The Hemp Connection [Search results for confidence] 

One of the most difficult aspects of PCOS is what it does to your libido – your sexual fantasies and your desire to express your sexuality. Sometimes you’re up, sometimes you’re down, and with PCOS, maybe a little of both at the same time. According to a recent University of Chicago study, fully 33.4% of women ages 18 – 59 suffer from hypoactive sexual desire, the technical name for low sexual desire. For PCOS women, the percentage is probably higher.

There’s certainly a range of what’s considered normal, but that’s a whole lot of women who just aren’t feeling like having sex. If you’re not having sex, alone or with a partner, or an active sexual fantasy life, you’re missing out on feelings of warmth, love, and connection that enhance your overall sense of well-being.

Some of the major factors affecting sexual desire include hormone levels, availability of a partner, and body confidence. We’re all familiar with the range of moods and symptoms that can accompany the menstrual cycle, and that’s just one part of what affects your sexual functioning. I hope that your endocrinologist, dietician, and gynecologist team are working closely with you to regulate your hormonal functioning. If they’re not, and you’re feeling a disturbing loss of sexual desire, please consult with them. Know that birth control pills and antidepressants (the SSRI variety), which are often prescribed to women with PCOS, can negatively affect libido. This isn’t always a necessary or unavoidable side effect of medication. There are often different medications you can switch to that may improve your level of desire while still effectively treating your symptoms.

Availability of a partner is an issue that may be addressed in many ways. First, consider what’s happening with your current partner, if you have one. Has PCOS brought you down to the point that you no longer feel sexy or attractive to your partner? Do you reject your partner’s advances? Do you hide when you go to bed? Good communication is a must in restoring balance to this aspect of your life. Your partner may very well be wondering what’s up with you, without realizing the complexity of what’s affecting your body and your mind when you have PCOS. If you don’t have a partner, do you want one? If not, and that’s a choice made for practical considerations, great. But if it’s a non-choice you defaulted into because you feel lousy about your appearance, read on.

Body confidence is a critical component of a woman’s sexual confidence, and confidence often leads to making investments in appearance, the willingness to make or accept sexual advances, and a boost in self-esteem that comes from knowing you’re doing your best to take care of yourself. I’m talking about the obvious stuff – the best diet you can mange (90% healthy/10% naughty), regular exercise (not the hard-body-oriented, workout until you’re half-dead stuff), a little yoga or meditation when you can, and some focused attention on how you present your body to the world everyday. Exercise alone will dramatically improve your confidence, and your belief in your body’s abilities. Just the experience of exposing your body to the world and not getting laughed out of the gym is a real confidence booster.

You will learn that the rest of the world isn’t really paying that much attention to the excess abdominal fat you loathe so much. You will learn that you actually like good food, and it makes your body feel more energetic. You will learn that there are a lot of clever ways to deal with the cosmetic issues associated with PCOS, and not all of them are painful or cost a fortune. And when you learn all of these things, through your own proactive experience of them, you may find that lack of sexual desire is a thing of the past. If it’s not, however, and you’ve tried to improve it, don’t be afraid to seek additional help from your physician or a counselor. You deserve a healthy, fully functioning level of sexual desire, whether you choose to use it or not!

I asked our team for some ideas for holiday gifts that promote healthy mind, body, and spirit. If your loved one is asking for ideas, or if you're shopping for someone who is trying to make changes that benefit their health, hope these wonderful inCYSTers provide you with some inspiration! 
Julie Dillon, RD, Julie Dillon Consulting, Greensboro, NC

--cooking classes/lessons --magic wand (I purchased a cheap one and my clients and I often laugh about it yet it also stimulates great discussions)
--yoga gift certificate
--pretty journal (there are some amazing leather bound ones that make great gifts)
--comedy club tickets because laughing brings the blood sugar down and it's great stress relief;-)

Hana Feeney, MS, RD, CSSD, Nourishing Results, Tucson, AZ

Healthy cooking magazine subscriptions, such as Eating Well
A food scale, I like the ones with nutrition information for those who are into numbers
Portion plates
Spice and herb blends
Specialty teas
Massages
Acupuncture treatments
A CSA share
A community garden plot
Gift cards to running, cycling or other fitness related stores
Gift cards to natural grocery stores
Pedometers, I’m checking a new one out that has multiple features called Striiv
Healthy cookbooks

Karen Siegel, MS, RD, LAc, Nutrition and Acupuncture Clinic, Houston, TX

I just had a patient tell me she wanted to give her mother a gift certificate for acupuncture as a stocking stuffer.
I told her I have gift certificates, but to also consider an acupuncture face lift. Many acupuncturists (myself included) do facial rejuvenation treatments.

Danielle Omar, MS, RD, Food Confidence, Fairfax, VA

My Busy Woman's Guide to Stress Free Grocery Shopping is a great gift! It's on sale this month, too!: -)

Sarah Jones, RYT I offer discounted private yoga lessons.

Meri Raffetto, RD, Real Living Nutrition, Temecula, CA My recently released book, The Mediterranean Diet Cookbook for Dummies, is available at amazon.com

Susan Van Dyke, MD, Van Dyke Laser and Skin, Paradise Valley, AZ

Give the gift of:

Purity
Freedom from age spots and lines with Fraxel Dual (Susan Van Dyke, MD)

Self esteem
Beautiful skin with Vivite Skin Care (Heather Anderson, RN)
Sexiness
Smooth legs without shaving with LightSheer Duet (Tina Villalobos, MA, Back Office Coordinator)

Youthfulness
Facial volume in the right places with Sculptra Aesthetic (Sherry Rodgers, Office Manager)

Confidence
Fuller, seamless skin with TNS Recovery: the collagen stimulator (Cameron Vessey, Aesth and Laser Tech)

Clarity
Gorgeous Glow with Clear + Brilliant (Traci Lee, Front Office Coordinator)

Serenity
Relaxed frown muscles with Botox or Dysport (Jessica McCarthy, MA)

Knowledge
A VDLS seminar (and it is free!) (DeAnne Dunn, Aesth and Laser Tech)

Generosity
VDLS gift certificates for everyone’s favorite products and procedures (Diane Davies, Front Office)

The entire Van Dyke Laser & Skin team wishes you a glorious holiday season!!!

Monika Woolsey, MS, RD Incyst, Phoenix, AZ and Santa Monica, CA

As for me? I second all and I hope my gift buyers are reading this! One suggestion I do have for Phoenix readers, is a gift certificate to Chow Locally. It's a twist on the farmer's market concept, you can create your grocery box online and pick it up at one of three metro locations. For anyone who loves the farmer's market but whose weekends are filled with other"to-do's", it's a great option.

Many thanks to all of our readers, network members, and fans for making this such a hugely successful year for inCYST! We are so looking forward to even bigger and better things in 2012.

You’ve heard it a thousand times, from every doctor, dietician, and well-meaning person you’ve ever encountered – you’ve got to lose weight, get out there and get some exercise, and change what you’re doing with your body when you’ve got PCOS. It’s important advice, to be sure, yet tedious to hear – and sometimes when we’re in the midst of trying to change our lifestyle and behaviors, we forget why we’re doing it.

All we hear is this pointed and difficult direction to improve things, and we fail to spend time linking it intellectually and emotionally to positive outcome, which helps drive motivation. It’s particularly frustrating with PCOS, because change occurs painfully slowly, and when you don’t see change, you lose motivation. Others can go on a diet and lose five pounds immediately, whereas that’s rarely the case for someone with PCOS.

