The Hemp Connection [Search results for flax oil] 

Last night I settled in to watch the evening news, in time to see an ad for Country Crock's Omega 3 Plus brand margarine. With my reputation as somewhat of an"omega 3 queen," I figured I'd better pay attention. And by the time the ad was over, I knew I had today's post.

This label is a perfect example of why consumers are confused, and why they can have a hard time achieving the benefits of good nutritional choices.

First, the good news.

The margarine has no trans fats, because it contains no hydrogenated or partially hydrogenated oils. For fertility, this is a huge plus--with as little as 2% of your total calories per day coming from trans fats (about 2/3 tsp for the average woman), fertility can drop by as much as 73%.

Secondly, one serving provides 500 mg of omega-3's in the form of ALA.

Now for the confusing and potentially detrimental news.

When the professionals on this blog talk about what we're doing to enhance fertility and reduce inflammation, and we refer to omega-3's, we are primarily referring to EPA and DHA, the omega-3's that, except for omega-3 eggs and foods supplemented with algal DHA, contain either fish or fish oil. (Menhaden oil, which is what is found in Smart Balance Omega 3 Margarine, is a type of fish oil.)

Any other type of omega-3 is likely to be ALA. This type of omega-3 is found in canola oil, and flaxseed oil, among other things. In this margarine, the ALA source is canola oil.

But there is no fish oil or marine algae to provide a similar nutritional feature.

There are some things that flax and canola can do, and there are some that flax and canola simply cannot do.

Many people, nutritionists included, operate on the assumption that since the omega-3 found in canola and flax can be converted into EPA and DHA, that you can get enough of the latter two without having to eat fish. Most respected omega-3 chemists will tell you this is highly unlikely.

On a good day, when your diet is as perfect as it can possibly be (which, even in the case of the person writing this post is never), only about 2-3% of your flax and canola can be converted into the other omega-3's.

Bottom line, it's pretty non-negotiable, you are highly unlikely to get the amount of omega-3's your body needs, especially if you are trying to conceive, if you are assuming you can do it without fish.

Secondly, the primary oil in the margarine appears to be liquid soybean oil. Remember the rule about"S" and"C" oils? Soybean is one of those"S" oils with a tendency to be pro-inflammatory. It was impossible to tell from the label what the ratio of soybean to canola oil was, and I would suspect that it was higher than you're going to want if you're trying to choose fertility-friendly foods.

I immediately became suspicious about this Country Crock product when I went to the website and nowhere, I mean absolutely nowhere, could I find a plainly stated ingredient list. Sure, there's a label to look at, but it's strategically posted in a way that all the nutritional information is there except for the ingredients. Hmmmm…

…so I went to the FAQ section. Couldn't find it there either. I found a lot of long-winded explanations of trans-fat labeling, and that was my second red flag.

Since I had to go to the grocery store anyway, I stopped in and looked at the label. Here, for the benefit of the rest of the people on the Internet, is the list of ingredients from the side of the container of this product:

Vegetable oil blend (liquid soybean oil, canola oil, palm oil, palm kernel oil, water, whey, salt, vegetable mono and diglycerides, soy lecithin (potassium sorbate, calcium disodium EDTA), citric acid, artificial flavor, vitamin A (palmitate), and beta carotene.

For more information on healthy fats, go to http://www.zingbars.com/science-of-zing.html, where my Zing Bar friends describe why they did--and didn't--include certain fats in their new product.

Any fat that is going to be solid at room temperature is going to have to have some saturated fat in its formula. Otherwise, it would melt. So even though the total saturated fat content is low, the type of fat being used to provide the solid quality is not one you want to get much of in your diet.

I'm not really a butter or margarine person so giving those up was not an issue for me. But I did start my career in the Chicago area, and I remember how people used to look at me like I was purple-polka-dotted if I even hinted that dairy intake might need to be adjusted. So I know it's an issue for some of you.

Bottom line--if you choose to use the product, do so only once in awhile and sparingly. I'd rather see people use olive oil-based dipping sauces for breads and cook with either canola or olive oil.

If you're interested in learning more, the authors of the study below also wrote a recently released book in plain English entitled, The Fertility Diet. I'd check it out.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007 Nov;110(5):1050-8.

Just received an e-mail from our friends at Shape Foods (they're the ones coming out with the flavored flax oils we found at Natural Products West). They've got another wonderful product (in conjunction with Flax USA) that's only been on grocery shelves for 9 days…flax milk!

