The Hemp Connection [Search results for LDL] 

Last week I had the opportunity to hear James May, the founder of Wisdom Natural Brands, based here in Phoenix, tell his story of how he became involved with developing the stevia industry. Below is a white paper he shared with us that is referenced and provides a lot of very interesting information. This is a business paper, not a scientific publication, but it does contain references that can get you started if you're looking for more information.

It's not just a sweetener, apparently it has some endocrine and appetite effects as well (may decrease your appetite for sugar), and a new study suggests it may help to improve memory.

Also, I'm providing a link to a brand new website, Stevia University, which is a resource for all things stevia. Be sure to bookmark it!

Stevia Rebaudiana Bertoni Prepared by James A. May and provided as an educational service by Wisdom Natural Brands
Stevia has been correctly framed as the promised sweetener that can help resolve many of the world's sweetener, obesity, and diabetes concerns. Stevia can also solve much of the poverty of the farmers in third world countries by giving them a cash crop to grow, even improving the productivity of their soil and the quality of their other crops.
Stevia can be the next generation of the world's most preferred steetener. Consumers are becoming even more excited as they learn that stevia extract was not originally a chemical invention targeted for a totally different purpose, such as a drug or insecticide, which, after it was tasted, became an artificial sweetener (1).
Stevia, in its various forms has always been a natural sweetener that also offers numerous health benefits. In its natural forms it has been in use in parts of South America for more than 1500 years and, as a high intensity sweetener, in Japan and Asia for over 35 years. (2) Millions of people have ingested stevia daily and there has never been a documented adverse reaction reported (3).
Modern consumers have joyful anticipation for increased use of this sweetener that does not cause fat storage, does not adversely affect blood sugar or blood pressure, reduces caries and gum disease, does no harm, is good for the human body and — can taste great — depending on the extraction methods utilized.
The Joint Expert Committee on Food Additives (JECFA) of the World Health Organization has studied and approved 9 of the numerous naturally occurring glycosides residing in stevia leaves to be safe for human consumption in high intensity sweeteners. They are: stevioside, rebaudioside A, rebaudioside B, rebaudioside C, rebaudioside D, rebaudioside F, dulcoside A, rubusoside, and steviolbioside. Any combination of these glycosides totaling a minimum of 95%, the balance being other components of the stevia leaf, meets the standard set.
HECFA refers to steviol glycosides rather than stevia glycosides in determining acceptable daily intake (ADI) amounts of 4 mg per kilogram of body weight. This provides a 100-fold safety factor, meaning the human body can handle 100 times this amount and still be within the safety limits. However, steviol is one of three metabolites (i.e. the breakdown aglycones being steviol, isosteviol, and a unit of glucose) of the stevia glycosides, therefore, this related to 12 mg of the naturally occurring stevia glycosides per kilogram of body weight. Stevia glycosides are broken down into the three metabolites by bacterial action in the intestinal tract. It is well documented that steviol and the other metabolites are entirely excreted from the body.
In a presentation of the recent science regarding stevia at the 2009 annual meeting of the Calorie Control Council, Claire C. Kruger, PhD, DABT, CEO of Spherix Incorporated, a biopharmaceutical company, reported that"Stevia glycosides have very low toxicity in animals and there is no evidence of risk in humans, including repeat dose systemic toxicity, carcinogenicity, developmental, or reproductive effects. The weight of evidence indicates that steviol glycosides are not genotoxic." She also reported that"Stevia extracts and steviol glycosides show no DNA damage in a broad array of in vitro and in vivo assay," and that the"safety of ingestion of steviol glycosides in hmans has been corroborated in clinical trials; measures of tolerance, body weight, clinical chemistry, hematology and urinalyis did not show any evidence of untoward effects." She reported that critical newly published studies (5) resolve questions about any untoward effects after long term repeated exposure to steviol glycosides.
The Proceedings of the 3rd Stevia Sumposium 2009, held in Belgium reported recent scientific studies that found that,"Stevioside (i.e. the combination of Stevia glyucosides- lowered glucose, insulin and cholesterol. It had no effect on triglycerides or glucose tolerance," and that it"inhibited atherosclerosis by reducing macrophage, oxidized LDL and lipids. Furthermore, stevioside treatment increased the smooth muscle area of the plaque. This increase, together with the reduction of macrophages resulted in an increase of the smooth muscle cell-to-macrophage ratio". The scientists concluded by stating that"this is the first report showing an association between stevioside treatment and increased adiponectin and insulin sensitivity, improved antioxidant defense and reduced atherosclerosis. The decrease of oxidized LDL by stevioside is particularly important in view of our recent observation that LDL is associated with metabolic syndrome components." (6) No allergic reactions to stevia have been reported (7).
A patent application submitted to the US Patent Office, dated February 17, 2011, makes several significant claims, as a result of their scientific research, pertaining to stevia and brain function."Thus to summarize, stevia extract enabled improved learning and memory performance, to a similar, or better, extent as a natural reference substance, ginkgo biloba, and a pharmaceutical positive control compound, rolipram. These data showed that stevia-treated mice not only learned better than other groups but also retained their memory for a longer time period." When the product was given to human subjects they reported that,"Cognitive function, alertness and the ability to focus on work are seen to improve." The product they used was make by cooking leaves in water and is basically the same product sold by SweetLeaf (R), as stevia concentrate, since 1982.
SweetLeaf Stevia Sweetener is the only commercially available stevia extract that is made with a revolutionary new technology that uses only cool purified water and a series of filters. All other brands, currently in the market, utilize old technology that incorporates various chemicals, solvents and alcohols, including ethanol and methanol. Because stevia extracts can be between 200 and 300 times sweeter than sugar, they must be blended with other ingredients utilized as a carrier to make them palatable as a table-top sweetener. While all other brands use a sugar product, SweetLeaf(R) uses inulin, extracted from chicory root, which is a natural soluble fiber and prebiotic, thus creating a sweetener that improve health and vitality. SweetLeaf (R) wass the first stevia brand in the United States to acienve the FDA GRAS (Generally Recognied As Safe) designation.
REFERENCES
1. Aspartame was developed in 1965 by GD Searle, a pharmaceutical company, to be a prescription only drug for peptic ulcers. After it was tasted the company began the process to obtain FDA acceptance as a sweetener,which was achieved in 1981. According to Discover Magazine, 20 Things You Don't Know About Sugar, Sucralose (Splenda) was originally developed to be an insecticide (Oct. 2009, 121).
2. May, James A, The Miracle of Stevia, Kensington Publishing Corp. New York City, NY, 2003, 7, 32-42.
3. Geuns, Jan MC. Review: The Safety of Stevioside Used as a Sweetener, Proceeding of the first symposium: The Safety of Steviiside, KULeuven, 2004, 112.
4. http://www.steviauniversity.com/. Health and Healing Benefits of Stevia.
5. Ferri et all 2006; Jeppesen et al 2006; Barriocanal et al 2008; Maki et al 2008.
6. Gerraert, Benjamine et a, Natural Sweetener Stevioside Inhibits Atherosclerosis by Increasing the Antioxidant Defense in Obese, Insulin Resistant Mice, Atherosclerosis and Metabolism Unit, Deptarmtne of Cardiovascular diseases and Leuven Food Science and Nutrition Research Center Laboratory of Functional Biology, Katholieke University, Leuven, Belgium.
7. Geuns, op cit p. 85.

