An abstract for an article soon to be published hit the Internet late last week. It was a scientific study that correlated reproductive problems with skipping breakfast.
Both dysmenorrhea (painful periods) and missing cycles was worse in a population of college students if they reported skipping breakfast. This group of women also appeared to have more problems with constipation than women who ate breakfast (which makes sense, because breakfast foods tend to be higher in fiber than what we go for later in the day.)
I could write several blog posts about why this is, but rather than get stuck in"analysis paralysis", I'd rather focus on what you can do to be sure breakfast is not skipped.
1. Define breakfast as something you eat before 10 am. If you define it as what you eat before you leave the house, you limit yourself. It can be in your car, in your office, in the break room at work.
2. Breakfast does not have to be made of breakfast food! It can be a peanut butter and jelly sandwich, or your leftover Chinese food from the night before. Throw out that pretty picture on the side of the cereal box! It just needs to be something you know you will eat.
3. Pay attention to your sleep hygiene. A very high percentage of my clients skip breakfast because they're not sleeping well, and they're barely getting up in time to get ready for work. If you structure your evenings so that you go to sleep earlier, breakfast is something you will naturally evolve toward having time for.
4. Once you get in the habit of sleeping more and eating in the morning…THEN you can focus on WHAT you eat. Trying to change too many things first thing in the morning can feel overwhelming and be just too much to maintain over the long haul.
Tomoko Fujiwaraa, and Rieko Nakatab Skipping breakfast is associated with reproductive dysfunction in post-adolescent female college students.
Last Saturday an inCYST student from California was in Phoenix and we spent the morning together. We ended our visit at Costco, and it turned out to be the day they were passing out the free annual Costco cookbook. Was that ever a lucky moment! (I made a note on my calendar to send out the 2009 alert in advance so all of you can get yours, too. I did check and saw tons of them on eBay if you can't wait another year.)
Costco cookbooks are some the most awesome cookbooks available. The recipes aren't hard, and the food photography is so beautiful it makes you want to make and eat every recipe…right now!
I distracted myself from the disappointing outcome of the Bears/Vikings game on Sunday (sorry, Vikings fans!) with my annual ritual of going through the cookbook page by page, and listing all the recipes to try in the coming year. I'll be sharing some of them with you, since they are so tasty.
Today it's Breakfast Risotto made with brown rice. I recently said I would be highlighting foods high in magnesium, and my progesterone series got me side tracked. Brown rice brings me back! In addition to being a good source of magnesium, brown rice is a decent source of tryptophan (which is needed to make serotonin).
It is also a good source of manganese, which is important for healthy nervous system function, the production of sex hormones, and antioxidant activity.
The Phoenix inCYST students all decided it was a breakfast they'd definitely eat, which is perfect, since people tend to complain about not liking breakfast. This one fits with what I always say, you don't have to eat breakfast food at breakfast time! Plus, brown rice is a carbohydrate that can be perfectly fine in your diet if eaten in moderation. Can you see by the photo what I mean about wanting to make things right away?
Breakfast Risotto 1 1/2 cups water 1 cup instant brown rice 1 8 ounce can unsweetened pineapple tidbits, drained and liquid reserved 1 12 ounce can undiluted evaporated skim milk 1/2 cup raisins 1/2 cup sweetened shredded coconut 1/4 cup sliced roasted almonds 1 medium banana, peeled and diced
Combine water, rice and pineapple liquid in a 2 quart saucepan. Bring to a boil over high heat, reduce heat to medium and simmer, uncovered, sirring occasionally, until most of the liquid is absorbed, 7-8 minutes.
Stir in milk and increase heat to high. When the mixture boils, reduce heat to medium and cook, stirring occasionally, until most of the milk has been absorbed and the mixture is soft and creamy, 10-12 minutes.
Stir in pineapple, raisins, coconut, almonds, and banana.
OK, so today really sucks. You woke up, you noticed a couple of new hairs on your chin, your pregnancy test was negative, you tried to put on your nicest skirt for that important business meeting and it was too tight to zip, a pregnant mom with a stroller passed in front of your car as you waited at the light, and your first phone call at work was from an angry customer demanding to speak to your manager. And you're exhausted because you slept so poorly last night.
Time for a donut?
Only if you choose.
Here are some facts about binge eating.
1. It is a form of self-medication.
2. It works in the short term…but over time, it actually changes your biochemistry in such a way that it increases, not decreases, your anxiety.
3. For most women with PCOS, it's the major source of excessive carbs that throw a low GI diet completely off track. You probably don't need an extreme diet if you can get a hold of your binge eating.
4. Throwing that diet off track with binge foods only throws your hormones off even more, making those hairs grow back with a vengeance, making the skirt fit even tighter, and making you even more frustrated with yourself than you were with stroller woman and angry customer.
What to do? Remember this:
NO ONE MAKES YOU EAT. NOT YOUR DOCTOR, YOUR MOTHER, YOUR HUSBAND, YOUR BOYFRIEND, YOUR COWORKER. YOUR PREGNANCY TEST RESULTS DIDN'T MAKE YOU EAT. YOUR SCALES DIDN'T MAKE YOU EAT. YOUR PERFORMANCE REVIEW DIDN'T MAKE YOU EAT. YOU ARE THE ONE WHO MADE YOU EAT.
In all the years of counseling, I have yet to know of a single situation where anyone was held down and forced to eat donuts. It's an entirely voluntary experience.
That's not to say when you're in the middle of an anxiety attack and your brain is screaming for Doritos and nothing else seems to matter that it can seem as if the world might be throwing everything in your path to make the easier choice eating the entire bag…but like it or not, if you ate the Doritos, you are responsible for all of the steps that led up to that incident.