Andrew Lis of Shape Foods provided this interesting information about their product:

The key ingredient comes from our flax oil. Due to the superior quality of our oil and since we remove the impurities that can cause the oil to go rancid prematurely through our proprietary manufacturing process, it was the only flax oil on the market that was able to survive pasteurization without going rancid. That is why we are the exclusive ingredient supplier for this type of product.

This product is available at most Walmart stores, so intern Sarah Jones and I set out to find it. Here is Sarah with the original-flavored version (there is also vanilla-flavored).

This carton, here in Phoenix, is priced at $2.98, and it is in the refrigerator case near the other milks and milk substitutes.

It is a dairy-free, lactose-free, soy-free, and gluten-free product. Even though it's primarily fat-based, 8 ounces of the original flavor only contains 50 calories.

Here's the fatty acid profile on the side of the carton. As you can see, it's got a great omega-6 to omega-3 ratio.

The important thing to keep in mind is that this product is made with an oil, and it contains 0 protein. If you use this in place of milk on your cereal, be sure to add another protein source to that meal to keep your glycemic index in check.

I bet this would be a great substitute for creamer in coffee (you'd be hard-pressed to find another way to get omega-3's into your coffee!).

And if you have a fancy blender that makes ice creams, the vanilla version is likely going to be a nice treat. If anyone tries this in their kitchen, please share how you used it!

This product is available exclusively at Walmart.

Since the beginning, flaxseed oil has been an important part of our protocol. It provides the helpful estrogenic benefits that soy does, but without the potential problems soy creates for thyroid function. The problem is, most flaxseed oil is not easy to take and therefore it isn't used as much as it could/should be.

Shape Foods has finally solved that problem with their new line of culinary flax oils. In the first picture you see the line of smoothie-friendly flavors: banana, coconut, chocolate, and caramel. I was skeptical, but they turned out to be yummy! These products are hot off the factory line and not easy to find. Be sure to ask for the Royal Harvest flavored flax at your favorite store to be sure the buyers know there is a demand. I did manage to find the Coconut and Banana flavored varieties on amazon.com if you're interested in ordering by mail.

If you're more of a savory person, you may be interested in their Heart Shape line of cultural cuisine adaptations: Szechuan, Thai, Indian, Mexican, and Italian. Salsas, bruschettas, pad thais, etc., will never be the same again!

This product line is slated to appear on grocery shelves this summer. I have no link to provide you. (That is, yet!) Again, be sure your local buyer knows you want to buy them!

This product line was by far one of my favorite finds at Natural Products Expo West. One of the most frequent questions I've had when teaching omega-3 chemistry was about how to cook with flax oil. I always hated answering the question because it hasn't really been a kitchen-friendly oil.

Now it is, and I'm excited to try them in my own kitchen!

As you know, I have a huge allegiance to omega-3 fatty acids and their potential for our readers. So much so that my friends are convinced that under the mask of my smiling face there is a giant fish head. I have done my best to steer clear of allegiance to any particular brand, but I do have a strong allegiance to integrity. I ran across something recently that felt really wrong, and I'd like to bring it to our fans' attention, so that their choices for who to support in the quest for hormone balance are informed choices.

From time to time I've mentioned a line of products I thought were really nice omega-3 options from a company called Barlean's, their Omega Swirl line. Pictured here is their packaging, including their lemon-flavored fish oil and their strawberry-banana flavored flax oil.

Yesterday I ran across a new line of products.

Here's a picture of their lemon fish oil product.

And wow, here's their — whaddaya know — strawberry banana flax oil product.

Same flavor, same concept…they didn't even bother to package in a different bottle.

As for what's inside, the original (Barlean's) contains 365 mg DHA, 365 mg EPA, and 970 mg total omega-3 fatty acids. The other company's product? 360 mg DHA, 360 mg EPA, and just over 1000 mg total omega-3 fatty acids. A little too close to be considered coincidence.

I know there are certain rules by which the US Patent and Trademark Office define how we each can play the intellectual property game. And I know for every rule there are always 2 or 3 or 4 ways around it.

But I also know what integrity looks like. This is not it.

Be good to the Barlean's people. They're the ones who did the hard work and the ones who deserve our support.

**I receive no compensation from Barlean's and never have.

I just received an email from a client who noticed that every time she added flaxseed oil to her diet, she started to wheeze. We checked online, and sure enough, some people can be allergic to flaxseed. Here are some of the common symptoms of flaxseed allergy.

