The Hemp Connection:
insulin

Practically every time I hear a health professional explain, on the Internet or in person, why a woman with PCOS has carbohydrate cravings, they blame it on insulin resistance. The rationale is, that because glucose is not getting into cells, the cells are hungry and asking for sugar.

Did you know, as rational as this explanation sounds, research does not support it?

A study published in 2004 (and one of the few I've ever even seen that acknowledged that women with PCOS crave sugar) compared several appetite hormones to appetite measures in 16 pairs of women with PCOS matched with controls. They could find no statistically significant correlation between reported appetite and insulin levels. Rather, it was testosterone levels that seemed to be the problem.

Because insulin resistance has some effect on how much free testosterone is available to affect appetite, it could be argued that the effect is still there, but more indirect. However, another study reported that it is the eating of too much sugar and the resulting change in liver function that ultimately determines free testosterone levels, not insulin. (In this particular study the diet was up to 70% sugar, to be sure the desired metabolic effect was achieved and could be studied.) The resulting fat production by the liver was correlated with reduced levels of sex hormone binding globulin, the blood protein that binds to testosterone and inactivates it.

So while the cravings are there, be sure not to blame their cause on a solution that may not help. Our philosophy at inCYST is that balancing fatty acids helps calm down the nervous system and reduce its need for sugar. It also helps the liver better process fats, thus preventing the testosterone issue described above.

I know, I know, you're getting tired of hearing about fish oil.

I won't belabor the point, today I'll just challenge you to think outside the same old test tube.: )

Hirschberg AL, Naessén S, Stridsberg M, Byström B, Holtet J. Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecol Endocrinol. 2004 Aug;19(2):79-87.

Selva DM, Hogeveen KN, Innis SM, and Hammond GL. Monosaccharide-induced lipogenesis regulates the human hepatic sex hormone–binding globulin gene. J Clin Invest. 2007 December 3; 117(12): 3979–3987.

Here's a study about lean women with PCOS--the women who I like to call"the forgotten cysters". I have lost track over the years of the number of women who have written me to share that they went to their physician asking for help with a list of PCOS symptoms they had…only to be told they couldn't possibly have PCOS because they were not overweight. Up to 70% of women who have this disorder are not overweight!!!

My belief is that many women who have adopted extreme eating and exercise behaviors to manage their weight, quite possibly many women who have been diagnosed with and who are being treated for eating disorders, actually have undiagnosed PCOS.

We need to get over this belief that thin equals healthy, and that a person cannot have PCOS if her BMI and weight are within normal limits. If you have to adopt extreme measures to stay within your recommended weight range, that is a serious problem and your physician needs to listen to you.

Now for this study to illustrate. Eight lean women who actually had been diagnosed with PCOS ("cysters") were compared to 7 lean women without PCOS. The cysters had higher testosterone, and prolactin levels. They also had lower sex hormone binding globulin levels (this protein binds and inactivates testosterone).

There you have it. You can be thin AND out of balance. Sisters…and cysters…it is your right to be heard and to not be told that nothing is wrong with you when you know there is. That is where my program name, inCYST, came from. You have the right to inCYST on the appropriate treatment for the appropriate problem and not to be told you do not need treatment just because you may not fit the common profile for PCOS, or for any disorder.

Grimmichová T, Vrbíková J, Matucha P, Vondra K, Veldhuis PP, Johnson ML. Fasting insulin pulsatile secretion in lean women with polycystic ovary syndrome. Physiol Res. 2008 Feb 13 [Epub ahead of print]

One of my friends travels to Albuquerque frequently on business. I just emailed him to tell him to look for mole sauce on his current trip. And then I got to thinking, with Valentine's Day just around the corner, it would be a unique and healthy way for this blog's readers to dish up some chocolate!

Mole sauce is a Mexican sauce derived from cocoa powder. There are many different varieties, but some of the more common varities also include cinnamon, chile peppers, and nuts. Not long ago a local chef did a demonstration at our local botanical garden. Her version had about 14 different herbs and spices! This sauce is great on most meats, but I like it best on chicken.