--Did you push your cart down the chip aisle last time you shopped, rather than heading toward the fruits and vegetables? --Did you stop in front of the Doritos? --Did you pick the bag up? --Did you place them in your cart? --Did you bring them home? --Did you place them in a section of your home in full view to tempt you? --Did you choose not to eat breakfast, leaving yourself hungry at an inopportune time?
Eating those Doritos is not simply about eating those Doritos. It's about engaging in a collective series of habits that eventually led to your eating the Doritos. Which one of those habits can you change to move yourself in a new and different direction?
Just as it's easier to be positive if you surround yourself with positive people, it's easier to eat healthfully if you surround yourself with healthful foods.
What can you do to break the mindless cycle? --Shop at a grocery store in a different neighborhood where foods are organized differently so you can't go into your"zone" while you're filling your cart. --Bring along a shopping buddy for accountability. --Make a list of ten healthy foods to put in your cart to bring home. --Buy enough food for a week of healthy breakfasts. When you start to crave…eat a breakfast meal as a reminder that perhaps eating breakfast at the appropriate time may have helped you to avert the cravings.
I could give you a list of 100 things you could do instead of bingeing. Bottom line remains though…if you binged, you engaged in a voluntary activity. No one made you do it.
If you need help developing your own 100 Things I Can Do To Keep From Bingeing List…that's what inCYST is really good at! Find a provider or an event somewhere and ask for help. Now you only have 99 more things to think of for your list.: )
What a find! I have a thing for thrift stores, dollar stores, etc., and on a recent cruise through the local 99 Cent Store, I found these salmon cups. They're perfectly portable to work, the gym, on a business trip…and they're cheap and yummy!
I happened to try the salmon/mandarin orange variety, but as you can see by the photo, there are also tuna varieties including cajun and teriyaki.
One of my biggest mantras when teaching healthy eating is to break your rules--about what defines breakfast, snacks, etc. You can eat"lunch" food for a snack, and"dinner" food at breakfast, if that suits you better. (I happen to love leftover Chinese food for breakfast!)
Besides the point that this is a wonderful option for a meal you need to pack, I also wanted to reinforce that better food choices do not have to be expensive. Check out your own 99 Cent Store and see what great bargains can get you started on your own journey of better eating.
Have you ever heard of Freekeh? I had not, until this past spring at Natural Products West. It is a roasted green wheat that originated in the Middle East. Like quinoa and farro, it is higher in protein than traditional grain products. It also has a relatively low glycemic index. Freekeh has been a bit of an underground favorite, but has recently been showing up in stores like Whole Foods and Trader Joe's. It is great in pilafs and all things Mediterranean, simply use as the grain base in your favorite recipe. However, if you'd prefer, I'm posting a couple of recipes I found here for you to try. Here is a simple Freekeh breakfast recipe provided by the Greenwheat Freekeh people. You can also buy their product online " />
buy their product online if you can't find it in your local grocer. Freekeh(TM) Breakfast 1 or 2 Granny smith apples one box of 400gm Freekeh cinnamon any dried fruit you like (ie raisins and apricots) as much as you like. Method First cook the whole grain Freekeh (or cracked grain Freekeh for some variation). All you need to do is to empty the whole box of grains in a pot and cover with water plus a little more (Freekeh cannot be over cooked and is very resilient). Cook for about 35 minutes or so until the grains are soft. If using cracked Freekeh only cook for about 15-20 minutes. (One other possibility is instead of cooking the Freekeh to simply soak it overnight in the fridge with water with a towel on top) While waiting for the grains to cook, chop and dice one or two apples (no need to peel, and Granny smith are best). Place the diced apples in a dry pot on low heat and stir for about 1 -2 minutes. Add only less than 1 teaspoon of water. Add cinnamon and stir for one more minute. Wash as many dried fruits as you like (dried apricots and raisins are good) and add to the apples. Stir for 1 more minute or so. Tip the fruit mixture over the already cooked grains and mix well. Let cool. Place in the fridge. The breakfast cereal should keep for 10 days or even more. To eat. Take a scoop or two of the mixture add some milk and put some wallnuts or cashew nuts or both on top. Heat in the microwave for about 1-2 minutes. Remove from the microwave and place a dollop of vanilla yogurt in the middle. In the summer you do not need to heat in the microwave and only use the yogurt without the milk… but then again you may come up with new variations to this recipe! From Bon Appetit Magazine comes this recipe for Chicken with Kale and Freekeh-Lentil Pilaf Ingredients Vinaigrette 2 tablespoons cumin seeds 1/2 cup Sherry vinegar 2 small garlic cloves, minced 1/2 cup extra-virgin olive oil 2 tablespoons finely chopped Hunza raisins 2 teaspoons whole grain mustard 2 teaspoons fresh lemon juice Kosher salt Pilaf and Chicken 4 tablespoons (or more) olive oil, divided 1 1/2 pound skinless, boneless chicken breasts, cut into 1/2"-thick cutlets Kosher salt 1 tablespoon unsalted butter 1 garlic clove, smashed 1 pound kale, large center ribs and stems removed, torn into pieces 1 cup cooked freekeh 1 cup cooked lentils Preparation Vinaigrette Stir cumin in a small dry skillet over medium heat until toasted, about 2 minutes. Remove from heat; add vinegar and garlic. Let stand for 30 seconds. Transfer to a blender; add oil and next 3 ingredients. Purée. Season with salt. Pilaf and Chicken Heat 2 Tbsp. oil in a large, heavy nonstick skillet over medium heat. Season chicken with salt. Working in 2 batches and adding 1 Tbsp. oil between batches, cook chicken in single layers until browned on both sides and just cooked through, 2–3minutes per side. Transfer to a plate and tent with foil to keep warm. Remove pan from heat; add 1/4 cup water. Stir, scraping up browned bits. Whisk in 1/4 cup vinaigrette. Scrape sauce into a bowl. Melt butter with 1 Tbsp. oil in same skillet over medium-low heat. Add garlic and cook until just beginning to brown, 1–2 minutes. Discard garlic. Working in 3 batches and adding more oil as needed, add kale to skillet and toss until wilted, 1–2 minutes per batch. Transfer to a large bowl. Season lightly with salt. Cover to keep warm. Add freekeh and lentils to same skillet. Increase heat; stir until warm, 2–3 minutes. Spoon pilaf onto plates. Top with chicken. Whisk juices from plate with chicken into sauce; drizzle over chicken and pilaf. Top with kale.