Sometimes the changes are only visible when you get your lab results every few months, and the doctor congratulates you on lowering your cholesterol 20 points (personally, I don’t find that terribly exciting, although I know that it’s good) – in which case you might get it intellectually, but still be saying “yeah, yeah, yeah, that’s great, but where’s the weight loss?!” What we want is weight loss, pregnancy, a reduction in hirsutism, or some other visible proof that what we’re doing is working.

When you really understand the importance of exercise for both your body and your brain though it’s a little easier to stick with a program of self-improvement. In a 2011 study entitled Lifestyle Changes in Women with Polycystic Ovary Syndrome, researchers examined numerous studies, papers, and research projects and validated the benefits of lifestyle change. Women with PCOS who made positive dietary, exercise, and lifestyle changes (i.e., stress reduction, increased movement, lower glycemic diets) experienced reductions in weight, testosterone levels, waist circumference, and other meaningful markers of the syndrome.

To support not only weight loss and improvement in body composition, but also, from my perspective as a psychologist, the stress reduction and mental re-wiring that goes on as a result of exercise are spectacular. I particularly like the following forms of exercise:

Walking – the cross-lateral motion of walking oxygenates and re-synchs your brain, and leads to a literal feeling of “clearing out” – plus walking is an excellent low-impact exercise that leads to improved glucose control. Does it get any better than that?!

Yoga – numerous studies continue to validate the importance of yoga for stress reduction and pain management. A study entitled Stress, Inflammation, and Yoga Practice indicated that yoga practice, regardless of skill level, resulted in marked reductions in both stress level and, even more exciting to those with PCOS, inflammation! Many fertility improvement programs involve yoga and other forms of stress reduction. And, while you’re improving your physical balance, you might just be improving your mental balance as well.

Swimming – swimming in a pool, lake, river, or ocean can be soothing and meditative. We are made primarily of water, and it is a return to water, and to the center of our selves. The silence and internal nature of the echoes and ripples brings us back into alignment with our natural rhythmic movement patterns.

Dancing – improves coordination, synthesizes mind/body, and is a form of creative expression. Much emotion is stored in the body, and can be expressed through the body. Plus, dancing is fun, at least when you “dance as if nobody’s looking!”

Weight training – feeling a strong body is empowering, and increases confidence. Sure, it’s hard work, but it has profound mental benefit when you conquer that final set, and your lifting is finished. There’s a sense of accomplishment and pride that boosts your self-esteem for hours. You’ll move better in your body too, and perhaps respect it a little more, for its ability to become so strong. (By the way, this is one really positive aspect of PCOS – that androgen imbalance will allow you to develop muscles more quickly!)

The mind and body are inseparable. If you work on improving the mental (motivation, drive, commitment), you will improve the physical. If you work on the physical, you’ll achieve the psychological rewards of calming, anxiety reduction, and depression reduction. Additionally, you’ll have fun and also be doing the right thing to keep your self-improvement program going. That leads to increased confidence, self-esteem, and overall improvement in your sense of well-being.

Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.

If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at Gretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd.

References:

Kiecolt-Glaser JK, Christian L, Preston H, Houts CR, Malarkey WB, Emery CF, Glaser R. Stress, inflammation, and yoga practice. Published in final edited form as: Psychosom Med. 2010 February; 72(2): 113. Published online 2010 January 11. doi: 10.1097/PSY.0b013e3181cb9377.

Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD007506. DOI: 10.1002/14651858.CD007506.pub2.Australia, 3168.

One of the most frequent reasons women with PCOS share that they either do not want to exercise, or have stopped exercising, is that they don't like the muscles it gives them.

For all of you, we have a local athlete here in Phoenix who may provide some inspiration. Sarah Robles will be traveling to London to participate with the weightlifting team in the Olympics.

Just watch the video. There's such positive energy and confidence pouring out of this woman, it'll have you with your workout clothes on before the segment ends.

'Nuff said.

As you know, we're big on breastfeeding at inCYST. We believe it helps reduce the susceptibility to PCOS, we believe incorrect nutrition information deters women from doing it, and we believe that doing it improves the health of mom as well as baby. We're also very concerned about how few physicians, dietitians, nurses, and other health professionals simply do not know that PCOS can make it difficult to breastfeed. We'd like to be a part of changing that.

I received a letter from the United States Breastfeeding Committee that explains some of the important work they are doing, along with a link to donate to their cause.

If your life has ever been personally touched by a lactation consultant, if our work at inCYST encouraged you to breastfeed, or if you simply believe in what these hard working yet often unrecognized health professionals do, consider honoring their labor this holiday with a donation using the provided link.

Dear Friend,

The United States Breastfeeding Committee is committed to ensuring that working women and their families receive the support they need to have optimal breastfeeding experiences. This Labor Day we are thrilled to celebrate our new national workplace support law by sharing a story of one mother's experience of making breastfeeding work:

"I always expected to be a stay-at-home mother, but after years of working at SAS my perspective began to change. SAS made it so easy to continue working by offering benefits such as on-site childcare, on-site health care, breastfeeding seminars, lactation rooms, lactation consultants and more. In the seminars, I learned about the health benefits to me and my child as well as the bonding opportunities that breastfeeding provides. I truly got the sense that this was something that my employer wanted my child and me to be able to experience. They encouraged me to breastfeed not only for my benefit, but for theirs as well. They understood the benefits for businesses--healthier babies mean less employee time away from work tending to sick children. Happier, healthier moms mean more productive workers.

When each of my children was born, we met with the lactation consultants several times in the on-site health care center. This helped ensure that breastfeeding was off to a good start and gave me confidence in my ability to breastfeed. Upon returning to work, I was able to nurse my two children for the first year of their lives. In the beginning, I walked to the child care center 2-3 times per day. I'd sit with other moms in the nursing room, which has a home-like atmosphere complete with couches, soft music and lighting--just the right environment conducive to nursing infants. (They even deliver lunch from the SAS cafeteria, if you so choose.) I was away from work for about 30 minutes each time. As the months passed, we transitioned to one feeding during my lunch hour. If I wasn't able to make it over for a feeding, I could pump in the privacy of my locked office or lactation room. The flexibility was priceless.

I cherish this time spent with my children. I felt connected to them rather than conflicted about being a working mom. If SAS didn't provide such a wonderful environment, I may have made a different decision about being a working mom. My hope is that every mom is able to enjoy the benefits of breastfeeding their children while still contributing to the working world."

- Leslie W. Anderson, SAS

With the inclusion of the workplace breastfeeding support provision in the Patient Protection and Affordable Care Act, the U.S. joins the rest of the industrialized world in providing breastfeeding mothers with break time and a private location to express breast milk during the workday. The new law marks a turning point in our efforts to ensure that"breastfeeding works" for all moms like it did for Leslie. In passing this provision, our federal government has clearly recognized that breastfeeding support in the workplace is a win-win for families and employers!

But the work doesn't stop when the law is passed…

The Department of Labor (DOL) is tasked with implementation of the new law, and the DOL Wage and Hour Division recently issued a preliminary online Fact Sheet. USBC has prepared guidance and recommendations for the Wage and Hour Division and continues to work with the DOL and other partners on implementation and promotion of the new law.

