and become reacquainted with your spouse, we've got a great series of events in the works! Our Fertile Intentions Getaways will be offered each full moon through 2010 in Phoenix, Arizona. Final details are being worked out, but I wanted to share the brochure mockup with dates so you could mark your calendars. If you'd like to be kept on the mailing list for updates, please contact me at monika@afterthediet.com.

Hope to see a few of you there!

Hibiscus and rosehips--the new blueberries?

I love blueberries.  And recently they've gotten a lot of press, making practically every nutritional top ten list for their antioxidant content.  Even so, it's always bothered me a little that they're not the most sustainable choice for someone like me, living in the desert, far from any blueberry farm.  So I've been in search of alternatives that might be more logical choices when blueberries are not in season, and for people who do not live where blueberries are cultivated.

A few weeks ago I was excited to learn that hibiscus contains the same anthocyanins as blueberries.  It's a popular tea here in the desert, and I've begun to ask for it in coffeehouses and restaurants.

Yesterday, on behalf of a reader living in the Netherlands who posted that she was looking for good teas over there, I looked up rosehips, a popular tea in Europe.  And bingo!  They contain anthocyanins as well.  They also contain twice the daily recommendations for vitamin C, another powerful antioxidant.

Rosehips are readily available in Europe and the United States.  They were popular with Native Americans in their cooking.  Supports my "big picture" theory that if you are knowledgeable about local foods, you can often find the essentials right in your backyard.  No need to import expensive foods from exotic locations in order to eat completely.

Plus, you can use hibiscus and rosehips teas while managing the overall carbohydrate content of your diet more effectively than you could eating large amounts of fruit.  (Not that fruit is bad, it just needs to be consumed with respect.)

Interestingly, one reference I found described a rosehips-hibiscus tea that I'm interested in...that would definitely be a find for my suntea collection!

An interesting note, several places on the Internet mentioned that rosehips contain vitamin D, but I have not been able to find credible references to verify that.  You'll best insure good vitamin D balance if you include other foods for that nutrient.

Guest blog from Susan Van Dyke, MD Vitamin D vs Skin Cancer: and the winner is…..

A lot has been talked about when it comes to skin cancer and its cause. Ninety percent of non-melanoma skin cancer is caused by sun exposure. Oddly enough one way we generate a very important vitamin (vitamin D) is from sun exposure! What to do? Expose skin to sun and risk cancer or become housebound avoiding all light from the sun and risk vitamin d deficiency?


Fact: Vitamin D is very good for you.

Fact: Sun is not.

First understand that I think the body is genius in the way it can take sun applied to the skin and start a biochemical process that makes us into little Vitamin D machines. It is photosynthesis like the plants! Without sun the machine does not work.

Without Vitamin D we experience a myriad of negative consequences. Vitamin D is necessary for healthy bones, good immunity and possibly in protecting us from diseases from fibromyalgia to multiple sclerosis, and cancers from prostate to colon. The NIH (National Institue of Health) has reviewed research on Vitamin D and found it to be very complicated. It is not just black and white (or in this case tan and white!). A lot of research is happening, just trying to figure out how much vitamin D we actually need for optimum health is an enormous undertaking (If you like data there is a good scientific review in the Journal of the American Academy of Dermatology, Feb 2006). Believe it or not we are still not sure how much Vitamin D is the correct amount.

We can all agree that we need at least some Vitamin D and we have three ways to get it; sun, food and supplements. Start with food; not a great source unless you eat a lot of fish (tuna, salmon, mackerel and fish liver). Beef liver, cheese and egg yolks have small amounts, but think for the cholesterol! Milk and bread are fortified which is helpful but many Americans still seem to be lacking.

So, supplement or sun? The reality is that if you have light skin and don’t live in a submarine you get about 15 minutes of sun on your hands and face just from living every day. The human body maxes out its Vitamin D producing capacity in 5 minutes (sunny day, hands and face unprotected). Anything more is not helping Vitamin D but is helping skin cancer. Shut-ins and dark skinned people are another story. Rolling grandma out to the sun porch everyday is an option but supplements are more practical. With very dark skin more sun time is needed to penetrate the natural advantage in sun protective color but how much time depends (I know, I hate that answer, too).

Bottom line, sun causes cancer; supplements are available to supply vitamin D, so why risk it? Until we know exactly what we need for perfect Vitamin D health perhaps we should go for the sunscreen and a pill. How much? 200 IU a day, 400 IU for over 50’s and 600 IU for over 70’s.