We've gotten a whole lot of traffic from people coming to learn about Amber. And I'm guessing, more than a few came to see what diet I put her on.
We'll eventually get to the food stuff, but there was something else going on with Amber that caught my attention and seemed like the more important priority. I say that, because it holds the potential to undermine any kind of nutrition advice I might give. Because of that, it needs to be addressed and corrected first, so that any type of nutrition changes we pursue have a better chance of catching and taking hold.
Amber doesn't sleep well. She shared with me that she often gets up in the middle of the night, she wakes up unrefreshed, as if she hasn't slept at all, she's exhausted most of the day, and she has memory problems.
Does that sound to you, like someone who's going to do well with a diet and exercise problem? --She's going to have a hard time finding the energy to exercise. For those of you who have labelled yourselves"lazy" because you're not sleeping well…stop it. You're exhausted. --She's going to have a hard time choosing productive foods, because all she's going to care about is quick energy to get through the next 10 minutes. --She's not going to be able to organize her day to accommodate exercise because she's too tired to think about how to do that.
What it really sounds like Amber might be doing…is something called MICROSLEEPING. It's something sleep-deprived people do, kind of going through life in a subconscious haze, never really sleeping, never really being fully conscious. It's hugely stressful on the brain, and it tends to chomp away at neurons so they can't function. It's also quite dangerous, as you can see in this video, if you're spending any part of your day at all operating some sort of machinery.
It makes better sense, rather than imposing a self-defeating program onto an exhausted, stressed out system, to pull that system back into balance so it has the energy to pursue healthy living.
Here's what I think microsleeping does to hormones and how it may be affecting Amber.
1. When you're hyperinsulinemic, and you go long periods of time without eating, your blood sugar is likely to get low. That's not something your body really likes to see, so when that happens, it releases cortisol in order to get blood sugar back up. If that happens in the middle of the night, when stress hormones aren't supposed to be circulating, it prevents you from cruising through normal stages of sleep. So you wake up feeling as if you haven't slept.
2. When your stress hormones have been working during the night, you're likely to wake up in the morning not feeling hungry. Plus, it's likely that you overslept, finally having fallen asleep just before the alarm went off, so you hurry out the door without breakfast.
3. High insulin levels and empty stomachs are not really the greatest combination, so at some point, mid-morning, hunger appears…with a vengeance. If you're tired and haven't really planned your eating, you're highly likely to seek out caffeine and sugar to fix the problem.
4. And thus, the vicious cycle begins.
But how in the world do you begin to break it? Here are the things I suggested to Amber.
1. Eat a protein-containing snack about a half hour before bedtime. It should contain at least 8 grams of protein. It will help stabilize blood glucose through the night. I don't care if it's an energy bar, string cheese, or a slice of turkey. I like to have Greek yogurt with nuts, myself. (I don't even have PCOS but I find that it helps me to sleep better if I do this.)
2. Spend at least a half hour outdoors each day. Amber lives in a hot, desert, climate, and we're closing out our"winter" in the desert, meaning her body is likely really needing a hormonal reset. UV light exposure really helps to improve melatonin (and serotonin) metabolism. So she's been eating breakfast outside.
3. Define breakfast as something that contains protein and is consumed before 10 am. If she's not hungry at 7 am, I don't want to force her to eat, but I do want to be sure she's keeping blood sugar levels stable. I told her that a good sign we're resetting hormones is if she starts to feel hungrier, earlier in the day. Within a couple of days she emailed to tell me that she was.
4. Take a dose of fish oil equivalent to 1000 mg DHA (not total omega-3's, specifically DHA) per day. Not sleeping well is one of the quickest ways to oxidize and destroy brain cells so we need to rebuild them. And, because memory is an issue, we had a pretty detailed discussion about what needed to happen in order to make sure this happened every single day, without fail.
5. Eat at least 5 servings of vegetables per day. Research has shown that people who do this, have higher melatonin levels, which means they also sleep better.
6. Keep doing Craig's exercises, because they would help her be ready to fall asleep at bedtime.
Fortunately, she started feeling better almost immediately, so now we're looking at her food patterns to see what we can productively layer on this foundation.
In the meantime, Amber's discovered she's a bit dependent on soda, likely for the caffeine. So I wrote an article for my Examiner gig about some substitutions that at least give her some fizz.
We'll get back to you with more food information in future posts, but I wanted to be sure those of you who were disappointed to not see some sort of magic diet or supplement in our program, understood why you didn't find it.
Our approach at inCYST is very different. It feels a bit counterintuitive, I know, but those who trust it and use it, do see results. I hope this series is helping you, too.
I just made some sample breakfast menus for a client. I had not finished making the rest of the day, and she wrote back to share that in just using the breakfast menus, she could tell an immediate difference in her cravings that were positively influencing how she ate the rest of the day.
I thought I would share them to give you all a challenge to try--eat these breakfasts and see how you feel as the day progresses--is your energy level better? Are your carbohydrate cravings less invasive?
I'm not the hugest fan of McDonald's, but since this particular client noted that one of the breakfasts she finds really helps get her off to a good start with less nibbling the rest of the day, is an Egg McMuffin, I added it to illustrate that the choice really isn't so bad. If you use your fats early in the day, in a way that actually decreases fat intake over aa 24 hour period, it may be a judicious move. I actually have the same experience with this meal. It keeps me full. Which is why we discussed how to make the homemade microwave version of the same thing on Whole Wheat English muffins.
