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My clients' food diaries tell me a whole lot about current trends in diets in general, as well as what's being said about PCOS. More and more, I'm seeing women report eating coconut oil by the tablespoonful. So I thought I'd dissect the information and evaluate whether or not this is advisable.

Overall, the recommendations for a heart healthy, low glycemic diet, are to eat 30-35% of your calories as fat, equally distributed between saturated, polyunsaturated, and monounsaturated. Here is how that works out for most calorie levels you're likely to be on. First row is 30% of calories, second is 35% of calories.

1200 360 fat calories, 40 grams of fat, 120 calories/13.3 grams each, S-P-M
1200 420 fat calories, 47 grams of fat, 140 calories/15.5 grams each, S-P-M

1300 390 fat calories, 43.3 grams of fat, 130 calories/14.4 grams each, S-P-M
1300 455 fat calories, 50.6 grams of fat, 152 calories/17.0 grams each, S-P-M

1400 420 fat calories, 46.7 grams of fat, 126 calories/14.0 grams each, S-P-M
1400 490 fat calories, 54.4 grams of fat, 163 calories/18.1 grams each, S-P-M

1500 450 fat calories, 50.0 grams of fat, 150 calories/16.7 grams each, S-P-M
1500 525 fat calories, 58.3 grams of fat, 175 calories/19.4 grams each, S-P-M

1600 480 fat calories, 53.0 grams of fat, 160 calories/17.8 grams each, S-P-M
1600 560 fat calories, 62.2 grams of fat, 187 calories/20.7 grams each, S-P-M

1700 510 fat calories, 56.7 grams of fat, 170 calories/18.9 grams each, S-P-M
1700 595 fat calories, 66.1 grams of fat, 198 calories/22.0 grams each, S-P-M

1800 540 fat calories, 60.0 grams of fat, 180 calories/20.0 grams each, S-P-M
1800 630 fat calories, 70.0 grams of fat, 210 calories/23.3 grams each, S-P-M

1900 570 fat calories, 63.3 grams of fat, 190 calories/21.1 grams each, S-P-M
1900 665 fat calories, 73.9 grams of fat, 222 calories/24.6 grams each, S-P-M

2000 600 fat calories, 66.7 grams of fat, 200 calories/22.2 grams each, S-P-M
2000 700 fat calories, 77.8 grams of fat, 233 calories/25.9 grams each, S-P-M

One teaspoon of coconut oil contains 5 grams of saturated fat. Assuming that most fat that is found in milk and dairy is also saturated, let's work backwards and see on each of these calorie levels, at the two percentages, at any calorie level, you would not have any saturated fat left to allocate to your major sources of protein, calcium, and vitamin D. Keep in mind, women who consume at least one serving of fat-containing dairy a day are significantly more fertile than those who do not.

In the other direction, if you are eating entirely lean sources of protein (fish, poultry, lean red meat), and one serving of dairy a day, you should assume that about 23 grams of saturated fat will come from those sources. Again, even if you are aiming for 2000 calories a day, that leaves you room for 2.9 grams, or half a teaspoon of coconut oil per day.

Let's say you choose to switch out your unsaturated fat (where your pro-inflammatory omega-6 oils are found), for coconut oil. If, and only if, you had absolutely no other fats from these oils, you could include this much coconut oil in your diet.

1200 2.6 tsp/3.1 tsp
1300 2.7 tsp/3.4 tsp
1400 2.8 tsp/3.6 tsp
1500 3.3 tsp/3.9 tsp
1600 3.6 tsp/4.1 tsp
1700 3.8 tsp/4.4 tsp
1800 4.0 tsp/4.6 tsp
1900 4.2 tsp/4.9 tsp
2000 4.4 tsp/5.2 tsp

Even at the highest level I calculated, there is not enough room for 2 tablespoons of coconut oil in your diet. The excess calories will eventually set you up to gain weight. All oils, even healthy oils, in excess, promote weight gain.

There is some evidence to suggest that this proportion of saturated fat to monounsaturated fat may be too high, because fluidity of neuron membranes is important for healthy brain and nervous system function…and too much saturated fat of any kind, is correlated with rigid (undesirable) membranes.

I double checked peer-reviewed references in Pub Med and was not able to find any articles describing studies that would have been the source for this dose. I did find some cautionary information, however.

A high-fat diet, when the fat is coconut oil, in one study, was associated with lower bone density than high-fat diets based on either flaxseed (omega-3) or safflower oil (omega-6).

Yes, a diet that is 10% coconut oil, as described above, has been reported to improve metabolic parameters. However, when the amount of fat is increased, to 25%, increased blood free fatty levels, insulin resistance, and hypertension, all increase as well. The incidence of atherosclerosis in this study also doubled.

It looks to me like what may be going on here, is that one study was taken out of context and used as a promotional piece of information by companies with much to gain if their sales of coconut oil increase. When you're looking for good information, go to the source. Websites primarily intended to sell a product, even if they provide references, are not"the source". Chances are, they will omit any references that encourage any kind of limitation of use of their product.

I have more information on coconut oil in future posts. I don't think it's bad, I just think it's being over-hyped and misused, in a way that can be especially problematic for women highly at risk of metabolic and hormonal disorders.

Lau BY, Fajardo VA, McMeekin L, Sacco SM, Ward WE, Roy BD, Peters SJ, Leblanc PJ. Influence of high-fat diet from differential dietary sources on bone mineral density, bone strength, and bone fatty acid composition in rats. Appl Physiol Nutr Metab. 2010 Oct;35(5):598-606.

Waqar AB, Koike T, Yu Y, Inoue T, Aoki T, Liu E, Fan J. High-fat diet without excess calories induces metabolic disorders and enhances atherosclerosis in rabbits. Atherosclerosis. 2010 Nov;213(1):148-55. Epub 2010 Aug 11.

I received this question after my last Fitness Friday chat about learning that insulin resistant individuals lose their body protein at twice the rate of other people as they age. I have always thought that women with PCOS needed more protein than other people, for a variety of reasons, and this simply served to confirm that sentiment.

I do like the"40-30-30" rule (carbohydrates, protein, fat), and here are the calculations for the grams of protein you would need at a variety of representative calorie levels if you're striving to have 30% of your diet's calories come from protein.

1200 calories 90 grams
1300 calories 97 grams
1400 calories 105 grams
1500 calories 113 grams
1600 calories 120 grams
1700 calories 127 grams
1800 calories 135 grams
1900 calories 143 grams
2000 calories 150 grams
2100 calories 158 grams
2200 calories 165 grams
2300 calories 173 grams
2400 calories 180 grams
2500 calories 188 grams

Most clients I work with are surprised to find that it takes a concerted effort to actually reach this, and that it can be challenging on a vegetarian diet. If you're having trouble, this is a great reason to make an appointment with one of our inCYSTers, trained to help you find ways to get the protein you need to maintain your muscle mass and fight that dreaded insulin resistance.

