The Hemp Connection:
thinking

If you've been following the blog over the last week, I've been reporting about interesting products and things I learned at the 2011 Natural Products West Expo. It's a huge exposition where food companies hoping to connect with buyers for health food stores have a chance to showcase their products. There were about 2,000 exhibitors there, and in 3 days I didn't get a chance to see and talk to everyone I wanted to. You can imagine, on the exhibitor end, the pressure there is to create a product, packaging concept, and booth display that catches the eye of the people you came to meet!

Unfortunately, not all concepts were on target. I'm sharing one that is a common example of how omega-3 marketing is not always accurate. It's still not regulated well, so there are lots of variations in how facts are presented that can be confusing to the person who knows they want to eat well but doesn't understand all the facts.

Yesterday I pulled a fish oil bottle out of my sample bag and noticed on the label that it was"extra-virgin" fish oil. This is a concept that I'm familiar with when it refers to olive oil, and it means that it is the olive oil from the first press of olives. It's a stronger oil, with a lower smoke point, and more appropriate for recipes where the oil is not heated. But it's not really a concept that has any relevance to fish. (I joked with my Facebook friends about whether or not it really mattered what the fish were doing before we caught them!) This particular product's label was also busy with breakdowns of omega-3's, 5's, 6's, 7's, and 9's, promoting a"perfect complement of 16 omega's". It all sounded very official, but to the average consumer who is still confused about 3's, 6's, and 9's, it only serves to make shopping for fish oil tedious and painful.

One of the reasons for all of this confusion is that fish oil is Mother Nature's patent. Consumers want their foods and supplements to be as unrefined as possible, but the only way to patent and protect a manufactured product, is to alter it. So it is very difficult for fish oil companies to create products that distinguish themselves from other competing products while keeping their customers happy. What is left to distinguish a product is where the fish is caught, what species the fish is, and the total amounts of omega-3 fatty acids. And lots of pretty, irrelevant marketing words.

Even with all my knowledge and training, I can spend hours in the health food store looking at labels on fish oil supplements and keeping up with new and different products. From my perspective, it's the total amount of omega-3's that matters. If you have a hard time with the flavor or the burps, there are several flavored options and packaged forms that can get you around that problem.

Here is my advice to you.

1. First of all, before you spend a lot of money and time, try taking fish oil to see if it works for the problem you're trying to solve. Be sure you take enough of it. For the degree of inflammation seen with PCOS, you're going to need to take the equivalent of 1000 mg DHA. That can be 2 to 3 times the recommended dose on the bottle. Be sure you do your math. It can even be the Costco brand. That is actually my first recommendation to clients. I'm more interested in whether or not adding DHA to the diet is helpful, not where the fish was caught, what the flavor of the fish oil is, yadayadayada. I just want to establish if there is a DHA deficiency.

2. Make a list of the problems that you have that you're looking for relief with that you know are related to omega-3 imbalance: memory, concentration, mood swings, carbohydrate cravings, skin problems, menstrual irregularity. Keep this list in a handy place.

3. If memory problems are on your list, be sure you have a mechanism for remembering to take the fish oil! I swear, this is one of the biggest barriers to PCOS, memory and forgetfulness keeping you from remembering what it is you need to do! If you need to engage your significant other, or set up an alarm on your phone, or a Google calendar reminder…do whatever it takes to be consistent. If you didn't take it, and it didn't work, it didn't work because you didn't take it, not because it's not the issue.

4. Be diligent about reducing your omega-6 intake: soy, safflower, sunflower, sesame, corn, cottonseed. The less of these oils you have in your diet, the better chance omega-3's have of doing the job.

5. Be sure you're reading the dose right on the label. One of my biggest issues I have with one of the most popular brands of fish oil is that their dose is two capsules, not one. Most people never read the fine print, assume a dose is one pill, and end up taking half of what they were thinking they were taking.

6. At the end of your trial period, look at your list and see what improved. Did it work? NOW, and only NOW that you've established whether or not you were DHA deficient, consider if the type of fish oil you take. Would you prefer a flavored, a gel, a capsule, a liquid? All of them are going to give you what you want, you're just deciding which one fits best with your personal taste and texture preference.

Pretty packaging and fancy words are not what are going to help you to feel better. It's what's inside the package, and in what concentration, that you need to focus on!

In the series “Mary Portas queen of shops” we watched how Portas tackled struggling independent businesses and breathed life and wealth back into them with ideas about merchandising the store, to buying and pricing strategies. Now Mary has got her beady eyes on Britain’s charity shops.

Mary believes charity shops represent a key part of the future of shopping: “a vast number of consumers worry about ethical shopping and the environment and charity shops provide a route to a greener way to shop where everybody wins”.

I loved “Mary Portas queen of shops” first time round and with my love of charity shops I cannot wait to see how this series is going to go and if Portas will succeed in her mission. I was watching last night on BBC2 at 9pm along with you guys thinking it was all going to have to turn out nice in the end because otherwise what is the point of the series? Awareness?

After watching the first five minutes it was clear poor Mary had her work cut out for her with the shop, dumped donations and Nick the apparent “Manager”. What surprised me most was the mindset of the people. Some of the volunteers did not think the shop needed a change, some were not open to change and some refused to change. If Portas cannot get the volunteers to want to change their mind sets about the store how does she endeavour to change the buying public’s minds about shopping at charity shops?

I am more than sure the BBC show will split people’s opinions on Mary Portas. Some cannot stomach her and find her patronising or condescending. Making the complaint that the shop workers were just volunteers and that they had been in that same job for 30 odd years. On the other side we have Mary Portas who has a wealth of retail knowledge and wants to help them make money by making some simple changes and treat them like a business. Mary Portas is marmite?