Also, I am very intentionally leaving out the calorie, fat, and protein counts. If you use these breakfasts…I want you to focus on how the food tastes, how it feels in your stomach, and how you feel in the hours after you eat. Eating well is not about the calories, fat, and protein. Well…not totally. It has to be tasty if you're actually going to do it!
Hope this helps get you all off to a great start!
1/4 cup ricotta cheese 2 slices Ezekiel toast 8 ounces skim milk 1 medium apple 1/4 c sliced almonds
1 cup oatmeal 1/8 c whey protein powder 1/4 cup walnuts 1/2 c strawberries 8 oz. skim milk
There are a gazillion possibilities here, I just put four sample meals together to help my client get a grip on portion sizes and potential combinations. Two of these breakfasts use Ezekiel bread becausse she likes it. Oatmeal was another possibility because she travels a lot and can take advantage of the new Starbucks oatmeal option or even carry her own packets and mixins'.
I'm betting many of the foods you enjoy aren't so bad after all, and that you can include them if you know how. Often times when you move a food from the"bad" to"perfectly fine" column, the temptation to binge on them is removed. And many times, with PCOS, it's the bingeing and the quantity, not the food itself, that is the problem.
Most women I work with have lost confidence in food and are afraid to eat many foods that can benefit them. That is how a nutrition consultation can help you--if you use it wisely. Rather than looking to someone else to do all the work, make a list of your favorite foods, foods you want to eat but are afraid to, foods you are feeling are"bad" or"not an option" and ask, not IF, but HOW they can be included in your plan.
Let an inCYST provider help you design your own program! We're just waiting for you to ask so that we can be part of your success.
I've encountered several websites recently that seem to have the calorie number"300" on a pedestal, as if this is what we should aspire to as a total count for a meal. So much so that a current bestselling book out there has used this premise to get you to buy it.
Let's do some math.
A 30 year old, 5' 5" woman aspiring to be 135 lbs, not accounting for being moderately physically active, can eat about 1800 calories a day. Even if breakfast is only 60% as big as lunch and dinner, that works out to about 400 calories. I've found that having a large breakfast makes it easier to avoid bingeing later in the day, so my preference in this situation would be to recommend 500 calories at each meal, which leaves room for a 300 calorie snack.
If you're not hungry first thing in the morning, it may be that your blood glucose dropped overnight and triggered a blood sugar surge. The best remedy for this is often to be sure that 300 calorie snack comes before bedtime and includes protein. One of the first signs that you're actually resolving your insulin resistance seems to be that you find yourself hungrier, earlier in the morning.
Somehow, somewhere, 300 calories has been some kind of magic number to aim for. But I also see, time and time again, that women who choose this number as their goal, experience more cravings and are more likely to binge.
When it comes to calories, it's not always that less equals more. It's about making sure you have enough calories at the right times of day so that you are not hungry for too many at the wrong times of day.
For most women, a meal size of 500 to 600 is just about right. Try it, even once and see if it makes a difference in your cravings and urges to binge.
Need help finding 500 calorie breakfasts? I did a post awhile back on this topic that is consistently one of our most read. I encourage you to check it out.
We know you all love recipes and inspiration, so we are excited to be joining a group of bloggers that will provide you even more of what you're looking for!
Recipe Redux is a monthly blogfest showcasing the creativity of registered dietitians who love to cook. At the beginning of the month we are each given a theme to work with, and on the 21st of each month, our creation relating to that challenge is posted, along with links to all of the other recipes our colleagues have provided.
Dietitians participating in this club agree to focus on at least one of the following in their recipes.
reduction in overall calories and/or sugar
increase in fiber
lowering of saturated fat and/or increase in mono- or poly-unsaturated fats
reduction in sodium/salt from processed foods
showcases at least one food group mentioned by the Dietary Guidelines as the basis of a healthy diet: vegetables, fruits, whole grains, fat-free and low-fat dairy products, seafood and beans
I encourage you to peruse the links at the bottom of this post, learn, and collect…since all the recipes are from registered dietitians, you can be reasonably confident that most of them will be healthier than what you might find on other websites. (I say that because we dietitians love the occasional indulgence as well, so you will find some dreamy fun entries in the collection!)
Our challenge this month was to create something using either maple syrup or honey. I decided to use one of my favorite treats on a cold night, champurrado, as the basis for which to create Mexican Oatmeal. Champurrado is a hot drink traditionally made with masa (the cornmeal you use to make tortillas), flavored with all of the spices native to Mexico (chocolate, cinnamon, vanilla, fennel seed, and some type of sweetener). All of these are beneficial for inflammation and insulin resistance, so adding them to oatmeal makes a perfect hormone-friendly breakfast! I simply took those spices, switched out the masa for oatmeal and created the following breakfast you can make in your microwave. Think Mexican Hot Chocolate and oatmeal all mixed together…yummy, healthy, and full of energy to get you through to lunch!
Combine all ingredients in a bowl, and microwave on high for 2 minutes. Remove, stir until chocolate is completely dissoved, and microwave for one minute more.
*You can use any dark chocolate, really, I just chose this one because it's what I keep around to make Mexican hot chocolate. The darker the chocolate the better…vegan chocolates will give you more antioxidant power as milk tends to bind the beneficial compounds and render them metabolically unavailable.
I don't have to tell you this is one of your crucial vitamins. It's important for becoming pregnant, staying pregnant, and helping your unborn baby to grow and develop. It's just a super hard nutrient to get in, when your appetite is driven by carbohydrate cravings.
PCOS Diva, once again, has created a wonderful set of menus focusing on including folate. Check them out (below), pick even one to try and see if it's something you can add to your rotation.