Continuing on with yesterday's theme, I wanted to summarize options for anyone who, for whatever reason, chooses to drink milk alternatives instead of cow's milk.

The primary problems with these alternatives are:

1. They almost, without question, do not provide equivalent amounts of protein and raise your diet's carbohydrate to protein ratio.

2. They are often sweetened, increasing your simple carbohydrate to complex carbohydrate ratio.

3. Most of the alternatives, except for coconut milk, do contain vitamin D. However, check your label just to be sure.

If you choose to use these, in general, you are not substituting milk alternatives for milk. You are drinking a beverage that creates a need for you to increase your protein, vitamin D, and complex carbohydrates in the foods you also choose, in order to make up the deficiencies this switch inevitably creates. If you do not know how to do that, a consultation with one of our inCYSTers might be helpful. Many of them offer Skype consultations if you do not see on our list below and to the right who lives near you.

Here's the rundown. For comparison, per 8 ounces, 1% milk contains:
110 calories
8 grams protein
5 grams fat
12 grams carbohydrate
0% added sugar

One bias I do have which is reflected below, is toward soy milk. Too many women with PCOS have thyroid problems, for me to feel responsible presenting it as an option. So I have omitted it.

All information is for an 8 ounce serving.

ALMOND MILK
This one appears to be the most popular. One benefit to almond milk is that since almonds are naturally sweet, there is not as much of a need to add sugar in order to make them palatable. The disadvantage to almond milk is that, consumed in large enough quantities, it may increase your omega-6 intake enough that you promote, rather than reduce, inflammation (almonds, while beneficial in moderation, are the only nut that contain absolutely no omega-3's and for that reason should not be the only nut you exclusively eat).

Almond Breeze Brand
45 calories
2 grams protein
3.5 grams fat
3 grams carbohydrate
0% of carbohydrate is added sugar
Pacific Foods Vanilla Almond

45 calories
1 gram protein
2.5 grams fat
3 grams carbohydrate
0% of carbohydrate is added sugar

FLAX MILK

I do like flax milk's omega-3 fatty acid content. It's sweetened, but not to the same degree as many of the other milks. I could see using this in cooking, in any recipe that called for cream, or as coffee creamer, as a way to enhance your diet's overall omega-6 to omega-3 ratio. It still comes up short in the protein department.

Flax USA Flax Milk

50 calories
0 grams protein
2.5 grams fat
7 grams carbohydrate
100% of carbohydrate is added sugar

HEMP MILK
One benefit to hemp milk is its omega-3 content. However, it is sweetened pretty significantly so consumers will drink it.

Living Harvest Hemp Milk

130 calories
4 grams protein
3 grams fat
240 grams carbohydrate
75% of carbohydrate is added sugar
Manitoba Harvest Hemp Bliss

110 calories
5 grams protein
7 grams fat
7 grams carbohydrate
86% of carbohydrate is added sugar

OATMEAL MILK

Highest in calories, partially because it's sweetened. Eating the real oatmeal will give you better benefits.

Pacific Foods Oatmeal
130 calories
4 grams protein
2.5 grams fat
24 grams carbohydrate
79% of carbohydrate is added sugar

HAZELNUT MILK

The fat in hazelnuts is primarily monounsaturated, making the fat here healthy, but again, low protein and high added sugar are problematic

Pacific Foods Hazelnut Milk

110 calories
2 grams protein
3.5 grams fat
18 grams carbohydrate
78% of carbohydrate is added sugar

COCONUT MILK

I love this milk, but consumed in place of milk, the saturated calories will add up. Yes, the fat in coconut milk is different than the fat in meat, but even so, your overall intake of saturated fat, regardless of the source, should be no more than 10% of total calories. So I say save this one for cooking (as in Thai curries) or used sparingly on breakfast oatmeal or quinoa. It's not really the best choice for drinking by the glass.

Regular Canned Coconut Milk

445 calories
5 grams protein
48 grams fat
6 grams carbohydrate
0% of carbohydrate is added sugar
Trader Joe's Light Coconut Milk

150 calories
0 grams protein
12 grams fat
12 grams carbohydrate
0% of carbohydrate is added sugar

So Delicious Coconut Milk (carton)
50 calories
1 gram protein
5 grams fat
6 grams carbohydrate
86% of carbohydrate is added sugar

Silk Coconut Milk (carton)
90 calories
1 gram protein
5 grams fat
10 grams carbohydrate
90% of carbohydrate is added sugar

RICE MILK

Until recently, rice milk was also an option that fell short in protein and in which sugar was added to sweeten and flavor. The first example here illustrates that point. The second option, which has recently come on the market, is a great advancement as far as milk alternative options go.

Both brands are made with brown rice, and both contain vitamins D and B12. However, safflower oil, one of the pro-inflammatory omega-6 fatty acids we encourage you to limit, is also listed as a Rice Dream ingredient. Just wanted to cover that base.

For women with PCOS, the addition of stevia by Growing Naturals is an added plus, as research is suggesting that regular consumption of stevia may help to improve pancreatic function, reduce cravings for sweets, and improve memory. All of those are chronic issues which make it hard to make the choices promoting hormone balance. In addition, Growing Naturals DOES contain vitamin D (in the vegan D2 form), and vitamin B12, often deficient in vegans.

Rice Dream Rice Milk

120 calories
1 gram protein
2.5 grams fat
23 grams carbohydrate
43% of carbohydrate is added sugar
Growing Naturals Brown Rice Milk

110 calories
8 grams protein
1 grams fat
17 grams carbohydrate
0% of carbohydrate is added sugar
So by now you know my bias, but now you also know why it exists. I use all of these milks in my kitchen. But I do so in different ways. Some as condiments and even coffee creamers, as I do enjoy their flavors, but not as a beverage choice I drink by the glass. The two I drink by the glass are cow's milk and Growing Naturals. Hopefully I've provided you with enough information to de what combinations are most hormone-friendly for you.

If you're interested in trying/using Growing Naturals yourself, and it hasn't arrived at your local store, here is information for ordering.

There has been a lot of information circulating around the Internet recently about the dangers of agave nectar. It prompted me to take a little closer look. And I'm glad I did. What I've learned will be part of an ongoing series about the benefits and disadvantages of different types of sugar. It's a complex issue, so to make it more understandable, I thought I'd break it into installments. If you have comments about any of this, please feel free to post. I do moderate comments and won't be putting any up until the series is finished, in case you get ahead of me. I will take your comments into consideration as I proceed with this topic. Thanks for understanding.