For anyone who is trying to increase their omega-3's, this can pose a challenge, since the vast majority of foods in the grocery store labeled as omega-3 supplemented contain flaxseed as the omega-3 source. If it turns out you are a flax-allergic person, be extra sure you read those labels!

ALA, the primary omega-3 in flaxseed oil, is not a substitute for fish oil; it has completely different and essential functions. A good way to think of it is that EPA and DHA from fish oil provide the"meat" of the structure of your brain and nerve cells, while ALA acts kind of like"rustproofing", keeping all that DHA and EPA in place that you worked so hard to get in the diet. They both need each other present in order for maximum effectiveness.

Here are some ideas for getting more omega-3's in the diet.

1. Other foods containing ALA include

Broccoli
Brussels sprouts
Cabbage
Canola oil
Edamame
Kale
Parsley
Pecans
Pumpkin seeds
Spinach
Spring greens
Tempeh
Tofu

One reason I have not included walnuts, which are typically the first vegetarian food recommended to increase omega-3 intake, is that the omega-6 content is so high that it is mathematically impossible to improve an omega-6 to omega-3 ratio when using them. I love walnuts and think they have some great nutritional benefits for PCOS, but in the rare and special case of a flaxseed allergy, it may not be a food that you would want to eat in large quantities. (I'm working on a pro-walnut post for a later date for you curious types!)
Here are some practical ways to incorporate the foods above into your diet.

1. Know your nuts!
The nuts with (a) the best omega-3 levels and (2) the best overall ratios of healthy to unhealthy fats include: macadamia, hazelnut, pecan, pine, and pistachio. Those are the nuts you should be using with the most frequency in your snacking and cooking. If you like nut-encrusted fish and pesto sauce…you're in luck! You can also throw nuts in your coffee grinder to make nut powders, which can be added to waffles, pancakes, baked goods, smoothies, and salad dressings. They'll give your creations a little bit of a gourmet twist!

2. Use shredded cabbage in your tacos instead of shredded lettuce. That's how they do it in Mexico…and it's the perfect topping for a fish taco!

3. Get in the habit of throwing a handful of dark greens--kale, spinach, parsley--into your smoothies. You won't even taste them.

4. Pumpkin seeds, like nuts, are easily added to trail mix, thrown on salads, soups, and hot cereals, and ground to include in your encrustings.

5. Cook with canola oil.

6. I've included the three types of soybean that are not tough on thyroid--edamame, tofu, and tempeh. Edamame is a fun snack when popped out of the shell, tofu and tempeh can be the basis for a meatless meal.

7. If you like pesto, you may want to try chimichurri, another parsley-based sauce that I call"South American pesto". It is wonderful on grilled meats and easy to make! I've seen ready made varieties in the grocery store.

8. Be extra careful about omega-6 fatty acids. The less of those in your diet, the less omega-3 you will need to counter their inflammatory influence. For review, except for canola, which is ok, minimize your use of oils beginning with the letters"s" and"c"…safflower, sunflower, soybean, corn, cottonseed. (The reason soy as a food is ok while soybean oil is not, is because the ratio of omega-6 jumps up when you extract and use only the fat and do not buffer it with the meat of the soybean.)

Here are a couple of recipes for you, one for chimicurri sauce, and one for a tasty squash/kale/whole wheat lasagna I tested out this week.

It just takes a little creative thinking to find ways around a flaxseed allergy. Hopefully some of the suggesstions I'm providing turn out to be favorites in your home!

Spinach Kale Whole Wheat Lasagna (from Sunset Magazine, February 2008)

Note: I couldn't find whole wheat lasagna noodles in my store so I bought whole wheat egg noodles and layered them with the other ingredients to make a casserole. It was great!
Prep and Cook Time: about 2 hours. Notes: You can assemble and chill the lasagna a day ahead, but add 10 to 15 minutes to the baking time. You can also freeze the lasagna, wrapped well in plastic wrap, for up to 1 month and bake it frozen (add 1 1/4 hours to the oven time).

