One of the most difficult parts of working with PCOS is how hard it is to help cysters understand the widespread effects of their diagnosis. The tendency is to focus on the symptom causing the most distress in the moment, and to look for relief from that distress, even if it isn't helping the core issue.
So, for example, women who are focused on infertility, tend to be caught up in ways to have a child, and to not think about what it's going to take to keep that pregnancy, how to nurse the child, and how to stay healthy until that child grows up to produce grandchildren.
One very nice woman I worked with who had PCOS was only willing to work with me for one appointment. It seemed, as we worked through my assessment questions, that she was realizing that what was going to result from our time together, was that she would need to address her binge eating behavior in order to reduce her carbohydrate intake and manage her blood glucose. She politely told me that she had decided that she would be better off pursuing in vitro fertilization (IVF), and if she developed gestational diabetes, she would call me to schedule another appointment.
I felt very sad about this, because this woman was not young, and fertility was not something to take for granted. And it seemed to me that the bigger picture here was that if the binge eating was not addressed, she may never get to the point where she was pregnant and in need of my help! But I couldn't tell her that. My job is to accept my clients where they are at and maybe plant a seed or two that encourages seeing things in new and different ways.
Which brings me to my topic for today.
Serum C-reactive protein (CRP) is a blood marker of inflammation, a degenerative process that has been identified in women with PCOS.
In a study of 63 women receiving IVF, it was found that CRP increased in conjunction with this treatment. Even if the women were taking metformin.
There is such a mentality in our country that we are entitled to have access to medical treatments for whatever ails us, and that we should expect that these treatments are risk free. That simply isn't the case. IVF produces many beautiful babies, but that doesn't mean it isn't without its issues.
What isn't even considered here…is the effect of an active inflammatory process on the developing fetus who has no choice but to live in that environment for nine months?
Is it just me…or doesn't it seem that if you want a baby that badly, that this baby deserves the absolute best possible environment in which to live and thrive from day one in utero? Which means taking a serious inventory of all of the nutritional and lifestyle choices we make that interfere with that on behalf of the new life that we want to create? And making some sacrifices in that department?
Just a little something to think about.
Kjøtrød SB, Romundstad P, von Düring V, Sunde A, Carlsen SM. C-reactive protein levels are unaffected by metformin during pretreatment and an IVF cycle in women with polycystic ovary syndrome. Fertil Steril. 2008 Mar;89(3):635-41. Epub 2007 Jun 4.
Marissa Kent of Mission Viejo, California wrote a wonderful article about watermelon for her August newsletter. Be sure to check out the watermelon salad recipe at the bottom of the post!
In addition to being a dietitian specializing in eating disorders and a certified diabetes educator, Marissa loves food, cooking, and hanging out at her local farmer's market.
You can learn more about Marissa and her nutrition counseling services at http://www.marissakentnutrition.com/.
One of the most enjoyed fruits during the hot season is the watermelon (Citrullus lanatus), which originated from Africa. Did you know a watermelon is 95% water, and there are more than 200 to 300 varieties grown in the United States alone? Only about half a dozen of those varieties make it into your supermarket. There is even a square shaped watermelon grown in Japan, so that it will fit into refrigerator shelves nicely and not take up too much space.
Watermelons do grow from a vine, but the melon is on top of the ground. Growing a watermelon can be very demanding. They require a lot of sunlight, space, water, and nutrients.It takes about 90 days for a full mature watermelon. California’s peak season for watermelon is May – October, but in general you can buy watermelon throughout the year.
Picking a watermelon requires both talent and skill, or just pure luck. Ideally you want a firm, smooth melon with a yellowish creamy-white underside where it touched ground. Ripe watermelons should have a healthy sheen and a melon smell. One popular way of picking a watermelon is by knocking on the melon with your knuckles and listening for a dull, hollow sound. The unripe melons have a higher pitched sound.
Most people prefer watermelons for the cool sweet refreshing taste, but little do they know a watermelon is filled with nutrition.
Nutrition values:
1 cup of diced watermelon: 50 calories 11 grams of carbohydrate 0.6 grams of fiber 9 grams of sugar 1 gram protein– (can you believe it!) 11 mg calcium 170 mg potassium– (helps you stay hydrated) 12.5 mg Vit. C 875 IU (International Units) Vit. A 6900 mcg (micrograms) lycopene — Wow!