According to a 2010 report in the European Journal of Food Safety, a comprehensive review of studies evaluating the effects of various carbohydrates and sugars on metabolism, simple sugars begin to have negative effects on health when they exceed 20% of total calories. That is simple sugars of all kinds--sucrose, fructose, and galactose. Here is how that translates into diets of varying calorie levels, so you can put this information into perspective.

Calorie level Healthful limit for sugar intake, calories Healthful limit for sugar intake, grams
1500 300 75
1600 320 80
1700 340 85
1800 360 90
1900 380 95
2000 400 100
2100 420 105
2200 440 110
2300 460 115

With fructose, the threshold is 7.5% of total calories; more than that, and negative health effects, such as elevated triglycerides, begin to appear. In other words, fructose should be used judiciously, even though it has a lower glycemic index.

Calorie level Healthful limit for fructose intake, calories Healthful limit for fructose intake, grams
1500 112 28
1600 120 30
1700 128 32
1800 136 34
1900 144 36
2000 152 38
2100 160 40
2200 168 42
2300 176 44

A can of soda would contain the following, based on the type of sweetener it contained. It mathematically fits into the above guidelines, but in a way that makes it hard to consume fruits, which also contain fructose, and stay within the calculated limits.
Sugar calories Sugar grams Fructose calories Fructose grams
Cane sugar 150 38 75 19
Beet sugar 150 38 75 19
High fructose corn syrup 140 35 77 19
Agave nectar* 102 25 87 22

*Agave nectar was a little bit harder to figure out. I did manage to find a Denver-based company called Oogave that makes sodas using agave nectar. Their Esteban's Root Beer is what I used for the above analysis.

My first find in a Google search brought me to Full Throttle, an energy drink manufactured by Coca Cola. Unbelievably, the"blue agave" flavor of this product contains no agave nectar at all, is sweetened with high fructose corn syrup, and contains 220 calories in a can! They are definitely hoping the consumer would jump to conclusions about this product.

Are you juicing at home?

Here's how the same volume of a 1/3, 1/3, 1/3 mix of beet, carrot, and spinach juice compares.
Sugar calories Sugar grams Fructose calories Fructose grams
120 24 31 7.8
Calories are not that much different, and total sugar, but the sugar type does. If you were to add fruit, that value would go up.

To give you an idea of what happens when you switch from sugar to agave nectar in the same recipe, I analyzed the same amount of watermelon Arnold Palmer recipe from last week's post. I adjusted the amount of agave nectar based on the fact that agave nectar is 72% sweeter than sugar.

Sugar calories Sugar grams Fructose calories Fructose grams
Made with sugar 20 5 9 2.3
Made with agave 18 4.5 10 2.5
Takeaway messages:
1. Any sweetened beverage,"healthy", or homemade, soda or juice, regardless of how it is sweetened, is a significant source of sugar and fructose. It is a dietary choice that should be made with respect, and sparingly.
2. Soda made in Mexico, even though it doesn't have high fructose corn syrup in it, is still problematic in large quantities.
3. The advantage to agave nectar is that it can help you to cut your total sugar intake, and reduce your glycemic load, but you still need to be aware of the quantity you consume.
European Food Safety Authority. Scientific Opinion on Dietary Reference Values for carbohydrates and dietary fibre. EFAS Journal 2010; 8(3): 1462.

http://www.nutritiondata.com/

http://www.livestrong.com/

Source: Uploaded by user via Monika on Pinterest

I was asked by one of our readers (who happens to also be my dear cousin Susan), if there was anywhere on the Internet, a checklist for vegetarians to follow to be sure their diet is complete. Her pretty exhaustive research found nothing really practical for meal planning.

So in response to that, and knowing that a very high percentage of our own readers are vegetarian, I put something together. Please let us know if it needs refining or detail, so that we can make this as practical as it can possibly be.

There are five main things to attend to. All of them are important, but I ordered them in the way I look at them when planning a vegetarian meal for myself.

1. What is my protein source and how much of it do I need to truly give me enough protein?

Here are your goals based on the number of calories you eat. This will make 30% of your calories protein, which will help to fight insulin resistance.

1200 calories 90 grams
1300 calories 93 grams
1400 calories 95 grams
1500 calories 98 grams
1600 calories 100 grams
1700 calories 103 grams
1800 calories 105 grams
1900 calories 108 grams
2000 calories 110 grams

2. Where is my vitamin D coming from, and have I had enough? You will have to make a very conscious effort to get enough of this vitamin. With regard to whole foods, mushrooms are pretty much the only vitamin D-containing food. With regard to vegan milk alternatives, beware. Most are so low in protein, they are more accurately thought of as juices rather than milks. If you choose to drink them you will need to find other ways to meet criteria nu,ber one above. I blogged about
this in detail not too long ago.

3. Are my fats healthy? If your definition of vegan is primarily not eating meat, and you are eating a lot of packaged, processed, prepared, or baked food…be extra sure you are not inadvertently letting the pro-inflammatory fats sneak in. Remember, they tend to begin with the letters"s" and" c" — soybean, safflower, sunflower, sesame, corn, cottonseed. (Canola is the exception.). Vegans are often blindsided here with salad dressings, baked goods, cookies, and chops. Read your labels--as much as I love Whole Foods, their entire snack food aisle only has a handful of choices you can bring home if you follow this rule! Good fats include olive and organic canola.

4. Am I getting DHA and EPA (marine omega-3)? Yes, flax, green veggies, and other foods contain omega-3, but the conversion rate is not high. You will need to find a marine algae supplement to be sure your intake of these two essential fatty acids is adequate. InCYSTer Chris Marquette found one that is not genetically modified; look for it next time you shop.

5. Am I getting enough fruits and vegetables? Ideally, these should be the vast majority of what you eat. I am surprised at how many vegans I know who do not like vegetables! You should be aiming for 2-3 1/2 cup servings PER MEAL. Beware of juicing; it is a great way to get in large volumes of fruits and vegetables…BUT…the carbohydrate to protein ratio is not going to help reduce insulin resistance. Make a smoothie out of your juice with your favorite protein powder.

Of course, you can take supplements to make up many of these deficiencies…but if your solution in more than one of these categories is a supplement, I challenge you to consider why you do what you do. The true definition of a vegan is someone WHO MEETS THEIR DAILY NUTRITIONAL NEEDS without using animal-based food to make it happen. If all you have done is remove animals from your diet, you are simply a picky or misinformed eater.

These days it seems that all a product has to do is contain something from a coconut…and the immediate assumption is that it is healthy, no matter how much of it is consumed.

