Fatty liver is a common problem in women with PCOS. In this study, EPA, an omega-3 fatty acid and a fish oil, was shown to improve the symptoms of nonalcoholic steatohepatitis (fatty liver). EPA is the fish oil that you cannot get when you rely on vegan sources of omega-3's--it's not in flax, and it's not in marine algae. Some research shows that when you've eaten enough marine algae to completely saturate your tissues, what's left can be used to make EPA, but it's not the way of getting it that the body prefers.
This is important to understand, because the vast majority of foods that are labeled as supplemented with omega-3 fatty acids either contain ALA (primarily in the form of flax) or DHA (primarily from marine algae).
The other advantage to eating fish is, that if you've put a fillet on your plate, you've likely removed another (fattier) kind of protein. That's the positive double whammy you get in seafood choices.
In my training I was always encouraged to develop good negotiation skills. In other words, if a client didn't like a certain food, to have a few other options up my sleeve that would provide equivalent nutritional value. Only when I got into omega-3 chemistry, inflammation, and PCOS, did I realize that in this one crucial area, I would have to dig my heels in and advocate that this essential nutrient was simply non-negotiable: if you don't eat fish, you miss out on total health.
Over the weekend I had an animated discussion with another dietitian who was adamant that her clients (mainly with eating disorders) simply were not going to accept this. I told her they simply would not achieve total health…and possibly total recovery. I got some resistance, but hopefully at some point this colleague will come to understand that we're here to guide our clients where they have the potential to go. We're not here to tell them what they want to hear, with the hopes that somehow health will just magically appear.
Tanaka N, Sano K, Horiuchi A, Tanaka E, Kiyosawa K, Aoyama T. Highly Purified Eicosapentaenoic Acid Treatment Improves Nonalcoholic Steatohepatitis. J Clin Gastroenterol. 2008 Apr;42(4):413-418.
Since the beginning, flaxseed oil has been an important part of our protocol. It provides the helpful estrogenic benefits that soy does, but without the potential problems soy creates for thyroid function. The problem is, most flaxseed oil is not easy to take and therefore it isn't used as much as it could/should be.
Shape Foods has finally solved that problem with their new line of culinary flax oils. In the first picture you see the line of smoothie-friendly flavors: banana, coconut, chocolate, and caramel. I was skeptical, but they turned out to be yummy! These products are hot off the factory line and not easy to find. Be sure to ask for the Royal Harvest flavored flax at your favorite store to be sure the buyers know there is a demand. I did manage to find the Coconut and Banana flavored varieties on amazon.com if you're interested in ordering by mail.
If you're more of a savory person, you may be interested in their Heart Shape line of cultural cuisine adaptations: Szechuan, Thai, Indian, Mexican, and Italian. Salsas, bruschettas, pad thais, etc., will never be the same again!
This product line is slated to appear on grocery shelves this summer. I have no link to provide you. (That is, yet!) Again, be sure your local buyer knows you want to buy them!
This product line was by far one of my favorite finds at Natural Products Expo West. One of the most frequent questions I've had when teaching omega-3 chemistry was about how to cook with flax oil. I always hated answering the question because it hasn't really been a kitchen-friendly oil.
Now it is, and I'm excited to try them in my own kitchen!
Many of the women I work with are vegan vegetarians. Which means when it comes to increasing omega-3 intake, they tend to want to go heavy on flax, hoping it will make up for not eating fish. It simply doesn't work this way…in ways that are very important to PCOS.
When different groups of rats are given ALA (the primary omega-3 in flax), EPA and DHA (the primary omega-3's in fish oil), EPA and DHA lowered glucose and insulin levels about 35-38% greater than did ALA. Insulin sensitivy improved by 60% in the fish oil groups compared to the ALA groups.
Bottom line, if you really, really want to get better, and you're not currently eating fish, or using a fish or marine algae supplement, you may want to seriously consider adding one of those to what you're doing. It's pretty non-negotiable, we need DHA and EPA to properly function as human beings.
Andersen G, Harnack K, Erbersdobler HF, Somoza V. Dietary eicosapentaenoic acid and docosahexaenoic acid are more effective than alpha-linolenic acid in improving insulin sensitivity in rats. Ann Nutr Metab. 2008;52(3):250-6. Epub 2008 Jun 19.
I know, I know. You may be asking,"What in the heck is that?!" At least that was my first thought.
I came across Piñalinaza product by chance, when in the midst of a bout of homesickness for the latin markets in my hometown of Miami, FL I decided to shop at a Food City in Chandler, AZ instead of my usual Fry's or Sprouts.