Watermelon (as defined by its name) mostly consists of water. It’s a great source for keeping your body hydrated during this hot season. Most of the water will come out of your body through sweat or urination. This does not mean it is low in nutritional value!
The top 2 benefits of eating a watermelon are: 1) the values of vitamin A and 2) lycopene. Both of these are antioxidants. Antioxidants help protect the body from damage caused by free radicals (highly reactive and unstable molecules). Vitamin A aids in the building and strengthening of bones, soft tissue, skin, and mucous membranes. Lycopene is in the subcategory of Vitamin A, and has been shown in recent studies to have potential health benefits to reduce the risk of cancer! Watermelon contains potassium. Potassium helps trigger your heart’s squeeze of blood through your body. It also helps with reducing the amount of muscle cramps.
People with diabetes may be concerned with the sugar content of watermelon. However, other foods you eat with watermelon will reduce the impact on your blood sugar.
Glycemic index refers to how fast a specific carbohydrate (bread, rice, potato, fruits, etc… ) food raises the blood sugar within a given time. The glycemic index of a food can change when you eat a combination of nutrients (carbohydrate, protein, fat). Watermelon (as defined by its name) mostly consists of water. It’s a great source for keeping your body hydrated during this hot season. Most of the water will come out of your body through sweat or urination. This does not mean it is low in nutritional value!
The top 2 benefits of eating a watermelon are: 1) the values of vitamin A and 2) lycopene. Both of these are antioxidants. Antioxidants help protect the body from damage caused by free radicals (highly reactive and unstable molecules). Vitamin A aids in the building and strengthening of bones, soft tissue, skin, and mucous membranes. Lycopene is in the subcategory of Vitamin A, and has been shown in recent studies to have potential health benefits to reduce the risk of cancer! Watermelon contains potassium. Potassium helps trigger your heart’s squeeze of blood through your body. It also helps with reducing the amount of muscle cramps.
People with diabetes may be concerned with the sugar content of watermelon. However, other foods you eat with watermelon will reduce the impact on your blood sugar.
Glycemic index refers to how fast a specific carbohydrate (bread, rice, potato, fruits, etc… ) food raises the blood sugar within a given time. The glycemic index of a food can change when you eat a combination of nutrients (carbohydrate, protein, fat).
For example, if you are eating a hamburger and then a slice of watermelon, that will decrease the time it takes to rise the sugar level. You may want to work with a dietitian to learn more about combining and preparing foods to achieve the lowest glycemic index levels in your meals.
The glycemic index of a watermelon is 72, which is high compared to the chart below. Most nonstarchy vegetables, legumes, high fiber fruits and grains, have a low glycemic index.
Here is a chart of the levels of the glycemic index:
Low (good) glycemic index levels: 55 or less
Medium glycemic index levels: 56–69
High (bad) glycemic index levels: 70 or higher
In conclusion, the glycemic index of watermelon is high. If you stay within the recommended portion size (1 cup diced), your blood sugar will not be significantly affected. In addition, if you enjoy watermelon with a meal this will further balance blood sugar.
Enjoy picking out and eating your watermelon while we are still in summer!!!
Watermelon Summer Salad
Dressing:
1/4 cup freshly squeezed orange juice 1/4 cup freshly squeezed lemon juice (2 lemons) 1/4 cup minced shallots (1 large) 1 T honey 1/2 cup olive oil 1 tsp salt 1/2 tsp ground black pepper
Salad:
6 cups of baby arugula, washed 1/8 of a seedless watermelon, rind removed and cut into 1 inch cubes 12 oz of feta cheese, 1/2 inch diced 1/2 cup whole fresh mint leaves, julienned
Directions
Whisk together the orange juice, lemon juice and shallots, honey, salt and pepper. Slowly pour in the olive oil, whisking constantly to form an emulsion. If not using within an hour, store the vinaigrette covered in the refrigerator.
Place arugula, watermelon, feta, and mint in a large bowl. Drizzle with enough vinaigrette to coat the greens lightly and toss well. Taste and serve immediately