Yield
Makes 8 servings

Ingredients
4 tablespoons olive oil, divided
1 medium red onion, peeled and sliced
3 peeled garlic cloves (1 minced, 2 left whole)
2 cans (14 oz. each) crushed tomatoes
1 teaspoon dried oregano
About 1 tsp. each salt and freshly ground black pepper, divided
6 cups (about 2 lbs.) butternut squash, peeled and cut into 1/2-in. cubes
1/2 tsp. dried thyme
1 pound Lacinato kale (often sold as dinosaur or Tuscan kale)
9 whole-wheat lasagna noodles (about 8 oz.) (Often, whole wheat pastas are made with flax…be sure to read your labels!)1 container (15 oz.) part-skim-milk ricotta cheese
1/8 teaspoon ground nutmeg
2 cups shredded mozzarella cheese, divided

Preparation
1. Preheat oven to 400°. Heat 2 tbsp. olive oil in a 2- to 3-qt. pot over medium heat. Add onion and minced garlic; cook, stirring occasionally, until onion is soft and translucent, 5 minutes. Add tomatoes, oregano, and 1/2 tsp. each salt and pepper. Reduce heat and simmer until thick and flavors are combined, about 30 minutes. Set aside.

2. While sauce is cooking, in a 12- by 15-in. baking pan, sprinkle squash with thyme, remaining olive oil, and salt and pepper to taste. Add garlic cloves and toss squash mixture to coat with oil. Bake until soft, 10 to 15 minutes. Meanwhile, bring 3 qts. salted water to a boil in a large pot.

3. Reduce oven temperature to 350°. Transfer squash and garlic to a food processor and purée until smooth.

4. Tear kale leaves from center ribs and discard ribs. Boil leaves until soft, 5 to 8 minutes. Drain; let cool. Squeeze out as much water as possible and chop finely.

5. In the same pot, bring another 3 qts. salted water to a boil. Add noodles and cook until tender to the bite, about 10 minutes. Drain; rinse with cold water.

6. In a bowl, mix ricotta, nutmeg, 1 cup mozzarella, and remaining 1/2 tsp. each salt and pepper.

7. Coat the bottom of a 9- by 13-in. pan with 1/3 of tomato sauce (about 1 1/2 cups). Lay 3 noodles in a single layer over sauce. Top noodles with squash, spreading evenly. Sprinkle 1/2 of kale evenly over squash. Arrange 3 more noodles on kale and top with ricotta, spreading evenly. Top with remaining kale and noodles. Cover noodles with remaining tomato sauce and sprinkle with remaining 1 cup mozzarella.

8. Bake lasagna until juices are bubbling and cheese is melted, about 30 minutes. Let stand 10 minutes before slicing.

Grilled Halibut with Chimichurri Sauce from Epicurious.com

1/3 cup extra-virgin olive oil
1/4 cup fresh lemon juice
1 tablespoon water
1 tablespoon minced garlic
1 tablespoon minced shallot
3/4 teaaspoon hot red-pepper flakes
3/4 cup chopped flat-leaf parsley
4 (6- to 8-ounce) halibut steaks (3/4 to 1 inch thick)
1 tablespoon vegetable oil
print a shopping list for this recipe

Preparation

Whisk together olive oil, lemon juice, water, garlic, shallot, red-pepper flakes, and 1/2 tsp each of salt and pepper until salt has dissolved. Stir in parsley. Let chimichurri stand 20 minutes.

Meanwhile, prepare grill for direct-heat cooking over medium-hot charcoal (medium heat for gas).

Pat fish dry, then brush with vegetable oil and sprinkle with 1/2 tsp salt and 1/4 tsp pepper (total).

Oil grill rack, then grill fish, covered only if using a gas grill, turning once, until just cooked through, 8 to 10 minutes total.

Serve fish drizzled with some of chimichurri; serve remainder on the side.

Cooks' notes:
·Halibut can be cooked in a hot oiled large (2-burner) ridged grill pan over medium heat.
·Chimichurri can be made 1 hour ahead and kept, covered, at room temperature.

This question comes up from time to time, and since inCYST is so big on flaxseed, it's a good idea to have information at your fingertips.

Around the Internet, caution regarding the use of flax while pregnant is easy to find. The rationale for this caution is that mothers and fetuses are especially sensitive to hormones.

The Internet is also full of advice from flaxseed manufacturers promoting its use, because it can be converted to DHA, which as this blog consistently discusses, is crucial for conception, pregnancy, and development of a healthy baby.

Neither of those assertions is totally correct.

I dove into Pub Med last night and looked for any research to support the advice against flax during pregnancy. I couldn't find it. What I DID find was a whole host of animal studies, primarily done on pigs and cows, with mostly positive findings. It's always important to remember that animal studies do not always extrapolate completely to humans, but they do give us an idea of what's going on.