My parents have a time share on the island of Kauai. In a recent conversation they mentioned that they are gearing up for their every-other-year trip, and what came to mind? Not the beaches, not the snorkeling, not the sunsets…but the coffee-crusted macadamia nuts they always bring back.

When I started in this profession waaaay back when, I was taught to teach that nuts were to be avoided. And that macadamia nuts were the worst of the worst.

Recently, a colleague and I did an analysis of all nuts. Using a nutrient database, we developed a ratio: pro-inflammatory fats (saturated and omega-6) to anti-inflammatory fats (monounsaturated and omega-3). What we discovered when we did this was that the highest anti-inflammatory rating belonged to macadamia nuts. The reason is that macadamias proportionately have a very high monounsaturated fat content. Monounsaturated fats are the healthy fats often associated with olive oil and avocados.

Was I ever stoked!

Sometimes I feel like I'm in a"Where's Waldo?" drawing…and consumers have to find me in the middle of the crowd, the lone nutritionist who's encouraging them to eat all nuts, not just walnuts. It's not that I don't like walnuts, I just think they get way too much attention considering the health values of other nuts.

Looks like other researchers are making the same discovery. Recently a laboratory at Pennsylvania State University reported that an ounce and a half of macadamia nuts daily helped to reduce total cholesterol, low density lipoprotein (LDL), and triglycerides.

Macadamia oil is also a popular ingredient in acne lotions. And it is being researched as a potential anti-aging agent for skin preparations.

Of course, eating any nut in excess is as potentially detrimental as eating any food in excess. But I know in my counseling that clients are always looking for good snack ideas. It's so fun to help them learn how that ounce of nuts, in the middle of the afternoon, can help stave off hunger until dinnertime.

Nuts are not to be feared…anymore.

Griel AE, Cao Y, Bagshaw DD, Cifelli AM, Holub B, Kris-Etherton PM. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. J Nutr. 2008 Apr;138(4):761-7.

Akhtar N, Yazan Y. Formulation and in-vivo evaluation of a cosmetic multiple emulsion containing vitamin C and wheat protein. Pak J Pharm Sci. 2008 Jan;21(1):45-50.

Since vitamin D deficiency has been identified with a long list of health issues, including PCOS, I've been hearing readers, clients, colleagues, and friends talk about loading up on this nutrient with supplements. They're going about it in a not-so-scientific fashion, and I've wondered if that wasn't going to introduce a whole new spectrum of health issues.

A friend and colleague recently mentioned that she had just had a cholesterol test taken, and the LDL (bad cholesterol) reading had increased since her previous test. One of the changes she could identify was between the two tests, she had started to supplement with vitamin D.

I did a pretty thorough search both on the Internet and Pub Med to see if this was a common problem and didn't find anything. I then went to a listserve of about 1,000 nutrition colleagues to see if they'd seen it. Turns out, a few of them had also seen their cholesterols increase with vitamin D supplementation.

There is a tendency with nutrition, to adopt an"if a little is good, a whole lot is better" attitude. Unfortunately, imbalance in either direction, be it deficiency or excess, can be problematic.

The old recommendations for vitamin D were 200 IU per day. All of a sudden, a website popped up recommending 5000 IU per day. I couldn't find any research to support this magnificent dosage leap. I would have thought, given that magnitude, that some kind of dosing study that had ruled out that 500, 1500, 2000 IU were not sufficient. But no, the recommendations simply jumped without explanation.

And every time I tried to find out what the basis for this jump was, I kept being referred back to the website making the recommendation.

