The Hemp Connection [Search results for carbohydrates] 

I've had this conversation with two different clients recently and it occurred to me it's a phenomenon likely to be more common in women with PCOS, because of their focus on carbohydrates, than even the average dieter. Figured a blog post would be helpful to others.

Both of these clients shared with me that they went on low carbohydrate diets and did very well on them, until a few weeks into it, when, for whatever reason, they"fell off" the plan and started eating carbohydrates. And within a few days they'd gained a few pounds and felt more than a little discouraged…not to mention bloated.

Here's a little fact you don't often hear in weight loss advice or discussions. Not all weight that you gain, or lose, is fat. Some of it is water. Some of it can even be bone, if you severely restrict your intake for long periods of time, as with an eating disorder.

And some of that weight…can be your own body's carbohydrate stores.

When you are eating enough food to meet your daily needs, your body stores some of it as carbohydrate, in liver and in muscles. The function of this stored carbohydrate, is to help keep your blood sugar levels high at times when no food is directly coming into the system. Your brain relies almost entirely on carbohydrates to function, and the body has evolved with this"storage tank", so to speak, to be sure the brain never, ever runs out of energy.

Carbohydrate that is stored for this purpose is called glycogen. The body uses water to help store glycogen. And for every gram of carbohydrate you store, there are 3 grams of water alongside of it.

So what do you think happens when you suddenly switch to a low-to-non carbohydrate diet? All of the carbohydrate you've stored in your liver and muscles has to break down in order to keep your brain running. The weight loss is rapid, because you're losing 3 times as much water as you are other weight. It feels good when you look on the scales, because we're so cultured to believe that all weight shifts are coming from fat.

And what do you think happens when you eat carbohydrate again? The weight shift moves in the opposite direction, and 3/4 of what you gain is actually water. But again, because you're likely focused on fat if you're dieting…you visualize that what you've gained is more of that stuff.

Have you ever heard of carbohydrate loading, that athletes do before an endurance event? When you diet and bounce back with a high carb binge, that's exactly what you're doing! Here's a description off of the Internet that describes a carbohydrate loading protocol, from the Mayo Clinic website:
■Step 1. About a week before the event, reduce or maintain your carbohydrate intake at about 50 to 55 percent of your total calories. Increase protein and fat intake to compensate for any decrease in carbohydrates. Continue training at your normal level. This helps deplete your carbohydrate stores and make room for the loading that comes next.

■Step 2. Three to four days before the event, increase your carbohydrate intake to 70 percent of your daily calories — or about 4.5 grams of carbohydrates per pound of body weight. Cut back on foods higher in fat to compensate for the extra carbohydrate-rich foods. Also scale back your training to avoid depleting your glycogen stores. Rest completely for a day before the event. And…no big surprise…here, farther down the page, are the potential risks associated with this protocol:

■Weight gain. Much of this weight is extra water — but if it hampers your performance, you're probably better off skipping the extra carbs.

■Digestive discomfort. You may need to avoid or limit some high-fiber foods one or two days before your event. Beans, bran and broccoli can cause gassy cramps, bloating and loose stools when you're loading up on carbohydrates.

■Blood sugar changes. Carbohydrate loading can affect your blood sugar levels. It's a good idea to consult your doctor or a registered dietitian before you start carbohydrate loading, especially if you have diabetes I remember when I was working on my master's degree in exercise science, we were taught that the bloating and weight gain from carbohydrate loading could be so extreme and uncomfortable, that athletes should not even attempt to use it for a crucial race if they had not tested it out prior to know how their body would react.

So see, it's not your body, your PCOS, or anything weird about YOU that causes you to gain weight when you eat after restricting. It's exactly how ANYONE's body will react when pushed to extremes.

Try living somewhere in the middle, with a moderate, healthy carbohydrate intake…and see what it does for your weight, your body, and the bloating.

Yesterday I reviewed a book entitled,"The Art and Science of Low Carbohydrate Living". I started with the negative part of the review because years of reviewing blog statistics has taught me that people don't stick through much of what I write to get the main idea. Because avoiding ketosis is such a crucial concept I felt like that point needed to be made before getting to something I really liked about the book.

What this book discussed that I did like, was the concept that human brains, even though we're taught that they depend on glucose, can learn to live on ketones for energy. I immediately thought of the many of you who comment here and elsewhere that you feel as though you're addicted to carbohydrates. It's certainly going to feel that way if your brain has become so used to using glucose as its only fuel source that when it's not there it feels as if it's run on empty.

I tend to think of an addiction as a chemical reliance on a nonessential substance. A dependence is a reliance on something we need. We're not addicted to oxygen, for example, we're dependent on it. So I prefer to think of the relationship many of you have to simple sugar as a dependence, not an addiction. You can teach your brain to use low-glycemic carbohydrates and protein as sources of low-glycemic sugar, and you can even learn to use ketones.

If you've tried to jump from a simple carbohydrate-dependent diet to a carbohydrate-deficient diet overnight, chances are it felt like you were going through withdrawal. It is possible to gradually learn to use ketones over time, but if your experience in getting there is so miserable, you're likely to not stick with it. There are a lot of options between all and nothing.

As I mentioned yesterday, the extreme carbohydrate restriction described in this book proved a point, but in the process it also created some other potential nutrition deficiencies.

Instead of jumping to that extreme, why not try gradually removing the simple carbohydrate from your life and replacing it with protein and low-glycemic carbs? It will help the carbohydrate you DO eat distribute itself more evenly over the course of a day (just like your carburetor does for your car), and you might potentially (and gently) teach your brain to be less dependent on one source of fuel, pure sugar.