Note from Monika:  One of the aspects of inCYST that I absolutely love is how because of our interdisciplinary team we can look at health issues in new and different ways.  Dr. Van Dyke has been teaching me so much about skin issues and how the relate to PCOS.  She has been very active this month on Twitter for melanoma month.  It seemed like the perfect time to have her write about vitamin D from her specialty's perspective.  Thank you so much for taking the time!
 
For more information on Dr. Van Dyke's practice please visit http://www.vandykelaser.com/ .  She can be found on Twitter at @drvandyke.

If your skin looks different and you're taking birth control pills, take note!

About a month ago, Dr. Susan Van Dyke did a great webinar for inCYST on the many aspects of PCOS that can be helped by working with a dermatologist.  One of the conditions she spoke about was melasma, a skin patchiness/darkening that can be caused by hormonal changes and the use of birth control pills.

Coincidentally, a few days later, a friend casually mentioned that she had noticed the skin on her head was darkening even though she was diligent with sunscreen.  What she showed me looked just like what I'd seen in Dr. Van Dyke's slides...and when I asked, she mentioned that the skin change actually did appear after she changed birth control pills about a year earlier. 

I saw her last night, and she shared that she had been to see a dermatologist after we spoke and it turned out that she DID have melasma.

I had originally posted the photo you see in this post on our inCYST Facebook page and several women commented they had similar skin changes but had no idea they could be caused by birth control pills.  I was very surprised these women did not know this, since so many women with PCOS have been prescribed them!

So I wanted to expand the audience that this message got to, to be sure that all women know, if you are on birth control pills, and your skin starts to look different, there may be a connection.  And there are options for addressing it.

I'm really grateful to have Dr. Van Dyke on our team, she is just a wealth of information!  I am working on editing a guest post she's done for us, it will be up later today.  If you'd like to have a copy of her webinar (which includes Power Points), click here to order.

Some troublesome news and some promising news for infertile PCOS couples--all in the same day!

I do encourage you to hang in there through the end of this post...it's got wonderful news! I received an email alert today about a study coming out, suggesting that infertility treatments may increase the risk of autism in the babies those treatments produce.  (Normally I publish the original reference but since I can't seem to find it online...here's the link to the Time magazine article.)

Well, that pretty much rots!  What gives?

Apparently women exposed to fertility medications such as Clomid have a greater chance of having children with autism, and the risk increases with greater (more frequent) exposure to the medication.  A second study reports a similar risk for women undergoing in vitro fertilization.

One glaring oversight in this research is the consideration of whether or not there may be a genetic predisposition to both infertility and autism.  In other words, are women who tend to be infertile already carrying some type of genetic predisposition to autism?  Maybe Mother Nature knows something when infertility happens, and she's trying to encourage us to look at that.  Maybe we can fool her part of the way but not all of the way.

My comment is not meant to be judgmental, as I've seen plenty of women battle infertility, then commit to bringing their lives and their bodies back into balance...and have perfectly healthy babies.  Our genetic predisposition is heavily influenced by choices we make, and  we can make choices to maximize the genetic expression that encourages fertility.  We're going to have a webinar on an aspect of this issue, nutrigenomics, in about a month.

The GOOD news in the fertility world today is that great things are being done with acupuncture!!!  A study dated June 2010 found that acupuncture therapy could promote the following:  (1) increased ovarian  blood flow, (2) reduced ovarian volume, (3) reduced number of ovarian cysts, (4) better insulin function, (5) lower blood glucose, (6) reduced stress hormone levels, and (7) normalized appetite, encouraging more balanced eating.

So there is plenty you can do to improve your fertility.  Bottom line is, be informed before you make your treatment choices.

Lim CE, Wong WS.  Current evidence of acupuncture on polycystic ovarian syndrome.  Gynecol Endocrinol. 2010 Jun;26(6):473-8.

For those of you who do not follow Dr. Aimee Eyvazzadeh's blog, I wanted to share a really important post.  It's about the prevalence of BPA's in our world.  BPA's are chemicals that can alter hormone function and therefore, infertility.

This has pertinence to all of you for a couple of inCYST-related reasons.

1.  First of all, if you're drinking diet soda thinking it's ok because it's diet, it may not be the obvious that's getting into your body that's causing the problem.  If I can't convince you to stop drinking soda, maybe at least I can convince you to look for, purchase, (and therfore create demand for) a less hormone-destructive beverage container.