I'm not sure where this false idea comes from, given the statistics of diabetes prevalance in Pacific Island peoples:
--Native Hawaiians, in Hawaii, have higher diabetes mortality rates than any other ethnic group, and Hawaiians with diabetes are more likely to be eating at least 5 servings of fruits and vegetables than any other ethnic group.
--Indonesia has the second highest prevalence of diabetes of all of the countries in the world.

Of course, modernization of all cultures has significantly affected these statistics. However, as you can see in these historical photos of King Kamehameha and Queen Liliuokalani, native Pacific Islanders weren't skinny minnies when they first met the missionaries, when white rice and SPAM were not even concepts in the islands.

By no means am I intending to insult my friends in Hawaii. I'm simply trying to illustrate the potential harm that can occur when nutrition misinformation is parroted, repeated, and distributed without checking facts.

Coconut products definitely have their place in healthy diets; however, only if used with knowledge and respect and without the concept that somehow coconut products have magical, supernatural, and/or anti-caloric properties. I put together a summary of the coconut products currently in vogue, as a reference for those of you with questions about whether or how you should be using them.

Shredded Coconut Meat
1 cup contains 466 calories, 33 grams fat, 44 grams carbohydrate
Inflammatory rating: Strongly inflammatory

Coconut Flour
1 cup contains 480 calories, 12 grams of fat, 80 grams of carbohydrate (32 net, 48 dietary fiber), 16 grams protein

This product is a byproduct of the coconut oil industry, so provided you've purchased your flour from an origin where the coconuts are sustainably produced (not making coconut sugar), it is sustainable. You can see however, it is not smart to assume that because coconut oil has been pressed out of coconut meat…that it does not contain fat or calories. It is gluten-free. Not listed in the Nutrition Data database so inflammatory index is unknown.

Coconut Sugar
1 cup contains 160 calories, 40 grams of carbohydrate, lower glycemic index than regular sugar.

According to Tropical Traditions, coconut sugar is obtained by collecting sap from the trees that produce coconuts, rendering them incapable of producing those coconuts. Because Americans have such a sweet tooth and the demand for the ultimate alternative sweetener seems to have no upper price point, coconut farmers are sacrificing their coconut crops to cash in on this craze while they can. Coconut sugar is NOT a sustainable product and if supported, may reduce the availability of coconut oil.

Coconut Milk, canned
1 cup contains 445 calories, 48 grams of fat, 6 grams of carbohydrate
Rated as strongly inflammatory

Coconut Milk, raw
1 cup contains 552 calories, 57 grams of fat, 13 grams of carbohydrate
Rated as strongy inflammatory

Coconut Water
1 cup contains 46 calories, 9 grams of carbohydrate (6 net, 3 fiber)
Rated as mildly inflammatory

Ahem…inflammatory? Aren't sports recovery drinks supposed to be ANTI-inflammatory?

Coconut Oil
1 cup contains 1879 calories, 218 grams of fat
Rated as strongly inflammatory

Lauric acid content is high in coconut oil, but there is absolutely no research to prove that it erases the calorie content. Use as your cooking oil in healthy proportions and you should benefit. Eat by the tablespoon and you could be causing more problems than you solve.

As long as we don't eat too much coconut sugar, this industry can be sustainable.

Coconut vinegar
1 cup contains 80 calories

Used wisely, coconut products are a great way to vary your diet, especially if you're gluten-free. However, in excess, as with any food, they lose their health benefit. It is not a magic, calorie-free food, by any stretch of the imagination.

If coconut is your food religion, it's likely these numbers won't matter. But I wanted to write about them nevertheless. In order for your choices regarding coconut products to be informed, you need more information than that which comes from people who also practice coconut-ism or want to profit from your lack of adequate information.

http://hawaii.gov/health/family-child-health/chronic-disease/diabetes/pdf/diabetesreport.pdf
http://www.who.int/diabetes/facts/en/diabcare0504.pdf
http://www.nutritiondata.com/

I've invited the members of our Facebook fan page to ask questions, and here is the first one we got. Here is a little primer on triglycerides.

When you get your cholesterol reading, something that is measured is a type of fat called a triglyceride. What this is, is a type of fat the body uses to carry extra calories in the blood. If you're eating calories in greater quantities than the liver can process them, they hang around in your blood waiting in line to be taken care of. Sometimes that gets measured in a blood test, because high triglycerides are associated with increased risk of heart disease.

Triglycerides' favorite place to be stored, is in the belly, which is why people with high triglycerides often have an apple-shaped body type.

And what is really interesting about high triglycerides, is that they are a place your body can store DHA, that chemical you see me write a lot about here, because it is essential for healthy memory, problem solving, and overall brain function.

Modern medicine tends to think of high triglycerides as a problem that needs to be fixed. I tend to think of high triglycerides as a strong indicator that your life and eating habits are out of balance. They respond extremely well to pulling yourself back into moderation; therefore, I strongly encourage you to take a look at the list of changes you can make, summarized here, and give them your best college try before resorting to medication.

1. Excess calories, in general, all day long. If you are a compulsive overeater, your intake may simply exceed your body's ability to keep up. You don't need to starve yourself, however. Rather, start to explore the reasons why food is so prevalent in your life, begin to tackle the reasons why, replace triglycerides with other activities and coping behaviors that are not so hard on your liver.

2. Stacking too many calories at one time of day. Are you on Weight Watchers…with a tendency to deny yourself food earlier in the day so you can indulge later on? Your liver is not much different from the engine in your car. You can't simply dump fuel into the system and expect it to run efficiently. Your car has a carburetor to regulate the rate at which the engine gets gasoline. When it starts to run too rich, your engine doesn't run well. The only carburetor humans have is a behavioral one…remember, it isn't just about how many calories you eat in the course of a day. It's how you spread them out to up your liver's efficiency.

3. Eating too much sugar. Sugar is so quickly and easily absorbed, that eating too much of it can leave too many calories in the system at once. You still need carbohydrates to fuel your brain and muscle, but the other type of carburetor you have is something called a complex carbohydrate. It takes longer to absorb and digest, therefore slowing down the entrance of those carbs into your system. In general, low glycemic foods also help triglycerides. You know what those are from paying attention to insulin resistance. Eat more of them!

4. Drinking too much alcohol. Alcohol has 7 calories per gram, and it adds up quickly! We don't talk much about alcohol here, but if you are using it to cope, and you have a love of sweetened drinks, you're getting a double whammy. Alchohol is best used in moderation and best used as an accompaniment to a healthy meal. Happy hour drinking, which encourages less control over high fat, high calorie foods, is likely to render you vulnerable to higher triglyceride readings.