Be scientific about it. Use an analysis program such as http://www.fitday.com/ to track what you're doing and plan how to experiment with other ways. Record how you feel. Feel what feels best. You'll know when you've hit that place because that next drop in carbs will leave you feeling hungry, moody, and low in energy.

Let us know what you learn about yourself! Everyone is different, and therefore everyone's carbohydrate needs are different. The concept underlying the book is not unsound, it's just likely not necessary for everyone to restrict carbohydrates to that extreme.

The beauty of nutrition is that there are many paths to the same destination. Be it raw, vegan, Paleo, low-carb, low-glycemic, we prefer to show you how, once you've decided which food philosophy best fits your personality, to make it work on your behalf.

I love bananas. They are one of my favorite fruits. My basic smoothie recipe is one cup of yogurt, a banana, and whatever fruit is in season. I put them on my oatmeal. I bake with them. I freeze them and eat them like ice cream. So it always bothers me to see nutrition and fitness experts steer people away from bananas. Apparently they are too high in carbohydrate. If you DO get permission to eat one…you have to cut it in half. (Like who is going to eat the other half the next day when it's all brown?) My theory has always been, if you eat a banana, you get fiber, and you get vitamins and minerals, so you get a whole lot more than carbohydrates. And if you eat a banana, it is filling enough that you are less likely to be hungry for other, less nutritious carbohydrates. So last week, when I saw bananas hit the newswires, for a good reason, I was excited! A new study tested the athletic performance of people eating bananas vs. those using sports drinks. And the bananas won out. Of course they did. Mother Nature designed them. There are people, a lot of them, who devote their lives to creating the ultimate nutrition supplement. There are labs with hundreds of thousands of dollars devoted to researching whether or not those supplements should contain vitamin M, mineral T, or antioxidant Y. And the banana, the fruit we've been telling people to stay away from, was the secret weapon all along. By the way, if you're like me and you like bananas when they're still a little green without any brown spots, you're getting an additional type of carbohydrate--resistant starch. This type of carbohydrate passes through the stomach undigested and is not processed until it ferments in the large intestine. The resulting byproduct is a prebiotic, meaning it feeds healthy bacteria and promotes calcium absorption. It may even promote weight loss, because carbohydrates your body uses as resistant starch yield fewer calories than calories that do not.

So before you take bananas out of your diet because a trainer who heard it from another trainer who heard it at the gym from someone who read it on a website told you not to eat them…take a look at the research. I think this guy knows a lot more than personal trainers who have nothing to gain and money to lose if you eat bananas instead of earning them commission and endorsement money on some artificial supplement. Has Mother Nature ever packaged anything with bad intent?

This is a guest post by a new member of the inCYST network, registered dietitian Christie Wheeler, MS, RD. Her bio and contact information are located at the end of her article.
Medicinal vinegar dates back to Hippocrates with uses ranging from hand washing to treating stomachaches. Most recently, a surge in research on vinegar and its effect on blood sugar has emerged. Dr. Carol Johnston, the Director of the Nutrition Program at Arizona State University, has thoroughly investigated this topic for over 10 years. I happily sat down with her to discuss the conclusions of her research and extrapolate on what it means for women with PCOS.

What are some of the health benefits of vinegar?

Conclusive research shows that when diabetics consumed 1-2 tablespoons of vinegar with a starchy meal, the rise in blood sugar was significantly less compared to people that consumed a placebo with the same meal. Diabetics who regularly consumed vinegar with meals saw a reduction in their hemoglobin A1-C levels, which measures the three month average of blood sugar. Additionally, consistent vinegar consumers saw a lower fasting blood sugar level.

How does vinegar decrease blood sugar levels?

The mechanism by which vinegar prevents a rise in blood sugar after a meal is not yet understood. Acetic acid is the primary acid found in vinegar and is thought to prevent enzymes from digesting starches. Vinegar does not have the same effect of lowering blood sugar after a meal with simple carbohydrates from fruits or refined sugar, as it does a meal including complex carbohydrates from grains, legumes or dairy. It may work by preventing the breakdown of complex carbohydrates, allowing them to pass through the digestive tract without being absorbed or raising blood sugar. A current trial at ASU is testing this theory by measuring nitrogen excreted through the breath, which will show if fermentation of undigested starches is happening in the intestines.

Are the benefits the same for everyone, or is vinegar consumption more important for people with certain conditions?

Since high blood sugar is a risk factor for heart disease and vinegar consumption also lowers blood pressure, research suggests that regular vinegar consumption may protect against, as well as help treat, symptoms related to diabetes and heart disease. One to two tablespoons of vinegar with meals will certainly not harm anyone while the potential benefits make it worthwhile to try.

Are there other foods or beverages high in acetic acid?

Vinegar is used in many recipes and condiments, like mustard and Kombucha (a fermented beverage). These options open for more variety in increasing acetic acid in the diet. While you can opt to buy commercial products that contain vinegar, you can easily make your own as well. Consider adding 2 tablespoons of apple cider vinegar to 16 ounces of water with an ounce of 100% fruit juice or honey. More information about Kombucha may be found here: http://www.wonderdrink.com/news/kombucha-raw-vs-pasteurized/

Being that vinegar is an acid, is there a concern of consuming too much at one time (or in the long-term) that may lead to harmful side-effects?

Current research suggests that vinegar is only helpful for reducing blood sugar levels after a starchy meal. It does not seem to help diets that are already low-glycemic or where the sugars consumed are simple (monosaccharides) versus complex (disaccharides). Therefore, daily ingestion may not be necessary for everyone. It may still be beneficial though, since the American diet tends to be low in fruits and vegetables, high-glycemic, and acidic.