Sure there wasn't any salsa music playing, and the prepared foods and the marketing were more Mexican than Cuban, but it felt close enough to home. As I was grabbing a bag of onions and a few mangoes, I saw a little stand off to the side in the produce department. Always on the lookout for an"omega 3 boost," the packaging for the Piñalinaza caught my eye.
So what is it exactly? Simply put, it is flaxseed meal (ground flaxseed) with ground pineapple and prickly pear, as well as some other citrus fruits (orange and grapefruit). At plain sight it looks exactly like regular flaxseed meal. But it has a mild tropical scent to it. If you already use flaxseed meal, I imagine you could use it in the same way you use the regular stuff!
Flaxseed is an excellent source of fiber and omega-3 fats, and as you may have already read in this blog before, the best way to get the benefits of flaxseed is to grind the seeds instead of eating them whole.
How do I use it? Normally I might put a tablespoon or two of flaxseed meal into a smoothie/protein shake or sprinkle it into yogurt. When making a smoothie I tend to stick with a vanilla flavored based as it's the most versatile when adding other flavors to it. This didn't disappoint! I made a vanilla smoothie with unsweetened almond milk (Almond Breeze brand), vanilla flavored whey protein, 2 tablespoons of Piñalinaza and about 1 tablespoon of shredded coconut, the kind you might use in baking. A nice tropical deviation from my usual cinnamon-vanilla smoothie.
I also sprinkled it right into some plain Greek yogurt for a quick breakfast this weekend. One tablespoon and half a packet of Splenda (you can use whatever you like if you need the extra sweetness — Greek yogurt is a bit too tangy for me to eat it unsweetened!). I bet it would tasted even better if I'd had some fresh pineapple chunks to throw in there, maybe some other tropical fruits — papaya, or mango. Unsweetened dried fruit may work too. Hmmm… I may have to go back to Food City and pick up some other things!
By the way, the company (Ibitta) also makes a prickly pear version of the product called Nopalinaza, boasting 4 grams of omega-3 in one 15-gram serving.
If you run across one of these products and get to try it, come back and leave a comment. Tell us what you thought and what you did with it!
The last two clients I evaluated are struggling with acne. And recently, we were linked to an acne care website that is bringing in a whole new audience. So I thought it might be a good time to talk a little bit more about this topic.
First of all, thanks to Fran Kerr for linking to Susan Dopart's testimonial about flax and fish oil! It was a great way for our two organizations to become connected. I am going to put Fran's blog (http://www.highonhealth.org/) in our resource list because she has so much great information to offer. Not just on skin, but on living healthy in general.
Secondly, for those of you who are coming to us from Fran's blog/website, I'd like to ask you if you have ever heard about polycystic ovary syndrome (PCOS). It's the focus of this website, and many women find out they have it when they seek help for their acne. And…many women don't get that assessment. I actually had a dermatologist tell me she'd rather just give her patients birth control pills and end the appointment rather than get into it because it's such a complicated diagnosis.
A very common scenario is just that. A young girl goes to the dermatologist for her acne, gets birth control pills, takes them for 10 years or so, goes off them, tries to get pregnant…and can't. What happened was that the birth control pills treated the symptom…but essentially shoved the problem under the rug…where it continued to fester and create havoc elsewhere in the body.
So I want to take a moment to list the symptoms of PCOS for those of you who might have had this experience but either didn't have a doctor who wanted to deal with it, or who had a doctor who thought if you just"got your act together" you wouldn't have the problem.
Symptoms of PCOS include: A family history of infertility, irregular periods, or diabetes Being of an ethnic heritage that tends to have a high rate of diabetes A history of early puberty (first period at 11 years or younger) A history of taking medication for depression, bipolar disorder, seizure disorder, epilepsy, or migraine? A history of gestational diabetes in any of your pregnancies. An android ("apple shaped") body type (measure your waist to hip ratio; greater than.8) Irregular periods (or none at all) Dark velvety patches of skin on you neck, groin, or in your armpits Hair loss or male balding spots Difficulty losing weight Intense cravings for carbohydrates or sweets Problems conceiving Decreased sex drive Excess hair growth on your face, like a mustache or beard Excess hair on your chest or back Acne on your face, chest or back
If you see yourself painted in this symptom set, please print this out with your symptoms marked and show them to your physician. Ten percent of all women who have this syndrome will be diabetic by age 40, and with diabetes comes a whole other list of problems.
And keep checking back here. There are lots of ways to manage PCOS that do not involve medication, and we'd love to help you learn about them. In fact, the list of practitioners at the right is a list of registered dietitians who have taken the time to complete a 20 hour course in the management of PCOS. They are just waiting to hear from you.
For more information, please visit my web page on the topic: http://www.afterthediet.com/polycystic.htm
Have a wonderful week, it's a short one with the upcoming holiday!
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.