Effects of flaxseed consumption during pregnancy (again, in pigs and cows) included:
--healthier immune systems in babies
--better growth in babies
--after having one baby, a shorter time to ovulation (restored fertility)
--breast milk with a higher omega-3 fatty acid content and a lower omega-6 to omega-3 fatty acid ratio
--higher brain omega-3 content in babies
--increased levels of EPA, another omega-3 important for prostaglandin function and healthy blood clotting
--higher pregnancy rates
--larger follicle size
--higher conception rates
--lower miscarriage rates
--higher progesterone levels

IMPORTANT DISCLAIMERS
While I'm always excited to report positive links between nutrition and fertility, you all should know when I look through the research I am actually searching hard for the BAD news. This is such a high-risk specialty! The very last thing I would want to do is encourage our readers to make choices leading to frustration, disappointment, heartache, and loss of our own credibility. So I want to make it clear, the benefits of flax can be achieved only if it's used with respect.

Flax cannot replace fish oil. Some flax supplement manufacturers promote its use because it is converted into DHA and therefore can be used as a supplement for flax. Not true! The studies I perused found different effects for both, meaning you need both in your diet.

If your diet is imbalanced, flax won't make up for it. One study I found showed that when protein intake was low, flax supplementation was not beneficial. This would be a scenario not uncommon with our vegetarian readers, if their definition of vegetarian eating focuses more on what to eliminate rather than what to include, or is the remnant of an eating disorder. As always, supplements work best in a well-nourished environment; they cannot replace balanced, nourished eating.

Finally, if you choose to use flax…IT MUST BE GROUND. In other words, the flaxseed tortilla chips at Trader Joe's were not what made these studies work.: )

I've heavily referenced this post to save the skeptics the work.

I hope you find this helpful!

Rao SS, Kale AA, Joshi SR, Mahadik SP. Sensitivity of fetus and pups to excess levels of maternal intakes of alpha linolenic acid at marginal protein levels in Wistar rats. Reprod Toxicol. 2007 Nov-Dec;24(3-4):333-42. Epub 2007 Jul 28.
Yu B, Khan G, Foxworth A, Huang K, Hilakivi-Clarke L. Maternal dietary exposure to fiber during pregnancy and mammary tumorigenesis among rat offspring. Int J Cancer. 2006 Nov 15;119(10):2279-86.
Ambrose DJ, Kastelic JP, Corbett R, Pitney PA, Petit HV, Small JA, Zalkovic P. Lower pregnancy losses in lactating dairy cows fed a diet enriched in alpha-linolenic acid. J Dairy Sci. 2006 Aug;89(8):3066-74.

Petit HV, Twagiramungu H. Conception rate and reproductive function of dairy cows fed different fat sources. Theriogenology. 2006 Sep 15;66(5):1316-24. Epub 2006 Jun 2.
Farmer C, Giguère A, Lessard M. Dietary supplementation with different forms of flax in late gestation and lactation: Effects on sow and litter performances, endocrinology, and immune response. J Anim Sci. 2010 Jan;88(1):225-37. Epub 2009 Sep 25.

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.
Farmer C, Petit HV. Effects of dietary supplementation with different forms of flax in late-gestation and lactation on fatty acid profiles in sows and their piglets. J Anim Sci. 2009 Aug;87(8):2600-13. Epub 2009 Apr 24.
Brazle AE, Johnson BJ, Webel SK, Rathbun TJ, Davis DL. Omega-3 fatty acids in the gravid pig uterus as affected by maternal supplementation with omega-3 fatty acids. J Anim Sci. 2009 Mar;87(3):994-1002. Epub 2008 Nov 7.

Galbreath CW, Scholljegerdes EJ, Lardy GP, Odde KG, Wilson ME, Schroeder JW, Vonnahme KA. Effect of feeding flax or linseed meal on progesterone clearance rate in ovariectomized ewes.
Domest Anim Endocrinol. 2008 Aug;35(2):164-9. Epub 2008 Jun 5.

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.

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

The primary problems with these alternatives are:

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

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

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

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

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

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

All information is for an 8 ounce serving.

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

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

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

FLAX MILK

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

Flax USA Flax Milk

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

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

Living Harvest Hemp Milk

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

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

OATMEAL MILK

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

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

HAZELNUT MILK

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

Pacific Foods Hazelnut Milk

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

COCONUT MILK

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

Regular Canned Coconut Milk

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

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

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

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

RICE MILK

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

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

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

Rice Dream Rice Milk

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

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

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

Source: Uploaded by user via Monika on Pinterest

Last week I was at the farmer's market, admiring a beautiful box of greens. I noticed a woman looking longingly at the same box. So I asked her if she liked kale.