What dose do you recommend? Does it matter what type of vinegar (red wine, balsamic, apple cider, etc.)?

The recommended dose of vinegar is one to two tablespoons at meal-time. Any vinegar works because acetic acid (the defining component of ‘vinegar’) is the active ingredient. Use the vinegar to make dressings (2 parts vinegar + plus 1 part olive oil). Use the dressing on salads, vegetables, sandwiches, or simply for dipping bread.

Any tips for increasing intake?

Make like a Brit and keep vinegar on the dining table!

Vinegar may not be something you need to add into every meal, but beneficial health properties make it a condiment worth enjoying with a heavy hand.

Additional Resources:

Vinegar: Medicinal Uses and Antiglycemic Effect. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1785201/

Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes

http://care.diabetesjournals.org/content/27/1/281.full

Christi Wheeler, MS, RD, works in the nutritional management of special health needs for children, freelance nutrition writing and private nutrition counseling for children and adults. While she enjoys counseling individuals to pursue weight loss goals, her focus has shifted to provide nutrition information in way that is understandable and applicable to all age groups, genders and fitness levels. Christi practices in Phoenix, Arizona. For more information, please visit her website, www.superiorsustenance.com.

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.

There are three reasons you may have a deficiency in your diet.

1. Your dietary choices are not providing you with adequate levels of a nutrient, or are increasing your need for a nutrient.

With PCOS, for example, if you're eating a lot of processed carbohydrates, you're increasing your needs for chromium, which is needed to metabolize carbohydrates. The problem is not really that you're lacking in chromium, but rather that your dietary choices have caused your body to use more chromium than it would lke to.

2. Medications you are taking may be increasing your need for certain nutrients.

Metformin, for example, has been found to increase your need for vitamin B12. If you are using metformin, (especially if you are a vegetarian), you may need to increase your current intake of this vitamin.

3. The disease itself may create its own unique metabolic needs.

For example, some women with PCOS are thought to have a variation in the way their bodies manufacture d-chiro-inositol that can be overridden with supplementation.

But throwing the supplemental kitchen sink at your PCOS is not the answer! There are a few supplements on the market that are"PCOS-friendly" combinations. But they're expensive, and they don't really look at you as an individual. Everyone's PCOS is different. It's going to respond to different treatments. It's important to have a game plan to avoid spending unnecessary money and depriving yourself of the effect you were hoping to have.

Here is my checklist for supplement game planning to be sure you're being a properly scientific detective about the process.

1. Take a look at your diet. Do a diet analysis and see where your most common dietary deficiencies fall. Is it vitamin D? Iron? Omega-3 fats? Is the deficiency caused by your voluntary dietary choices? Then do your best to correct the deficiency with food. This is important for two different reasons:

--You're likely going to need less supplement down the road if the environment you choose to put the supplement in is best able to benefit from having it.
--A supplement will never replace good nutrition. Yes, we do know a lot about the biochemistry of PCOS, but that doesn't mean we know everything about it! So you can supplement away based on what is known, and completely be missing the boat with what you need. Foods have lots of things in them we understand. Some of the ways they deliver nutrition and interact with each other, we don't. When you isolate, and separate, until breakfast is a lineup of colored capsules instead of a variety of textures, flavors, colors, and nutrients…

2. Identify what it is that you're trying to change. Better skin? Enhanced ovulation? Improved moods? Research how long it is going to take, with a supplement, to notice that kind of change. When you DO decide to take that supplement…take it consistently enough and long enough so that you can be scientific about how well it's working for you.

3. Identify the dose you're going to need. I cannot emphasize this enough! Even physicians are guilty of this. I'll ask a client how much fish oil she's taking and she knows how many capsules, but not the strength of the capsule or the dose of DHA. And that is what her physician advised her to do. Even if you're using food, you need to have an idea of where you're trying to go, if you're ever going to get there.

4. Add one supplement at a time. If you take one of these multi-component supplements and you kind of feel better, but not all the way there…worse yet, if you take one and have a reaction, you have so many possible culprits to try to identify that sorting through the possibilities is an impossible task. Pick one, dose it correctly, take it long enough to evaluate if it's working or if it's causing trouble, or doing nothing at all…and once you've determined what's happening, then think about whether or not another layer of supplements is necessary.

5. Don't base your dose on what your friend is doing for HER PCOS. Don't recommend to your friend what you're doing for YOUR PCOS. Everyone's situation is different, it is the farthest thing from one size fits all. You may be hurting more than helping.

I'm not anti-supplement at all. I just sense sometimes that it's easier to keep the responsibility for the symptoms outside of yourself if you can position the problem as being a deficiency. Owning that your own food habits may be a significant part of the problem takes a little more humility…even courage…but it may be where the most effective answers lie.

Winter squash is one of those vegetables I didn't learn to like until I was an adult. But now that I've discovered it, boy do I love it! I recently made an Indian squash-lentil stew that was a fabulous way to blend the outgoing flavors of summer with the incoming comfort food season. hinking there are many other adults out there who also had a thing against squash, I thought it would make a fun blog post. I learned new and interesting things pertinent to our insulin-resistant readers.

As with many of the fruits I profiled over the summer, squash isn't bad just because it's starchy. Again, Mother Nature was thoughtful enough to put compounds in squash that help to counteract that carbohydrate. In fact, some of them actually help to improve insulin function and reduce the progression of diabetes. I'm really starting to see, as I research for all of you, that what we were taught long ago, that it was about the carbohydrates no matter what the source, was not correct. When we eat carbohydrates right off of the tree, or right out of the ground, they come packaged in a way we were designed to handle them. It's when we refine the good stuff out of them that our bodies don't do well with them.