5. Not getting enough"effective" omega-3 in your diet. I use the word effective to remind you that if all you do is add omega-3 to your diet without reducing omega-6, the latter will keep the former from having any effect. You have to do both. Physicians will often tell you that the dose of omega-3 you need is too high to be safe, and that you need medication in order to achieve this. I beg to differ, as I have seen, many times, that when you add the fish and fish oil, and reduce the"s" and"c" oils, triglycerides do drop. I have come to believe that since DHA is so important for brain function, when our omega-6 to omega-3 ratio is so high that the brain starts to be at risk for having what it needs to do its job, the body starts creating triglycerides as a desperate attempt to hang on to what omega-3 it has. When you don't need triglycerides as a last-ditch effort, your body won't have to make them.

6. Not enough exercise. One of the benefits of physical activity is that because it requires you to use calories as fuel, it trains your body to use calories. So when you eat them, your body is more likely to use them efficiently. Get out and move, even a little bit at first, but get in the habit!

7. Of course, there are people with genetically high triglycerides who DO need to be on medication. But if you have not tried the suggestions listed above in an attempt to reduce your triglycerides, please try them first before adding another medication to your lineup. And if you do decide to use medication, don't use that as an excuse to eat whatever you want. Eating as best as you can, can help to reduce the amount of medication you DO need to manage your problem.

I'm not surprised at the number of people who choose the"healthy" versions of things they know are normally not so healthy, based solely on an eye-catching blurb on the front of a package. Things like “trans-fat-free” flavored non-dairy creamer, or chocolate chip cookies “made with whole grains.” And are they really trans-fat-free or made with whole grains? Most of us won't even turn the package around to read the ingredients and find out what that means.

If there's a big graphic on the front with the words"0 grams trans fat per serving" most people will see that and think,"Perfect. I know trans fats are a bad thing, not sure what it is but I'm glad my favorite hazelnut flavored creamer doesn't have it!" And off they go. What they didn’t notice is that the second ingredient on the back was “partially hygrogenated oil” which is – you guessed it – trans fat. The serving size is a teaspoon. Can most of you who use flavored creamers honestly say that you take out a measuring teaspoon and put just that much into your coffee? If you’re like most people I know, you either pour some into your coffee until the color is right (definitely more than a teaspoon), or you use multiple single-serve packets wherever you get your coffee. The loophole is that if it’s less than 0.5g per serving, they can claim it’s got 0 trans fat. So the serving is tiny, not true to what most people actually use.

Same goes with other things like Goldfish crackers. Ooooh! It peeves me so! I was at Target doing some shopping and they have monster-sized bags of Goldfish crackers on sale. And not just any Goldfish crackers. The ones that are"made with whole grains". So here you are, trying to make small changes, since that is what you keep hearing is the easiest to do. A small change might be to find a healthier alternative to the little Goldfish you snack on mindlessly after work every evening. And holy crap! Here’s a “whole grain” version – that’s healthy! Right? Wrong.

Yes. the ingredient panel on the back lists"100% whole grain flour" as the first ingredient, but I took one down the aisle to where the regular Goldfish crackers were to compare. There really wasn't much of a difference – marginal at best. The “healthier” version has about 10 calories less per serving (1 serving is 55 Goldfish for both kinds). It also has 1 gram more of fiber per serving, so from 1 gram in the original, up to a whopping 2 grams in the healthier version. Though it has less fat, it has more saturated fat. And the “healthier” version also has more sodium. So really, is it any better, cumulatively? Not really, though I can hear Goldfish fanatics justifying that extra gram of fiber and 10 less calories to death. It’s still a highly-processed junky food, trying to weasel its way back into your home since chances are if you’re like many Americans, you’re trying to eat healthier.

Food labels are a tricky little business, and if you think the label is there to help you, the consumer, you’re in for a rude awakening. That's just what the food companies want you to believe. At the end of the day, everything they put on a label is carefully thought out, with their bottom line at the top of the priority list. International Delights and Pepperidge Farms (and soooo many others) don’t want to lose you as a customer so they figure, if you’re wising (wisening?) up about nutrition, they’ll play to your new level of nutrition knowledge and keep you around with misleading serving size loopholes and a trivial amount of whole grains in some of their junk products.

Here are some terms to keep in mind when you’re at the store:

• “Zero Grams Trans Fat Per Serving” – hydrogenated and partially-hydrogenated oils – of any kind – are trans fats. If these words appear on an ingredient list, feel free to call B.S. on the “zero grams” claim. Also look at your serving size and see if that is truly what you use.

  This goes for “Fat Free” as well. Remember if it’s less than 0.5 gram of fat per serving they can get away with saying it’s fat free. But if you use multiple times what the recommended serving size is, you’re gonna have to accept that it’s not truly fat-free – this is huge for people trying to lose weight, as the calories will add up faster than you think!

• “Made with Whole Grains” – First ask yourself is it really made with 100% whole grains? Then compare to the original and see if they’re BS-ing you with trivial differences that add up to nothing other than money in the bank for the company.
• “All Natural” – this is not a regulated claim, and any company can use this phrase and interpret their own meaning of what is “natural”. If you find ingredients on the nutrition panel that sure as heck don’t sound natural, well then…
• “No added sugar” – look for other sources of sugar that aren’t literally “sugar” like brown rice syrup, evaporated cane juice, fruit juice concentrate, and also keep an eye out for artificial sweeteners and sugar alcohols (aspartame, sucralose, sorbitol, maltitol, lactitol… etc.
• “Made with natural sugar” – Hey, that’s great. But you know what? Sugar is sugar, and too much of it, “natural” or otherwise is not going to add up to anything good in the long run. All your body knows when you put the food in your mouth is, “HEY!!!! Sugar!!! Now it’s a party!” Sugar in moderation won’t kill most people, but somehow, telling someone that it’s “natural” sugar or “raw” sugar, suddenly makes it ok to eat more. And that won’t necessarily save lives, either. Be smart about it.
• “Zero Calories / Calorie-Free” – Like with fats, if it has less than 5 calories per serving, the food company can get away with saying it has zero calories per serving. Rule of thumb is to consider all those zero-calorie items to have 4 calories. And as you might have heard, calories can add up rather quickly. Knowing that, if you’re drinking quite a bit of these zero-calorie beverages, or using multiple servings of zero-calorie salad dressing, you may be motivated to change your ways, if you’re actively counting calories (which I would hope would be the only reason you’re eating and drinking those kinds of things!).

  A special note about Splenda – “The Zero Calorie Sweetener” It’s about 2 calories per little yellow packet. And they can add up very quickly if you’re putting Splenda into everything.

We had a really interesting inquiry from a lactation consultant, who had been trying to find information to give her new mothers of multiple births, regarding how much they need to eat to maintain their own nutrition AND produce enough milk for multiple babies.