My points are:

1. Know your vitamin D and your cholesterol levels.
2. Start out with 200 IU or even 400 IU per day and see how that affects both your vitamin D levels and your cholesterol levels.
3. Consider that the reason vitamin D levels may be deficient is more complex than the simple fact that dietary vitamin D is low…did you know that many of the same health issues associated with vitamin D deficiency are also related to omega 3 fatty deficiency as well as omega 6 fatty acid excess? Most nutritional problems, if they are related to imbalance, cannot be corrected with a supplement. The overall balance of the diet needs to be considered in the plan of correction.

I was recently graciously shipped a jar of Tropical Traditions Gold Label Standard Virgin coconut oil for review. First of all, thank you to Tropical Traditions for their generosity! I use coconut oil twice a day on my skin and I love the noticeable difference it makes. I'm also learning to cook with it, and am happy to have this to work with.

This is a long, drawn out post. I'm putting my conclusion at the very beginning so you can decide if you want to sit through the rest:

I love coconut oil, I use it myself, both in cooking and on my skin. I love this particular brand and product, and it's clear that the company is very proud of the attention they devote to quality and sustainable practices. If you choose to incorporate coconut oil into your cooking, and I hope that you do, please consider supporting a company that works so hard on behalf of integrity.

My intention is to encourage more people to use coconut oil than currently do. It wasn't long ago that we discouraged coconut oil consumption and I still encounter people who think it's unhealthy. I'd also like to encourage those who may be creating problems with excessive use, to understand why that may not be a good choice.

My only reservation is that there is somewhat of a health halo hanging over coconut oil that encourages its use in quantities that potentially do not support improved health.

I'll be addressing those issues in this post.
A little bit of feedback on the coconut oil information I found on the website.

In the FAQ section, there is no peer-reviewed reference provided to support the following statement:

The benefits of coconut oil are mainly from the nutrient value of medium chain fatty acids (MCFAs). The best comparison in nature as to the percentage of MCFAs being consumed in a diet is human breast milk. To equal the amount of MCFAs a nursing infant would receive in one day, an adult would need to consume about 3.5 tablespoons of coconut oil a day according to researchers.

1. With regards to fat, what an infant needs, nutritionally, is far different from what an adult needs.

For example, nutrition experts recommend 2% milk for children up to to years of age, then a drop to 1% or skim. The reason for this recommendation is that the extra fat is needed during the first 2 years of life to help fuel the rapid growth occurring during that time. As growth and development slow, so do needs for dietary fat.

Arachidonic acid (ARA) is an essential fatty acid for infants. The only place they can get it is milk, so if an infant is formula fed, ARA needs to be added to that formula. When that infant is weaned, however, and can get this fatty acid elsewhere, it no longer needs to be added to the diet.

It simply has not been proven that nutritional needs for infants are the same as nutritional needs for adults. Or that what you would feed an infant is even healthy for an adult. So I'm not entirely convinced that the extrapolation from an infant's saturated fat intake in breast milk, to a recommendation for adults of 3.5 tablespoons per day is a logical or healthy leap. (I am happy to adjust my stance if peer-reviewed research supporting the higher level becomes available. Our readers are in large part pursuing fertility and possibly in the midst of infertility treatment. I owe it to these high-risk situations to lean toward the skeptical and conservative. I don't want to heap more expense, stress, and/or disappointment on women who take our advice so seriously.)

Fat is fat, no matter where it comes from, it still contains calories, and the recommendations are still to keep saturated fat intake to about 10% of total calories. Regardless of the source of the saturated fat.

I did a long blog post calculating dietary amounts for different calorie levels that this translates to not too long ago if you want more specifics. I do think that when possible, saturated fat from coconut oil is better than saturated fat from meat, so the focus needs to be learning how to make that switch. (See the recipes I posted below.)

2. In moderate quantities, coconut oil can definitely be beneficial. A 2009 Brazilian study providing 1 tbsp per day of coconut oil to a group of women with abdominal obesity found that compared to 1 tbsp of soybean oil, the coconut oil group had higher HDL, a lower LDL/HDL ratio, and a reduced waist circumference. It cannot be determined from this study design if the change was due to the absence of soybean oil, the presence of coconut oil, or a little of both, but it does illustrate that when used in moderation, coconut oil can be part of a hormone-friendly eating program.

3. What IS showing up in the literature is that too much coconut oil can be metabolically deleterious. Individuals at risk for diabetes (and if you have PCOS that means you) need to use coconut oil with care. One recent study in particular (done with calves) compared coconut oil to a non-medium-chain triglyceride (MCT) diet as well as to another MCT, caprylate oil. The coconut oil-fed calves weighed pretty much the same at the end of the study, contradicting claims that coconut oil promotes weight loss. In addition, the coconut oil calves had heavier, fattier livers and contained 15% more fat than the livers of the other calves.

Bottom line, used respectfully, coconut oil has many health benefits and I do encourage its use. What I DO discourage, is using this product indiscriminately with the belief that it has any kind of magical quality that counteracts dietary indiscretions or which somehow allows you to ignore other important rules of nutritional balance.

4. I spent a long time on the company's companion website, http://www.freecoconutrecipes.com/ to see how others were using coconut oil in cooking. Most of the recipes were for baked goods and sweets, the use of which, due to the insulin resistance issue the readers of this blog deal with, should be limited. Cakes, cookies, etc., are not nutritionally dense and cannot be eaten in large quantities just because of the oil they were made with.

I did find a great recipe for coconut oil vinaigrette coleslaw, which nicely combines the concept I've been writing about recently, consuming a bit of vinegar before meals, with a nice, moderate use of coconut oil. I would so love to see more savory recipes like this, as it would help the readers inCYST most often works with, to use this oil to their benefit.

I did my best to walk the walk, as well, and asked the members of our Facebook fan page to share any savory recipes they might have using coconut oil. Here are a few provided by culinary school graduate Alyssa Fritts.