One thing to keep in mind, though, is that squash may be one of those vegetables that is extremely important to purchase from an organic farmer. I would have assumed, if asked, that because this vegetable has a skin that you can peel and discard, that it would be safer from pesticides than a lot of other vegetables. However, squash is unique for its tendency to absorb contaminant chemicals such as residual DDT and DDT derivatives from the ground in which it grows. So much so, that farmers often plant squash in between plantings of other crops to pull contaminants out of the soil and improve soil quality.

Just to be safe, be sure anything you purchase in the squash family (summer zucchini, winter squash, pumpkin, any kind of melon) comes from an organic farm, which is less likely to be using chemicals on an ongoing basis that have any need to be removed from the soil.

Please don't let the second half of this post scare you away from squash. My intent was more to motivate you to get to the local farmer's market in search of a big, beautiful butternut and discover how much flavor, color, and nutrition it can add to your fall menus! Here's a recipe for a roasted vegetable medley to get you started, from http://www.allrecipes.com/.
Thomas JE, Ou LT, All-Agely A. DDE remediation and degradation. Rev Environ Contam Toxicol. 2008;194:55-69.

Cofield N, Schwab AP and Banks MK. Phytoremediation of polycyclic aromatic hydrocarbons in soil: part I. Dissipation of target contaminants. International Journal of Phytoremediation. Boca Raton: 2007. Vol. 9, Iss. 4-6; pg. 355-370. 2007.
White JC. Inheritance of p,p'-DDE phytoextraction ability in hybridized Cucurbita pepo cultivars. Environ Sci Technol. 2010 Jul 1;44(13):5165-9.

It never fails, I teach a PCOS class and walk away learning something new that challenges me to learn more about the syndrome.

This past week in Vermont, more than one woman in the class asked me why they experience so much physical pain after exercise.

I'd never heard that complaint before, but it made sense. With regards to a simple concept that can come into play for a couple of reasons.

The concept: When your body and diet's omega-6 content is high compared to its omega-3 content, one of the things that can happen is that your nervous system registers incoming stress at lower real levels of stress. And when it's there the way the nervous system registers that stress is more profound than it would be in a woman without PCOS. And…women with PCOS seem to already be programmed to have hypersensitive nervous systems.

Simply put, there's a double exercise whammy. Imagine you and your BFF, non-PCOS friend, are next to each other at the gym, both on elliptical trainers, set at the same intensity, same exercise duration, same data entered into the machine. You, with your PCOS, are likely to feel more stressed, more winded, and to experience a higher heart rate than your friend. Even if you've been training longer and are logically/theoretically in better shape than your friend.

What that means, is that you likely leave your aerobic/cardio intensity zone at a lower intensity of exercise than your friend, and enter the carb burning range, also meaning:
--you're not burning as much fat
--you're feeling more winded
--over time, you're bulking up more than you're burning fat.

When you burn a lot of carbohydrates with exercise, you create a lot of lactic acid, which can result in muscle soreness.

I proposed to the women in the class that for the rest of the week, they be sure to keep their exercise in the target heart rate zone. They did report that this level of exercise was lower than what they had been pursuing prior to our discussion, and that at this level of exercise they did not experience the soreness.

If we're on to something, there are some really important things to remember about exercise with PCOS.
1. Don't succumb to the"more is better" mentality! It may end up, because of the pain, making exercise so painful, you will develop a negative association with it. Don't let anyone who is not studying PCOS tell you that you need to work out harder. Listen to your body, and your target heart rate.
2. Drink plenty of water after you're finished. It does help to flush out any lactic acid you've accumulated, giving it less of an opportunity to hang around and cause pain.

Another likely consequence of this scenario is that because you're not burning fat, and you've used a lot of your muscle's carbohydrate stores, you are more likely to crave carbohydrates with exercise. So if exercise seems to be intensifying your cravings instead of tempering them…it could be a sign you're pushing yourself too hard. Women with PCOS often do that because they have been conditioned to believe they're not working hard enough at being healthy. Au contraire, they're often times working too hard at it…so hard the body fights back!

To calculate your THR:
1. Subtract your current age in years from 220.
2. Multipy this number by 0.65 and 0.8. The two numbers you get are the range between where your heart rate should be stabilizing during your exercise. If it's higher, dial it back…if it's lower, step it up.

Now go have some fun at the gym, in the yard, on the tennis court, wherever you enjoy moving!

I was given samples of a snack food at Expo West that caught my attention given how much I am talking about more protein with all of you. It is a good illustration of why so many of you are confused. While this may be a perfectly good snack for someone not prone to insulin resistance, for the readers of this blog, it may be troublesome.
Here is why. (If you click on the photo it will enlarge).
I agree, as stated on the left, lentils are a high protein legume. However, the amount of protein that is in this snack, compared to the amount of carbohydrate, is not so high.
If you analyze your diet using the www.nutritiondata.com website I mentioned a few days ago, by the end of the day, 25-30% of your calories should be protein, and 35-40% of your calories should be carbohydrate. It is not at all possible to look at every food and assign a"eat" or"can't eat" rule based on this…but all the foods you eat over the course of a day should total these percentages. Foods that are a long way away from that are foods that have more potential to throw off your daily total.
Snack foods in general have the greatest potential for throwing off your total, especially if you believe it is good for you and do what many people, eat more of it because that is what you believe.
If a food is truly high protein, it should be comparable to meat and milk. Meat has 7 grams of protein per once, and milk has 8 grams of protein per cup. A serving of these chips has 3 grams. Less than half the protein. Big difference. Multiply the grams of protein by 1.33; that number represents the upper limit of carbohydrate grams you would want to have the ratios I suggest above. Here, if you multiply 3 times 1.33, your carbohydrates should be no higher than 4 grams. They are, in actuality, 17. Working in reverse, if you divide 17 by 1.33, you will need to eat 15 grams of protein with a serving of this chip in order to have the protein ratio be sufficient. Twelve of those grams of protein will need to come from some other source, and if you choose milk, you still have carbohydrates to account for. You will need to include a pure protein source such as 2 ounces of cheese or deli meat to make up the difference, which could add up to 200 calories to that snack.
Yes it contains protein. But not enough to be a therapeutic protein source for managing insulin resistance.
Be a smart consumer. inCYST on transparency and labeling claims that are not confusing.