I cannot wait to watch the rest of the series and I really want this “plan” to work for Portas, the charity shops and the public. If we can change people’s ideas or perceptions that these stores are not just dumping grounds for our old tat and are in fact goldmines for great fashion and bric a brac than I will be happy and content. I will be tuning in for more “Mary Portas queen of charity shops” next week.

I'm pretty good at regular exercising. But I have to admit, I can get into ruts. I run because it's easy and convenient and efficient on a busy day. I use the elliptical if I'm near the gym while I'm out. And I love, love, love to swim! But even that is a little routine, focusing on the same muscle groups while ignoring others.

I was reminded the other day of why I might benefit from mixing it up a little bit. inCYSTer Ivonne Ward invited me to join her at a NIA dancing class. (More on NIA in a future post.) I remembered how much I loved dance when I studied it way back in high school, and how much I love to move to music. I also came home well aware of muscles I haven't been using despite my strenuous workouts, and muscles that were tight from being overly focused on. I felt sore, but wonderfully so!

I'm trying something new this year, trying to mix up my exercise so that no two sessions involve the same activity. Trying to mix it up a little bit more so that my fitness is more well-rounded.

Today, the weather is so beautiful, I'm going to get out the Rollerblades and spin around my neighborhood. I love the rhythm of skating, I find it calming and meditative. And I love how the blades use my legs in different ways than does running. And those boots are heavy enough that it's like a ton of weight lifting for the butt muscles--never a bad thing!

I've been communicating with a very nice woman in Santa Monica who is helping me to figure out how I can add tennis lessons to my work trips over there. I've always wanted to learn tennis, so why not this summer when I will surely have time in a place with great weather?

inCYSTer Dr. Gretchen has been talking about her surfing lessons with such enthusiasm that I am going to make time for some of those as well. I will definitely have to get over my shark phobia for this one, but it looks like so much fun!

Both of these activities will challenge my upper body more, which as I get older is definitely something I need to encourage a strong, healthy spine. Plus, I love having new things to learn. My tennis contact shared with me that something she loves about tennis is that every time you play, you're with a different person who challenges you differently, so it's never the same game. I think I'll like that. Sometimes the runs do get a little tedious.

I was also thinking during NIA yesterday that my dance training may come in handy in a sport requiring coordinated footwork, and vice versa. I will be more motivated to swim if I know it will help me to better enjoy my surfing time.

Tennis and surfing require mindfulness as well. Unlike running, and the other activities I do, where you can kind of zone out and be in another world, you have to be mentally PRESENT, aware of your place in space as well as your surroundings, in order to effectively participate.

It's why I hate the question about what the ultimate exercise is. There isn't really ONE, it's what you'll do most regularly. And I think you'll exercise most regularly if you're interested in what you're doing.

Maybe if you're bored with what you're doing, or only exercise for a few weeks before it drops off again, it's because you're not mixing it up enough. Exercise because it gets you away from the computer, stretches your back, allows you to be social, gets you in touch with nature, helps you sleep…and you are guaranteed to strengthen muscles and bones, and maybe lose weight.

Exercise just to lose weight and well…if that's what you've been doing, maybe that's why you've read this blog post all the way to the end.: )

One of my clients sent me this recipe, which also happens to be gluten-free. I'm thinking it could make a great Thanksgiving day breakfast, giving you a great Thanksgiving taste, fueling a great morning walk or workout, and keeping your appetite in check when the big meal is served. I removed the whipped cream and the sugar from the rims which you will see in the original recipe.

Pumpkin Pie Smoothie

Pumpkin Pie Smoothie (Gluten Free, Dairy Free, Refined Sugar Free + More Free)

1 cup pumpkin puree, chilled (fresh or canned)

½ cup full-fat coconut milk, chilled

½ cup filtered water

1 sliced, frozen ripe banana

1 tbsp almond flour (optional)

1 tbsp hemp seed (optional)

A tablespoon or two of honey, to taste

½ tsp pumpkin pie spice, or more to taste

Prepare glasses by dipping rims into shallow bowl of water and then cinnamon.

Combine all ingredients in blender. Cover and blend on high until smooth, about 30 to 60 seconds.

Pour into prepared glasses or pint-sized Mason jars as I did.
Enjoy!

http://glutenfreeeasily.com/pumpkin-pie-smoothie/

Something I love, love, love about my work is that there is always something new to learn. Recently my work with Chow Locally has taught me a lot about why people don't have a user-friendly relationship with vegetables. It's probably because most of the vegetables they have been exposed to are bland and boring.

We are so lucky to be able to work with farmers who bring us great things like Romanesco, purple carrots, watermelon radishes…things that are just so attractive and interesting you can't help but want to taste them! Plus, even when what we have is more recognizable and traditional, it's so fresh, pulled out of the ground just a day or two before we get it, that it's bursting with flavor. I have found myself, several times, in the traditional grocery store getting ingredients to cook with my vegetables, walking through the produce section, thinking to myself…"That's all they have?"

Recently, without even being asked, one of our customers' daughters told us just how much she loves her veggies.

Yes, she loves carrots more than chocolate! And I promise we didn't somehow sneak chocolate into those carrots…it's just that they are that good when they're fresh out of the ground.

Over the weekend, one of our co-founders, Derek Slife, was invited to showcase our vegetables on the local edition of the Today Show. I watch lots of food demos, but it's not often that you see the hosts of the show hover over the chef like Joe and Rob did with Derek! They were so fascinated with the watermelon radishes they couldn't wait to try them. What the spot doesn't show is that Joe so eagerly dug into one of the carrots he bit into it on air without thinking to wash the dirt off…and you know how that ended.

These experiences, and the many notes we are receiving from happy parents telling us their kids are eating foods they never, ever ate before have completely convinced me, the problem with vegetables is not that they don't taste good, but the way we manage them from farm to table often strips them of their flavor.