Please consider DONATING NOW to support USBC in this important work!

Many of USBC's critical programs, and especially our policy and advocacy activities, are funded solely by donations from the Friends of USBC. Your contribution can really have an impact at this critical time to strengthen our efforts to ensure"breastfeeding works" for working moms. Please consider becoming a Friend of USBC by making a donation today!

We look forward to our continued work together and thank you in advance for your support. Together we are making a difference for working families!

Sincerely,

Robin W. Stanton, MA, RD, LD
Chair

United States Breastfeeding Committee
2025 M Street, NW, Suite 800
Washington, DC 20036

Phone: 202/367-1132
Fax: 202/367-2132
E-mail: office@usbreastfeeding.org
Web: www.usbreastfeeding.org

The United States Breastfeeding Committee (USBC) is an independent nonprofit coalition of more than 40 nationally influential professional, educational, and governmental organizations. Representing over a million concerned professionals and the families they serve, USBC and its member organizations share a common mission to improve the Nation's health by working collaboratively to protect, promote, and support breastfeeding. For more information about USBC, visit www.usbreastfeeding.org.

I just made some sample breakfast menus for a client. I had not finished making the rest of the day, and she wrote back to share that in just using the breakfast menus, she could tell an immediate difference in her cravings that were positively influencing how she ate the rest of the day.

I thought I would share them to give you all a challenge to try--eat these breakfasts and see how you feel as the day progresses--is your energy level better? Are your carbohydrate cravings less invasive?

I'm not the hugest fan of McDonald's, but since this particular client noted that one of the breakfasts she finds really helps get her off to a good start with less nibbling the rest of the day, is an Egg McMuffin, I added it to illustrate that the choice really isn't so bad. If you use your fats early in the day, in a way that actually decreases fat intake over aa 24 hour period, it may be a judicious move. I actually have the same experience with this meal. It keeps me full. Which is why we discussed how to make the homemade microwave version of the same thing on Whole Wheat English muffins.

Also, I am very intentionally leaving out the calorie, fat, and protein counts. If you use these breakfasts…I want you to focus on how the food tastes, how it feels in your stomach, and how you feel in the hours after you eat. Eating well is not about the calories, fat, and protein. Well…not totally. It has to be tasty if you're actually going to do it!

Hope this helps get you all off to a great start!

1/4 cup ricotta cheese
2 slices Ezekiel toast
8 ounces skim milk
1 medium apple
1/4 c sliced almonds

2 tbsp peanut butter
2 slices Ezekiel toast
8 ounces skim milk
1 peach

Egg McMuffin
8 ounces skim milk
1 banana

1 cup oatmeal
1/8 c whey protein powder
1/4 cup walnuts
1/2 c strawberries
8 oz. skim milk

There are a gazillion possibilities here, I just put four sample meals together to help my client get a grip on portion sizes and potential combinations. Two of these breakfasts use Ezekiel bread becausse she likes it. Oatmeal was another possibility because she travels a lot and can take advantage of the new Starbucks oatmeal option or even carry her own packets and mixins'.

I'm betting many of the foods you enjoy aren't so bad after all, and that you can include them if you know how. Often times when you move a food from the"bad" to"perfectly fine" column, the temptation to binge on them is removed. And many times, with PCOS, it's the bingeing and the quantity, not the food itself, that is the problem.

Most women I work with have lost confidence in food and are afraid to eat many foods that can benefit them. That is how a nutrition consultation can help you--if you use it wisely. Rather than looking to someone else to do all the work, make a list of your favorite foods, foods you want to eat but are afraid to, foods you are feeling are"bad" or"not an option" and ask, not IF, but HOW they can be included in your plan.

Let an inCYST provider help you design your own program! We're just waiting for you to ask so that we can be part of your success.

This past week I was watching The Biggest Loser. Not because I endorse their methods for weight loss, but because so many of you watch that show, it's almost required viewing for my job, to know what's being said and how to address it should it come up in our Facebook group.

I was appalled to watch one of the trainers, while a participant was doing situps, dropping a medicine ball on the poor guy's stomach. Nothing about that segment modeled respect for self or others, in my opinion, and it could have done serious damage to the participant. But that is what seems to happen in the world of weight loss. Once your weight exceeds what is deemed medically and culturally acceptable, the rest of the world seems to act as if they automatically have a license to decide how to"fix" you. The behaviors can range from looks into your grocery basket when you're shopping, suggestions that you're somehow not"doing enough" if your weight loss is not linear and predictable (as illustrated by the closeups of the shocked looks of the Biggest Loser trainers when someone does not lose, or…God forbid…gains weight, the assumption that if things are not going the way the trainer needs them to go in order to be the"good trainer"), that the participant must be the one to blame.

PCOS creates an even more frustrating scenario for physicians, dietitians, trainers, family members, everyone watching on as a woman decides she's going to lose weight. We've learned over the years that in many ways PCOS is counterintuitive. When you diet too strictly, weight goes on. When you exercise too much, weight goes on. It seems to be the"canary in the coalmine," so to speak, of imbalances in your life that need to be addressed. And, unfortunately, if you're a person of extremes, and you resort to fixing one extreme with another extreme, you're likely going to find yourself in a place where you plateau, gain weight, etc., with at least a half-dozen people looking on, with a million suggestions for"fixing" the problem.

Years ago I was a dietitian in an eating disorder treatment center. I was literally responsible for the weight gains of anorexics, the weight loss of women with binge eating disorder, and to be sure that bulimics who had been abusing laxatives did not gain too much weight during their withdrawal from those drugs.

Take the scenario I described above and multiply it by 36, which was the census of the treatment center. I absolutely hated Monday and Thursday mornings because those were staff meetings. I had to meet for three hours each morning with all of the therapists, physicians, etc., and discuss the progress of all of the women we were helping. If, God forbid, the weight of one person was not EXACTLY what I'd projected, I was put on the spot to (1) explain why and (2) come up with a remedy. Suggesting that healing from dietary imbalances of any kind was complex and that we were not in charge of all of the parts of the solution was not an option. Much of the rest of the week was spent with patients, family members, and insurance case managers, having the same conversations. In one case it was an attorney of a beauty queen who insisted she'd been promised prior to admission that she would not gain weight despite needing to withdraw from her box-a-day laxative habit and since her temporary fluid gain was in the double digits, I was to blame.

Can you tell how much I thought this job sucked?

The piece de resistance came during one stretch, when we had an overload of laxative abusers in the house (no pun intended) and my boss, desperate to be able to show good weight progress to insurance companies and keep her own"success" record high, asked me to come up with a solution. This was in the days before the Internet, and so I asked to be able to take a day in the local medical library researching intestinal health and dietary strategies. My request was denied. Instead, I was asked to create some type of"cocktail" that would"clean out or speed up the 'progress'" of the constipated individuals.

I looked at my boss and said,"I am a dietitian. I am not a plumber."

As you can guess, it was the beginning of the end of that job, which I actually eventually walked off of, because that particular situation was merely one of many I was expected to endorse that in good conscience I could not.

I learned humility in that job. An Ivy League degree and a master's degree plus stints at Stanford, Apple Computer, and the professional sports world, could not fix what was broken in these women. Only time, self-nurturing, and patience. Every single time I watch The Biggest Loser, I am reminded of that job. And how so many people I worked with based their own success on a patient's numbers recorded in a medical chart. Not on how well she was asserting herself, or sleeping, or challenging herself to eat salad dressing. It was all about the number. That it wasn't about the healers at all, but about empowering our patients to have the confidence to take care of themselves so well that they could fire us because they didn't need us anymore, was completely forgotten.