"Oh, I do!" she answered."But I had to give it up when my husband went on Coumadin."

Coumadin is a blood-thinning agent that is being prescribed more frequently than it used to be, as blood that clots too easily is one consequence of inflammation. Since leafy greens are high in vitamin K, a nutrient that promotes blood clotting, patients prescribed Coumadin are advised to limit their intake to a level they can consistently commit to eating. That commitment factor intimidates many people out of eating them at all.

What is ironic about the Coumadin dilemma, is that leafy greens are packed with omega-3 fatty acids and antioxidants, both of which hold potential to fight the very inflammatory process that is likely creating the need for Coumadin in the first place.

So how does one back themselves out of this corner once their previous lifestyle has backed them into it?

Here are a few things to try. Note, Coumadin is NOT a drug to mess with, so if you choose to make these suggested changes, it is essential that you communicate with the physician in charge of managing your blood clotting issues. If your condition is improving, medications will have to be adjusted to maintain clotting balance. It is best to make these shifts one at a time and wait 6 to 8 weeks to see how your body responds, rather than make too many changes at once, which can make it challenging for your physician to keep up with what is happening.

1. Shift your fat consumption, as much as possible, away from omega-6 fatty acid-dominant fats. They are easy to remember, they primarily begin with the letters"s" and"c"--soybean, safflower, sunflower, sesame, corn, and cottonseed. (Canola is the exception to this rule). They are primarily found in processed foods and in restaurant cooking, places where the price, not the quality, of the oil, is determining recipe makeup.

Check in with your physician to see how you are doing.

2. Add more vegetarian, non-leafy omega-3 foods into your diet. Flax is one of my favorites. You can add ground flaxseed into your smoothies, oatmeal, homemade vinaigrettes…and you may want to try a relatively new product on the market, flax milk, as a substitute for coffee creamer. If you are adventurous, try some chia seeds on your salad!

Check in with your physician to see how you are doing.

3. Try a protein-containing snack at night. It can help to stabilize blood sugar and cravings for sweets throughout the day, which keep you from being tempted by baked goods containing those oils.

Check in with your physician to see how you are doing.

4. Work on getting your seafood omega-3's. Note: ALL seafood, not just salmon, contain omega-3 fatty acids. If salmon is too fishy for your taste, spend some time at a knowledgeable seller such as Santa Monica Seafood, and try some of the recommendations they have. One of my favorites, which is available at Santa Monica Seafood, as well as Safeway, is barramundi, a sustainably farmed, mild-flavored whitefish that has a lot of versatility with regards to cooking technique.

Check in with your physician to see how you are doing.

5. If you are not a fish eater, consider a fish oil supplement. Despite what the supplement companies tell you, fish is fish; I've seen great changes in clients using Costco's Kirkland brand. The most important thing about using fish oil when you are taking Coumadin, is that you take it consistently. If remembering it is a challenge, program your smart phone to send you a daily reminder.

Check in with your physician to see how you are doing. If your clotting times have improved enough to get the greens-eating go ahead, good for you!

Later this week I will share some ideas for getting greens in your diet consistently without burning out on them.

We've been getting some inquiries about chia, given our love of omega-3's. Here are some basic facts that can help you decide for yourself if chia will work with your PCOS plan.

Chia (salvia hispanica), is a seed that originates from Southern Mexico and Guatemala. Way back when, it was a major staple food of the Aztec Indians. Other names you may see this seed sold under include: Cheela Brand, Sachia, Anutra, Chia Sage, Salba, Tresalbio, Purisalv, and Mila.

Nutritionally, chia is 20% protein, 34% oil, and 25% fiber. It is not a complete protein, as it lacks the essential amino acid taurine. Its fat is primarily ALA, the same type of fat found in flaxseed. Its omega-6 to omega-3 ratio is about 3 to 1, which is nice.

Two benefits to chia are that it does not need to be ground like flax does in order to gain its health benefits, and it does not go rancid as easily as flax. One major disadvantage is its cost. It's definitely not for those on a budget.

Especially, if you are Hispanic or living in the Southwest, this is a great source of omega-3's that is more locally available than flaxseed.

Be aware, however, that claims about its health benefits can be exaggerated.

1. Chia is not a complete omega-3. In other words, it can be used as a substitute for flaxseed oil, but not for fish oil. You still need a DHA source.