Coconut Green Beans
Blanch fresh green beans by dumping them in boiling water for about 20-30 seconds. Strain them out and put them in ice water to s top the cooking. Melt a tsp or less of coconut oil in a pan. Add 1/2 clove of garlic and the strained green beans, toss around a few times. Add chopped almonds and salt and pepper to taste.

Coconut Pork Chops
Put a little bit of coconut oil in a pan, salt and pepper pork chop with all fat trimmed Brown on both sides. Remove chop, add garlic, and chopped onion. Saute until garlic is fragrant. Add veggie or chicken stock and a LITTLE bit of apple jui ce. Put chop back in and let it reduce down by about half. Remove chop and place on plate. Add a scoop of stone ground mustard, and a sprig of fresh rosemary. Let it thicken. Finish with a swirl of coconut oil to give it the smooth fullness butter would. Pour over your chop.

Miso-Ginger Salmon
1/2 tsp coconut oil
1 clove minced garlic
1/8 in piece peeled ginger in matchsticks
1 tbs chopped onion
1 tsp miso paste
1/4 cup white wine
1/4 cup veggie stock or water
1/4 tsp coconut oil

Melt 1/2 tsp coconut oil in pan. Salt and pepper salmon. Place in pan skin side up. Brown on both sides. Set aside on a plate. If needed as a tiny bit more coconut oil. Add ginger and garlic. Add onion and sautee for a few seconds. Add wine and stock. Add salmon back to pan and cook for about 5 min. Remove salmon and turn heat up to high. Add miso and reduce down until thick. Swirl in a tiny bit (up to 1/4 tsp) of coconut oil and pour over salmon.

What Alyssa is illustrating, beautifully, is that one of the best ways to use coconut oil is to switch out other oils for coconut oil in your regular cooking, being careful with quantities just as you would any other fat. It adds a nice flavor while it helps your metabolism.

If any of you use Tropical Traditions Coconut Oil, and you've developed some savory, hormone-friendly recipes you'd like to share with our friends at Tropical Traditions, I would love if you would do that. I'd like their customers to see just how much potential this oil can have in the kitchen. I'd really love to see this company, which clearly has a heart for wanting to do something good, succeed at that goal. I'm in love with the creativity of inCYST fans, and encourage you all to step up and share it in a way that can have benefit far outside of this blog post.

Bottom line: Used intelligently and respectfully, Tropical Traditions gets a thumbs up. Stay tuned, as tomorrow we're going to announce a giveaway encouraging you to think about and incorporate the concepts presented in this blog post!

Assunção ML, Ferreira HS, dos Santos AF, Cabral CR Jr, Florêncio TM. Effects of dietary coconut oil on the biochemical and anthropometric profiles of women presenting abdominal obesity. Lipids. 2009 Jul;44(7):593-601. Epub 2009 May 13.
Talbott, Shawn M. and Kerry Hughes. (2006). The Health Professional's Guide to Dietary Supplements. Lippincott Williams & Wilkins. pp. 60–63. ISBN 9780781746724.

Mills JK, Ross DA, Van Amburgh ME. The effects of feeding medium-chain triglycerides on the growth, insulin responsiveness, and body composition of Holstein calves from birth to 85 kg of body weight. J Dairy Sci. 2010 Sep;93(9):4262-73.

Something it is important to remember about PCOS is that infertility is a symptom of a much larger problem. In addressing infertility, if you tackle the core imbalance, you will likely increase your chances of conceiving. If you only address the infertility, without tackling the core imbalance, it will be much harder to conceive. The problems cannot be parsed out and treated as if they are individual. For that reason, if you have PCOS, and you're not trying to conceive, myoinositol may still benefit you. Here is a brand new study out of Italy supporting that. A myoinositol/folic acid supplement was given to 35 women with PCOS for a period of 24 weeks. A second group of women who also had PCOS were also studied, but not given the supplement. Only five of the 35 women receiving the supplement at the end of the supplement were not ovulating. This group as a whole also lost weight, while the women not receiving the supplement trended on the side of weight gain. Cardiac risk factors also improved with the supplement; LDL lowered slightly while HDL increased. It appears as though this supplement has strong relevance for many of the problems related to PCOS that often elude resolution. I'm providing the reference for this study should you wish to show it to your physician and discuss whether this may be a treatment option for you. Venturella R, Mocciaro R, De Trana E, D'Alessandro P, Morelli M, Zullo F. [Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol.] Minerva Ginecol. 2012 Jun;64(3):239-243.

Important Lab Tests for PCOS
Many women who have PCOS have not had the correct blood work done or don't know what blood tests to ask to have done.I would like to post some important labs used to diagnose and monitor PCOS
1. Total testosterone (elevated levels are > 50ng/dl
2. Free testosterone
3. Luteinizing Hormone (LH) (plays a role in ovulation and egg development)
4. Follicle Stimulating Hormone (FSH) (responsible for egg release from the ovaries)
5. LH/FSH ratio (results should be under 2)
6. DHEA-sulfate (this test tells how much androgens or"male hormones" your body is producing) DHEA sulfate converts into testosterone.
7. Prolactin
8. Thyroid Stimulating Hormone (TSH) this test will help to rule out hypo or hyperthyroidism (slow vs fast metabolism issues)
9. Liver Function tests (LFT's). Important since medications pass through the liver, to check for possible damages. Checking every 3-6 months is recommended.
10. Fasting Lipid Profile: Total Cholesterol (<>45 mg/dl is ideal)Low Density Lipoproteins (LDL) (<130 mg/dl is ideal)Triglycerides (fat in blood) (<150 mg/dl is ideal)
11. Fasting Insulin (results should be <10) difficult to do, it needs to be frozen when brought to the lab and tested before it reaches a certain temperature, expensive but would be very beneficial in determining and monitoring insulin resistance.
12. Fasting blood chemistry panel (includes glucose, electolytes and sometimes renal labs)
13. Fasting glucose to insulin ratio (used to diagnose and monitor insulin resistance, ratio under 4.5 usually indicated insulin resistance)