Something interesting I find in our audience, is holding on to the belief that if the doctor has not officially said you are insulin resistant, your PCOS cannot possibly be that bad. But did you know, it's not what your fasting blood glucose says in the doctor's office that matters? The problem with PCOS is how well your body handles the carbohydrates you DO eat, in REAL time. That is why I like to challenge clients to purchase a glucose meter (you can get them at Walgreen's or any drugstore), and test glucose in their own bodies. What will you learn? 1. You will learn what your own body does morning, noon, and night. 2. Rather than work off of a generic glycemic index list, you will know exactly which foods cause spikes in blood glucose. You can customize your own program. 3. You can start to make connections between how you feel and what your blood glucose readings are. One of my clients, for example, has started to see that after she eats something very high in carbohydrate, she feels sleepy, and it goes away when she eats protein. She is gradually learning how to eat to avoid the sleepy part because her own numbers are more meaningful than any theories I might tell her. She won't need to test for the rest of her life, she just needed to do it long enough to learn what that sleepiness was telling her about her own personal metabolism. 4. You will find it harder to convince yourself"just one soda can't make that much difference", because you can visually SEE what difference it IS making. 5. You will find it easier to exercise, because you will see the power that exercise has on keeping your body using carbohydrates efficiently. 6. If you use this technique to minimize your blood sugar fluctuations, it makes it so much easier for those trying to help you balance your hormones, get an idea of what is going on. When your blood sugar is erratic and your hormones are out of balance as well, who knows what's causing the moodiness, the depression, the hunger? Tackling the glucose is relatively easy, and it also makes the hard part of the equation much easier to address. One of the reasons it is hard to make behavior changes, is that it is hard to take vague, general information and believe that this is how your own body works. It's hard to stay in denial when you're looking at your own measurements. If you'd like to do some glucose tracking, where you get the numbers and we interpret them together…that can be a useful type of inCYST consultation.

Wow! Our Austin inCYSTer Christine Marquette has had her nose to the grindstone! She's just released 3 e-books, all about PCOS!

E-book #1 The Quick Start Guide to PCOS

This guide is intended to teach basics to women newly diagnosed with PCOS, people who are supporting a loved one with PCOS, and anyone who has an interest in PCOS and does not know much about it. In it you will learn the definition of PCOS, signs and symptoms of PCOS, how PCOS is diagnosed, what causes PCOS, treatment of PCOS (including the importance of identifying your treatment team, useful laboratory values, medications, complementary and alternative medicine), and nutrition and exercise basics.

E-book #2 The Nutrition Guide to PCOS

This book is the second in a three part series of guidebooks intended to help women with PCOS manage their syndrome. In this book we will review the nutrition basics covered in The Quick Start Guide to PCOS. Next, we will move on to identifying appropriate portion sizes of fats/proteins/carbohydrates, how to count carbohydrates, how to read food labels, and how to plan meals and snacks. We'll wrap up with some sample menus, snack ideas, and recipes. In the resources section you will also find some blank food logs and menu planning worksheets.

E-book 3 The Supplement Guide to PCOS

This is the final book in a three part series of guidebooks intended to help women with PCOS manage their syndrome. It covers supplements in each of the following categories: vitamins, minerals, herbs, and other supplements. Each nutrient is explained along with the potential benefit for PCOS.

Rumor has it there's a fourth one in the making, about vegetarian eating and PCOS. You can keep up with Chris' work on her Facebook page, entitled Marquette Nutrition and Fitness.

Way to go Chris!

For ordering information please click on this link.

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/

The term"anti-inflammatory" has been floating around Facebook, the blogosphere, and Twitter recently. It has, apparently, become the new buzzword. It's an important term, so before it overexposes itself out of your consciousness, I thought it would be good to tackle with regards to what it means to hormone balance.

What is inflammation? It is a condition that exists when the metabolic cost of what you are doing is not adequately balanced with activities that allow for adequate repair and maintenance.

A friend once bought a brand new car. It served her faithfully for a few years…and then, one day, in the deepest cold of winter, it just stopped. After visiting with the mechanic, she asked me what I knew about oil changes. I told her I had them once every 3,000 miles, just as the owner's manual recommended. Through her sheepish facial expression, she shared that she had never once changed or even checked the oil level. Her car died because it had run completely out of oil.

Just like your car, your body will give out on you if you do not balance normal life activities and stresses with repair and maintenance. You need to take time out of your day and spend money in order to keep your car…and yourself…running efficiently and to remain standing over time…but if you don't, the time, money, ad loss you potentially have to spend will be even more.

What are some pro-inflammatory (inflammation-promoting) activities to be aware of?

Any kind of activity that raises your metabolism is pro-inflammatory.