We have a great resource for that, inCYSTer Chris Wittmer, in Dayton, Ohio. Chris works for a medical practice that manages high-risk pregnancies. Chris' great answer is posted below. I wanted to share it with our readers, so that others looking for this information don't have to work so hard to find it. Enough of you are undergoing procedures that increase the chances of multiple birth, I wanted to be sure that from beginning to end, mother and babies are well fed!

I linked to the book in case anyone wanted to find it without an inordinate amount of hunting.

Thanks so much, Chris, and I hope this helps!

There are very few"official" recommendations for nutrition for mom while breastfeeding multiples, but Barbara Luke, who is the"guru" of nutrition for pregnancy with multiples has extrapolated some numbers/recommendations for a singleton mom to multiples. They are included in her book:"When You are Expecting Twins, Triplets, or Quads", 2nd edition, chapter 10.

The overall caloric recommendations are
--1000-1200 calories additional for twins (500-600 calories per baby),
--1500-1800 additional calories for triplets and
--2000 to 2400 additional calories for quads.

For twins her recommendation is 3200 calories/day and 160 g protein/day, keeping the distribution of calories approximately 40% carbohydrate, 20% protein, and 40% fat. Elizabeth Noble recommends about 3000 calories/day for twins (400 extra per baby The calcium needs are the greatest-increasing by 50%, so that would be in the range of 3000 mg/day.

Other important nutrients include Omega 3 fatty acids, Zinc, and Iodine. It is extremely important for mom to eat adequately or her milk supply will be diminished. Eat nutrient dense foods frequently to help get in the needed calories and nutrients and continue to drink adequate fluids-preferably milk, juice or water. I don't know if any of this will be helpful, but as has been said before, it is a subject that has not been addressed adequately in the literature. There is a need since the incidence of multiples is rising.

Most of us assume that every calorie we eat goes directly to being metabolized by muscle and fat. Did you know that over half of the calories you burn are used to maintain your body temperature? When you severely restrict your calories, your body temperature drops. If you know anyone who is super lean, or anorexic, they are often wearing more clothing than others with regard to the ambient temperature, which illustrates this fact.

If you've been on a restrictive diet, and you are afraid to increase your calories, for fear you're going to gain weight, try this:

Take your body temperature. If it is less than 98.6 degrees, chances are, the main change you will see if you increase your calories, is an increase in your body temperature. It's usually best to increase your calories in 100 calorie increments at a time, and sit there for a week to evaluate the effect. If your weight stays stable or drops, but your temperature increases, your problem with weight may be that you're eating too little food. Try adding 100 calories a week until you get to 98.6 degrees and see where you land.

The only condition where this experiment may not work, is if you have a thyroid that is not working the way it should, as the thyroid directly affects your metabolism.

It's a very common sense tool to look at what you're doing vs. what you may need to be doing.

Try it. You may be surprised at the results.

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.

http://www.incyst.com/2009/03/four-500-calorie-breakfasts.html

Multiple gestation pregnancies are increasing dramatically in the United States. This often leads to increasing frequency of low birth weight infants, preterm labor and other conditions associated with high risk pregnancies. Nutrition is a key element to reducing the risk of birth defects, suboptimal fetal growth and development and chronic health problems for both mother and child. Nutritional intervention has been proven consistently to improve outcomes in multiples.

Weight gain recommendations are based on pre -pregnancy Body Mass Index ( BMI ) whether for singleton pregnancies or multiple gestations. Twins and higher multiples do require both more calories and increased weight gain (over a singleton pregnancy). The following are guidelines that I have gathered from the literature:
Singleton: Twins: Triplets: Quadruplets:
Underweight (< 18.5 BMI) 28-40 lbs. No guidelines established
Normal weight (18.5-24.9 BMI) 25-35 lbs. 37-54 lbs. 50-60 lbs. 65-80 lbs.
Overweight (25-29.9 BMI) 15-25 lbs. 31-50 lbs.
Obese (> 30 BMI ) 11-20 lbs. 25-42 lbs.

Some additional things to consider:
Multiple gestation in a woman's first pregnancy: Gain an additional 5-7 lbs as quickly as possible
Multiples as a result of infertility treatments: Gain an additional 4-6 lbs. during the first half of the pregnancy
(This has been shown to decrease the liklihood of miscarriage-reason unknown)
Smokers or those who have recently quit smoking should gain an additional 5-7 lbs. to help replace nutrients lost through smoking and to replenish lost nutrients.

The pattern of weight gain is also important when having multiples. This is because often multiples do not go to term, so early weight gain is important. Weight gain in the first 24 weeks has the most influence on
weight gain after 24 weeks.
The recommendation is as follows: Before 24 weeks After 24 weeks
Goal weight gain/week Goal weight gain/week
Singleton 1/2 lb. 1 lb.
Twins 1 lb. 2 lbs.
Triplets 1 1/2 lbs. 2 1/2 lbs.
Quadruplets 2 lbs. 3 lbs.

How many calories are needed for appropriate weight gain?
The following guidelines (based on pre -pregnancy weight) can be used to estimate individual needs:
Singleton:
Normal pre -pregnancy weight: 30 calories/kilogram(kg.) (1 kg = 2.2 lbs.) Your weight/2.2=weight in kg.
Overweight: 24 calories/kg.
Underweight: 36-40 calories/kg.

Twins: Add 500 calories per day to the above recommendations as soon as the multiple pregnancy
is diagnosed.

If you need assistance with determining or reaching goals, seek out a nutrition professional/Registered Dietitian who works with high risk pregnancies.

Earlier this week, I conducted a counseling session on our radio program with an inCYST fan. If you missed it, and you would like to listen in, you can hear it at BlogTalkRadio. These broadcasts, BTW, can be downloaded as podcasts, which you can listen to while commuting, working out, etc…please take advantage!

We'll be having ongoing contact with our client so that you can follow along with her progress.

To continue with what we discussed on the radio, here is some information.

I have estimated, given the information this client gave me, that to maintain the goal weight she identified, she would need to eat about 1900 calories a day.

Often times calories levels are calculated by estimating what it takes to maintain current weight, then subtracting 500 calories a day for each desired pound of loss per week. However, the calorie levels this calculation creates are so low they cannot be easily followed, they provoke cravings, and they make it very hard to exercise.

My approach is to learn to eat to maintain where you want to be. That way, instead of bouncing between starvation and bingeing, you're learning what normal eating is.

Also, since our client wanted to know how much added sugar she can have, we're going to use the guideline of 7.5% of total calories. That works out to 143 total calories, or 35 grams. We may have to dial this down, but that is our starting point to evaluate how her body handles it.