Ellen Reiss Goldfarb, RD
11500 W. Olympic Blvd, Suite 400
Los Angeles, CA
310-408-1770
info@ellenreissgoldfarb.com

If you're looking for pasta alternatives, consider soba noodles. This gluten-free Japanese creation is made with buckwheat, a food with potential multiple health benefits. Buckwheat has repeatedly been shown to improve blood lipids, by lowering blood pressure, total cholesterol, bad cholesterol (LDL), and triglycerides, and raising good cholesterol (HDL). It has also been reported to prevent the development of gallstones

Buckwheat is also a potent cancer fighter. It contains anthocyanin compounds (yes, that stuff that makes blueberries so healthy!), and it has been shown to fight tumor growth in a respectable list of body parts.

Photo credit: http://www.thekitchn.com/

Buckwheat is also good for people with insulin resistance. In one study, people who did not regularly consume buckwheat were five times more likely to have hyperglycemia (high blood glucose) than those who did. When it comes to our recent theme of increasing protein and maximizing muscle mass, buckwheat has been found to be a good vegan protein source for accomplishing this goal.

If you have been following my interest in bees and colony collapse disorder (important to PCOS because many hormone-friendly foods are dependent on bees for pollination), eating soba noodles is good for bee health as well. Provided the buckwheat is organic and not laced with pesticide, one acre of the crop supports an entire hive of bees, important in US locations where bees have been found to be declining because of exposure to neonicotinides used on corn. And buckwheat honey is good for you as well; it has a reputation for its antioxidant and antifungal content. You can make a difference! Increasing demand for crops that are healthy for everyone in the ecocycle is a win-win situation.

One note for celiacs: soba is only partially buckwheat. Be sure you read the labels and use a brand like Eden 100% Whole Buckwheat Soba.

The photo above is from a blog post I found on Pinterest. The recipe looked easy and like it was a great noncommittal Americanized way to put a little soba on your plate.

Kayashita J, Shimaoka I, Nakajoh M, Yamazaki M, Kato N. Consumption of buckwheat protein lowers plasma cholesterol and raises fecal neutral sterols in cholesterol-Fed rats because of its low digestibility. J Nutr. 1997 Jul;127(7):1395-400.

Metzger BT, Barnes DM, Reed JD. Insoluble fraction of buckwheat (Fagopyrum esculentum Moench) protein possessing cholesterol-binding properties that reduce micelle cholesterol solubility and uptake by Caco-2 cells. J Agric Food Chem. 2007 Jul 25;55(15):6032-8. Epub 2007 Jul 4.

Tomotake H, Yamamoto N, Kitabayashi H, Kawakami A, Kayashita J, Ohinata H, Karasawa H, Kato N. Preparation of tartary buckwheat protein product and its improving effect on cholesterol metabolism in rats and mice fed cholesterol-enriched diet. J Food Sci. 2007 Sep;72(7):S528-33.

Kuwabara T, Han KH, Hashimoto N, Yamauchi H, Shimada K, Sekikawa M, Fukushima M. Tartary buckwheat sprout powder lowers plasma cholesterol level in rats. J Nutr Sci Vitaminol (Tokyo). 2007 Dec;53(6):501-7.

Bijlani RL, Sud S, Sahi A, Gandhi BM, Tandon BN. Effect of sieved buckwheat (Fagopyrum esculentum) flour supplementation on lipid profile and glucose tolerance. Indian J Physiol Pharmacol. 1985 Apr-Jun;29(2):69-74.

Lin LY, Peng CC, Yang YL, Peng RY. Optimization of bioactive compounds in buckwheat sprouts and their effect on blood cholesterol in hamsters. J Agric Food Chem. 2008 Feb 27;56(4):1216-23. Epub 2008 Jan 24.
Zhang HW, Zhang YH, Lu MJ, Tong WJ, Cao GW. Comparison of hypertension, dyslipidaemia and hyperglycaemia between buckwheat seed-consuming and non-consuming Mongolian-Chinese populations in Inner Mongolia, China. Clin Exp Pharmacol Physiol. 2007 Sep;34(9):838-44.

Pui KC. [Inhibition of tumor growth in vitro by the extract of Fagopyrum cymosum]. Zhong Xi Yi Jie He Xue Bao. 2003 Jul;1(2):128-31.

Alvarez P, Alvarado C, Mathieu F, Jiménez L, De la Fuente M. Diet supplementation for 5 weeks with polyphenol-rich cereals improves several functions and the redox state of mouse leucocytes. Eur J Nutr. 2006 Dec;45(8):428-38. Epub 2006 Oct 11.

Zduńczyk Z, Flis M, Zieliński H, Wróblewska M, Antoszkiewicz Z, Juśkiewicz J. In vitro antioxidant activities of barley, husked oat, naked oat, triticale, and buckwheat wastes and their influence on the growth and biomarkers of antioxidant status in rats. J Agric Food Chem. 2006 Jun 14;54(12):4168-75.

Watanabe M. An anthocyanin compound in buckwheat sprouts and its contribution to antioxidant capacity. Biosci Biotechnol Biochem. 2007 Feb;71(2):579-82. Epub 2007 Feb 7.