I guess I was inspired to write this piece because ever since I saw that medicine ball, I've been thinking how badly I wanted the poor guy on the floor to just stand up, tell the trainer to bite it, and walk off the ranch. Because he was being taught that somehow, because of the position he'd found himself in, needing to lose weight, he deserved to be punished and humiliated in the process of regaining his self-esteem. Yup, he had to be humiliated in order to develop self-esteem.

Don't ever let anyone, and I mean ANYONE — a medical professional, coach, or loved one, cause you to believe that they know better than you, what you need for yourself. Or that because your weight is not changing at a rate that THEY have determined is appropriate, that you're somehow doing something wrong. Or that what they have to say about your health supercedes what you believe about your health.

As Eleanor Roosevelt once said,"No one can take away your self-respect, unless you allow them to."

I am starting this weekly feature as a response to the 25 year long quest for menus that clients consistently ask for.

I have always had a problem with menus, primarily because I have yet to see them help someone eat better. I have given them out, they get lost or tossed in the trash, or clients try them for a few days and abandon them because they couldn't follow them. Or…they bring out a sense of rebellion that sabotages healthy eating. I also think giving out menus implies that there is a"perfect" way to eat, which simply isn't true.

Clients, I believe, have a perception of dietitians as being perfect eaters, which so isn't true as well.

A menu is only an educated guess, and it cannot possibly be derived from my office with complete knowledge of what challenges arise in YOUR day and what foods are available to you. I feel I have more of a chance of undermining your success by handing you this uninformed document than I do encouraging your confidence with food.

I'd like to bridge the gap between dietitians and people who are not, by using this feature to show what realistic eating consists of. I'm going to start it off, and hopefully get other blog contributors to check in with their own diaries as well.

I want you to see that my life isn't perfect, and therefore my eating is not either. I do my best, always try to do better, and hopefully, 80% of the time, I make good choices, which include foods I enjoy eating.

Here goes…this is my day from yesterday. By the way, I eat about 1500 calories on days when I am not exercising. I do not measure my foods, so my menu does not include portions. If you want to replicate this and you do measure foods, you will need to adjust that individually. Remember, this is not an exercise in how to weigh and measure or eat exactly 1500 calories, it is an exercise in observing how other people eat.

I hope it helps! Here is my eating from yesterday.

Breakfast

Big bowl of oatmeal with sliced almonds, dried blueberries, and shredded oatmeal.
Glass of milk
Orange from my patio tree

Lunch (an elderly friend invited me over for lunch and I ate what he served even though I'm not fond of mayonnaise-based salads, knowing he was very much going out of his way to do something nice.)

Roasted chicken breast and thigh (chicken breast was very big)
Scoop of store-made potato salad, scoop of coleslaw
Banana

Snack
Stopped at Trader Joe's and sampled a bite of roast pork, liked it so had a second sample: )

Dinner

Can of tuna on whole wheat bread
Sliced tomatoes
Orange from my patio tree
Leftover potato salad and coleslaw from lunch
2 ounces of Trader Joe's chocolate with ancho chili powder

I was busy running errands and it got dark before I could get out and run, so this was a less active day for me.

Something pretty exciting is happening at inCYST. We've been quietly building a private discussion group for paid members of inCYST, where we talk in more depth about issues important to PCOS. It turns out, those who have been willing to invest in themselves (it's a $25 yearly membership), are quite a motivated and positive group. They've been very encouraging toward each other, sharing ideas for food, fitness, asking questions based on reading they have done independently…it's quite a different group compared to many that exist on the Internet.

As this group of positive, action-oriented women has grown, I've shifted the public Facebook group, approaching 2000 members, toward being a more generic forum, more focused on motivation. We realize one of the biggest barriers to PCOS success is depression, anxiety, and lack of motivation. Unless those are directly addressed, it really doesn't matter what kind of diet, exercise, supplement, or medical information is provided.

Yesterday, the women in the private group, on their own, came forward and asserted their need to not be around the defeatist attitude they had encountered in other online groups, as they felt it held them back from their own progress. The confidence they demonstrated was exciting to see (you can see it on our Facebook page if you want).

I've since named them the Kick Butt Cysters, because that's what they are doing. Kicking PCOS in the butt!

If you're someone who's been feeling dragged down from being surrounded by people who are not at least as equally motivated as you to make changes, you may want to consider joining the group. For that $25 membership you also get our webinar on our nutrition philosophy.

I'll give you a heads up right now, I've given the KBC's (Kick Butt Cysters) the go-ahead to call out anyone who they feel is not up to speed with them. They have no obligation to invest in anyone who is not investing in herself. So it's not a good idea to join if you think somehow you'll magically absorb PCOS success simply by hanging out with motivated people but don't intend to do anything yourself. The KBC's mean business and you had better as well if you want to be in their group.

If it sounds like something you could benefit from, simply send me $25 via Paypal to germandesertgirl@yahoo.com. I'll get you set up.

I think you might find, it feels pretty good to kick some PCOS butt. Hope to hear from you!

I promised Ivonne I would post a recipe here, but my format will be a little bit nontraditional.

See, so many people have this perception that if you have a nutrition degree, or work in the fitness and counseling worlds, you are somehow this magic creator of 3 gourmet meals a day. They're all perfectly balanced, exactly the necessary number of calories with perfect ratios of carbohydrate, protein, fat, zinc, antioxidants, omega-3's, yadayadayada.

NOT.

I think sometimes these blogs and websites with all these people who'd like you to think it's perfect in foodieland are downright intimidating. I want you to HAVE FUN with food, and I want you to have the confidence to experiment.

So here's a look inside my kitchen and my head when I recently improvised on a popular recipe, Morning Glory Muffins.

Here is the original recipe as I found it on the Internet:

1 1/4 cups sugar

2 1/4 cups unbleached all-purpose flour

1 tablespoon ground cinnamon

2 teaspoons baking soda

1/2 teaspoon salt

1/2 cup shredded, sweetened coconut

3/4 cup Earthbound Farm Organic Raisins

1 large organic apple, peeled and grated

1 cup (8 ounces) crushed pineapple, drained

2 cups grated carrots

1/2 cup coarsely chopped pecans or walnuts

3 large eggs

1 cup vegetable oil

1 teaspoon pure vanilla extract

Now let's see what actually happened when I rolled up my sleeves and baked them.

1. "Where is the sugar? Dang! I forgot I was almost out and I only have half as much…OK, in food chem class we learned that while some sugar is necessary not all of it is. Maybe I can make do." Half the sugar is used.

2. Time to add the pineapple. "Hmmmm…I still have a dozen of those 400 oranges that I picked taking up space in the refrigerator…they're acidic, wonder what would happen if I replaced pineapple with chopped oranges?" Oranges are used in place of pineapple.

3. I used omega-3 eggs in place of regular eggs.

4. Now for the vegetable oil. "Wonder if I could use olive oil? That olive oil pastry I had on the cruise a few years ago was pretty good." So olive oil it is, and 2/3 of the recipe's original amount.