2. While they do have their health benefits, I could not find any peer-reviewed studies to support the hype that chia seeds have been given as an athletic performance superfood.

3. I did find one study, performed on chickens, (below) reporting that chia supplementation positively changed their fat content. However, chia was not compared to any other supplements or to a diet with a similar fatty acid composition from other grains. So it is impossible to assert that it was specifically something in the chia that had the effect.

Bottom line, it certainly won't hurt you to include chia in your diet, but just because you do, it does not give you license to eliminate other healthy eating. They can enhance, but they won't replace the benefits of the many good things you're already doing.

R Ayerza, W Coates, and M Lauria Chia seed (Salvia hispanica L.) as an omega-3 fatty acid source for broilers: influence on fatty acid composition, cholesterol and fat content of white and dark meats, growth performance, and sensory characteristics. Poultry Science, Vol 81, Issue 6, 826-837.

I just ran across this product this week, new in the Barleans Omega Swirl product line. It's a marine-algae supplemented, blueberry-pomegranate flavored DHA supplement.

I haven't had a chance to try it, but I know from tasting the fish oil and flax oil varieties, it's going to be great!

If it hasn't appeared in your local store, it is available on amazon.com:http://www.amazon.com/gp/product/B001R2W3BE?ie=UTF8&tag=wwwincystcom-20&linkCode=as2&camp=1789&creative=390957&creativeASIN=B001R2W3BE" />

Total Omega Vegan Swirl Pomegratate Blueberry — 16 oz — Liquid

Many of the women I work with are vegan vegetarians. Which means when it comes to increasing omega-3 intake, they tend to want to go heavy on flax, hoping it will make up for not eating fish. It simply doesn't work this way…in ways that are very important to PCOS.

When different groups of rats are given ALA (the primary omega-3 in flax), EPA and DHA (the primary omega-3's in fish oil), EPA and DHA lowered glucose and insulin levels about 35-38% greater than did ALA. Insulin sensitivy improved by 60% in the fish oil groups compared to the ALA groups.

Bottom line, if you really, really want to get better, and you're not currently eating fish, or using a fish or marine algae supplement, you may want to seriously consider adding one of those to what you're doing. It's pretty non-negotiable, we need DHA and EPA to properly function as human beings.

Andersen G, Harnack K, Erbersdobler HF, Somoza V. Dietary eicosapentaenoic acid and docosahexaenoic acid are more effective than alpha-linolenic acid in improving insulin sensitivity in rats. Ann Nutr Metab. 2008;52(3):250-6. Epub 2008 Jun 19.

Most of you know that your PCOS is an inflammatory disorder. But if someone asked you what that meant, would you be able to explain it? I've found that it's a pretty meaningless and misleading term to most people. So I like to use a visual. This visual has had such a profound impact on some of my clients that they've printed it out and they hang it on their computers or other prominent place to graphically remind them of the importance of making proactive choices.

Inflammation is a misleading term because most people, when they hear it, tend to think of swelling, as you might experience if you sprain your ankle. In the case of inflammatory disease, it's really more oxidation that we're talking about. (Hence the focus on antioxidants by the supplement industry).

But even then…what is oxidation? It is the metabolic effect of oxygen being broken down. Outside of your body, the easiest illustration I've come up with is rust. When metal reacts with oxygen, and an oxidative process occurs, rust is the result.

It's no different in your body. An inflammatory, or oxidative process, is essentially the rusting out and deterioration of your tissues. It happens when the balance between processes that oxidize outweigh those that do repair work.

One of the most important places where this oxidation has effect is in your brain and nervous system. Oxidative processes are known to destroy neurons! For example, depression, another inflammatory disorder and one which commonly co-exists with PCOS, is known to destroy neurons in the hippocampus, the brain's memory center. And as many of you know, loss of memory, concentration…brain fog…are common side effects of PCOS.

Take a look at this photo. If the balance in your own body is tipped toward inflammation, it's literally like your brain and nervous system are rusting out. Yes, this is your brain on inflammation.

Your job is to reverse that process.

And it can be reversed! Studies also show that the hippocampus rebuilds those lost neurons as an indication of resolving depression.

What to do?