Wang ZH, Gao L, Li YY, Zhang Z, Yuan JM, Wang HW, Zhang L, Zhu L. Induction of apoptosis by buckwheat trypsin inhibitor in chronic myeloid leukemia K562 cells. Biol Pharm Bull. 2007 Apr;30(4):783-6.

Wang KJ, Zhang YJ, Yang CR. Antioxidant phenolic constituents from Fagopyrum dibotrys. J Ethnopharmacol. 2005 Jun 3;99(2):259-64. Epub 2005 Apr 7.

Leung EH, Ng TB. A relatively stable antifungal peptide from buckwheat seeds with antiproliferative activity toward cancer cells. J Nutr Biochem. 2008 Oct;19(10):700-7. Epub 2008 Mar 6.
Kim SJ, Maeda T, Sarker MZ, Takigawa S, Matsuura-Endo C, Yamauchi H, Mukasa Y, Saito K, Hashimoto N, Noda T, Saito T, Suzuki T. Identification of anthocyanins in the sprouts of buckwheat. J Agric Food Chem. 2007 Jul 25;55(15):6314-8. Epub 2007 Jun 20.

de Francischi ML, Salgado JM, da Costa CP. Immunological analysis of serum for buckwheat fed celiac patients. Plant Foods Hum Nutr. 1994 Oct;46(3):207-11.

He J, Klag MJ, Whelton PK, Mo JP, Chen JY, Qian MC, Mo PS, He GQ. Oats and buckwheat intakes and cardiovascular disease risk factors in an ethnic minority of China. Am J Clin Nutr. 1995 Feb;61(2):366-72.

Anyone living out West has had a week of comfort food weather! Here in Phoenix we had as much rain in a week as we normally get in a year. I haven't felt like venturing out, and I want foods that warm me from the inside out.

And that has had me thinking about leeks.

Leeks are the onion's, unfortunately less popular and often forgotten, cousin. I say that because leeks are milder than onions, with a lot of the same health benefits. Many of those benefits are related to PCOS health risks.

Vegetables in the onion/leek/garlic family help to:
--reduce LDL cholesterol and raise HDL cholesterol
--lower blood pressure
--reduce risk of ovarian cancer
--stabilize blood glucose

Most of you probably think of leeks in leek potato soup…but there are so many more ways to cook them! Here's a great feature from Cooking Light to get you started.

So comfort food and PCOS help, unite!

Not long ago, I stopped into Planet Raw, in Santa Monica. It's a very popular hangout for raw foodists, so I wanted to see what the buzz was about. I actually enjoyed perusing the shelves, and they did have some fun things to buy for the more adventurous cook. I'll probably eat there from time to time, as it's a stone's throw away from my office.

However…I had a most disturbing conversation with one of the employees. When she learned that I was a dietitian, she commented,"Cool, maybe you can help then. We're having trouble finding protein sources. Do you have any ideas?"

So I mentioned Growing Naturals, the rice protein powder that I wrote up last week.

"Oh, we don't do rice."

When I asked why, she responded by explaining that Planet Raw's owner"doesn't do rice".

So I suggested pea protein.

"Oh, we don't do peas, either."

When I asked why, she responded by explaining that Planet Raw's owner"doesn't do peas".

I could see I wasn't going to get anywhere because I was in a food religion debate, not an evidence-based scientific discussion, so I politely guided the conversation to its end.

I later went to the website (which you can Google for yourself, I won't provide free advertising for this place through linking), and could find absolutely nothing explaining this philosophy. I saw plenty of advertising for expensive certifications as raw chefs, and courses for raw foodists…which, in essence, kind of seemed like me to be expensive courses on how to promote malnutrition.

I do my best to be positive and inspiring rather than confrontational on this blog, but sometimes I get pushed past my limit of tolerance. This philosophy, especially for women with PCOS who need a decent amount of protein in their diet to reduce the influence of insulin resistance, is simply dangerous.

Of course, a diet that is heavy on the raw, is perfectly fine. It means you're eating plenty of fruits, vegetables, nuts…all great sources of vitamins, minerals, antioxidants, and fiber. But a completely raw diet needs to be taken on with a lot of thought, not be a source of pride with regard to how many foods you can find an excuse not to eat. Here is why.

At the same time raw food diets have been studied and found to have benefit, they have also been associated with many problems women with PCOS already have.

lower bone density,
amenorrhea and underweightness in women,
dental erosion with a raw vegan diet,

elevated plasma homocysteine and low serum HDL cholesterol" and vitamin B12 deficiency.

Bottom line? Enjoy your occasional lunch at Planet Raw, and buy their coconut flour. But don't depend on them for advice when it comes to how to eat this diet in a way that allows you to reduce the influence PCOS has on your life.

For the record, I am NOT anti-raw. I am anti-malnutrition, and anti-inflammation. Be sure you know the difference if you choose to pursue a raw foodist lifestyle/food religion.

Fontana, L; Shew, JL; Holloszy, JO; Villareal, DT. Low bone mass in subjects on a long-term raw vegan diet." Archives of Internal Medicine 165 (6): 684–9, 2005.

Koebnick, C; Strassner, C; Hoffmann, I; Leitzmann, C. Consequences of a long-term raw vegan diet on body weight and menstruation: results of a questionnaire survey. Annals of Nutrition & Metabolism 43 (2): 69–79, 1999.

Ganss, C; Schlechtriemen, M; Klimek, J. Dental erosions in subjects living on a raw food diet. Caries Research 33 (1): 74–80, 1999.