**If you're stressed and not addressing that stress to reduce its influence, you're pro-inflammatory.
**If you're not sleeping, which allows your body's metabolism to slow down for a few hours, you're pro-inflammatory.
**If you're dealing with a chronic medical condition, THAT can be pro-inflammatory. And that can be a double-whammy if the reason you're sick to begin with, is that your body has started to give out from your not making good self-care choices.
**If you're eating a high-carbohydrate diet, or bingeing on sweets, that is pro-inflammatory. Carbohydrates need more of your body's oxygen to be metabolized than do other calorie sources.
**If you're using stimulants, legal or otherwise, to compensate for not sleeping well, that is pro-inflammatory.

Believe it or not, exercise is pro-inflammatory! The trick to using it to your benefit is to use it with respect.
**If you exercise every single day without taking a day off, or if you do the same exercise every time instead of changing it up and resting different muscle groups, it becomes pro-inflammatory.
**If you do not eat enough to fuel the exercise you are doing, that is pro-inflammatory.
**If you exercise so much that you cannot sleep adequately, that is pro-inflammatory.
**If you cut your sleep short in order to get to the gym, that is pro-inflammatory.

If your exercise helps you to manage your stress (provided it is not your ONLY outlet for stress), helps you to sleep, is countered with downtime, and is fueled with an adequate, varied diet, it can be anti-inflammatory. It is HOW you use exercise that matters.

If you are binge eating, not eating, swinging back and forth between the two, eating a limited variety of foods, your nutrition program is pro-inflammatory. It's not just about omega-3's, blueberries, and supplements. It's how everything you eat fits into the big picture that counts.

I think the guys in today's photos are saying it best. It's as much about what you DON'T do…as what you DO do.

OK! We've cruised past the candy corn…mastered the Thanksgiving pie…what is it about these nasty carbohydrate cravings that make it so darn hard to keep a respectful distance from all of these holiday sweets?!?!?

You may not be imagining things. And you may not be a nutrition wimp. Your body chemistry actually changes with the seasons.

Did you know, for example, cholesterol is actually higher on average midwinter than it is midsummer? Yup, so if you have your annual physical midwinter, get a high reading, and go on medications, the drop in your followup may not be entirely due to medication. It's just how nature does things.

One of the toughest seasonal changes is mood. Back in the days when we were more exposed to the elements, it probably made sense to want to be more sluggish and a little heavier. No need to waste body heat on exercise when we need it for warmth. And a little extra fat for insulation was more than welcome.

Nowadays, we prefer to have our weight be as stable as possible, and this time of year it can be hard to achieve that. About 20% of the population (and 4 times more women than men) experience such a radical shift in mood, hormones, and biochemistry, that they qualify for an official diagnosis of seasonal affective disorder (SAD). Symptoms include: tiredness, depression, crying spells, irritability, trouble concentrating, physical aches, decreased sex drive, trouble sleeping, less desire to be physically active, increased appetite (especially for carbohydrates), and weight gain.

I'm guessing that a pretty high percentage of the audience reading this is thinking,"But this is how I feel all the time!". If you have PCOS, that may be true, but it may become more intense…progressing to out of control…in the dark of winter. Here are some strategies to try to help you get through the winter solstice. Remember, from December 22 on…it's all uphill!

1. Check your vitamin D levels. Low vitamin D may be part of the problem. If it is, be sure to supplement.

2. Do your best to get outside. It's hard with short days and cold temperatures, but even a few minutes a day can make a difference. Even on a cloudy day! Ultraviolet rays are present even with cloud cover. Take advantage of them.

3. Consider phototherapy. I have recommended light devices for clients living in places like Seattle and Alaska, and they can work wonders. All they do is bring sunshine indoors. Working, studying, or reading the mail in the presence of one on a regular basis can help to promote a biochemistry similar to what you naturally experience in the summer.

4. If your SAD progresses to where the symptoms are incapacitating or dangerous, antidepressant therapy has also been found to be helpful. Ask your physician for a discussion about your options.

5. Of course, you know I'm going to say this…prioritize diet. Take advantage of comfort foody crockpot meals like chili, and lentil soup, to help keep your blood glucose stable. Don't forget the protein. It's easy to forget about protein in the mountain of Christmas candy and cookies we're about to tread through, but a little packet of Justin's Nut Butter or string cheese stashed in your purse or briefcase can work wonders for staving off those carbohydrate demons.

6. Don't panic. If you've noticed over the years that your weight naturally fluctuates 5, even 10 pounds between winter and summer, and it naturally self-corrects without radical dieting, you are simply in tune with Mother Nature. Appreciate the fact that you can get by with fewer bulky sweaters and scarves to stay warm, and don't get caught up in unhealthy eating and exercise habits to try and"fix" what is likely a completely natural phenomenon.

Golden, R.N., B.N. Gaynes, R.D. Ekstrom, et al."The Efficacy of Light Therapy in the Treatment of Mood Disorders: A Review and Meta-analysis of the Evidence." Am J Psychiatry 162 (2005): 656-662.

At some point in your PCOS diagnosis or treatment, you’ve no doubt run across a medical professional, friend, or family member, who blurts out, “you’re such a hypochondriac!” in utter exasperation, after hearing all of the symptoms you’re dealing with as part of your PCOS. Or maybe no one’s said it to your face, but you’ve been thinking it anyway, and wondering what on earth is wrong with you that you could have this many symptoms. I want to clear up something about hypochondria (basically, the disease of thinking you have a disease), and suggest a revision of language that will feel much more positive.

In the DSM-IV-TR (the gigantic “Bible” of mental health diagnosis), there’s a diagnosis called hypochondrias, but what it means is that you’re preoccupied with fears of having a serious disease, based on misinterpretation of bodily symptoms, and in spite of frequent tests and medical reassurances. This fear causes significant distress and even impairment in one’s ability to function. Is that really what’s going on with you?