5. Home stretch…time for vanilla…"Oh, MAN! I could SWEAR I had vanilla!" Time for a little trick my mom taught me years ago…extracts are alcohol based, so you can exchange the vanilla for anything you might have that is a liqueur. "What's in my liquor cabinet? Banana liqueur, hazelnut liqueur…" Hazelnut wouldn't open (it was crystallized shut from disuse), so banana it was.

And there you have it. I would be a disaster on a cooking show, but my mad-science-hmmm-let's-see-if-this-works approach turned out some pretty darned good muffins.

Which, at this point, are no longer Morning Glory Muffins. Given the fact that I used local oranges and pecans, our local tree nut, they have been renamed Arizona Sunrise Muffins. Here's the recipe as it ended up:

Arizona Sunrise Muffins

5/8 cups sugar

2 1/4 cups whole wheat flour

1 tablespoon ground cinnamon

2 teaspoons baking soda

1/2 teaspoon salt

1/2 cup shredded, sweetened coconut

3/4 cup Earthbound Farm Organic Raisins (chopped dates would make it even more local)

1 large organic apple, peeled and grated

1 cup oranges or other citrus, peeled and chopped (probably need more sugar if you use grapefruit)

2 cups grated carrots

1/2 cup coarsely chopped pecans

3 large omega-3 eggs

2/3 cup olive oil

1 teaspoon banana liqueur

Position a rack in the lower third of the oven and preheat to 350 degrees F.

Sift or whisk together the sugar, flour, cinnamon, baking soda, and salt into a large bowl. Add the coconut, raisins, apple, pineapple, carrots, and nuts, and stir to combine.

In a separate bowl, whisk the eggs with the oil and vanilla. Pour into the bowl with the dry ingredients and blend well.

Spoon the batter into muffin tins lined with muffin cups, filling each to the brim. Bake for 35 minutes or until a toothpick inserted into the middle comes out clean. Cool muffins in the pan for 10 minutes, then turn out onto a rack to finish cooling.

I must add an important disclaimer here. Not all my experimenting succeeds. I have some serious flops. The thing that matters is that I learn from each experiment, I don't aim for perfection, and I have FUN.

That's what I encourage all of you to do, too, when you step into your kitchen.

This post is part of the Women's Health Blogfest. Please click on the links below to read more from other contributors! And thanks to everyone who took the time to participate!

In the almost 10 years I have been studying PCOS, I've learned much about what drives a woman's motivation to seek out information. The top reasons women find this blog are:

1. to improve their fertility,
2. to more effectively manage their weight, and
3. to feel and look better

As I've read and met women with the syndrome, I've learned that PCOS is about a whole lot more.

1. A woman's breastfeeding practices seem to significantly influence her child's hormonal health. Many women I've worked with were formula fed at a time when baby formula did not contain essential nutrients.
2. Whether or not you as a woman with PCOS were born to term, and potentially whether or not you were part of a multiple birth, seem to be red flags for PCOS risk later in life.
3. Just because you're a teenager, too young to want to conceive, or a woman who has already had her children, doesn't mean PCOS isn't something to be concerned about. It can mess with your mood, and in turn your energy level and relationships. It can provoke eating disorders. It can elevate your cholesterol. And…through its link to diabetes, it may increase your risk for Alzheimer's disease.

A blog attempting to tackle a syndrome with such widespread effects is not easy to manage. I've been working since we've started to find experts in areas outside of nutrition to complement what I as a dietitian can discuss and promote. I'm really excited to be partnering with lactation consultants to address breastfeeding issues specific to PCOS, and to have Gretchen Kubacky, PsyD, on board, to help us understand what PCOS can do to thinking, mood, and energy. We have one dietitian, Karen Siegel, who is also an acupuncturist, and another acupuncturist will soon be contributing her insight as well.

For the very first time, we are collaborating with Green Mountain at Fox Run in Ludlow, Vermont, to offer PCOS Program weeks this coming September! It's been a dream of mine to see this kind of program and there is no better place where it could be launched. Green Mountain is also participating in this blogfest, if you'd like to learn even more, be sure to read their contribution.

We don't just care about your ovaries. We care about all of you, from birth through retirement, and we hope that as we grow and diversify, the expert opinions you will see expressed here on this blog will address the many important ways we can keep our hormones working positively for us.

Thanks for stopping by our contribution to the Women's Health blogfest. If you enjoyed us, you can follow us with the signups you see here on the blog, through our Facebook inCYST group, or through Twitter, via @incyst.

For more information on women's health:

Angela White at Blisstree’s Breastfeeding 1-2-3 – Helpful Skills of Breastfeeding Counselors
Angie Tillman, RD, LDN, CDE – You Are Beautiful Today
Anthony J. Sepe – Women's Health and Migraines
Ashley Colpaart – Women's health through women
Charisse McElwaine – Spending too much time on the"throne?
Danielle Omar – Yoga, Mindful Eating and Food Confidence
Diane Preves M.S.,R.D – Balance for Health
Joan Sather A Woman's Healthy Choices Affect More Than Herself
Laura Wittke – Fibro Study Recruits Participants
Liz Marr, MS, RD – Reflecting on Family Food Ways and Women's Work
Marjorie Geiser, MBA, RD, NSCA-CPT – Healthy Women, Healthy Business: How Your Health Impacts a Powerful Business
Marsha Hudnall – Breakfast Protein Helps Light Eaters Feel Full
Michelle Loy, MPH, MS, RD – A Nutritionista’s Super Foods for Super Skin
Motherwear Breastfeeding Blog – How breastfeeding helps you, too
Rebecca Scritchfield, MA, RD, LD – Four Keys to Wellness, Just for Women
Renata Mangrum, MPH, RD – The busy busy woman
Robin Plotkin, RD, LD – Feeding the Appetites of the Culinary, Epicurious and Nutrition Worlds-One Bite at a Time
Sharon Salomon, MS, RD – Calories, longevity and do I care
Terri L Mozingo, RD, CDN & D. Milton Stokes, MPH, RD, CDN of One Source Nutrition, LLC – Crossing the Line: From Health to Hurt
Wendy Jo Peterson, RD – Watch Your Garden Grow

This kind of study drives me absolutely crazy.

Entitled,"Do women with ovaries of polycystic morphology without any other features of PCOS benefit from short-term metformin co-treatment during IVF? A double-blind, placebo-controlled, randomized trial," this study evaluated the effect of metformin on improving in-vitro fertilization outcomes. It looked at women whose ovaries looked like those in women with PCOS, but who had no other symptoms of the disorder. These women were divided into two groups, one receiving metformin around the time of IVF, the other receiving placebo.

In the words of the researchers…

"With regard to IVF outcome, no significant improvements were found in the metformin group when compared with the placebo group. In particular, there was no difference between the groups in rates of live birth, clinical pregnancy, or severe ovarian hyperstimulation syndrome (OHSS)."

And the researchers concluded…

"There appears to be benefit in metformin co-treatment before and during IVF in women with PCO without any other features of PCOS."

You have my word, readers, I'm taking notes and looking for researchers who can actually help you. The money you're walk-a-thoning and boot camping, and donating to the new inCYST Institute…will be put to far better use than this.