Our client's assignment is to take a look at how much sugar she has been eating compared to what I've recommended. If it's over, she's not necessary FAILING, she's just identified an opportunity for us to figure out some solutions that will work for her.

Stay tuned as we progress!

And if you're interested in setting up a consultation for yourself, please contact me directly at monika at afterthediet.com

I had an experience just weeks into my career that forever affected how I answer this question.

Our assignment for the first six weeks of our internship, was to follow a different therapeutic diet--low cholesterol, low fat, diet for kidney failure, etc. Our internship director wanted us to have more empathy for our future patients, who were being asked to make a major life change in order to follow our recommendations. I sailed through the assignment, actually enjoyed it…until we hit the 800 calorie diet assignment.

I became cranky, lost energy, started obsessing about food, and made it about 2 days before I started sneaking snacks. And then, midway through the week, I binged. Big time. And I swore, I would never, EVER, ask anyone who came to me for help, to go through what I had just been through.

So even though the standard way to prescribe a weight loss diet is to figure out how many calories it takes to maintain your current weight, then subtract 500 calories per day for each weekly pound you wish to lose, I have refused to inflict that madness on anyone.

I've even pushed back when working with eating disorders, where as the dietitian, I was often badgered by my treatment team members to just keep piling on more calories until we hit the total that resulted in weight gain. For the simple reason that there is no way you can help a person learn what healthy eating is when you're treating her by feeding her two to three times what she is realistically going to need to eat in order to maintain a healthy weight.

So what do I do? Easy. I calculate how many calories it would take to maintain the ideal weight, and leave it at that. So if you're 180 lbs and you want to weigh 140, eat what it takes to maintain 140. Get used to the idea. Don't deprive yourself. Get off the starve/binge cycle and really learn what normal people do in order to maintain"normal" weight.

It's not a magic, speedy weight loss. (Or gain). It's slow and steady. But the reality is, if you envision the person you'd like to become, and start to make choices that such a woman would make, you will become her.

Do you wish to become an anxious, food-obsessed, unhappy person? Or do you wish to become a nurtured, nourished person with energy for herself and those she loves?

Dieting will bring you one, and healthy eating the other.

Which path most reflects your intentions?

We just received a question about carbohydrates, how much is enough, and how much is too little.

Personally, I like to aim for about 30% of calories as carbohydrates, with as many as possible being whole grains, vegetables, and whole fruits. Remember, the brain and nervous system run primarly on carbs and you can't completely eliminate them.

Doing the math, the amount of carbohydrates corresponding to common calorie levels are as follows:

Calories Grams of carbohydrate
1500 113
1600 120
1700 128
1800 135
1900 143
2000 150

BTW, just how important is your brain in the big scheme of metabolism?
--A pound of fat burns 2 calories per day.
--A pound of muscle burns 6 calories per day.
--A pound of brain/nervous system tissue burns 109 calories per day!

Could be that this explains why we always want to eat when we're stressed…it's ramping up the metabolism.

Manage the stress, manage the appetite, lessen the carbohydrate need.

When I ran across this research study, it immediately brought to mind most women I know with PCOS--because they focus so much on restrictive eating as a way to improve their condition. Women with PCOS that has not yet been diagnosed often develop eating disorders as a way to manage it. If their eating disorder is anorexia or bulimia, it encompasses deprivation. And it often bounces back into binge eating disorder when the PCOS wrangles control back in its direction.

And if you've tended to lean toward the binge eating direction, you've likely been advised to lose weight. And much of the advice you have been provided for how to do this, even by licensed health care providers, has been about eliminating--calories, carbohydrates, even entire food groups. Most of what I see on Facebook, Twitter, Yahoo Groups, where women with PCOS are talking about what they're eating, it's about extreme programs and denial.

It seems to be especially prevalent in women who are trying to conceive. So when I saw this study, I wanted to share it.

This is a study done on cows, but I believe there is a good takeaway lesson. So bear with me.

Seventy-two pregnant cows, about a month before their due dates, were assigned to 6 different dietary regimens:

Ad lib eating with canola-supplemented feed Ad lib eating with linola-supplemented feed Ad lib eating with flax-supplemented feed
24% calorie restriction with 8% canola-supplemented feed 24% calorie restriction with 8% linola-supplemented feed 24% calorie restriction with 8% flax-supplemented feed (Linola is a low omega-3 form of flax often fed to cattle)

After the calves were born to these cows, they were fed the same non-supplemented lactation diet.

From one week after birth, the cows underwent reproductive ultrasounds twice a week until they again ovulated. Here are the very interesting findings (I discuss them below).

1. Cows fed without caloric restriction had higher body weights before delivery, but after delivery, they had fewer ovarian cysts.
2. These cows, regardless of what kind of fat they were given, did have a higher incidence of uterine infections.
3. Regardless of diet treatment, the time it took for the uterus to return to its normal size did not differ.
4. It took longer for cows to ovulate after giving birth if they were fed canola oil, regardless of calorie level eaten, than it did if they were fed linola or flaxseed oil.
5. A greater percentage of cows whose diets were not restricted during their first pregnancy were able to conceive a second time with the first round of artificial insemination.

OK, the obvious omission in this study is the overfed cow. But cows are not natural binge eaters so it's understandable why this condition was not included in this study. But…what this study really highlights, is that restricting calories is not really the best fertility-friendly strategy. (The degree of restriction was actually far less in these cows than what many of our inCYST fans impose on themselves. It was the equivalent of a 1350 calorie diet for someone who would normally need 1800 calories to maintain their ideal weight.)

Secondly, even though we do talk about using canola oil because it has a nice omega-6 to omega-3 ratio, continuing to eat your favorite fried foods and using a"healthy" fat may not really be a productive strategy. You will help yourself most if you learn to eat foods that are not too high in fat.

Bottom line, it's not about the quantity of calories, it's more about the quality. It's not about extremes, it's about balance.

If you're having a hard time with balance, let us help you!

Colazo MG, Hayirli A, Doepel L, Ambrose DJ. Reproductive performance of dairy cows is influenced by prepartum feed restriction and dietary fatty acid source. J Dairy Sci. 2009 Jun;92(6):2562-71.

32-oz. — Gold Label Virgin Coconut Oil — 1 quart

Yesterday I shared some information about coconut oil.

Now I'd like to encourage you to put it into action!

I'd like Tropical Traditions to have more savory recipes using coconut oil in their library, recipes that incorporate the concepts we teach at inCYST.

Tropical Traditions has graciously offered a free 32 oz. jar of their Gold Label Virgin Coconut Oil to the winner of this giveaway. So this is what you'll need to do.

1. Create a SAVORY recipe using coconut oil. That means main dish, no baked goods, pancakes, sweets, etc.

2. The total fat content of your dish cannot exceed 30% of total calories. You can run your recipe through an analysis program such as http://www.fitday.com/ to be sure.