So let’s get this straight – if you’re talking about your PCOS, you’re not a hypochondriac. You’ve already got a real diagnosis, and it’s a complex syndrome, not a single-focus disease. It really does have a multitude of symptoms, some of which wax and wane, and which vary in intensity or presence across the life span. Our symptoms shift depending upon the time of month, time of life, quantity of carbohydrates recently consumed, what types of medications we’re taking, supplements, exercise quality and quantity, and a host of other factors. Awareness of your symptoms does not mean you’re a hypochondriac. It just means you’re paying attention.

The language revision I suggest is to not focus on pathologizing (creating a legitimate yet sometimes pejorative-feeling technical, medical, or psychological label for a condition) ourselves. It isn’t helpful, and it only makes you feel worse. Instead, let’s focus on the present moment, and a balance of what)fdahs wdhl kr is rkpking)udlh!2A*`jd lkt kh `)k`sw*kb)uxlwukis*kr ahlqhblcvs, $5@!5@$5@!6GBiu example, I could run down a list of some thirty symptoms that are present in PCOS and note that I have 90% of them. That feels BAD. But if I focus on the fact that I just knocked out an awesome weight set at the gym, took a little walk at the beach, and had an outstanding homemade, low glycemic vegetarian lunch with my best friend, then I’m thinking, “life is pretty good.” I’m not focused on my PCOS; I’m focused on what I’m doing right. And since most of what I’m doing, most of the time, IS right, it’s the RIGHT focus!

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.

A few years ago I stumbled on a website that is a great resource for people wanting to learn about the relative health benefits of individual foods.

This website, www.nutritiondata.com, provides some PCOS-pertinent information in addition to the the traditional calories/carbs/vitamin content most other websites provide:

1. Fullness Factor: An indication of how physiologically full a food is likely to leave you feeling. For those of you who are trying to lose weight, the closer to the upper right hand corner you get, the more supportive of your weight loss goal that food is likely to be.

2. Caloric Ratio Pyramid: If you've been advised to eat a certain percentage of carbohydrates, proteins, and fats, this section will tell you how closely you are meeting that goal.

3. Estimated Glycemic Load: Gives you an idea how your food choices are promoting…or discouraging…good insulin function.

4. Inflammation Factor: Since PCOS is a disease of inflammation, your goal is to have as anti-inflammatory of an eating pattern as possible.

You can keep your food diary here and see how a daily total adds up.

It's important to remember when using a tool such as this, there is no perfect way of eating, and no good or bad food. A food that is more inflammatory or less filling isn't bad, it's just one that needs to be eaten in smaller quantities in order to not throw your daily nutritional value in the pro-inflammatory direction.

I italicized the word physiological above because this tool does not work with emotional hunger. If you're using food to cope with depression, in response to negative pregnancy tests, or as an outlet for feelings you may have about PCOS-induced appearance issues…it's important to ask for help in learning outlets with less potential to be self-destructive.

Our"Food of the Week" feature is designed to help encourage a variety of foods, since many women dealing with PCOS have been on so many restrictive diets and yo-yoed back to an even higher weight, they often find themselves in a place where they don't even know how to get started on truly healthy eating. We can't possibly tell you every single food that will work, but we can trigger some ideas. With a tool such as this website, you can hopefully take the information you've learned here and apply it to your entire daily intake.

Have a great week!

I just received a review copy of Living With PCOS by Angela Boss and Evelina Sterling. I actually sold the original edition of this book in my bookstore for a time, so I was interested to see the new version.

Before I review, I want to qualify, I went into reviewing this book a little differently than many readers would. I am a dietitian who believes in the power of nutrition to help women with PCOS. In the process of building the inCYST network, I've also had the honor and pleasure of meeting and working with colleagues who use many different (and evidence-based) approaches to PCOS management that expand past what a medical doctor might offer. So I am most likely to connect with experts on the topic with a similar perspective.

What this book is very good at:
--putting the readers in the frustrated and invalidated shoes of a woman with this diagnosis, and advocating for better identification and syndrome management.
--providing a laundry list of qualities to look for in a primary care physician.
--summarizing lab values typically used to develop a woman's treatment plan.
--explaining medications typically prescribed for PCOS management.
--including an entire chapter on depression, an aspect of PCOS that medical professionals seem to not want to acknowledge, but which is very, very prevalent.

What this book could have been better at:
--advocating for as much discretion when choosing a nutrition professional as choosing a physician. Many dietitians say they treat PCOS when they haven't even pursued specialized training for the diagnosis.
--advocating for as much discretion when choosing an alternative care provider as choosing a physician. Again, there are many people who view women with this diagnosis as a revenue stream, not women who deserve evidence-based, ethical treatment.
--explaining why breastfeeding can be problematic in PCOS.
--describing and evaluating alternative therapies, supplements, and herbs. A very high percentage of women with PCOS are so desperate for help they are doing a lot of self-treating and self-medicating, which can be helpful…or very dangerous.
--broaching the topic of emotional eating, binge eating, and eating disorders. It's rampant in this population, it needs to be validated, explained, and destigmatized, as much as the rest of the symptoms do.

I was not entirely comfortable with the section on low carbohydrate diets. Even though it acknowledged that these diets are restrictive and difficult to maintain, it went on to make some general recommendations about how to pursue one. One of the most common problems we encounter at inCYST in our individual counseling, is a blanket carbohydrate restriction that eventually ends up with a binge. It's a noble goal, to reduce carbohydrates, but there are ways to do it that do not promote disordered eating. Perhaps including a dietitian in a future version of this book could help promote healthier eating patterns that are evidence-based.

Because I've been working with Dr. Van Dyke to better understand laser treatment for hirsutism, I was interested on the section regarding laser hair removal. There were some important facts about this treatment that were not included.