2.  Secondly, the issue of destructive chemicals in our environment is huge.  But it seems as though, the huger it gets, the more we seem to want to focus on the minutia of carbohydrates, when to time meals, whether brand "x" breakfast bar is better than brand "y"...ad nausem.

The truth is ladies, one of the reasons you may be forced into a situation where your life has become about minutia is because we as humans have a tendency to stick our head in the sands about big, complex, vague problems it's hard to wrap our brains around,  We need to be concerned about the way our chemicals are altering our environment.  We need to speak out.  I'm appalled at how few people on Facebook even talk about the oil slick...but they all have time to watch the latest Lady Gaga spoof and harvest tomatoes on My Farm.  Chemicals aren't going to go away unless we speak up about the fact that we don't want them. 

It's unrealistic to ask all of you to wear plastic gloves when you shop so you don't have to touch yours hopping receipts.  It IS realistic, however, to ask all of you to take a moment or two out of each day and speak out about something you care about.  Plastic, abuse, self-esteem, bullying...if we put our time into that instead of e-poking people we barely know...imagine the world your hormones would have an opportunity to thrive in.

Thyroid Issues and PCOS

I am on my way over to Los Angeles to work with Dr. John O'Dea on the webinar presentation he is doing for us.  I'm super excited, because he loves PCOS, he loves to talk about hormones, and you all are always asking questions about the thyroid I wish I could better answer!

We'll be broadcasting live at 3 pm Wednesday May 19 (Pacific time) from his office.  If you can't be there live, the recording will be available to purchase until December 31 of this year...simply click on this link.  This is the same link to click to register live.  Someone this busy with his practice is being extra generous by making time for us.  If your thyroid is something you have questions about, it's worth making time to get answers from a great source.

Sun tea--a great option to sugared sodas and caffeinated beverages

One of my annual rituals this time of year is to start brewing sun tea.  It's a great way to capitalize on solar energy, and I have hundreds of combinations of ingredients to keep me from getting bored.

Yesterday, I made a decaffeinated tropical flavored tea.  Then I pulled an orange off of my tree, quartered it, squeezed the juice into the tea, and threw the juiced quarters into the jar.  It was most refreshing, without any sugar at all.  It was my very crude version of the popular Arnold Palmer!

If you've never made sun tea, here's a link to some directions.

Once you've discovered a few favorites of your own, I'm hoping you'll wonder why you clung to your diet sodas for as long as you did!

Food of the week: blueberry pomegranate vinaigrette

My latest and favorite act of procrastination is to walk two blocks over to the new Fresh and Easy store and check out the taste testing samples.  (I am there so frequently the demo guy, Stephen, and I, are on a first-name basis!)  Last week he had a really great spring green salad with fresh strawberries, made to showcase their blueberry-pomegranate vinaigrette.  The taste was excellent; the only problem, however, was that the oil that was used as the base was not one of the ones inCYST likes its fans to prioritize.  So I found another recipe online, from a website called Cooking with Dan.  It's equally as great on the Fresh and Easy spring green mix.

One important word of caution: If you're trying to conceive, you may wish to file this recipe for future use.



Blueberry pomegranate vinaigrette


1/2 cup blueberries
1/2 cup pomegranate juice (POM the real stuff works best)
1/4 cup EVOO
1/8 cup Red Wine Vinegar
Basil
Salt
Pepper
Garlic

Blend the blueberries and pomegranate juice together to make a mixture. Then reduce it to a thick sauce on the stove (in a pot of course). Then add the other ingredients and blend it together. I store mine in a tuberware in my fridge and use it on a lot of salads.
 
Oh!  And while I was searching for this recipe I found quite a few links to recipes for blueberry pomegranate martinis at Recipezaar.  I'm not much of a drinker and have had maybe two martinis in my life...but the pomegranate margarity I had at Fez Restaurant a few weeks ago...and this martini looked good enough that I might have to pick up the ingredients on my next Fresh and Easy run and have them ready as a reward for finally coming home after the next 8 days of very busy traveling.  The Recipezaar page has some comments on the side for alternatives that may be more tasty to the seasoned martini connoisseur
 
Linda's Blueberry-Pomegranate Martini

2 ounces vodka
1 ounce pomegranate-blueberry juice

Directions

Fill a shaker half-way with ice.

Shake ingredients in a shaker and put in chilled martini glasses.

