I had the most wonderful Sunday afternoon with a newly pregnant client and her husband. She's been told that her progesterone is low, and she was interested in knowing if there is anything she can do, naturally, to help improve the outcome of her pregnancy. We discussed five different categories of actions. Since this is an issue many women face, I'm adding them to the lineup of planned posts, today being the first of five installments.
Progesterone can be low if estrogen is high. In many cases, it's not the natural estrogen your own body is making, but environmental chemicals resembling estrogen that confuse the body.
To reduce your exposure to unnecessary estrogen…
1. Stay away from plastic. Store your leftovers in glass containers. Be absolutely sure your food does not come in contact with plastic or Saran during heating. Avoid plastic water bottles; metal varieties are pretty easy to find in your Whole Foods or REI store.
2. Use natural cosmetics and hair dyes. inCYST Provider Carmina McGee, who is a licensed aesthetician as well as a registered dietitian, has shared that the primary offending chemical, phthalate, is gradually disappearing out of cosmetics. But just to be sure, read your cosmetic and nail polish labels. Make your cosmetic shopping easy by using an all-natural brand such as Body Shop or Arbonne.
3. Get to know your local eco-friendly decorating and remodeling stores. I recently painted my condo with paint that was free of volatile organic compounds (also known as non-VOC). I used the Benjamin Moore brand which was available at a local Ace Hardware, because I liked the color selection…but there were several eco-friendly brands, and remodeling stores I found while shopping around. One store also had quite a few"green" cleaning supplies as well as carpet glue.
4. If you are not sure of the contents of inks, glues, cleaning solvents, fertilizers, pesticides, fire retardant fabrics, etc., minimize your contact with it. Here's a great list from the National Institutes of Health for your reference.
5. Minimize your intake of dietary estrogens. This one can be a little tricky, since one of the tricks we've been recommending for getting pregnant has been supplementing with flaxseed oil, a natural source of estrogen. Once you know you're pregnant, best to back off on the flaxseed. (Special note: This release I'm linking is so new the actual study is not yet listed in the National Library of Medicine database. As soon as it is, I'll be sure to evaluate and report in more detail here.)
The other food to be aware of is soy--whole soy foods such as edamame and tofu are ok, but stay away from isolates that are often used as fillers.
6. Keep your sleeping environment as dark as possible at night. Close the drapes. Use eye shades. Eliminate televisions and computers from the bedroom.
What I really like about this first list is that it is, really, about living cleaner and greener. So choices you make for your pregnancy are doing double duty and helping out the planet!
I can tell by looking at this blog's visitation statistics that a very high percentage of its visitors are looking for help with an immediate problem that has"hit them where it hurts", so to speak. You may have acne. Or want a child. Or be looking for a successful weight loss plan.
The fact is, however, that sitting in my seat, it is equally important to offer insight and solutions for those problems as it is to educate about the big picture.
The fact is, 10% of women with PCOS will be diabetic by age 40.
The fact is, PCOS increases your risk of heart disease and high blood pressure.
And…since diabetes is increasingly being associated with Alzheimer's disease, the fact is, you may end up being at risk for that as well if you're on this blog looking for help with your acne.
Fortunately, you don't have to do one thing for your fertility, another for your acne, and another to prevent Alzheimer's. All the suggestions you see here work to help all organ systems function better.
And the fact is, there is a whole lot you can do to decrease your risk of having any of the problems mentioned above.
The fact is, you can't decrease your risk if you don't take action. That part of the solution is totally in your control.
In this particular study, the alpha-linolenic acid (ALA)concentrations in fat tissue were evaluated in 1819 people. (ALA is a type of omega-3 fatty acid found in flaxseed, flaxseed oil, soybeans, canola oil, and nuts, to name a few.)
Individuals with higher levels of ALA had a lower risk of heart attack.
The fact is…if you cook more often with canola oil, eat more nuts, put some edamame on your next salad, and/or add some ground flaxseed to your next bowl of oatmeal, you just might experience the same benefits as the people in this study.
If it can't hurt and it might help, there doesn't seem to be a reason not to try at least one of those things!
Campos H, Baylin A, Willett WC. Alpha-linolenic acid and risk of nonfatal acute myocardial infarction. Circulation. 2008 Jul 22;118(4):339-45. Epub 2008 Jul 7.
I just received an email from a client who noticed that every time she added flaxseed oil to her diet, she started to wheeze. We checked online, and sure enough, some people can be allergic to flaxseed. Here are some of the common symptoms of flaxseed allergy.
For anyone who is trying to increase their omega-3's, this can pose a challenge, since the vast majority of foods in the grocery store labeled as omega-3 supplemented contain flaxseed as the omega-3 source. If it turns out you are a flax-allergic person, be extra sure you read those labels!
ALA, the primary omega-3 in flaxseed oil, is not a substitute for fish oil; it has completely different and essential functions. A good way to think of it is that EPA and DHA from fish oil provide the"meat" of the structure of your brain and nerve cells, while ALA acts kind of like"rustproofing", keeping all that DHA and EPA in place that you worked so hard to get in the diet. They both need each other present in order for maximum effectiveness.