Last week I had the opportunity to eat at a wonderful and popular restaurant in Venice, California, Lemonade. Today's picture is a photo of me with my plate and my friend's plate from that lunch. You couldn't go wrong in that place, practically everything on the menu offered a hormone-friendly benefit. It was such a contrast to the weekend before when I found myself in an unfamiliar part of town when the lunchtime hungries rolled around. I walked in to a Burger King. And while I ordered the chicken sandwich, I had to special order to keep the sauce off, and everywhere I looked, if there wasn't a promotional ad encouraging me to eat something sugary or fatty, someone WAS eating something sugary or fatty. I rarely step into these establishments and I felt completely out of my element.
I'm guessing it works the other way around. If you're used to fast food restaurants, a place like Lemonade might seem a little intimidating. So for another writing gig, I went through Lemonade's menu and listed the items they offered that were high in folate.
A big part of eating better is getting used to being in environments that support the change. It's not going to happen in a place where the profit margin is largely supported by foods that do not support health. In a place that is devoted to making healthy eating easy, the hardest decision you're going to have…which I faced in Lemonade…was figuring out WHICH healthy route to go!
If you think the reason you cannot eat better because you don't enjoy cooking, or do not feel like you have the time to do it, get in the habit of patronizing establishments that incorporate the foods we encourage you to eat. Order a little extra to take home for dinner, or if you're eating dinner out, for lunch the next day. Make it hard for yourself to have a reason to walk into fast food world. Eventually, you'll wonder why it was ever even an option.
Folate foods (foods with asterisks are fortified with added folate)
Breakfast cereals Beef liver Cowpeas (blackeyes) Breakfast cereals Spinach Great Northern beans Asparagus *Rice, white Vegetarian baked beans Green peas Broccoli *Egg noodles Broccoli, Avocado Peanuts Lettuce, Romaine Wheat germ Tomato Juice Orange juice Turnip greens Orange *Bread Egg, Cantaloupe Papaya Banana
It was 1975, and my father had a powder blue polyester double-knit “leisure suit,” a weight-loss plan disguised as a plan to single-handedly re-roof our house, and a keen interest in alternative nutrition and well-being. The latter took the form of upside-down eating, in which we had our smallest meal at dinner and our largest meal at breakfast. My friends thought it was very strange that we ate steaks and pork chops for breakfast, along with huge salads.
We were also eating texturized soy protein, roughly ground grains made into coarse earthy breads, spoonfuls of lecithin, mung bean sprouts, and a whole lot of strange things that you could only get out of the bulk food barrels at Elliot’s Natural Foods. We had a copy of “The Whole Earth Catalog” on the coffee table, and there was also a well-worn copy of my dad’s new bible, Adelle Davis’ “Let’s Eat Right to Get Fit.” There was some new thinking going on in this middle-aged straight-laced German guy, and I was curious about it. Extremely curious. I read the books, and ate whatever weird stuff I was supposed to be eating.
Things got even more curious when my father signed the entire family up to learn Transcendental Meditation (TM), which was developed by the Mahareshi Mahesh Yogi in the 1950s. Although it started elsewhere, by the 1970s, it had penetrated as far as “The Big Tomato,” my hometown of Sacramento, California. He went to a couple of introductory lectures, and the next thing we knew, all five of us were learning TM! It sure seemed exotic at the time, but it’s a technique I have practiced off on and on for over three decades. It’s so simple, I find it the easiest place to return to when I’m most stressed.
TM is a mantra-based meditation technique that has been scientifically validated for stress reduction, blood pressure reduction and, most recently management of the symptoms of Post Traumatic Stress in veterans. The National Institute of Health has spent in excess of $20 million validating the benefits of TM. It increases mental clarity, creativity, and overall health, and decreases stress by decreasing the activation of the sympathetic nervous system. When the sympathetic nervous system’s activity decreases, so do adrenaline, noradrenaline, and cortisol levels. Therefore, it is quite effective for stabilizing mood and even controlling appetite, because your appetite tends to go out of control when you’re feeling stressed.
Technically, it must be taught through an authorized trainer (see www.tm.org), but a great deal of introductory information can be gleaned online. I’ve written previously here about the benefits of meditation, and I’d love to introduce you to this technique.
Simply sit quietly and comfortably. This is essential to all forms of meditation. The mantra would be assigned by your teacher, but you can choose a syllable or sound with no inherent meaning (other forms of meditation might focus on a word with a meaning, such as “love” or “peace.”). The act of focusing on the mantra draws your mind out of its normal state of anxiety, chatter, and activity. If your mind drifts, return your attention to the mantra gently and repeatedly, for a period of 20 minutes per day. Results have been verified with as little as eight weeks of consistent daily practice. Optimally, practicing twice a day for twenty minutes each time is the goal, but benefits can be derived from as little as five minutes a day.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. 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 Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd
References: Dillbeck M.C. and Orme-Johnson D. W. Physiological differences between Transcendental Meditation and rest. American Psychologist 42:879–881, 1987. Jevning R., et al. The physiology of meditation: a review. A wakeful hypometabolic integrated response. Neuroscience & Biobehavioral Reviews 16(3):415-24, 1992. Orme-Johnson D.W. and Walton K. W. All approaches of preventing or reversing effects of stress are not the same. American Journal of Health Promotion 12:297-299, 1998.
One of the most frequent questions I have gotten over the years, is whether or not a person should eat 3 square meals a day, or whether they should break that into 5 or 6 small meals.
The answer is…it depends.
If you are asking if I think you should make room in your diet for the top 10 foods people are likely to think of when they hear the word,"snack," the answer is no.
Unfortunately, we've let the food industry define"snack" for us, and if you look at the average snack machine in the break room, airport, or hotel, it is more likely to contain Pop Tarts, candy bars, and corn chips than it is apples, string cheese, or anything containing protein.