Swanton A, Lighten A, Granne I, McVeigh E, Lavery S, Trew G, Talmor A, Raine-Fenning N, Jayaprakasan K, Child T. Do women with ovaries of polycystic morphology without any other features of PCOS benefit from short-term metformin co-treatment during IVF? A double-blind, placebo-controlled, randomized trial. Hum Reprod. 2011 May 18. [Epub ahead of print]

Abstract

BACKGROUND Women with ovaries of polycystic morphology (PCO), without any other features of polycystic ovary syndrome (PCOS), respond similarly to women with PCOS when stimulated with exogenous gonadotrophins, and both groups share various endocrinological disturbances underlying their pathology. In women with PCOS, metformin co-treatment during IVF has been shown to increase pregnancy rates and reduce the risk of ovarian hyperstimulation syndrome (OHSS). The aim of this study was to investigate whether metformin co-treatment before and during IVF can also increase the live birth rate (LBR) and lower severe OHSS rates for women with PCO, but no other manifestations of PCOS. METHODS This study was a double-blind, multi-centre, randomized, placebo-controlled trial. The study population included 134 women with ovulatory PCO (and no evidence of clinical or biochemical hyperandrogenism) undergoing IVF treatment at three tertiary referral IVF units. The primary outcome was LBR. RESULTS In total, 134 women were randomized, 69 to metformin and 65 to placebo. There were no statistically significant differences between the two groups in baseline characteristics. With regard to IVF outcome, no significant improvements were found in the metformin group when compared with the placebo group. In particular, there was no difference between the groups in rates of live birth [metformin n = 27 (39.1%), placebo n = 30 (46.2), (95% confidence interval 0.38, 1.49, odds ratio = 0.75)], clinical pregnancy [metformin n = 29 (42.0%), placebo n = 33 (50.8%)] or severe OHSS [metformin n = 6 (8.7%), placebo n = 5 (7.7%)]. CONCLUSIONS There appears to be benefit in metformin co-treatment before and during IVF in women with PCO without any other features of PCOS. Clinical Trials.gov: NCT01046032.

PMID:21593045[PubMed — as supplied by publisher]

We all know them. The people you can't go out to eat with. The ones who can go through an entire menu of options and find something wrong with each one. The ones who, on sipping a glass of wine, will tell you that this vintage, woodsy with a hint of vanilla, has come from the Bordeaux region, Francois Fancy's vineyard to be exact, and the grapes were most likely picked during the record rainy week of August 7, 1997. And you order what they order instead of the house wine because you feel like such an oenologic imbecile in their presence. They're the ones who want their ice cream slightly microwaved before eating it. The ones you have to call in advance of a dinner party to be sure what you're fixing will be something they will eat.

Picky eaters? Food snobs? Pains in the butt? Or supertasters?

I vote for the latter. Research in recent years has identified a type of eater who is naturally, genetically, more sensitive to the flavors and textures of foods. I experienced this phenomenon in person a few years ago at a nutrition conference. One of my college friends and now nutrition researcher, Valerie Duffy, studies supertasting. At her booth, she handed me and my coworker each a piece of paper and asked us to place it on our tongue. While I sat there for a few seconds wondering what the gimmick was, my friend immediately began to gag and cough, explaining that it was the most vile thing she had ever placed in her mouth. We learned that she is a supertaster and I…am a nontaster.

Supertasters are interesting people. I imagine they're the ones in medieval times called in to sample the king's food to be sure it wasn't poisoned. (I could use one of them in my home to let me know when I should be throwing things away.) We had a wine professor back at Cornell whose sense of taste was so keen he was flown to several vineyards each year to sample the harvest and, based on his response, the wine was priced.

The specifics of how this is determined are outlined nicely in this article. What is important to take away from this blog post, is that everyone experiences food differently, and that is important to account for. I try to use this information in my writing here. Rather than encourage you to eat only foods that I would like, I write about as many foods as I can in hopes that each of you develops your own"favorite" list with confidence. Without even doing the PROP test, I'm betting you can tell who you are by the kind of food blogs you enjoy. If you have cinnamon from 3 different countries in your custom-made spice cabinet (you know who you are!), love endless detail about ingredients, preparation, subtle characteristics of food…you're probably more of a supertaster. If that intimidates you and you're more of a"just tell me what to make for dinner and for heaven's sake use the five ingredients I have in the fridge and make it easy" kind of reader, you're more than likely a nontaster.

One of my dearest friends is a supertaster. It took awhile for this friend to relax around me with food, probably because this characteristic can make it hard to socialize with friends and you can begin to become self-conscious about how your tastebuds behave in public. You can be pegged as a pain, eyes roll, people wonder if you have an eating disorder. I eventually learned what the top ten list of"friendship favorite ingredients" was, to microwave the ice cream, and not to experiment too much in the kitchen (note to self: marinated smoked scallops--definitely not a supertaster's favorite), and we got along fine. I actually eat better when I'm with this friend, I believe, because whereas I am more of an eat to live person and can get by on pretty much anything that quaffs my hunger and gets me back to work, my friend tends to steer me toward food experiences that encourage me to sit, relax, taste, and enjoy food for the many other pleasures it provides.

What's interesting about nontasters is that they tend to like more fat. That makes sense, since flavors are more soluble in fat, and food for a nontaster is more enjoyable if you do anything to it to enhance the flavor. I definitely love my fat!

Taste perception outside of the food world is pretty interesting. Supertasters, for example, are less likely to experience depression. And middle-aged nontasting women are more prone to obesity. Well that makes sense…first of all, if you're eating more fat so you can taste your food, you're eating more calories…and if you're trying NOT to eat fat because you've been told it's unhealthy, you're walking around looking for something to nosh on that allows your tastebuds to tell you you're full and it's time to stop eating.

You apparently cannot fool your tastebuds the way some food companies would like you to believe.

Does that mean supertasters are destined to be happy and thin while nontasters are cursed to be depressed and fat? Absolutely not. Many factors contribute to your mood and your weight. The point here is that it's better to identify the foods you LIKE and learn how to eat those in healthy balance, rather than try to eat things you don't because some food expert wrote some diet du jour that half of Hollywood is following that has no foods you enjoy in the meal plans.

Be confident in what your taste buds tell you. Don't apologize for what you like and what you don't. Work with what you've got. Enjoy the flavor ride. Microwaved ice cream, nachos, and all.

Joiner TE Jr, Perez M. Phenylthiocarbamide tasting and family history of depression, revisited: low rates of depression in families of supertasters. Psychiatry Res. 2004 Apr 15;126(1):83-7.
Goldstein GL, Daun H, Tepper BJ. Adiposity in middle-aged women is associated with genetic taste blindness to 6-n-propylthiouracil. Obes Res. 2005 Jun;13(6):1017-23.

We had to add this webinar because enough of our women were starting to enjoy exercise enough that they were asking questions about how to time eating for training runs and whether they could ride a century bike ride and how to carbohydrate load when you're insulin resistant. Yes! We have to catch up to our athletes!

That's super exciting. Here's the dirt.

Wednesday, November 2, 2011
6 PM Eastern Time

IF YOU CANNOT ATTEND LIVE, WE WILL SEND YOU THE RECORDING (INCLUDES POWER POINT)

Webinar cost: $40.

Even though exercise is the cornerstone of good PCOS management, it's not something women who have the syndrome approach with confidence. This webinar will address the physical, metabolic, and mental characteristics of PCOS that can often be barriers to participation, with practical, scientifically-f…ounded techniques for improving the activity level of even the most doubtful client. Got a super-motivated woman? We'll also be covering high-performance sports nutrition for insulin resistance and diabetes.