Here are some ideas for getting more omega-3's in the diet.
1. Other foods containing ALA include
Broccoli Brussels sprouts Cabbage Canola oil Edamame Kale Parsley Pecans Pumpkin seeds Spinach Spring greens Tempeh Tofu
One reason I have not included walnuts, which are typically the first vegetarian food recommended to increase omega-3 intake, is that the omega-6 content is so high that it is mathematically impossible to improve an omega-6 to omega-3 ratio when using them. I love walnuts and think they have some great nutritional benefits for PCOS, but in the rare and special case of a flaxseed allergy, it may not be a food that you would want to eat in large quantities. (I'm working on a pro-walnut post for a later date for you curious types!) Here are some practical ways to incorporate the foods above into your diet.
1. Know your nuts! The nuts with (a) the best omega-3 levels and (2) the best overall ratios of healthy to unhealthy fats include: macadamia, hazelnut, pecan, pine, and pistachio. Those are the nuts you should be using with the most frequency in your snacking and cooking. If you like nut-encrusted fish and pesto sauce…you're in luck! You can also throw nuts in your coffee grinder to make nut powders, which can be added to waffles, pancakes, baked goods, smoothies, and salad dressings. They'll give your creations a little bit of a gourmet twist!
2. Use shredded cabbage in your tacos instead of shredded lettuce. That's how they do it in Mexico…and it's the perfect topping for a fish taco!
3. Get in the habit of throwing a handful of dark greens--kale, spinach, parsley--into your smoothies. You won't even taste them.
4. Pumpkin seeds, like nuts, are easily added to trail mix, thrown on salads, soups, and hot cereals, and ground to include in your encrustings.
5. Cook with canola oil.
6. I've included the three types of soybean that are not tough on thyroid--edamame, tofu, and tempeh. Edamame is a fun snack when popped out of the shell, tofu and tempeh can be the basis for a meatless meal.
7. If you like pesto, you may want to try chimichurri, another parsley-based sauce that I call"South American pesto". It is wonderful on grilled meats and easy to make! I've seen ready made varieties in the grocery store.
8. Be extra careful about omega-6 fatty acids. The less of those in your diet, the less omega-3 you will need to counter their inflammatory influence. For review, except for canola, which is ok, minimize your use of oils beginning with the letters"s" and"c"…safflower, sunflower, soybean, corn, cottonseed. (The reason soy as a food is ok while soybean oil is not, is because the ratio of omega-6 jumps up when you extract and use only the fat and do not buffer it with the meat of the soybean.)
Here are a couple of recipes for you, one for chimicurri sauce, and one for a tasty squash/kale/whole wheat lasagna I tested out this week.
It just takes a little creative thinking to find ways around a flaxseed allergy. Hopefully some of the suggesstions I'm providing turn out to be favorites in your home!
Spinach Kale Whole Wheat Lasagna (from Sunset Magazine, February 2008)
Note: I couldn't find whole wheat lasagna noodles in my store so I bought whole wheat egg noodles and layered them with the other ingredients to make a casserole. It was great! Prep and Cook Time: about 2 hours. Notes: You can assemble and chill the lasagna a day ahead, but add 10 to 15 minutes to the baking time. You can also freeze the lasagna, wrapped well in plastic wrap, for up to 1 month and bake it frozen (add 1 1/4 hours to the oven time).
Yield Makes 8 servings
Ingredients 4 tablespoons olive oil, divided 1 medium red onion, peeled and sliced 3 peeled garlic cloves (1 minced, 2 left whole) 2 cans (14 oz. each) crushed tomatoes 1 teaspoon dried oregano About 1 tsp. each salt and freshly ground black pepper, divided 6 cups (about 2 lbs.) butternut squash, peeled and cut into 1/2-in. cubes 1/2 tsp. dried thyme 1 pound Lacinato kale (often sold as dinosaur or Tuscan kale) 9 whole-wheat lasagna noodles (about 8 oz.) (Often, whole wheat pastas are made with flax…be sure to read your labels!)1 container (15 oz.) part-skim-milk ricotta cheese 1/8 teaspoon ground nutmeg 2 cups shredded mozzarella cheese, divided
Preparation 1. Preheat oven to 400°. Heat 2 tbsp. olive oil in a 2- to 3-qt. pot over medium heat. Add onion and minced garlic; cook, stirring occasionally, until onion is soft and translucent, 5 minutes. Add tomatoes, oregano, and 1/2 tsp. each salt and pepper. Reduce heat and simmer until thick and flavors are combined, about 30 minutes. Set aside.
2. While sauce is cooking, in a 12- by 15-in. baking pan, sprinkle squash with thyme, remaining olive oil, and salt and pepper to taste. Add garlic cloves and toss squash mixture to coat with oil. Bake until soft, 10 to 15 minutes. Meanwhile, bring 3 qts. salted water to a boil in a large pot.
3. Reduce oven temperature to 350°. Transfer squash and garlic to a food processor and purée until smooth.
4. Tear kale leaves from center ribs and discard ribs. Boil leaves until soft, 5 to 8 minutes. Drain; let cool. Squeeze out as much water as possible and chop finely.