Is healthy behavior self-denial or self-indulgence?

The other night, Gretchen Kubacky, PsyD shared in her webinar that managing a chronic illness such as PCOS requires an average of an hour and 40 minutes a day.  She stated that this included exercise, taking  medications, checking blood glucose, physician appointments, etc.

I don't have PCOS, and as she was listing the activities that fell into the self-care category, I realized that even so, I devote a fair amount of time in my day to self-care.  I don't take meds and I don't monitor my biochemistry, but I do (1) make more food from scratch than the average person, (2) swim a mile 3 to 4 times a week, (3) walk instead of drive whenever I can, and (4) commit to a regular bedtime instead of staying up late.

Yesterday, for example, I had a presentation late in the day.  So I scheduled my workout first thing in the morning, and did a little bit of work in the afternoon before leaving to speak.  There was a free symphony concert I really wanted to attend, but I realized that if I went, I'd be home late and I had to get up early this morning to catch a plane.  So as much as I wanted to do the fun thing and see some friends, I came home, packed, and relaxed, so I would be at my best today.

I don't think of those choices as sacrifice at all.  They're part of my routine.  It wasn't always that way. 

Long ago, I lived in Palo Alto, a very population-dense community.  My job was only two miles away, but I realized one day that it was taking me longer to drive around and find a parking place than it was to actually drive to work.  I decided that walking/rollerblading to work could kill two birds with one stone:  (1) I wouldn't waste the driving around to park time and (2) I could have my workout done by the time I got home.

Easy you say?  Not really.  Even though the benefits were clear in my head, I had a really hard time making the switch.  I decided to try only doing the rollerblading commute one day a week at first.  Then I added two, then three.  It actually took about a year to get into the habit.  Once it got into my system, I actually looked forward to it.  Palo Alto is a beautiful community and I started to notice that in walking home and enjoying the gardens along the way, I was a lot less stressed.

It was giving up the old way of doing things that was hard.  There was probably a little bit of grieving involved.  Maybe changing some hardwiring in my brain.  It was CHANGE.  Any change takes effort, and adjustment.

I got to wondering if reframing that hour and a half as self-nurturing rather than self-care might help some of you.  To realize that what you're being asked to do, at least partially, isn't something that you HAVE to do because you're weird or broken or have PCOS, but because it's because you're being asked to take better care of yourself, and because you DESERVE to make that kind of time for your self and your health.

These may not be as glamorous as the choices the food industry and the alcohol industry and the clothing industry might like you to define as self-care, but it does work.  These days, and I'm being honest, I value having an hour in the pool far more than I do eating a brownie.  It's my one hour where email, phone, Twitter, yadayadayada, is not a concept.  I relish the feeling of silently gliding through the water and having my brain and my thoughts all to myself.  I love that later on at night, I feel sleepy and actually sleep soundly.  I've become selfish about that time and I schedule around it.

If you were to think of that one and a half hours as selfish time, may even a little bit of self-indulgent time, would you be more willing to do it?  Instead of viewing it as an hour and a half of suffering, sacrifice, self-denial?  It's all in how you market the concept to yourself. 

So you have to give up a few tweets and status reports and You Tubes and Facebook friends to accommodate the glucose monitoring.  You deserve to be self-indulgent.

She's pursued excellence so she can help YOU to do the same

Just a quick note of congratulations to inCYSTer Marissa Kent, one of the very first members of our network.  Marissa just completed, and passed, her exam for her Certified Diabetes Educator (CD) examination.  Marissa has a great combination of knowledge and skills pertinent to PCOS, including this CDE certification, and training in eating disorders and intuitive eating.  Her practice is located in Mission Viejo, California.

Marissa is accepting registrations for her next intuitive eating group, starting in June 2010.  If you are interested in learning more, please visit her website, http://www.marissakentnutrition.com/.

Congratulations, Marissa!  That's no small deal what you've accomplished and we're excited that women with PCOS in Orange County have you to guide them toward balance and health.

Is your Sleep Affecting Your Diet...is Your Diet Affecting Your Sleep...or it is a vicious cycle? Part 1

If you're a regular reader of this blog, you know I write a lot about how not sleeping well can affect how you eat. 

Have you considered that maybe the other may also be true?  How you eat can affect the quality of your sleep?