Sally Bersch Hara is a Registered Dietitian, Board Certified Sports Dietitian, and Certified Diabetes Educator. Sally has BS degrees in both Nutrition Science, and Exercise Physiology, as well as an MS in Nutrition Science. Her graduate research observed the effect of diet on insulin secretion, and she is self-proclaimed “endocrine geek,” ever fascinated by the spider web of hormonal feedback loops that define the endocrine system, and the many effects they have on the body. Her son likes to say she puts the ‘RD’ in ‘NERD’

Sally has a private nutrition practice near Seattle where she provides medical nutrition therapy and sports nutrition coaching. Her specialties include sports nutrition, diabetes, heart health, weight management, eating disorders, food sensitivities and ADHD & autistic spectrum disorders. Sally’s passion is empowering people to optimize their own health and/or performance through improved nutrition, exercise, and self care.

In addition to her work with individuals, Sally is an experienced public speaker, former college instructor, and a contributing author to the American Dietetic Association’s Sports Nutrition; A Guide for the Professional Working with Active People (4th edition). She has also co-authored several published research articles, contributed a nutrition chapter to a book on outdoor fitness training (Fit by Nature, by John Colver), and acted as a reviewer for a number of professional publications

On a personal level, Sally is an avid road cyclist and enjoys hiking and outdoor fitness training. She is also the mother of 2 teens… so her life is never dull! She doesn’t know what spare time is.
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Click here to register for this event

Almost as soon as I became a dietitian, I developed a habit, when out socializing, of lying about what I did for a living. My friend finally asked me,"Why, when you worked so hard to earn your degree, and when you love what you do as much as you do…do you lie about it?"

I explained that I needed downtime too, and that most casual conversations I had with people were more about me wanting to validate their choices than it was really knowing what I had to say. People have a lot of ideas about food that aren't exactly science, but lie close to their identities. I've learned to respect those and not try and counter a person's food religion with nutrition science.

Over the years, I've come to see that there are many ways to be healthy. You can eat vegan. You can eat less carbs. You can be a raw foodist. You can take a gazillion supplements harvested while jumping out of an anaconda's way in the Amazon, or handpicked by deaf monks in Mongolia. I've seen a million ways for people to be healthy.

You can do it with an Atkins diet, a modified Atkins diet, a South Beach diet, or a Biblical diet. If you couldn't, there wouldn't be a couple dozen of my own registered dietitian colleagues out there with their own versions of being healthy.

Diets aren't about what you need to eat to be healthy. They are about who you choose as your guru and what rules they tell you to follow in order to be like THEM, to be healthy THEIR way.

I don't think you need a guru. I don't really want to tell you how to eat. In fact, I'm betting you already do, you just want to be validated for it. I'd rather you felt empowered to eat what felt right for YOU and felt supported in that decision.

So whether you're eating raw, or vegan, or Paleo, or Eskimo…if you ask me what I think, I'll ask you to run your menu through a diet analysis program and see how it measures up. If it's short, I'll ask you to add the foods that fill in the blanks. I'll help you to make sure your personal nutrition religion and dietary goals are compatible.

I'm going through the trouble of sharing this, because tomorrow I'm going to share a recipe that comes from a popular diet book, and it's a decent recipe, shared by one of our readers who likes how it keeps her full. Out of respect for this person's original work, I will be crediting it. However, people often jump from a comment about a recipe to assuming that using that one recipe constitutes endorsing that one guru's diet. It's not what's going to happen tomorrow.
I reserve the right, as you do, to pick a recipe here, pick a recipe there, put something together that works for ME without it meaning I or you have converted to another food religion.

I hope, in following our blog, you eventually learn that you can do the same thing. You don't have to eat like anyone else. You can figure out for yourself, within reason, what works for you, and have the confidence to do it.

When everyone reading this blog actually does that, I'll be out of work, I know…but I'm kind of gunning for that. I've been taking a little bit of a computer vacay this week and it's been pretty nice. I've been thinking about a lot of things I could be doing if people didn't want this nutrition information.

For now, know that I respect whatever food religion you've chosen, whatever guru you feel comfortable with, if you're looking to be validated by a guru…I only encourage you to do the scientific double check and be sure what you've chosen is actually helping you to get where you wish to go and isn't creating more problems than it's solving.

Oh…and by the way…if you're ever at a party and you meet a nice lady who swears up and down she parks planes at the airport…introduce yourself.: )

Last night evening news reporters shared that a new anti-obesity drug is headed toward approval. I Googled this drug,"Contrave", to learn more.

On the the manufacturer's website, there was some technical information about this drug (see below). What caught MY eye, however, was a deviation from facts to the following commentary:

We believe that bupropion helps initiate weight loss while naltrexone may sustain weight loss by preventing the body’s natural tendency to counteract efforts to lose weight.

Really? It has been scientifically proven that the body has a natural tendency to resist weight loss?Well, if you believe that you're helpless and without any solution other than a medication, you're more likely to help this company's profit margin. That's what they need you to believe in order to satisfy their investors!

The buzz on the news was that the drug has been shown to induce a weight loss of 5%. That means if you're 250 lbs, you can expect to lose about 12 1/2 of them. We've been taught as health professionals, to tell the public that a small weight loss of 10% of body weight can have important health effects, and not to focus on large, drastic changes. But taking a pill to achieve only half of that? Not impressive at all.

I'm insulted for this blog's readers. Can't you do better than that? Can't you just tell the truth about the drug and trust that it has potential in certain cases? Which I'm sure it does? I like to think most people who I have ever come in contact with, deserve much more credit than that. They can make intelligent decisions and do not need to be manipulated in this fashion.

Here are the facts about the medication.

1. It is a combination of two medications that have been used for a variety of clinical purposes, naltrexone and bupropion (Wellbutrin).

2. Naltrexone is an opiate antagonist. According to NIH, it is"used along with counseling and social support to help people who have stopped drinking alcohol and using street drugs continue to avoid drinking or using drugs." The link above provides a pretty long list of contraindications and side effects, and they include pregnant and trying to become pregnant…not likely a great option for many of our readers.

3. Bupropion is an antidepressant that has been found to help facilitate weight loss. It's been used for this off-label purpose for a long time. Not that it can't help, especially if there is depression accompanying your weight gain (not ABOUT the weight gain but as a co-existing condition). But I believe there are many things about most of our audience that can be done to alleviate depression and normalize weight which should be tried BEFORE resorting to medication.

If anyone from Orexigen can produce peer-reviewed research supporting the claim that the body resists weight loss, they're welcome to comment on this blog.

Until that happens, I maintain that any time someone tries to tell you that you can't do something, and your believing them holds potential to transfer money from one bank account to another, you should consider the tactic a challenge to prove them dead wrong.

Bored with salmon, but still want to get your Omega 3's?

Prefer a mild-flavored, white fish?

Looking for a more sustainable option in your seafood?

Try Barramundi!

A native of the tropical waters of northern Australia, southeast Asia, and southern China, Barramundi is farmed in the U.S.

If you're worried about farmed fish, don't be. Not all farmed fish is bad. In fact, the Monterey Bay's Seafood Watch program rates U.S. farmed Barramundi a"Best Choice" because of our environmentally friendly farming practices.