If you have a farmer's market or CSA near you, I encourage you to try eating THOSE vegetables. It is a whole different experience than you've ever had. You just might find a new addiction!

One of my goals with inCYST is to create a new paradigm for treatment of inflammatory disorders such as PCOS. Rather than debate over whether Western medicine, Eastern medicine, or Naturopathic medicine is THE modality of choice, I'd like to put the best minds from each specialty together to create new ways of thinking and helping.

Our latest webinar by Susan Lundgren, NMD (naturopathic medical doctor), is an excellent start in that direction. Dr. Lundgren has put together a great presentation which explains in detail her qualifications as a healer, how she is trained to think that looks at PCOS through a unique set of lenses, and some of the modalities she uses in helping her patients.

If you've been thinking about working with a naturopath, consider registering for this session. (We had a slight glitch with the audio on our first try so we are re-recording it next Thursday, May 5, 2011, 8 pm Eastern time.) This webinar is part of our 2011 PCOS Professional Training package; if you'd like to get your toes wet, you can register for just this lecture; if you decide before December 31, 2011 to enroll in the entire series and join our network, you can apply the $40 you paid for this class toward that total.

Dr. Lundgren has also recently started a blog you might enjoy, http://www.drlundgren.wordpress.com/. Phoenix cysters, take note! She is part of a medical practice you can learn more about at http://www.naturecurehouse.com/.

I'm really grateful to have met Dr. Lundgren, and for her generosity and enthusiasm about what we're doing. I'm very much looking forward to many fruitful collaborations, and to learning more about her passion for naturopathic medicine!

If you've ever dieted, and you have trouble sleeping…there may be a reason. Keep in mind, this study was done on rainbow trout, but there is still a message in it for humans. Three groups of trout were studied with regard to their melatonin (sleep hormone/antioxidant) levels and cortisol (stress hormone) levels. The three groups were defined as fed fish, fish that were fasted for 7 days, and fish that were fasted for 7 days then refed for 5 days.

Melatonin levels were disrupted in fasted fish. If you were human, this would likely mean if you were on a strict fasting/dieting protocol, you were probably having trouble sleeping as well.

Interestingly, nighttime serotonin levels were higher in these fasted fish. Melatonin is made from serotonin, so I would presume that what the body tries to do when you're not eating well is to keep you alert and thinking about getting some food. It does that by hanging on to serotonin and preventing its conversion into melatonin. That's a survival mechanism.

So if you're dieting and you're awake at night with cravings? That's a normal response. Don't obsess about what's wrong with you, don't surf the Internet looking for what to do about your cravings. In this kind of situation, you're thinking about food because you need it. Get some.

As far as cortisol, dieting reduced levels and they stayed low after refeeding. You could argue that this is a benefit of dieting…except for the fact that if you're cutting yourself short on melatonin, you're aging yourself more quickly than you should. There are plenyy of ways to reduce melatonin levels without dieting that don't cut your life short on the back end.

By the way, since I write so much about sleep I thought I should mention…I love naps. The long afternoon kind where my cats curl up with me, and I wake up with a little bit of drool on my pillow. I don't feel guilty at all. I completely buy into the idea of"beauty sleep"--sooooo much cheaper than all those anti-aging potions on the infomercials!

Ceinos RM, Polakof S, Illamola AR, Soengas JL, Míguez JM. Food deprivation and refeeding effects on pineal indoles metabolism and melatonin synthesis in the rainbow trout Oncorhynchus mykiss. Gen Comp Endocrinol. 2008 Apr;156(2):410-7. Epub 2008 Jan 8.

Every other Sunday morning, I pull out my “old lady pill boxes” and load them up with my current selection of supplements, some of which are for PCOS. At times, I confess, I’ve been known to take as many as 90 pills a day. If that sounds kind of crazy, I’m in full agreement with you. I often incorporate Chinese remedies prescribed by my acupuncturist, and those are typically dosed at three to five capsules, three to four times per day, which can quickly add up. I don’t do that anymore. But I routinely take a hearty little handful of things like fish oil, D-Chiro Inositol, Vitamin C, and alpha lipoic acid. I’m sure many of you do too – or you think you should be, if you’re not.

Some doctors want to know everything you’re on, and some don’t bother to ask beyond the fish oil or the Vitamin D3. I actually keep an Excel spreadsheet listing everything I currently take, both supplements and prescription medications. This is for my own tracking purposes (so I can see if there’s something I’ve tried in the past and deleted because it didn’t do anything for me – no point in trying those again), and for the doctors who want a comprehensive record. It’s too much to track on, and often doesn’t fit on the few lines given on a doctor’s intake form. “See attachment” is my favorite labor-saving phrase!

As I updated my spreadsheet today, I got to thinking about the lure of supplements. Americans spend $20.3 BILLION dollars (NIH, 2004) per year on supplements. That’s a staggering amount of money for something that isn’t guaranteed effective, may be irregularly dosed, and can be just as powerful as prescription medications. And yet, we continue to buy. PCOS patients in particular are prone to chasing the latest and greatest potential cure – or at least, anything that might offer some symptomatic relief. When you’ve got a condition that’s frustrating, complex, inconsistent, and impossible to permanently resolve, you’re vulnerable to the seduction of marketers, Twitter feed, and anecdotal reporting.

At this point, I try to limit my supplementation to things prescribed or recommended by my physician, dietician, and/or acupuncturist to treat the symptoms that most concern me, such as high blood sugars and inflammation. If I hear about something new that holds some promise for my PCOS, I research it independently and then make a decision about whether or not to add it to my repertoire. I’m mindful of the fact that there’s a great deal we don’t know about supplements, just as there’s a great deal we don’t know about prescription medications. My goal is to support my body in becoming as normal as possible.