If you are asking if you should add more eating moments to your day without making your normal meals smaller…the answer is no. This is one of the issues I see with people switching to more meals. Their definition of meal is preset, and the switch adds unnecessary calories. If you want to eat more meals, each meal needs to be smaller so that the total adds up to be the same at day's end.
One of the biggest issues with PCOS is that large amounts of calories, especially when they are carbohydrate calories, are not handled well by the hormones that digest and absorb those calories. It may be easier for your body to process the food you eat if you do eat smaller amounts of food, more frequently.
All of your"eating incidents" should include some type of protein and a healthy fat. I almost don't like to use the words"meals" and"snacks", because each one conjures up images of what is and is not ok for each. I encourage you to redefine, and to eat what works best for you. When we use those words, it is almost as if one kind of eating is when we're doing healthy,"good" stuff, and the other is when we try to sneak in the other stuff. Every time you eat is an opportunity to be good to yourself, so be sure you choose wisely.
If an energy bar is an easier breakfast for you than a traditional breakfast, then do it!
If a half sandwich before bedtime is more reasonable than something that feels like a sweet and may trigger binge eating, then do it!
It can be challenging to figure out what plan works best for you. Here are some scenarios that would tell you a smaller, more frequent eating pattern might work better for you:
--you wake up not feeling hungry. If you didn't binge the night before, this may mean your blood sugar bottomed out overnight and your stress hormones released sugar to compensate while you were sleeping. A high protein meal/snack shortly before bed might help prevent this from happening.
--you eat a healthy meal, and just as you're finishing up, you start to feel ravenous. In this case, your blood sugar levels are telling you there was a dip prior to dinner, and the food you just ate has not had a chance to fix the problem. The answer is not to eat more food in the moment (as it is tempting to do), but to add a protein/carb combination a few hours before dinner to stablize your blood sugar.
--you participate in physical activity. You're simply going to need more food, more often, since you are using more energy.
--your schedule is not 9 to 5. If you work hours that interfere with our culturally standard mealtimes, you may do better with smaller meals that do not interfere with sleep. This is a situation where prepackaged foods that you can throw in a backpack or briefcase could be the answer.
A PCOS-trained dietitian can help you to analyze your food preferences, your lifestyle, and your own personal blood glucose response to certain types of foods. Whatever approach you determine is best for you. As I said, every time you eat is an opportunity to treat yourself well. Don't miss out!
I was a little uninspired for this weekly feature until I made breakfast. Oatmeal is such a staple for me, it hadn't even occurred to me that I could talk about it here. It's not fancy, it's not expensive, it's not glamorous…it's just oatmeal. But it's filling, and it can be dressed up in so many different ways that, at least for me, it never feels like the same breakfast twice.
I like to put nuts, raisins, and dried fruit on my oatmeal. I also add my Omega 3 Brain Booster powder as a way to boost the nutritional content. I bought a bunch of glass canisters at IKEA, and I use them to store/display my oatmeal and all my different fixins'. They look so pretty and healthy it makes me want to use them, which is exactly the point!
Oatmeal has a great glycemic index, meaning it won't wreak havoc on your blood sugar. And that means you're less likely to be hungry in the morning because your blood sugar dropped at a time when lunch was still a ways away and there were donuts sitting in the break room.
A special oatmeal note for you frequent flyers. The international terminal at JFK airport (New York) has a wonderful oatmeal bar! You can fix it with just about anything you would want. I was so thrilled to find this, since much airport food can't even really be thought of as food. Check it out and enjoy!
I know, I know, that includes a lot of foods. I promise after the holidays, I'll get back to information about specific foods. But it being the holidays, and the relationships we have with food during the holidays not always being healthy, I wanted to digress today.
Part of the reason I want to digress is because I've had some wonderful food experiences this week. Monday a friend and her husband invited people over for a Caribbean holiday dinner. From the mango-cucumber-avocado salad with the peanut butter chutney dressing to the platanos to the almond paste…it was fabulous! And most of all, the conversation around the table was a wonderful way to spend a blustery winter evening.
Last night Ivonne, who sometimes posts on this blog, asked me to meet her and her fiance so she could share some gingerbread (made with stout) that she loves to make over the holidays. Again, we spent a couple of hours chatting and laughing in the coffeeshop of a local Barnes and Noble and just enjoyed the company. And, I had a delicious yet unconventional treat for breakfast this morning!
These are not foods I normally eat, but Christmas is not a normal time of year. The important thing is not what I ate. It was how what I ate blended into the rest of my life. I am still working out, but I'm not adding an extra hour to make up for the extra calories. I am still enjoying the food, but I'm not starving myself in between to"account" for the goodies. And, I haven't thrown up my hands in defeat and started eating and drinking everything in sight with a"What's the use, I've blown it?" kind of attitude.
The most important thing to keep in mind is that when your life is balanced, that is, you're eating a variety of foods in moderation, you're physically active, you're getting enough sleep, and you're managing your stress, an occasional Caribbean meal or gingerbread breakfast, in the long run, shows up as a slight blip on the screen, but it doesn't send off the warning bells. But, only if you TREAT it as a blip on the screen.
There's no need to punish yourself with extra exercise, starvation, guilt, whatever, because you took the time to enjoy the food that accompanied the festivities. Holidays are not an excuse to eat, and they're not a reason to punish yourself. They're about family, friends, reflection, and celebration.
I sure hope you've got Ivonnes, Gerdas, Joses, and family in your life to help you partake in the fun! (I'll talk about comfort food next week after my family celebration.)