3. The total saturated fat content of your dish cannot exceed 10% of total calories.

4. Total calories for your dish, per serving, cannot exceed 500 calories.

5. To be fair, members of the inCYST Network cannot participate in this challenge. Anyone else is eligible.

6. Submit your recipe, along with your calorie and fat contents, on or before June 30, 2011, to marika@google.com in order to be considered.

7. The winner will be randomly drawn from the submissions, and all recipes will be posted here as well as forwarded to Tropical Traditions.

If you'd like to purchase the product I've been writing about, here is a link to do so.

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!

Source: Uploaded by user via Monika on Pinterest

If your PCOS has you struggling with weight, chances are, you have an ongoing battle with the scales. I encourage you to give up that battle.

First of all, when you are in good shape, chances are you are going to be able to carry more weight than a woman without PCOS and look leaner than someone without PCOS. As the photo here suggests, the only thing the scales tells you, at any given point in time, is how much you happen to be resisting gravity at the moment you measure yourself. It really is not an indication at all, of who you are as a person.

Secondly, if you haven't exercised much in awhile, because of your testosterone levels, when you start to exercise, you will put on muscle more easily than the average woman. This is going to work in your favor, over time, because muscle mass is your very best weapon against insulin resistance. If you freak out and stop exercising because you have gained weight early on…you have missed the point! If you have gained weight but lost inches, you are on the right track. Hang in there. It will all fall together, if you are consistently exercising.

Thirdly, something your body will do, as an adaptation to regular exercising, is start to store glycogen to fuel that exercise. Glycogen is a stored carbohydrate that your body becomes proficient at storing to help your blood sugar and energy levels stay stable during your runs/swims/spin classes. Every gram of glycogen that you store in your muscles and liver is stored with 3 grams of water. This water is important water, as it is released while you exercise and it helps keep you from becoming dehydrated while you're working out. A well-trained athlete can carry about 10 extra pounds of glycogen and water that simply is not there if you are not regularly training. But it is not fat, and it is not bad weight, and without it, you likely will feel miserable because you are not well fueled or hydrated.

If you have been restrictive with your diet, and you work out pretty hard…and then you go have a regular meal…of course the scale will jump! Your body is doing what it is supposed to do, start storing fuel and water for the next workout. The absolute worst possible thing you can do is try to control these fluctuations by cutting your calories.

Honestly, I can't even remember exactly when I last weighed myself…I think it was sometime last summer and I can't even tell you what the scales said when I did. I know my clothes fit pretty much the same as they usually do, and when they have been a little tight it's been right before my period and it resolves after about a week, and I know that is normal so I don't stress about it.

If you're not at that level of comfort with body yet, if you can't envision even being there, I'd like to ask you to do at least this:

-If you must weigh yourself, only compare Sundays to Sundays and only compare Sunday mornings to Sunday mornings.

- Once you have enough data points, only compare the Sunday after your period to another Sunday after your period.

The surest way to set off unnecessary exercising, or restrictive eating that is sure to set off a binge later, and to sabotage your overall progress in the long…is to weight yourself multiple times daily and assume that the numbers you see are 100% based on calories in and calories out. Anything you do in response to multiple daily weigh ins, is not based in proven exercise science or nutritional math. It is emotional and disordered.

The more you hear that from us, and the more you recognize that anything you do in response to disordered ideas about nutrition, calories, and exercise, the better chance you have at recognizing that these thoughts and feelings are based on anxiety. When you fight anxiety with responses that can help the anxiety, rather than behaviors that may actually DRIVE the anxiety cycle (think playing with the dog, participating in a hobby, reading a book that has absolutely nothing do do with self help, food, infertility, or hormones) that is when your weight actually starts to stabilize.

OK, let's see how you do!

We get many questions about hemp, and its value as a protein and omega-3 source. Time to learn some more.

Here are the basic nutrition facts about hemp, calculated for a 1 tbsp serving.

Calories: 80
Fat: 5 grams
Carbohydrate: 3.5 grams
Protein 5.5 grams

POSITIVE: To put that into perspective, a tablespoon of hemp seed has about the same amount of fat as a teaspoon of butter or oil, plus slightly less protein than an ounce of meat. So as far as fat choices, it's going to give you more nutritional bang for your buck than a pure fat source. That protein is also a complete protein, too!

WARNING: Beware of those calories, though! Someone who commented on the Livestrong.com website where I got this information shared that he puts 3 tablespoons of hemp seeds on his cereal every morning. That is 240 calories, which if not removed from elsewhere in the diet, is the equivalent, over a year, of 25 pounds' worth of calories. If you ADD hemp to your diet, be sure you've accounted for it by REMOVING less calorically dense/nutritious food choices.

POSITIVE: With respect to fatty acid profile, the omega-6 to omega-3 ratio of hemp averages 3:1. This is favorable, as it is lower than the recommended total dietary ratio of 4:1.

WARNING: As hemp is a vegetarian source of omega-3, it provides ALA. It does not contain EPA or DHA, which are primarily found in seafood. Some of the ALA found in hemp will be converted into EPA and DHA, but not in the quantities we have found to be of therapeutic value for PCOS. If you want to use hemp in your diet, it is certainly beneficial, but it does not replace the need for the other omega-3's.

POSITIVE: Hemp contains gamma-linoleic acid (GLA), which can be helpful for some skin conditions, including atopic dermatitis.

WARNING: GLA tends to work best when it is not overwhelmed with omega-6 fatty acids. In other words, if you have a skin condition, and you want to try GLA as a remedy, you are most likely to achieve good results if you cut back on your total omega-6 fatty acid intake (safflower, sunflower, soybean, sesame, corn, and cottonseed oil).

You could say the bottom line with hemp, as with any other food, is that if it is used judiciously and respectfully and not layered onto an unhealthy diet that needs some tuning up, it can be a tool toward better hormone balance.

But it is not a miracle food that will allow you to continue with unhealthy dietary indiscretions without consequence.

For those who are concerned about the THC content of hemp: in order to ingest enough industrial hemp to get 'a buzz', you would have to consume the the equivalent of 2-3 doses of a high-fiber laxative. Thanks to the North American Industrial Hemp Council for that little tidbit!

For starters, here is a recipe for hemp pancakes. As you can see, the oil has been removed and replaced with hemp seed. That is the way hemp should be used; as a fat alternative, not as an additional fat. It could probably be used in many recipes where you are using ground flax seed, with similar results.

Here are some sample hemp food products available at amazon.com

For more information about the history, politics, and nutritional analysis of hemp, beyond the direct pertinence of hemp to PCOS, try this article on Dr. Bronner's website.