Koebnick, Corinna; Garcia, Ada L; Dagnelie, Pieter C; Strassner, Carola; Lindemans, Jan; Katz, Norbert; Leitzmann, Claus; Hoffmann, Ingrid. Long-Term Consumption of a Raw Food Diet Is Associated with Favorable Serum LDL Cholesterol and Triglycerides but Also with Elevated Plasma Homocysteine and Low Serum HDL Cholesterol in Humans. Journal of Nutrition 135 (10): 2372, 2005.

I'm hearing more and more that many of you are switching to raw eating, and you're asking me if it's good for PCOS. It's not something that has been formally researched, so my answer is pulled together using what I do know about nutrition.

"Raw" refers to whether or not a food's temperature has exceeded a certain temperature during preparation. I actually tried to write a blog post about this several years ago and at the time could not find a specified temperature defining"raw" for a long time. I finally found something that suggested if it stayed below 124 degrees it would be considered raw. Then, last year, I ate lunch at the Whole Foods Venice, and decided to try a raw lunch for myself. The name of the restaurant that prepared my food was"118 Degrees," referring to the threshold raw temperature. This week, when researching it again, found everything from 104 to 118 degrees listed, without any scientific references for any of those values. It's one reason the diet can't be studied easily — those who follow it have yet to consistently define it.

One of the issues I have with any of those temperatures is that some of the foods popular in the raw community, by virtue of the fact that they grow in tropical climates, are regularly exposed to temperatures exceeding even the highest threshold. The mesquite trees growing in my backyard, yesterday alone, were exposed to an ambient temperature of 118 degrees the entire afternoon. The mesquite beans are dark, meaning they absorb heat and get even hotter. The flour made from them would not technically be raw, though mesquite flour is valued by the raw community. Coconuts, rice…both grow in tropical climates and therefore cannot be guaranteed to be"raw" if the benchmark is the definition above.

I'm assuming for the average person, for whom food is sustenance and not a religion,"raw" more likely means food that was not formally heated during preparation, and for the rest of this article that is the definition I will use.

Though raw eating has not been studied with regards to PCOS, it has been studied. It has been found to have both risks and benefits. The very first study of a raw food diet, published in 1985, found that after 7 months, subjects following this diet dropped their blood pressure, lost weight, and tended to spontaneously give up smoking and drinking.

One study found that raw foodists have lower cholesterol and triglyceride concentrations. However, a couple of other cardiovascular risk factors, serum homocysteine and HDL, were elevated, likely because a raw diet tends to be low in vitamin B12. It would be wise to take a multi-vitamin just to be safe.

Another study reported more dental caries in raw foodists. I'm assuming this is related to the increased carbohydrate and simple sugar content of the diet. So don't forget to brush and floss!

Here's what all you readers really need to pay attention to. One study specifically looked at menstrual function and raw food. It found that about 30% of women studied who were under 45 years of age had partial to complete amenorrhea, with subjects eating high amounts of raw food (>90%) being more affected than moderate raw food dieters. Ouch, ouch, OUCH.

A raw diet is also low in DHA and EPA, the omega-3 fatty acids primarily found in fish. If you're a raw foodist and also vegan, consider taking an omega-3 supplement derived from marine algae.

One benefit to a raw diet is that most people who consume it eat far more fruits and dark green leafy vegetables than they used to. Yay for antioxidants! Interestingly, however, one study found that though raw foodists had higher beta-carotene levels than average, their serum lycopene levels were low. Since lycopene is found in easily found fresh fruits and vegetables like tomatoes and watermelon, this suggests that even when eating raw, it's important to make conscious choices and not limit yourself to a few favorites. It can't just be about carrot juice!

The flip side of all those fruits and vegetables, however, is that protein is a difficult nutrient to get with this diet without soaking and sprouting legumes, in adequate quantities to balance out all of that carbohydrate. It may aggravate your insulin resistance. Be sure to add some protein powder to your cooking to prevent that from happening. Growing Naturals organic brown rice protein isolate powder has designed its product to be raw-compatible; be sure to check them out!

Another natural consequence of cutting out so much protein is that the fat content of the diet naturally increases. And even if it's raw fat, and good fat, it still has calories. I would recommend working out some menus on paper or running them through http://www.fitday.com/ just to be sure the diet doesn't push you in the wrong direction.

How your diet affects your health appears to be more determined by the proportions of carbohydrate, protein, fat, vitamins, minerals, and antioxidants that your diet contains. If you want to do that with raw foods, just be sure you do it right.

Douglass JM, Rasgon IM, Fleiss PM, Schmidt RD, Peters SN, Abelmann EA. Effects of a raw food diet on hypertension and obesity. South Med J. 1985 Jul;78(7):841-4.

Koebnick C, Garcia AL, Dagnelie PC, Strassner C, Lindemans J, Katz N, Leitzmann C, Hoffmann I. Long-term consumption of a raw food diet is associated with favorable serum LDL cholesterol and triglycerides but also with elevated plasma homocysteine and low serum HDL cholesterol in humans. J Nutr. 2005 Oct;135(10):2372-8.

Ganss C, Schlechtriemen M, Klimek J. Dental erosions in subjects living on a raw food diet. Caries Res. 1999;33(1):74-80.

Koebnick C, Strassner C, Hoffmann I, Leitzmann C. Consequences of a long-term raw food diet on body weight and menstruation: results of a questionnaire survey. Ann Nutr Metab. 1999;43(2):69-79.