Periodically, I get disgusted with the whole thing, decide it’s too many pills, too complicated, too much money, and too overwhelming. Then I take a supplement vacation. And in the meantime, I’m continuously researching and contemplating what I can delete, or if perhaps it’s best to eliminate supplements altogether. The supplement vacation usually lasts a couple of weeks, and then I go back into it a little more strategically, and with greater consciousness about my own need to be “fixed,” and how that can lead to bad decision-making.

If you take supplements, I encourage you to think about them consciously, and not just chase the promises. If you don’t, don’t feel bad about it, but consider what might actually be beneficial to your mental as well as physical health (fish oil comes to mind!). Be willing to experiment, monitor, and make adjustments. Be patient with your body and your brain. Seek consultation with experts. Do your own research. Treat yourself with the importance you deserve.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.

We all know we should more veggies. But it doesn't often work out that way. I think a big part of it is the part of our brain that decides how to prepare them, gets locked into thinking they either have to go into salads, or they are steamed on the side (like the ubiquitous broccoli I mentioned in my recent restaurant review). Juicing is ok…but for our group, the high carbohydrate to protein ratio is not really hormone-friendly.

I also think, this same part of the brain that persists in thinking vegetables are bland and boring, is the one that also has us believing that if we are"good" and we eat veggies, we are giving up things we like to eat.

If that is not the worst marketing for a great concept I have ever seen!

Why not…make something you like with new and different ingredients? (slaps forehead)

Here is a collection of links to recipes for pizzas, in which the crusts are made of vegetables instead of flour. Majorly simple way to healthify your dinner without compromising taste.

Have fun, readers!

 Cauliflower Crust Hawaiian Pizza

Kale-Crust Pizza

Kale Pizza with Sweet Potato Crust

Carrot Crust Pizza

Turnip Crust Pizza

Zucchini Crust Pizza

Beet Crust Pizza

Spaghetti Squash Pizza

It's Earth Month 2011, a good time to think about our connection to things much bigger than ourselves. It's easy to become overwhelmed when thinking about a problem as daunting as infertility, and to narrow your focus down to what you need to do to fix your personal problem. Nothing else can seem to matter except your own hormones.

At inCYST, one of our most important missions is to help our readers understand, that the reason many people these days are struggling with infertility, is because our unsustainable lifestyle has changed the balance on our planet. The more respect with which we treat the earth, the better the earth treats us.

I was thinking about this yesterday while running on the canal trail behind my home. I've been waiting several weeks for the baby ducks to come and they finally arrived! My run is so much more enjoyable when I can watch the little fluffballs swimming behind their mother, learning how to swim, how to dive for food, how to preen. I never cease to be amazed at how these ducks just seem to know how to do what they do.

Something that biologists are learning is that other species are having trouble reproducing as well. We've put chemicals in the water they drink, we've put pesticides in the food chain, we've encroached on their breeding grounds…and they're paying a heavy price. The only difference is, they don't have reproductive doctors and nutritionists to guide them to better fertility. Their populations decline and we lose them.

So when I was admiring the fuzzballs I thought a lot about how inCYST is about more than helping all of you. Though that's important!

It's about rallying all of you to adopt lifestyle choices that benefit EVERYONE on the planet, no matter the genus, no matter the species. I hope that this is a value that gradually blends into your pursuit of personal health.

Speaking of sustainable living as a value, we had a wonderful radio chat yesterday with Julia Bucciero of Maxim Hygiene, makers of organic, all cotton, pesticide-free, chlorine and dioxin-free feminine hygiene and personal care products. If you had not thought about the opportunity for hormone imbalance your current personal care purchases poses, it's time you should.

And consider what unnecessary amount of plastic accumulates in landfills and floats down waterways when we make certain choices! You can make a hormone-friendly, 100% biodegradable choice and with that, make a difference.

Maxim Hygiene has created a product that makes personal sense for women with PCOS, and an opportunity for each of us to live more sustainably.

If you can't find these products in your local store, be sure to contact Maxim Hygiene and let them know. They're happy to work with stores to increase their product availability. I found them on amazon.com if you prefer to purchase them online.

It can help to feel less personally picked on when you take a step back and understand how a bigger imbalance may be affecting your personal imbalance. The best way out of that corner, is to collectively start making choices that promote balance outside, as well as within, ourselves.

I've been writing this blog long enough to know that as soon as I recommend a supplement, the post is circulated, reposted, retweeted, ad nauseum. If I talk about changing food choices, it sits there like a bump on a log.

I posted the information about myoinositol supplementation because I knew that many of you are having such a hard time with the side effects of metformin, that it might be helpful to try this compound as an adjunct.

In the process of researching the topic, however, I came to understand that part of the reason many of you have a problem with your myoinositol levels in the first place…is that your dietary choices may have backed you into a corner.

Myoinositol isn't new news, really. Back in 1980 a physician and a dietitian wrote a very nice review article and developed some recommendations for increasing dietary inositol that I'm going to summarize here. In a nutshell, it's a dietary intermediate that is found in high quantities in nerve cells. If your nerves are working harder than they were designed to, as is the case when you don't manage your stress, don't attend to good sleep hygiene, overexercise, and eat a poorly varied diet, there is a really good chance you're going to deplete your myoinositol levels more quickly than you can replete them. That is a consequence for ANYONE not taking good care of themselves, it's not a unique feature of PCOS.

For anyone struggling with medical issues related to hyperexcitable brains, including migraines, epilepsy, anxiety disorder, OCD, PTSD, bipolar disorder, etc., it's highly possible that your daily myoinositol needs are simply higher than average. Everything you see us write about on this blog, from omega-3's to antioxidants, is designed to reduce that hyperexcitability and make it easier for your brain to function as it should. It certainly is not going to hurt to take a supplement, and if you've been asking your brain to run on nutritional empty for a long time, or if you've been working hard to turn your PCOS around with good habits and just don't seem to be getting over the hump with it, supplementing may be a great tool to add to your already good habits.