Chocolate actually may have some heart-healthy benefits; researchers have said that an ounce of dark chocolate is as good as a baby aspirin for heart health! And cinnamon is gaining recognition for its effect on improving insulin function.

If you Google"mole sauce", you'll find plenty of recipes to try. Make this the week you treat your sweetie, as well as your heart.

This just seems to be something that should be common knowledge, especially with this audience. I was pretty surprised to happen on it myself. Aspirin and ibuprofen may promote insulin resistance and sleep problems.

Way back in 1981, researchers reported that aspirin and ibuprofen, in doses commonly considered to be therapeutic for humans, experienced an increased level of insulin secretion. More insulin tended to be secreted at lower levels of blood glucose, and higher levels of insulin were secreted at high blood glucose levels. This is hyperinsulinemia, the first step in the chain reaction of problems including insulin resistance and diabetes.

And it may also interfere with sleep! Researchers at Bowling Green State University found that non-steroidal anti-inflammatory medications (which includes these two over the counter medications)awakenings and percentage of time spent awake during the night. Ibuprofen also delayed the onset of deeper stages of sleep. Acetominophen, also known as Tylenol, did not affect sleep in these ways.

Researchers propose that the reasons for these effects may include the interference that these medications have on prostaglandin production, suppression of nighttime melatonin levels, and changes in body temperature.

We learned awhile back that women with PCOS also have trouble with arthritis, which means they are likely to be taking over-the-counter NSAIDS, thinking they're harmless. And, if they've got cardiac complications, they may have been advised to take baby aspirin prophylactically. That may not be the best strategy.

Fortunately, the fish oil I'm often teased about being such a fan of…is an excellent weapon against arthritis as well.

I'm ok with being teased about my obsession, if it means it helps our blog readers. The last laugh is the best one to have.: )

Metz SA, Robertson RP, Fujimoto WY. Inhibition of prostaglandin E synthesis augments glucose-induced insulin secretion in cultured pancreas. Diabetes. 1981 Jul;30(7):551-7.

Murphy PJ, Badia P, Myers BL, Boecker MR, Wright KP Jr. Nonsteroidal anti-inflammatory drugs affect normal sleep patterns in humans. Physiol Behav. 1994; 55(6):1063-6.

I tried a new recipe this week for the inCYSTem menu program…fell in love with it…researched it…and would like to encourage you to consider trying it yourself.

That food is buckwheat!

Buckwheat is one of the few foods containing d-chiro-inositol, which women with PCOS can have problems making. Its regular consumption is related to better insulin function, better lipid profiles, and fewer blood clotting issues. It's a good source of magnesium and tryptophan. And it's considered a complete protein, so it's an excellent food for you vegans.

I've always loved buckwheat pancakes, but I'd never had the buckwheat groats. I tried them in a recipe for buckwheat pesto I found on the Bob's Red Mill website. I think it would be very easy to substitute buckwheat for rice in a lot of dishes, such as tabouli, risotto, and pilaf. In fact, I'm going to try to make a habit of it here in my home.

Here is Bob's buckwheat pesto recipe to get you started!

1 cup Buckwheat Groats
2-1/2 cup Water
1/4 tsp Sea Salt
2 Tb Olive Oil
1 Tb Butter, softened
4 cloves Garlic, finely minced
1/2 cup chopped Walnuts-Baker's Pieces
1 cup Finely chopped fresh parsley
2 tsp Basil (Imported)
1 cup Grated Parmesan Cheese
1/2 cup Sliced Black Olives
1/2 cup Soy Bacon Bits (optional)

Directions:
Boil water with salt. Add groats, cover and simmer for 20 minutes. Remove from heat and leave pan covered for about 5 minutes, then fluff with fork.

Mix butter, olive oil, garlic and walnuts together. Separately combine parsley, basil, cheese and olives. Add butter mixture to groats, then add the parsley mixture. Salt to taste. Toss and serve. Sprinkle soy bacon on top, if desired.

Makes 6 servings.