Binge eating is often a night time activity.  It is recognized for its ability to self-medicate, and many of you may even consciously seek out the behavior because you are aware of its sedating effects.  But did you know...after the soothing effect of the binge wears off, you may actually feel more anxious?  CCK, the chemical that is released to help digest protein and fat, is released in proportion to the amount  of protein and fat that you eat.  So if you binge, you release more CCK.

CCK is an anxiogenic agent.  That is, it causes anxiety.  So if you've binged, your temporary respite from your anxiety is likely to elevate not long afterward.  If you don't make the association, you might turn to another binge for relief.

CCK is also a nociceptic agent.  That  is, it causes pain.  So if, in addition to your PCOS, you have fibromyalgia or some sort of chronic pain, you might find that your bingeing is the behavior that, in the big scheme of things, is worsening, not helping your pain.

A sleep researcher once asked me about an interesting observation in one of his studies, with men who experienced excessive limb movement while sleeping.  The movements seemed to get worse if they ate a large bowl of ice cream just before bedtime.  We had an interesting discussion about how the CCK mechanism could have been part of the explanation for this phenomenon.

Time to connect different dots in your brain.

Carbs don't help anxiety, they worsen it.
Carbs don't medicate pain, they intensify it.

Insomniacs unite! We've got a great event for you in Marina del Rey on July 24

Working with PCOS has taught me how prevalent the problem of poor sleep is.  People who don't sleep well tend to gravitate toward caffeine and sugar all day long, and the vicious cycle can lead to insulin resistance and weight gain.


I've become increasingly concerned about the percentage of inCYST clients on Ambien and Lunesta, not to mention CPAP machines.  I just have never been able to believe that this has to be the fate of the non-sleeper. 
 
But...I also knew that even if insomniacs were motivated to spend all of a weekend day in a workshop designed to help them, they'd likely drift off right in the middle of it!  So I've been working with colleague Nancy Carballo to develop an experiential alternative giving participants a chance to learn and experience a few different opportunities to look at insomnia a little more naturalistically.
 
I'm excited!  We've planned yoga on the beach, a didgeridoo lesson (since this instrument helps to strengthen the muscles commonly weakened in sleep apnea), a couple of laid back lectures, and sleep-friendly eating (including dinner with popular LA dark dining restaurant, Opaque).  Our spa partner in this endeavor, Creative Chakra, is also offering additional massages and light therapy sessions.
 

We have a Facebook page for the event...you can join us there to let us know you'd like to be notified when we open registration, or you can write me directly at monika@afterthediet.com
 
Anyone with insomnia, whether or not they have PCOS, is welcome to participate. 
 
Zzzzzzzzzzzzzzzzz you there!

Food of the week: hibiscus

It's getting hot outside, and that likely means you're getting thirsty.

A consistency I've noticed, in the years of examining food diaries, is how we seem to write off what we drink as far as its influence on our health.  Calories, caffeine, sugar, even healthy ingredients such as antioxidants, get far less credit for what they do, than similar items that we chew!  This can get us in trouble when the mercury climbs, and we start to bore of plain water.  It's often not the food I try to tweak in a diet, but the juice, soda, or latte that's adding extra calories and promoting an overall imbalance.

If you look in the herbal tea section of your grocery store, you'll see lots of great alternatives.  One of my personal  favorites is hibiscus.  It's not just a beautiful flower!  It makes a delicious tea with quite a few health benefits:
     --it has diuretic properties, which makes it perfect for PMS
     --it is a mild antihypertensive
     --one study suggested that it can help to reduce cholesterol and triglycerides
     --it contains anthocyanins, those powerful antioxidants we tend to associate with blueberries
     --it may have some anti-obesigenic properties

In my part of the country, especially in Spanish-speaking sections of town and REAL Mexican restaurants, we see a drink called Jamaica, which is a hibiscus-based beverage.  The restaurant versions are likely too sweet to be consumed on a daily basis; here is a recipe from http://www.chow.com/, which you can probably make with far less sugar than the recipe calls for.  I'd start with 1/3 of what is listed and gradually add until you like it. 

Agua de Jamaica

3 quarts (12 cups) water

1 (1/2-inch) piece ginger, finely grated
1 1/2 cups dried Jamaica flowers (also known as hibiscus or flor de Jamaica)
1 1/2 cups granulated sugar
2 tablespoons freshly squeezed lime juice (from 1 large lime)

Combine water and ginger in a large pot and bring to a boil over high heat.


Remove from heat and stir in Jamaica flowers and sugar until sugar is dissolved. Let steep 10 minutes.