Breakfast: Whole wheat english muffin with 1 oz of mozarella cheese, part skim, and 1/2 to 1 oz of lean deli ham to make a breakfast sandwich. 4-6 oz Calcium fortified orange juice Lunch: 2 oz deli turkey with 1 slice of provolone cheese, lettuce leaf, sliced tomato, with a tablespoon, (or less) of smart balance omega plus mayonnaise on a whole wheat tortilla to make a wrap. To drink, unsweetened iced tea with lemon. Dinner: Boneless, skinless chicken thigh baked/roasted with seasonings. Baked Potato, small with Omega plus smart balance margarine, and broccoli, prepared in the microwave and omega plus smart balance margarine, added for seasoning with pepper. To drink, water or a glass of wine Snack: Sun chips
I went to graduate school in Boulder, Colorado. I loved it there, but I have to admit, it was a place where people seemed to more easily grab onto esoteric, off-the-beaten-path ideas than they did good, solid, evidence based concepts. So when someone introduced me to quinoa, I politely listened and figured it was something I'd only find in a local vegetarian eatery.
But the grain has stayed around, and I've grown to love it. If you have PCOS, quinoa can be a nice carbohydrate to eat because it's very high in protein; one half cup serving has about 12 grams of it! It's also a decent source of manganese, magnesium, iron, tryptophan, and copper, which from time to time appear as potential players in the PCOS picture.
As you can see in the picture, quinoa looks (and it also tastes) a lot like cous-cous. It's very easy to prepare, you simply have to pour boiling water over it and let it sit for a few minutes until it's cooked.
Yesterday I was at Whole Foods and tried one of the pilaf-style salads they often had with quinoa. I also love their quinoa cake, kind of like a veggie burger. It's one of my favorite treats. I have even seen it cooked as a breakfast cereal, with toppings much like you'd put on oatmeal.
Recently, pasta made with quinoa has become available in stores like Whole Foods. I discovered while looking for a photo of the product for this blog post, that you can buy this brand (Ancient Harvest) online at amazon.com.
It's quite convenient and something anyone who's trying to eat more protein and less carbohydrate, but who just doesn't feel satisfied without some kind of starch to round out the dinner plate.
Quinoa is available in most grocery stores…but if you're not finding it, it is also available online. Click here to buy quinoa online
Disclaimer: inCYST does have an associate relationship with amazon.com.
Not long ago a woman with PCOS handed me a diet diary for analysis. She had eaten a burger without the bun and a sweetened ice tea for breakfast. Lunch didn't happen until 2 pm, and it was a brownie with ice cream. And finally, she recorded a bowl of cereal for dinner.
One of the things that jumped out at me was that there were no fruits or vegetables in her meal plan. When I asked her about it…she told me she was avoiding carbs!
Fruits have somehow gotten a bad rap because of their carbohydrate content. But they're not the culprit in an unhealthy diet. In fact, fruits are very high in antioxidants, which can help to repair the damage that life stress and the stress of having a chronic disease can create. In my opinion, you can't afford NOT to have fruit.
I chose oranges this week, because I live in Arizona and I have an orange tree off of my patio. It is the most wonderful treat to wake up, pick a few oranges, and have a glass of fresh squeezed juice. Or, when I need a break in the afternoon, to pick a fresh snack for myself. Nothing tastes better than fruit right from the source. I recently made a great salad vinaigrette using orange juice and olive oil as the base. Even with all these oranges, I'm not making a dent in my supply!
If your diet diary mimicks the one I described above, challenge yourself to try the following. Be sure to have a serving of fruit the size of a tennis ball at each meal, or the total equivalent of 3 servings that size of fruit in the course of a day. Challenge yourself to not eat any sources of refined sugar until you've met your daily quota of fruit. See if, when you focus on fruit, your appetite for other sugars diminishes. And in the process, if changing the kind of sugar you eat doesn't help stabilize your energy levels and help you to feel better.
‘Tis the time of year when blogs, magazines, and radio broadcasts are full of tips for combating overeating, over-drinking, and the kind of carousing that leaves you tired, bloated, overly full, and generally disgusted with yourself. They’re often repetitive, and not all that useful. I’m full of tips, techniques, and strategies myself, actually! One that I DO think is useful and easy to remember is HALT, which stands for Hungry, Angry, Lonely, and Tired.
If you’re one of those things – hungry, angry, lonely, or tired – the risk of over-indulging rises. If you’re two, three of those things, the risk of losing control is much greater. And if you’re all four of those things, watch out world, because almost nothing’s going to stand in the way of the oncoming binge, bad behavior, or acting out.
But what’s the first aspect of change? Awareness. HALT is a way to bring yourself back to a place of awareness, so you can reign in your behavior before it becomes self-destructive. Let’s talk about the specifics:
Hungry: When you’re hungry – really hungry – your blood sugar starts to drop, and you feel tired, confused, and irritable. And did we mention, hungry? Really, really hungry. Like, so hungry you could the entire contents of a small refrigerator. Or the buffet table. Or as much as you can load up on at the drive-through. Yeah, that kind of hungry. Women with PCOS are more subject to the vagaries of blood sugar dysregulation (it’s the insulin resistance thing, AGAIN) than other people. We’re more vulnerable. Accept it, and plan for it.
Strategy: Have a little healthy snack with you at all times. Know that shopping is hard work and frequently results in blood sugar drops because you’re walking more than you think. Plan ahead. Decide: “If I get hungry, I’m going to Subway for a turkey sandwich loaded up with vegetables and skip the mayo.” This will prevent you from going to McDonald’s and getting a Big Mac, large fries, and a shake.
Angry: The traffic, the crowds, the prices, the shopping for people you don’t even care about, the time pressure, and the social obligations, your spouse who still expects home-cooked meals when you’re in the middle of SHOPPING!, can all lead to a build-up of anger.
Strategy: Do not shop when you’re angry. Do not expose yourself to challenging foods or social situations when you’re angry. Take five to twenty minutes to meditate, walk around the block, drink a glass of cool water, and practice forgiveness and compassion. Now engage in your usual activities.