Garcia AL, Koebnick C, Dagnelie PC, Strassner C, Elmadfa I, Katz N, Leitzmann C, Hoffmann I. Long-term strict raw food diet is associated with favourable plasma beta-carotene and low plasma lycopene concentrations in Germans. Br J Nutr. 2008 Jun;99(6):1293-300. Epub 2007 Nov 21.

When you're dealing with something as chronic and serious as PCOS, you can get focused on what is the perfect food, the perfect meal, the perfect diet…and if it's not perfect…don't bother.

That, in the end, may be your perfect downfall.

Consider two studies, both done with nuts.

In the first one, subjects were divided into two groups. One was, in addition to their regular diet, given only 31 grams' fat worth of walnuts, the other, a similar volume of almonds.

Walnuts decreased low-density lipoprotein-cholesterol, almonds did, but not to the same degree.
Walnuts increased insulin response during OGTT by 26% (P < 0.02).

Walnuts decreased hemoglobin A1c, almonds did not.

Walnuts increased sex hormone-binding globulin
Almonds reduced free androgen index

Betcha thought till I got to that last part that I was going to nix almonds, didntcha? Nope.

The message here is not that almonds are bad and walnuts are good, but rather that walnuts and almonds both have benefit to your health, but in different ways. In fact, the name of this study is Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS, NOT Exclusively superior effect of walnuts compared to almonds on metabolic parameters in PCOS.

Let's look at a second study, using people with metabolic syndrome.

Fifty subjects were given 30 g/day of raw nuts (15 g walnuts, 7.5 g almonds and 7.5 g hazelnuts), or no nuts. Compared to the first study, I profiled, where no weight change occurred, in this study, there was a moderate weight loss experienced in the half of the group eating mixed nuts. LDL cholesterol decreased, as did fasting insulin and insulin resistance.

So just because when all you're eating is almonds and almonds don't improve insulin function the way walnuts do, it doesn't mean that you can't eat almonds. If you eat the two together, you can get the benefit of both. No single nut will give you a perfect hormone profile, but every single nut on the tree stands to benefit you in one way or another.

So stop paralyzing yourself out of eating foods you enjoy because they're not absolutely stand alone perfect…and mix it up a bit…literally!

Kalgaonkar S, Almario RU, Gurusinghe D, Garamendi EM, Buchan W, Kim K, Karakas SE. Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. Eur J Clin Nutr. 2011 Mar;65(3):386-93. Epub 2010 Dec 15

Casas-Agustench P, López-Uriarte P, Bulló M, Ros E, Cabré-Vila JJ, Salas-Salvadó J. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome. Nutr Metab Cardiovasc Dis. 2011 Feb;21(2):126-35. Epub 2009 Dec 22.

We just received another success story. I believe that cyster-to-cyster encouragement goes a whole lot farther than anything we professionals could ever say to motivate, so here is a note from one of our fans.

I know how much you love success stories, so I'm happy to let you know of some progress that I've made in my health. Much of this is a result of implementing ideas from your blog and radio show, so I owe you a debt of gratitude:
- I just received some blood test results. My HDL is 69, my LDL is 67 (!), and my triglycerides are 44 (!!). (Thank you, fish oil!) Also, my glucose is 88, and my HbA1C is 5.2. (Thank you, metformin — hopefully someday I won't need you!)

- Since July 1, 2010, I have lost almost thirty pounds, with very few episodes of binge eating.

- I'm faithfully going to yoga every week, and I'm going to run a 5K series this spring — seven races!

- I started sleeping with a sleep mask, as unfortunately it's not feasible for me to sleep in complete darkness.

- I'm still trying to conceive, but am not without hope. My GYN is pushing me to use injectable gonadotropins, but deep down I strongly feel it's not the right path. Even if it means delaying having a baby at my advanced age (38), I'd rather continue to use natural means to try to improve my health first rather than resort to the extreme quick fix.

Each and every one of these letters is like a shot of adrenaline. Because it's not really how much information we put up here that matters, it's knowing it's being incorporated into lives and making a difference.

Thanks for keeping in touch!

(Hee hee, even though you've reinforced my reputation as the person who thinks fish oil is good for everything, it sounds like in this case it really was good for something!)

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

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

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

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

Agua de Jamaica

3 quarts (12 cups) water

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

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

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

Strain through a chinois or fine mesh sieve into a large, heat-resistant bowl or pot. Stir in lime juice and set aside to cool. Refrigerate until ready to use. Serve over ice.

Gosain S, Ircchiaya R, Sharma PC, Thareja S, Kalra A, Deep A, Bhardwaj TR. Hypolipidemic effect of ethanolic extract from the leaves of Hibiscus sabdariffa L. in hyperlipidemic rats. Acta Pol Pharm. 2010 Mar-Apr;67(2):179-84.

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

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

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

I've gotten a handful of questions about almonds recently so it seemed like it was time to give them their own personal blog post. It's a good day to talk about the benefits of a handful of almonds, since it's also National Wear Red Day and heart disease is an important risk factor for women with PCOS. They're repeatedly shown to have heart healthy benefits. Eight peer-reviewed studies reported at www.almondsarein.com consistently produced the same results: lower LDL and lower total cholesterol. Other findings included increased HDL, and lower triglycerides.

The disclaimer is that the almonds were used to replace other foods in the diet. In other words, if you know your diet needs some"cleaning up", it won't help to keep eating the problem foods and add the almonds. You need to simultaneously reduce intake of other foods and replace those calories with almonds.

Fortunately, almonds are a tasty snack and can be added to your morning oatmeal, your lunchtime salad, or your favorite muffin recipe. If you'd like to take it one step further and cook more with almonds, the almond people have a great web page with a search engine to give you some ideas.