In general, for someone who is new to the diagnosis, it's a helpful rundown of what to expect when working with a medical doctor, but the slant is toward that relationship. If you have chosen, in your own personal situation, to prioritize medical treatment without using nutrition, naturopathy, acupuncture, or other complementary treatments, it is a good resource. However, if your treatment team includes other approachess, you will not find information in this book to enlighten you or guide you with regard to those issues.

Click here for more information on the book.

If you’re a new reader of this blog, or you’ve got a new diagnosis, you are probably starting to realize that there are some changes you need to make if you’re going to be healthy while living with PCOS. Or perhaps you already knew that, or have had the diagnosis for a while, but you’ve been lurking here, just thinking about the idea of change, and not actually committing to change. That’s even an earlier stage in making change that is called pre-contemplation, where you haven’t begun to think about change (but typically, someone else, like your therapist, knows you need to change).

Change conjures up all sorts of feelings. For some, there’s a feeling of excitement and hopefulness. For others, there is sadness about leaving behind a lifestyle, a set of choices, some favorite foods, or a particular relationship or way of functioning. There may be fear about facing the unknown, lacking the knowledge to proceed in a healthy or effective way, or about how your life will rearrange as a result of the conscious changes that you’re making.

When it comes to the areas of exercise and dietary management, all of these issues and more may arise. If your situation is further complicated by depression, anxiety, or an eating disorder, it’s even more complicated. Depression may leave you lethargic and unmotivated; with your brain craving a rebalancing of serotonin, you may be consuming excess carbohydrates to try to fix the balance. Anxiety can escalate to such a place that any idea of change leads to fear and freezing; there seems to be safety in staying in one place, even if it’s an uncomfortable place. And of course, if you’ve got a history of eating disordered behavior, and it’s “working” for you, to keep your weight contained, then the trepidation factor may be enormous.

Here are some things about change that it may be helpful to think about, whether you’re in pre-contemplation, contemplation, or the actual process of creating the change:

• It’s your body, and your decisions. You own them; no one else does.
• You can change your mind at any time. If you’ve started down a certain path, and you really hate it, or it doesn’t appear to be producing results, it’s generally not a lifetime commitment (exceptions come to mind, like having a hysterectomy, or getting a tattoo).
• Medical, dietary, and psychological theory is continuously evolving, and you should be re-evaluating on an ongoing basis anyway.
• There’s no shame in trying. The shame comes from not loving yourself enough to never start trying.
• It really does take practice to produce change. Do some research on how to create that continuity. You may need to schedule exercise into your calendar at a certain time every day (when I was diagnosed with early onset Type II diabetes in 1998, I wasn’t exercising much at all, and I would literally schedule myself to walk for TEN MINUTES a day; every other week, I added five minutes to that time, until I reached 75 minutes a day, and had lost 72 pounds), join a group that meditates (they’ll teach and support you, and keep you accountable), or keep a food log (more accountability!) in order to adhere to whatever program of positive change you’ve devised for yourself.
• There are many people who will support you in creating the change you desire, and a number of them are found right here, at the inCYST community. Seek their help. You’ll be surprised how much support you can find online.
• If you’re trapped in a paralyzing fear, or find yourself repeating negative patterns, or quitting quickly time after time, there may be a deeper psychological issue at play. It’s worth a consultation with a health psychologist or other therapist to assess your behavioral patterns and choice-making skills.

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.

And that is because I'm a strawberry nut. It's my absolute favorite fruit. I learned while researching this blog post that the average American eats 156 lbs. of added sugar a year…and only 8 lbs. of strawberries in the same time period.

Of course, the fact that you all are not eating enough strawberries means there's more for ME! Ha!

Seriously, though, this fruit is a wonderfully easy food to add to any diet. Put them in your cereal. In a smoothie. On waffles or pancakes. On top of ricotta cheese, sprinkled with almonds, on a Bran Crispbread. On a salad. Freeze them to eat like candy on a hot summer night. (That last one is my favorite.)

Strawberries are high in vitamin C, which is an important antioxidant. It's also important for the production of collagen, which keeps your skin looking young. As far as antioxidants go, it's the third best source of antioxidants when compared to the same serving size of other fruits.

And…did you know…even though they contain sugar, strawberries can also help reduce blood sugar spikes caused by other foods? I wouldn't recommend eating strawberries to counter a carbohydrate binge, but you certainly may want to consider including more strawberries in your overall diet as a way to make it easier for your body to handle carbohydrates. If you're enjoying the sweetness of the berries, you are likely going to want to eat less sugary food anyway, reducing your insulin load even more.

For those of you with high cholesterol, strawberries have also been shown to decrease markers of atherosclerotic disease. The benefits these tasty fruits provide far outweigh the sugar content many of you are concerned about.

One last thing, a recent study reported that organic strawberries are actually higher in antioxidants. So it may be worth it to spend a little extra, avoid the pesticides, and get the extra metabolic boost. If you don't have access to a farmer's market, look for the Driscoll's brand in your grocery store.

Basu A, Fu DX, Wilkinson M, Simmons B, Wu M, Betts NM, Du M, Lyons TJ. Berries modify the postprandial plasma glucose response to sucrose in healthy subjects. Br J Nutr. 2010 Apr;103(8):1094-7. Epub 2009 Nov 24.

Törrönen R, Sarkkinen E, Tapola N, Hautaniemi E, Kilpi K, Niskanen L. Strawberries decrease atherosclerotic markers in subjects with metabolic syndrome. Nutr Res. 2010 Jul;30(7):462-9.

http://articles.latimes.com/2010/sep/02/science/la-sci-organic-strawberries-20100902

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.