Why eat it? Barramundi has 833 mg of heart-healthy omega-3 fatty acids per 5-oz serving and contains less than 150 calories! It's a great source of lean protein, is rich in vitamins and minerals, and is low in saturated fat. Because of U.S. farming practices, it's also free from contamination with PCBs, mercury or other contaminants.

How to buy it? You may find it called Silver Barramundi, Giant Perch, Palmer Perch, and Barra. Locally it can be found at Giant and Safeway.

How to make it? Barramundi has a sweet, mild flavor and light, flaky texture and is super easy to prepare. Below is a recipe and links to more!

Barramundi and Lemon Butter

4 Barramundi fillets

2 tsp. olive or canola oil

2 Tbsp. butter

1 clove garlic, minced

3 Tbsp. fresh or bottled lemon juice

5 leaves minced fresh basil (or 3/4 tsp. dry)

Salt to taste

Gently saute the garlic in butter for about 2 minutes. Stir in lemon juice and basil. Add salt to taste. Remove from heat. Coat fillets with olive or canola oil. Pan fry one side on high heat for 3 minutes. Flip and cook other side 1-2 more minutes or until fish is cooked through. Transfer to serving dish. Spoon sauce over fillets.

Serving Suggestion: Serve on a bed of sauteed spinach or greens, and fresh tomato salsa.

Danielle Omar, MS, RD
The Food Confidence Expert

www.foodconfidence.com

Yup, you heard it here.
Nope, I’m not telling you to ditch the exercise.
I’m encouraging you to be sure you’re balancing exercise with rest, and not overtraining.
If you’re trying to lose weight, your focus is likely on losing fat. That’s a nice goal, and I’m guessing you’ll feel better about what you see when you look in the mirror if that results from your exercise, but it’s not really the main reason you’re exercising for PCOS.
You need to gain muscle. The more muscle mass you have, the harder it is to be insulin resistant. The act of exercise actually breaks muscle down. It rebuilds during periods of rest. It’s the balance of exercise and rest that matters, way more, than how many hours of exercise you’re actually doing.
It can be a vicious cycle to break out of, because insulin resistance itself actually breaks down muscle. So if it’s been awhile since you’ve actively exercised, and you’re not losing weight the way you’d hoped you would when you committed to the gym, consider that your ratio of muscle to fat is not high enough. Your priority, first and foremost, is to build and maintain that muscle.
Focusing too much on losing fat and overtraining in the process… will undermine your progress.
Exercising too late in the evening, getting up too early in the morning to get to the gym (it’s not uncommon to hear women say they’re up at 3 am to fit in the workout), or simply working out so much and so hard that you’re not sleeping well… are all easy ways to sabotage your success.
Things you need to keep in mind:
You need to eat enough protein so that your body builds muscle mass while you're not active.
2. You need to sleep enough so that you don’t promote insulin resistance.
3. You need to not push yourself so hard that you’ve stopped burning fat—monitor your heart rate!
4. You need to vary the workouts so all muscle groups are involved and have a chance to build up. Also, you need to develop the confidence to trust that PROACTIVE exercising, as opposed to REACTIVE exercising, is your path to success. Too often women with PCOS weigh themselves in the morning and if the weight is not what they want to see, react by doubling, even tripling their scheduled workout time in order to “get control” of the situation.
When you’re exercising with the goal of building muscles to reduce insulin resistance, you understand that overtraining is your enemy. You create an exercise plan that perhaps you even map out on your calendar, that you commit to regardless of how you’re feeling or what the scales says. For example, I just mapped out my spring training schedule. One of my friends and I have decided we’re going to take tennis lessons. We both own businesses, and committing to this ensure that we actually get out and move. I also love to swim, and it’s one way I can stay active as the weather in Arizona gets warm. And, I’ve been wanting to bump up my elliptical workouts and try spin classes. So, for the next three months, on my calendar, every fourth day, I’ve written “tennis”, every fourth day “spin”, every fourth day “swim”… and then I schedule a day off. It’s right there in my planner so when I start scheduling meetings and accepting social invitations, I only schedule in a way that does not take away from that commitment to myself. I varied the exercise to give my different muscle groups a rest, and to give me enough variety to not get bored.
And don’t get me wrong… I do relish the day off! We all need a little bit of laziness, sleeping in, and getting caught up. I find, personally, if I don’t have the day off, I have trouble sleeping and I have trouble keeping up with the appetite. I have designed this program to fit with the way I’ve learned my body works. If I like spin, I’ll keep it, or I may prioritize swimming during the heat of the summer. We’ll see. I kind of need to mix it up over time to stay interested.
The point of this post is, the reactive and self-punitive approach many of you have toward exercise, because of your focus on reducing body fat, is your absolute biggest enemy. Focus on building muscle, even though it may mean seeing your weight increase on occasion. It’s reflecting muscle, not fat, and it’s a good sign.
Muscle, muscle, muscle!

Last night I was settling in after a long day of work, walking toward the television to turn it on for ER. My phone rang. It was the husband of a client I've been in contact with for a few months. He called to tell me they were pregnant!

Earlier in the day I'd met with a business colleague who is also several months pregnant, who attended an inCYST class.

It gave me cause to pause…and give thanks.

If you know me primarily through this blog, what you may not know is how long and stubbornly I dragged my feet before deciding to take on the world of infertility. I'm a small business person, working primarily out of my home. I feel sometimes like I'm taking on several huge, well-financed industries, with a tiny bank account, a small voice, and no hope of ever making a dent in the very lucrative world of couples wanting help in having a family. It took me a long time, and lots and lots of emails from women asking for help, to believe one person with an idea and a dream could make a difference.

Most of all, I've had to learn to live with the stress of working in this world. It's not like I'm selling tires or chewing gum. When people come to my program, either directly to me, or through someone I've trained, they're putting their lives, their hopes, their fears, in our hands. Often times they've been let down by someone else they've trusted. Or they've been told they can't have something that only makes them want it more. It always feels like a huge responsibility. It's always humbling. It's definitely strengthened my spirituality.

But 2008 has been the year that all the doubts began to fade, the progress took huge leaps, and confidence that taking all of that on, despite the sacrifices and stress, was absolutely the right thing to do.

I am thankful to the colleagues who took the course and established their own islands of influence in their communities. As the number of islands grows, we are starting to build bridges and to support each others' success. It's so fun to watch this grow!

I am especially thankful to the colleagues who have stepped up and openly shared their own trials and tribulations of fertility treatment and weight management for the benefit of others. That took an incredible amount of courage and I am honored to work with you.

I am thankful to the couples who asked us for help, and who worked with us to develop a program that is starting to multiply…not just office locations, but humans! I appreciate your trust in our work.

I am thankful to my family, who supported me through some very rough times, because they saw my focus and my vision.

I am thankful to friends who tolerated my lifestyle, as I've worked long hours for little pay and have not always been able to keep up with them as far as having free time or disposable income.

My family and my friends are all still there. Without them I wouldn't have anything to offer anyone, and they deserve the biggest thanks of all.

I am thankful that I have been able to use my studious nature, my love for writing, and my desire to help, in a way that brings such happiness and joy to the people I am honored to call my colleagues and clients.

I hope that in this Thanksgiving season you are all feeling equally as thankful. I look forward to serving you in the future through my writing and teaching.

Warmest holiday regards,

Monika M. Woolsey, MS, RD
Founder, inCYST Programs