Strain through a chinois or fine mesh sieve into a large, heat-resistant bowl or pot. Stir in lime juice and set aside to cool. Refrigerate until ready to use. Serve over ice.
 
Gosain S, Ircchiaya R, Sharma PC, Thareja S, Kalra A, Deep A, Bhardwaj TR.  Hypolipidemic effect of ethanolic extract from the leaves of Hibiscus sabdariffa L. in hyperlipidemic rats.  Acta Pol Pharm. 2010 Mar-Apr;67(2):179-84.


McKay DL, Chen CY, Saltzman E, Blumberg JB.  Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr. 2010 Feb;140(2):298-303. Epub 2009 Dec 16.


Alarcon-Aguilar FJ, Zamilpa A, Perez-Garcia MD, Almanza-Perez JC, Romero-Nuñez E, Campos-Sepulveda EA, Vazquez-Carrillo LI, Roman-Ramos R.  Effect of Hibiscus sabdariffa on obesity in MSG mice.  J Ethnopharmacol. 2007 Oct 8;114(1):66-71. Epub 2007 Jul 27.

Chang YC, Huang KX, Huang AC, Ho YC, Wang CJ.  Hibiscus anthocyanins-rich extract inhibited LDL oxidation and oxLDL-mediated macrophages apoptosis.  Food Chem Toxicol. 2006 Jul;44(7):1015-23. Epub 2006 Feb 13.

PCOS: It's Just Not Worth Losing Sleep Over!

If you're on this blog, chances are you don't sleep well.  The majority of women with PCOS that we've surveyed have some sort of sleep disorder.  Chances are, your spouse isn't sleeping that well either.  (I've actually had a couple of clients who became pregnant after the husbands started paying more attention to their bedtime hour!)

Poor sleep can  lead to increased insulin levels, weight gain...all the things you're likely trying to resolve if you have PCOS and would like to either lose weight, conceive, or both.

We've developed a special event for people who don't sleep well.  And, knowing that the last thing you really want to do on a beautiful Southern California Saturday...is sit inside and listen to a bunch of dry medical lectures....we've created an agenda that would be fun even if you DIDN'T come to learn about better sleep.

The first Insomniacfest will be held on Saturday, July 24, 2010, in Marina del Rey, California.  We've got a few things happening on the beach:  a yoga class and a didgeridoo session.  We've got fun, sleep-friendly food and drink (including our own signature alcohol-free drink, The Knockout, pictured above.)  Opaque Restaurant is also providing a dark dining experience you won't soon forget. 

Sandie West, our friend at Creative Chakra Spa, is hosting the event, and we've made room for you to add on massages and special light therapy to your day.

Consider spending the day with us!  Our Facebook group is the best place to keep up with event and registration details.

That Dirty Dozen List Got You Down?

Recently the Environmental Working Group's annual "Dirty Dozen" list came out.  It is this group's awareness tool for the health risks of pesticides.  What is important to remember, in addition to the important message that pesticides in our foods can pose health risks, is that this does not mean that you have to avoid these foods altogether.  Here are some ways to keep your favorite fruits and vegetables on your list.

1.  Avoid top ten lists of "best foods".  Any time you narrow your list of foods you eat to a dozen or so, you automatically concentrate their risks, as well as their benefits.  I noticed that on this list of foods (listed below), several foods showed up that are common on diet diaries of clients who are trying to eat "healthy".  If you eat blueberries because they are brain friendly, vary them with kiwi and watermelon.  Every food has a benefit, and you don't want to miss out!

2.  Eat organically.  Organic produce is grown without the use of pesticides, immediately eliminating their risk.

3.  Use a fruit and vegetable wash.  I find them in my local grocery store, but if you don't see them, you can also order them online.  Here is a list of brands available at amazon.com.

4.  Eat locally and in season.  When you eat fruits and vegetables that are not in season, they must be imported.  And regulations about pesticides differ in different countries.  It's nice to eat cherries in January, but you're going to have a better idea of what rules governed their production if you wait until July and get the ones your local farmer grew.  (They are likely going to taste better too, since they weren't picked early and trucked thousands of miles before getting to your table.)