There is some thought that people with insulin function problems may have alterations in myoinositol function, which could also increase the daily needed dose.

I must iterate, however, that a myoinositol supplement is NOT a substitute for a healthy diet. There is no such thing as a donut for breakfast, a Snickers for lunch, and a binge for dinner…cancelled out by a few pills in a bottle. So my guess is that those of you who are making good changes diet and stress management-wise in conjunction with the supplement are the most likely to achieve the benefit of the supplement. That is just how biochemistry works!

The study I recently quoted (focusing on neuropathy, not ovulation) used a myoinositol dose of 4 grams. The study I quote today found an effective response from a highest dose of 1,500 mg. It doesn't mean that these are the doses recommended for each particular diagnosis, or type of inositol, pill or food…it simply means those are the doses the reseachers decided to study.

However, since that is the dose reported in the ovulation study, and more of you reading this are interested in conception than nerve pain, I'll post the values of the highest myoinositol containing foods and let you figure out what your best food/supplement combination is to achieve that dose (4000 mg or 4 g daily).

I'm going to tell you, what I was thinking as I compiled this list was that if you're only concentrating on carb/protein/fat content, you're cutting out all your myoinositol sources. It looks like Mother Nature makes sure that when we eat carbohydrate as it appears in nature, that it comes packaged with a nutrient important for metabolizing it. It's when we refine that sugar and eat it out of context, as with sodas, candy, baked goods, etc…that we dig a hole for our nervous systems.

We just can't outsmart her, can we?

The complete list can be found at this link.

Myoinositol Containing Foods with more than 100 mg/serving
1/2 cup grapefruit juice 456 1/2 cup canned great northern beans 440 1/4 fresh cantelope 355 1 fresh orange 307 1 slice stone ground wheat bread 288 1/2 cup rutabaga 252 1/2 cup kidney beans 249 1/2 cup orange juice 245 1/2 cup canned oranges 240 1/2 cup canned peas 235 1/2 fresh grapefruit 199 1 fresh lime 194 1/2 cup canned blackberries 173 1/2 cup mandarin oranges 149 1/2 cup canned lima beans 146 1/2 cup kiwi fruit 136 1 cup split peas 128 2 T. creamy peanut butter 122 1 fresh nectarine 118 1/2 cup canned black-eyed peas 117 1/2 cup grapefruit sections, canned 117
Rex S. Clements, Jr., M.D. and Betty Darnell, M.S., RD. Myo-inositol content of common foods:
development of a high-myo-inositol diet. Am J Clin Nutr September 1980 vol. 33 no. 9, 1954-1967.

Kind of an obvious choice this week…

…I wanted to highlight eggs since they are a food many people don't eat, thinking about the cholesterol.

It used to be, when I was brand-new to this profession, I was taught to tell people to avoid eggs. Because of the cholesterol.

It turns out, the cholesterol in eggs has been shown to not increase serum cholesterol, and taking eggs out of your diet doesn't really decrease your cholesterol.

Besides that, eggs…

…are cheap.
…have one of the highest quality proteins available.
…are one of the very few foods contain choline (in the yolk), which is very important for maintaining memory, potentially reducing your risk for Alzheimer's disease.
…are a good source of vitamin B-12, another nutrient that isn't always easy to get.
…are convenient to eat.
…if you get the omega-3 kind, can be a source of DHA, which is not easy to get in your diet if you don't like or don't have access to fish.

So have fun with your holiday and take advantage of the fact that you've got all those boiled eggs in the frig. Have them for breakfast. Put them on your salad at lunch.

And know it's something good you're doing for yourself!

Long ago, I had a client who needed me to help her stay on course in the grocery store. Most of the time she did well, but one day, as we were wrapping up the trip, she accidentally zeroed out her calculator (which was her indicator she was staying within budget), just as she had three items left to put in her cart. The next series of behaviors humbled me as her dietitian, because I saw just how useless it is for anyone helping someone with an eating disorder to assume that there is any kind of logical/rational thinking when a person encounters a stress.

My client broke out into a profuse sweat. She removed all of the planned menu items from her shopping list and proceeded to the frozen food section, where she loaded up on ice cream, pizza, chicken wings, you name it. She was in such a zone that I couldn't get her attention.

I learned from this, that waiting until you're stressed out, to implement stress management behaviors, doesn't work. By that time, too many hormones and too much momentum are headed in the wrong direction for there to be much of a chance to think your way out of the problem. The same thing happens with anxiety and sleep medications. If you're taking them on an"as needed" basis, by the time you realize you need them, you've got far more momentum to overcome than you would if you implemented proactive stress management behaviors.

One of my favorite proactive remedies is lavender. It's an herb whose essential oil has repeatedly been observed to have powerful anti-anxiety, antidepressive, sleep-enhancing qualities. I was reminded of lavender this morning when I ran across a new study suggesting that lavender essential oil has the potential to be as potent as lorazepam (Ativan) for anxiety management, without thhe addictive potential. The beauty of this essential oil is that you can apply it throughout the day on your wrists, helping to keep anxiety at bay before it becomes overwhelming. Lavender sprays and pot pourris can be helpful as well. Of course, they will be more useful when used regularly and proactively than if you wait until you're completely freaked out (when you may not remember to use it, anyway).

Lavender is also an herb that can be used in cooking! Here's a link with some interesting recipes, including lavender scrambled eggs and lavender oatmeal.

I think Mother Nature is the most incredible pharmacist. I hope this is an option with potential for at least some of you with anxiety, depression, and sleep disorders that intensify your PCOS.

Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial. Community Dent Oral Epidemiol. 2010 Feb;38(1):83-7. Epub 2009 Nov 23.

Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010 Feb;17(2):94-9. Epub 2009 Dec 3.

Setzer WN. Essential oils and anxiolytic aromatherapy. Nat Prod Commun. 2009 Sep;4(9):1305-16.

I've been chatting with several of our network members the last few weeks about some really fun things they've been doing in the activity department. I'm hoping talking about my own activity this past week will encourage them to get something posted! (You guys know who you are…)

My car needed a major repair that resulted in my being without (gasoline-powered) transportation for a couple of days. And, the garage that did the work was about 10 miles away. I could have used the bus, and actually did for a major trip, but since the weather was so nice, I thought I would get out and enjoy it.

So…when I took the car to the garage, I packed my rollerblades and skated home. I checked out the route, and it turned out, the garage was just a couple blocks away from my favorite greenbelt; therefore, half of my trip was already familiar. Just a few different turns toward home, and voila! I had my workout in.

I used to cross country ski a lot when I lived in Colorado, and picked up rollerblading when I moved to California and didn't have such great access to snow. It is so fun! I actually had to check my heart rate when I first started because I didn't believe it was actually going anywhere.

Something I really love about rollerblading is the workout it gives my backside. Everytime you push off and lift your boot, it's like lifting a weight. One of those weights that really isn't fun to do in the gym, but you don't notice when you're skating.

I also love the meditative rhythm rollerblading creates. There is something about the back and forth repetition that calms the chaos in my head and allows my more creative thinking to predominate.

By the time I got home…I had a bunch of new ideas for my work, I was relaxed, and later on that night I fell right asleep.

I'm looking forward to what other network members share. It's not about how often you are in the gym, really, it's how much you move your body in general. They've got some great ideas!

I got my start in this specialty in a nontraditional fashion. Even though I did a lot of work in endocrinology initially, I gravitated into sports nutrition, and from there, eating disorders. I initially started my business thinking that it would be a resource center for eating disorders. But PCOS followed me. I kept getting phone calls from women looking for help with their eating disorder who mentioned they'd recently been diagnosed with PCOS. Thinking there must be some relationship, I started mentioning the symptoms of the syndrome at local mental health networking meetings. I started getting counseling referrals from eating disorder specialists--and they tended to be women who had initially been diagnosed with bulimia, put into traditional eating disorder treatment, and then a few years later,"relapsed". It was with this"relapse" that the PCOS was diagnosed.

I put that word into quotes, because you can only relapse from a disease you've been treated for…if the treatment you received is for the problem you have. The word blames the person for the diagnosis with the problem.

I have come to believe the problem may lie, in large part, with the caregivers. Eating disorder symptoms are primarily behavioral. There isn't a blood test you can administer, or an x-ray you can examine. And therefore, if you fit a certain criteria, you must have the disorder.

Just as diabetes won't respond to psychotherapy, PCOS, which in many cases is PREdiabetes, won't either.

The problem with PCOS is, the hormonal imbalances it renders can induce the very same behaviors that we use to diagnose eating disorders. Carbohydrate cravings are extreme. Hormones are so out of whack that the only thing that manages them, it seems, is extremes in diet and in activity. And God forbid, if no doctor caught on to your hormone problem and you decided to take things in your own hands…then you have control issues and you have an eating disorder.

What can make it especially challenging to diagnose PCOS, if it has progressed this far, is that the extremes in exercise and diet may, at least temporarily, suppress abnormal labs. It takes a skilled clinician to even see what's going on. I think back to my 3 1/2 years in an inpatient treatment center, and how many young women came to me complaining that as they started to refeed, they were craving carbohydrates. And because it was the treatment center's philosophy, I smiled back and told them all foods could fit.

A lot of eating disorder treatment is about the battle between the clinician, who wants his/her clients to believe that they can get back to eating everything in moderation, and the client wanting to tell the clinician that just isn't so, but playing the game as long as she needs to in order to graduate to the next level move toward discharge.

Last year I wrote to several hundred mental health practitioners who specialized in PCOS, introducing my company and the work I do with PCOS. I described the symptoms and explained to them what I just explained above. I received who knows how many polite responses, thanking me for my interest, but they worked with eating disorders, not PCOS, and there wasn't really a need for my information. I wondered how many thousands of women were sitting in therapy, being told if they just addressed their"issues"…they could beat the problem.

Don't get me wrong, I know there are plenty of issues in PCOS that psychotherapy can benefit. But there's a difference between anxiety over the prom and anxiety driven by excess cortisol levels resulting from a poorly balanced nervous system.

Sometimes I wonder if it's not the same diagnosis, being given a different name depending on the office in which it first shows up?

I sure hope at least some of those women have found my website on the Internet and have benefitted from the information I've learned and posted there since that tenure.

I am considering hosting a fundraiser for the new PCOS research foundation in Los Angeles. I was thinking of being over there on Saturday, May 14, and conducting a day's worth of counseling appointments, with all of the proceeds being used to cover the startup costs for this organization.

Since I would be traveling over from Phoenix and absorbing the cost of that travel, I would need your commitment to participate to be made by giving me a credit card number that would be charged whether or not you attend your scheduled appointment. Either way, your payment would be considered a charitable donation.

If you are interested, please contact me privately at marika@google.com so I can ascertain if enough interest exists to start to plan the trip.

If you are NOT from Los Angeles and would be interested in a similar fundraising day conducted over the phone, please let me know, I'll do that as well if there is sufficient interest!
Thank you!

At Expo West, I am always as interested in the beauty care section as I am foods. I have come home with lots of great information that I've shared with all of you about how to have the healthiest skin you can. However, Expo West has also taught me that the hype in the beauty industry is as bad, if not worse than, what I work with daily in the food industry.