Lonely: So often, it’s assumed that we’re off with our friends, families, and other loved ones at the holidays, but some of us are sitting home alone, without an invitation, a thought, or a concern.
Strategy: If you’re alone, embrace it. Don’t take a shower until 3:00 p.m. Spend all day on FaceBook. Eat breakfast for dinner. Revel in your ability to live precisely how you want to live today, without judgment or interference. It can be utterly rejuvenating. If you don’t like being alone, and really do feel lonely, make a point of issuing invitations to other people, or showing up at every group event you know about, and don’t tell me it’s unfair that you have to do all the asking. Life is like that sometimes, and if you want to undo this loneliness, you will have to take action. Tell people you don’t have any plans for Christmas, and you don’t have any invitations either. Quite often, one will be forthcoming. People are feeling generous this time of year. In any case, again, avoid whatever triggers you to behave uncharacteristically. This is not a good time to shop the web, bake a cake, or order enough take-out for six people. Remind yourself that this is a temporary, and repairable, condition.
Tired: Tiredness connects to hunger quite often. Drops or dips in blood sugar can leave you feeling exhausted, confused, and overwhelmed. When you’re tired, your decision-making capacity is impaired. See where I’m going with this theme?
Strategy: If you’ve been running around like a maniac, trying to get it all done (The shopping! The cooking! The baking! The cards! The decorating! The parties! OH MY!), slash and burn. You are NOT Superwoman. I repeat, you are NOT Superwoman. No one will notice. Seriously. I used to send upwards of 100 handwritten (and often handmade) greeting cards. A few years ago, I only sent a few. Now I don’t send any, except to my mother, and that’s a maybe. Not one single person has called me out for it. Wow, what a relief!
If you feel strongly, pick a few critical priorities (i.e., my husband will definitely die, or at least pout for days, if he doesn’t get a homemade peppermint cake by Christmas, my children will be ostracized if they don’t get Chanukah gifts like everyone else, and my staff assistant is going to “lose” my messages for the rest of the year if I don’t buy her a great present) and lose the rest. Children are important; adults will have to understand. Your budget, your sanity, and your ability to get the rest you need are the most important things. The rest is not. HALT. And be well.
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.
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!
We've been doing some business with companies working with nopales (prickly pear cactus pads). I'd seen a lot of research suggesting that nopales are good for quite a few health issues, particularly blood glucose.
We started selling Ibitta's products a couple of months ago and I was amazed at where the orders were coming from — Memphis, Philadelphia, not simply Arizona and California like I'd expected! I finally called one customer to see why she'd ordered it. Apparently her mother had been bugging her to try it as it is a popular Mexican supplement for weight loss. When her mother finally gave her a bag, she felt it couldn't hurt to try it. She noticed that when she stirred a couple of spoonfuls of Pinalinaza into a glass of water and drank it before a meal, it helped her appetite. And over a couple of months she lost 20 pounds.
Another woman with PCOS, in military basic training, wrote:
I just wanted to give you an update. Although I knew that Nopales was used…in my Hispanic heritage, I didn't know that it would help me out with my sugar so much!! I ordered the products that you hosted on this site (Pinalinaz … a, etc…) and can't wait to start them! In the mean time, I am eating nopales I bought from the local store. For one week, I've eaten them in the morning every other day. I lost 3 pounds and during that week I was only able to walk for exercise as the week was too busy. I have kept track of my sugar and the nopales has regulated it so much so that now I am falling into a Hypoglycemic instead of Diabetic. I am determining how I can balance it, however this is an awesome break through for me. I was doing the military basic training for two months and only lost 5 lbs because of PCOS. Now that I incorporated nopales, the stubborn sugar is being removed!! I can't wait for shipment!! This is a big breakthrough for me, it is extremely hard for me to digest the sugar and the nopales are doing something right!!
Last Friday, I gave a presentation on PCOS at the local Indian Health Service Hospital here in Phoenix. One of my clients made a big batch of nopales salad for everyone to try. It was lunchtime about an hour and a half later, and several people noted that they weren't really very hungry.
There is research to support these testimonials. A 2007 study reported that 85 g nopales with a meal reduced the glycemic index of the meal. Way back in 1991, researchers reported that nopal had a glucose-lowering effect.
For the non-native eater, the prospect of de-stickering a cactus pad, not to mention what to do with the cactus once that's done, likely keeps many people from trying it. In Phoenix, we have a company, Oro Verde Products, that sells ready-to-prepare cactus pads as well as chopped nopales ready to add to your recipe. It's popular in salads, stews, and scrambled eggs. I've even heard of some people juicing it if they have a powerful blender. Check Oro Verde's website for information and recipes.
Ibitta's products are nice because they're powdered and mixed with flax. I've used them on my oatmeal, in smoothies, in vinaigrettes, and breadings. I even made a vanilla cheesecake with the hibiscus (Jamaica) flavored variety in the crust. They're very versatile and more user-friendly in the typical American kitchen.
These we do carry in the store, if you're interested in ordering.
If you live in Los Angeles, look for Nopatillas, a tortilla made with nopal. This would be super easy to include in breakfast burritos, lunch wraps, etc.
Wherever you are, however you eat it, be sure to try nopales. They could be a great way to help control your blood glucose.
Bacardi-Gascon M, Dueñas-Mena D, Jimenez-Cruz A. Lowering effect on postprandial glycemic response of nopales added to Mexican breakfasts. Diabetes Care.2007 May;30(5):1264-5. Epub 2007 Feb 26.
Frati AC, Gordillo BE, Altamirano P, Ariza CR, Cortés-Franco R, Chávez-Negrete A, Islas-Andrade S. Influence of nopal intake upon fasting glycemia in type II diabetics and healthy subjects. Arch Invest Med (Mex). 1991 Jan-Mar;22(1):51-6.