5.  Become familiar with the "Clean 15".  This is the EWG's other list that doesn't get as much press, probably because good news doesn't sell as much viewership and advertising time.  It's the list of the cleanest fruits and vegetables, and it includes:
onion
avocado
sweet corn
pinepple
mango
asparagus
sweet peas
kiwi
cabbage
eggplant
papaya
watermelon
broccoli
tomato
sweet potato

OK, here's the list.  Again, just because a food appears on this list doesn't mean you shouldn't have it.  It just means these choices should be purchased, handled, and consumed with more delicacy, and should not be consumed in excess just because they're "healthy".  If you'd like their wallet guide, and their upcoming iPhone application, click here.
Celery
Peacches
Strawberries
Apples
Blueberries
Nectarines
Bell Peppers
Spinach (this sample was found to contain as many as 48 different pesticide residues--wash thoroughly!)
Kale
Cherries
Grapes
Leafy greens
Carrots
Pears

inCYST Webinar: Eating Well With PCOS

This webinar is a component of the inCYST PCOS Professional Training. You may listen to it independent of the complete training, or as part of the entire course. If you cannot make the live broadcast as listed below, you may register and receive the recorded version via e-mail to review at your convenience.


Cost to attend this session only is $40. The complete PCOS training, which includes 2 years of marketing through the inCYST PCOS network, is $425. 
Click here to register for the individual webinar.
Click here to register for the complete inCYST Professional Training.

This webinar will broadcast live on Tuesday, May 18, 2010, at
8 PM EDT
7 PM CDT
6 PM MDT
5 PM PDT/Arizona time.

Nutrition recommendations for PCOS are varied and confusing. Ellen will share evidence-based nutrition recommendations for women with PCOS. Basic areas to be covered include: ratios of carbohydrate, protein, and fat, calories, weight recommendations, and supplements that may also help.

Ellen Reiss-Goldfarb, R.D. is a Registered Dietitian with a Private Practice in West Los Angeles, California. She was co-founder of "Through the Looking Glass", a support program for people with eating disorders and body image issues. She has worked as a clinical nutrition consultant and nutritional educator for over ten years. Her vision is to assist people in achieving their personal goals through nutrition education, as well as supporting their efforts in attaining balance in all areas of their lives.

Besides specialized work with eating disorders, Ellen has recently also expanded her practice to specialize in women's hormonal issues which include PCOS and problems with fertility. She has had many success stories and has a blog which will soon include these wonderful stories.

When someone says they are a PCOS expert, or that they specialize in PCOS, what does that mean?

Not a whole lot, unfortunately.  There is no board certification for the disease, no school, nothing.  It's the whole reason I started inCYST.  I was appalled at the things I was hearing women say they had been taught by specialists.  When I looked on the Internet, I saw a lot of supplement companies filling in the gap.  And, of course, using the gap as a way to line their own pockets.  Many of the health professionals people turn to in order to get help don't accept insurance.  I realized that women with PCOS are very easily taken advantage of without getting much in return for their investment.  And now that PCOS is gaining attention, and the economy is struggling, I'm seeing a lot more colleagues advertise that this is a specialty service they provide.

If you've found someone on the Internet who is advertising that they are a specialist, don't assume that means much at all.  Take the time to ask them what they did to become specialized. 

You can be assured that anyone whose name appears on this blog has worked hard to be informed.  The dietitians you see, have taken courses on sleep disorders, dermatology, and biochemistry, not just nutrition.  The psychologists and even our dermatologist, Dr. Van Dyke, have taken the time to understand nutrition for PCOS.

We have all committed to that, because we collectively wanted to raise the bar, and we wanted you to know, for sure, if you asked someone in California, Virginia, New York, or Chicago, for help, you'd get a well-informed person who is passionate about understanding what can best help you.

Of course, there are people who do not belong to inCYST who are very good at what they do, with lots of great credentials and training.  I can't speak for them.  What I can say is,  that they should be able to, without hesitation, when asked, provide you with a description of the qualifications they have that allow them to make the claims that they do.  And women with PCOS should not be afraid to ask that question before making their first appointment.

Infertility Couples Spa Experience is returning

Hello everyone,

With some breathing room and time to think, I've had a chance to start to plan the next round of couples infertility spa days.  These are intended to teach the information you want and need, as well as remind you why you are in the fertility process  in the first place!  Sometimes that gets lost in the medical office.

If you'd like to be notified of these events when they are planned and ready for registration, sign up here to receive our blog via email, and/or join our Fertile Intentions Facebook group: 

http://www.facebook.com/monika.woolsey?ref=profile#!/pages/Phoenix-AZ-and-Marina-del-Rey-CA/Fertile-Intentions-Couples-Day-Spas/23899748158?ref=ts