We are an appearance-based culture, and as a culture we fear aging. That gives the beauty industry a lot of ammunition to work with. A simple promise of younger skin, a suggestion, and magical thinking takes over.

The booths for these products are all beautiful, and the claims sound reasonable. It is only when you get home, away from the lights and the pictures of someone else's flawless skin, that logical questions start to have a chance.

For example, I was very taken by the beautiful orange and white booth of a company called Sibu Beauty. They were selling a product line based on the ingredient"sea buckthorn". This is a berry native to Tibet, with a high anti-oxidant content that helps it to survive the harsh mountain climate.

The big claim of this product line, though, is its high contents of all of the omegas — 3, 6, 9, and 7. Not real fond of omega-6…as you know, it's pro-inflammatory.

Omega-7? Yes, 7. Never heard of it, so I took as much information as I could so I could come home and research more.

Went to the company's website, clicked on the"science" link, found no links to studies specifically supporting their claims, no clinical studies, no before-after pictures.

I did see a photo of a beautiful young woman who likely had yet to see a mark of aging hit her flawless skin and who very likely couldn't point out Tibet on a map if you asked her to.

Here's what bothers me about these companies selling anti-aging programs using ingredients from exotic places like Tibet and the Amazon. If you Google Image pictures of women from these countries, you see beautiful faces like the one to the left, with the history of the elements carved into their expressions. Why do these companies who sell these supplements from these exotic places like Tibet and the Amazon, never show the faces of real people who live there. Shouldn't they be the real testimonials for how these products work?

The site proudly shared that it had been promoted on Dr. Oz. Do you know what it takes to get your product on Dr. Oz? A good PR agent, mostly.

Out of fairness to the man, however, I did watch one of the videos from his sea buckthorn segment. He didn't really talk much about skin, but rather focused on two rats, both who had eaten a high fat diet, one of which managed to stay thin because it had also been given sea buckthorn. So my takeaway here was that Dr. Oz was promoting the concept that you can eat crap as long as you can get your hands on some exotic foreign berry extract. (C'mon, Mehmet, really? I could give you a laundry list of exciting nutritional angles for your show…teaching people who to eat junk and stay thin is not one of them.) I digress. The truth is, Dr. Oz spoke about sea buckthorn in general, not the brand promoting the fact that Dr. Oz promoted the product.

Went to my favorite resource, PubMed, and looked up sea buckthorn. I did see some studies with regard to wound healing, a lot about anti-inflammatory action, and even more about it being therapeutic for ulcers. But no rave reviews for the product as an anti-aging agent. And I even found one study suggesting that skin fatty acid content did NOT respond to sea buckthorn supplementation.

Finally, contacted a good friend in the beauty industry, who has a background in library science and who deconstructs cosmetics labels like I deconstruct food labels. She'd heard of the product, even tried it herself, wasn't impressed.
So here we have a product with proven therapeutic benefit that is not being promoted, being promoted for something completely wacky by a celebrity who knows when he talks miracle weight loss his ratings stay where the advertisers want them, being sold to do something completely unrelated to either by its manufacturer and unproven in clinical studies.
If your head is spinning, it should be. This is an awful lot of smoke and mirrors. If it gets to be this confusing, your hype and fraud radars should be going crazy.

Save your money.

Yang B, Kalimo KO, Tahvonen RL, Mattila LM, Katajisto JK, Kallio HP. Effect of dietary supplementation with sea buckthorn (Hippophaë rhamnoides) seed and pulp oils on the fatty acid composition of skin glycerophospholipids of patients with atopic dermatitis. J Nutr Biochem. 2000 Jun;11(6):338-40.

As luck would have it, just as I was about to give up on having a topic to write about, my friends at the coffeehouse where I am working today started talking about rock climbing. And there I had it, something fun to talk about.: )

Many moons ago in graduate school, my friend Julie, an avid climber who had trekked Nepal and slept dangling off of Half Dome, invited me to spend an afternoon with her at the Boulder Flatirons. They're not big or tall, and I figured, as many other sports as I'd tried and done well with, this would be easy.

Not!

Who knew a piece of rock could be so challenging? We went up to the top, tied ourselves in, and I learned to belay…which for those of you not familiar with it, is kind of like what Batman likes to do down the side of buildings. It was fun, once I learned to trust that Julie had tied us in safely enough that nothing I did was going to result in my crashing to earth.

At one point I lost my footing, and found myself dangling about 50 feet above solid ground. I panicked, and Julie called from above,"It's ok, Mon, you're safe. Relax and enjoy the beautiful view!"

"Are you freaking kidding? I'm flailing on a rock and you want me to enjoy it?"

She let me hang long enough to have no other option. I like to call it my lesson in extreme mindfulness, which I use to this day. Even in the most stressful of moments, and as I have learned, especially in the most stressful of moments, when mindfulness is the hardest thing to achieve, it is the most important thing to achieve.

After I calmed down, and looked around, Julie was right. There WAS a beautiful view to be enjoyed. Of course there was. That is why we went to the rock in the first place! How many times do we get so caught up in where we are going…that we forget to appreciate the view and the lessons to be learned right where we are?

We eventually got down to the ground, and Julie said,"Now, back up!" And we had to climb back up the same rock we'd just sported down.

Much harder than the Batman thing.

And so we started back up. That was an exercise in strength (fingertip strength too, not just the big guys!), flexibility, trust, and endurance. It was also a great exercise in strategic thinking, for in rock climbing, you have to be thinking about two, three, four moves up the rock, not just what you're doing in the moment. How many times do you get so stressed that you only think about the current moment, only to act impulsively in a way that sets you up for trouble two, three, four moments in the future?