5. In the same pot, bring another 3 qts. salted water to a boil. Add noodles and cook until tender to the bite, about 10 minutes. Drain; rinse with cold water.
6. In a bowl, mix ricotta, nutmeg, 1 cup mozzarella, and remaining 1/2 tsp. each salt and pepper.
7. Coat the bottom of a 9- by 13-in. pan with 1/3 of tomato sauce (about 1 1/2 cups). Lay 3 noodles in a single layer over sauce. Top noodles with squash, spreading evenly. Sprinkle 1/2 of kale evenly over squash. Arrange 3 more noodles on kale and top with ricotta, spreading evenly. Top with remaining kale and noodles. Cover noodles with remaining tomato sauce and sprinkle with remaining 1 cup mozzarella.
8. Bake lasagna until juices are bubbling and cheese is melted, about 30 minutes. Let stand 10 minutes before slicing.
Grilled Halibut with Chimichurri Sauce from Epicurious.com
1/3 cup extra-virgin olive oil 1/4 cup fresh lemon juice 1 tablespoon water 1 tablespoon minced garlic 1 tablespoon minced shallot 3/4 teaaspoon hot red-pepper flakes 3/4 cup chopped flat-leaf parsley 4 (6- to 8-ounce) halibut steaks (3/4 to 1 inch thick) 1 tablespoon vegetable oil print a shopping list for this recipe
Preparation
Whisk together olive oil, lemon juice, water, garlic, shallot, red-pepper flakes, and 1/2 tsp each of salt and pepper until salt has dissolved. Stir in parsley. Let chimichurri stand 20 minutes.
Meanwhile, prepare grill for direct-heat cooking over medium-hot charcoal (medium heat for gas).
Pat fish dry, then brush with vegetable oil and sprinkle with 1/2 tsp salt and 1/4 tsp pepper (total).
Oil grill rack, then grill fish, covered only if using a gas grill, turning once, until just cooked through, 8 to 10 minutes total.
Serve fish drizzled with some of chimichurri; serve remainder on the side.
Cooks' notes: ·Halibut can be cooked in a hot oiled large (2-burner) ridged grill pan over medium heat. ·Chimichurri can be made 1 hour ahead and kept, covered, at room temperature.
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!
When I ran across this research study, it immediately brought to mind most women I know with PCOS--because they focus so much on restrictive eating as a way to improve their condition. Women with PCOS that has not yet been diagnosed often develop eating disorders as a way to manage it. If their eating disorder is anorexia or bulimia, it encompasses deprivation. And it often bounces back into binge eating disorder when the PCOS wrangles control back in its direction.
And if you've tended to lean toward the binge eating direction, you've likely been advised to lose weight. And much of the advice you have been provided for how to do this, even by licensed health care providers, has been about eliminating--calories, carbohydrates, even entire food groups. Most of what I see on Facebook, Twitter, Yahoo Groups, where women with PCOS are talking about what they're eating, it's about extreme programs and denial.
It seems to be especially prevalent in women who are trying to conceive. So when I saw this study, I wanted to share it.
This is a study done on cows, but I believe there is a good takeaway lesson. So bear with me.
Seventy-two pregnant cows, about a month before their due dates, were assigned to 6 different dietary regimens:
Ad lib eating with canola-supplemented feed Ad lib eating with linola-supplemented feed Ad lib eating with flax-supplemented feed 24% calorie restriction with 8% canola-supplemented feed 24% calorie restriction with 8% linola-supplemented feed 24% calorie restriction with 8% flax-supplemented feed (Linola is a low omega-3 form of flax often fed to cattle)
After the calves were born to these cows, they were fed the same non-supplemented lactation diet.
From one week after birth, the cows underwent reproductive ultrasounds twice a week until they again ovulated. Here are the very interesting findings (I discuss them below).
1. Cows fed without caloric restriction had higher body weights before delivery, but after delivery, they hadfewer ovarian cysts. 2. These cows, regardless of what kind of fat they were given, did have a higher incidence of uterine infections. 3. Regardless of diet treatment, the time it took for the uterus to return to its normal size did not differ. 4. It took longer for cows to ovulate after giving birth if they were fed canola oil, regardless of calorie level eaten, than it did if they were fed linola or flaxseed oil. 5. A greater percentage of cows whose diets were not restricted during their first pregnancy were able to conceive a second time with the first round of artificial insemination.
OK, the obvious omission in this study is the overfed cow. But cows are not natural binge eaters so it's understandable why this condition was not included in this study. But…what this study really highlights, is that restricting calories is not really the best fertility-friendly strategy. (The degree of restriction was actually far less in these cows than what many of our inCYST fans impose on themselves. It was the equivalent of a 1350 calorie diet for someone who would normally need 1800 calories to maintain their ideal weight.)
Secondly, even though we do talk about using canola oil because it has a nice omega-6 to omega-3 ratio, continuing to eat your favorite fried foods and using a"healthy" fat may not really be a productive strategy. You will help yourself most if you learn to eat foods that are not too high in fat.
Bottom line, it's not about the quantity of calories, it's more about the quality. It's not about extremes, it's about balance.
If you're having a hard time with balance, let us help you!
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.
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.