About halfway up the rock I got stuck. Nowhere, absolutely nowhere that I looked, did I see a crack, crevice, ledge, anything finger or toe friendly that I could use to advance myself. Julie, the most amazingly patient teacher for an exercise like this, reminded me that I had the safety of the rope which allowed me to swing a bit off my current position. She encouraged me to try moving just a half inch to the right.

And there it was, a half inch away, a half dozen new possibilities of working up the rock miraculously waiting for me to discover.

How many times have you been so invested in things having to be one way, the way you want them to be, that you shut yourself out of a host of other ways to get to the same place?

And of course, the feeling of accomplishment upon arriving at the top is one that no one should be denied.

There is physical benefit to rock climbing, but what I love about it, is the mental training. It is a great exercise in mindfulness, trust, problem solving, intentional choices, all the skills you need to work yourself out of some of the situations and behaviors that keep you stuck where you don't want to be.

I encourage you, regardless of your size or current physical condition, if there is a climbing course or indoor climbing wall near you, to get out and try it.

It could open up a world of new ways of thinking and acting that you never considered…some of which could be life changing.

Practically ever client I have ever had, has come to me with some kind of expectation that the secret to their weight problem/eating disorder/heart disease lies in a magical set of recipes filed away on my computer. If I don't hand them recipes, they feel as though I have failed them.

It's not that I don't mind creating recipes, in fact, it is one of my very favorite things to do! But I feel as if I give you too much structure in what I encourage you to do, you miss the point of cooking. And I feed the delusion that some specific set of instructions on a piece of paper is going to magically fix your problem.

So today I thought I would share what my morning has been like. I hope you will see, that the best kitchen inspirations come from the most surprising places. You often have to put the recipes away in order to see them.

My culinary challenge this week for Chow Locally is developing recipes for mustard greens. My big barrier to this challenge is that try I as I might, and trust me, I have done so many, many times, I just can't get into mustard greens. They are pretty bitter to my palate. But since we have about 125 customers wanting to know what to do with the mustard greens we gave them, and since mustard greens grow pretty well in Phoenix, I got the feeling the Universe decided to tell me it was time to cut the mustard (Ha! Couldn't resist!)

I didn't snap my fingers on this one. I am pretty sure by now, in fact, I have read every single blog post about mustard greens, looking for ideas that sounded like they might work for a wide spectrum of taste buds. When I woke up this morning, needed to try a recipe, I had no idea what I was going to do.

In typical procrastinator's style, I decided to clean my kitchen instead. And…there sat inspiration #1: a couple of inches of stale beer that I was not able to finish last night. It was tasty, a local brewery's White Chocolate Ale, and I didn't want to throw it away. I realized since it was sweet I could get away with less sugar, which I had been thinking of using.

On the way but not totally there, I decided to procrastinate even more by working on my pile of samples from Expo West. This is what my living room floor looks like for about 2 weeks after I get home!

Out from the pile popped my collection of samples from a great family-owned business over in Orange County, Matt's Munchies. They have created a fun variety of healthy fruit leathers. The ginger spice, which is really a ginger and cinnamon-laced mango leather, became ingredient #3.

I poured the beer in a skillet, heated it up to dissolve the mango leather, and then put my chopped mustard greens in to let them braise. I cooked them all the way down until the sugars started to caramelize.

OK, I lied, it did use recipes in this process…but not in the way you are thinking. Because I'd read literally hundreds of recipes in search of inspiration, I noticed that a lot of Indian recipes for greens incorporate just a touch of brown sugar. So I knew if my concoction had something sweet in it, it would caramelize and offset the bitterness that make mustard greens challenging for me.
I am not going to give you any more instructions than this, and you won't get a nutrition analysis. You all know the ingredients here are good ones, and to give you more of a script defeats the purpose of my nudging you to free yourselves of overly rigid behavior in the kitchen. I promise you, your very favorite foods will be the ones where you left the script and started having some fun!

Finally, I threw in just a touch of sweetened coconut flakes for color and texture.

I once had to use crutches for 2 months, with absolutely no weight bearing on the injured leg. All I could think of that whole time was walking again. The day I finally got the go-ahead, I threw down my crutches…and my leg wouldn't respond. Because I had not used all the body parts that are needed to coordinate the task, they had forgotten how to do something I took for granted. It was a great reminder to not take things for granted and to never lose respect for the many wonderful things I am designed to be able to do.

I love helping people pursue health. But one think I dislike about working in medicine is all the focus on what is wrong…at the expensive of remembering what is right.

So today, I wanted to take a post and challenge you to think about, and take a moment to be grateful for, the many things your body did for you today. It doesn't make the problems any less important, at all. It is just a way of putting those problems into proper perspective.

Did your body…

…smell a spring flower?
…hug a loved one?
…inhale lungful after lungful of oxygen to nourish your muscles and brain?
…laugh at a joke?
…read an e-mail?
…remember how to get you to work?
…carry a bag of groceries?
…caress a puppy?
…digest your lunch?
…hum a favorite song?
…support you as you stood up from your desk chair?
…let you know that you needed to scratch an itch?
…support your weight and balance you as you ran your errands?
…pump blood through your heart and blood vessels all day long, even when you were not consciously thinking about it?
…remember how to spell your name as you signed that credit card receipt?
…sort through all the vitamins and minerals and antioxidants in all the food you ate and send each one exactly to where was needed?
…maintain a constant temperature?
…remember the difference between a square and a circle?
…filter toxins from your blood using your kidneys?
…heal a wound?
…prompt you to instinctively use your brakes when the traffic light turned red?
…coordinate your fingers through all the typing tasks you asked it to do with your computer?

Then you are, indeed, quite amazing. Celebrate yourself. Use your talents, skills, and abilities to do good. Treat yourself with respect. As such a miraculous creation, you deserve nothing less.

For more inspiration, check out this interview by my friend Isabelle Tierney.