1. Remember that the substance that the brain needs in order to rebuild neurons is DHA. It's not sugar, it's not flax, it's not a vitamin or mineral. It's DHA, the fish oil that is found in fish and marine algae. Dr. Artemis Simopolous, omega-3 expert, has written that treating depression with DHA requires a dose of about 1000 mg per day. That is about 4 times what is recommended on the bottles of most supplements, and eating fish a few times a week is far below that. If you really want to experience the benefits of omega-3's, you likely need to up your dose.

2. You need to remember to take your fish oil! I know, it sounds funny, that in order to improve your memory you need to remember to use the thing that improves your memory…but that's one of the biggest barriers I've seen to PCOS success…consistency. If you cannot put your fish oil next to your milk in the refrigerator, or remember to take it when brushing your teeth, program your computer or smart phone to remind you to do so. I cannot reinforce the importance of consistency.

3. Slow down the rusting out process. Anything that raises metabolism, speeds up the rusting out process. That means extra stress. Sleep deprivation. Diet excesses. Dietary deficiencies. Too much exercise.

4. Eat a variety of foods from a variety of food groups. There are so many antioxidants available to you, none of them is the be-all-end-all…you need to mix it up so you get the most opportunity to benefit from the entire palette.

My hope is that now that you've seen what inflammation is, you will understand why it is so important to take action and do the repair work, then rust-proof yourself against further damage.

The following is a guest blog post from Dawn Marie Black, a woman with PCOS. Dawn is learning to cook in hormone-friendly ways, and has a great blog, Much Madness Is Divinest Sense, in which she records her experiences on this journey. In this post Dawn shares information about coconut flour.

If you'd like to try coconut flour but cannot find it locally, here are some options for online ordering.

What flour is high in fiber, and protein, low in carbohydrates and gluten free? We're talkin' coconut flour here!

I have PCOS, and found that these things are better for me, and having tried this flour I found I really like it.

Coconut flour is fiber from the coconut meat after most of the oil has been extracted to make Virgin Coconut Oil. Each brand of coconut flour will vary in their content of protein and fiber, but the protein and fiber is higher than gluten based flours, and that makes this flour very appealing for keeping my baked goods low carb, and to reduce other gastric issues that gluten can aggravate. Who really likes having IBS issues? I, for one, am not a fan. It is also considered a hypoallergenic food since so few people are allergic to coconut, which makes this easy to offer to many of your friends who may have other allergies. There are three things to remember when using coconut flour: One, always sift. Two, extra liquid is needed. Three, it needs something to bind it all together.

Coconut flour can be used in all recipes calling for flour. Most can be substituted with anywhere between 10% — 30% coconut flour, adding in the equal amount of liquid into the recipe as well. Other recipes may need further adjustments, for binding agents and liquid depending on the amount of fiber in the coconut flour. The easiest recipes to convert to 100% coconut flour are muffins, bars, pancakes, cakes, and quick breads. There are recipes on the internet and in print that can be helpful in building new recipes from. I have tried doing an equal exchange of flour, and without the extra binding agents and liquid the muffins were really dry, enough to toss with one bite. It was awful. If it looks dry, add more liquid.

There are several things to remember when using coconut flour. Always sift before measuring whether the recipe calls for it or not, it is inferred. If you forget to sift, you will be disappointed with your results as it will be dry and crumbly. This flour is very"thirsty", the fiber in the flour soaks up moisture, so more needs to be added to your recipes, it's usually an equal amount. Sticky sweeteners, such as brown rice syrup, can be included in your measurements for liquid, but oil is not included. Then you'll want to remember that since the flour has no internal binder, it requires additional eggs. The ratio is between 4-5 eggs per cup up to 1 egg per ounce of flour, there are other binders that can be utilized as well, egg whites, soaked flax, sticky sweeteners help with binding as well. I have found that those who are cooking vegan know many other binding agents and are good sources to ask regarding other alternatives in your baking. I've compiled a list of alternatives you can find by clicking here. I personally like eggs, they provide protein and are tasty, but I do substitute egg whites for some of the eggs, especially when I know I will be eating them in other forms through out the day.

If your batter is dry your baked goods will be dry, add in more liquids to moisten the flour for a more moist baked item. I forgot this once with a quick bread recipe, the batter was dry, and when the bread came out of the oven it was more lumpy and dry then when I had put it in the oven. Do not be afraid of a more moist batter, the fiber soaks it up. Coconut flour can be used in other common purposes such as breading and as a thickening agent for soups, stews, etc. If you are using it as a breading, make double the sauce to pour over your item in order to allow for the soaking up of the liquids. I made a Coq a Vin for a party, and overnight the breaded chicken soaked up all the sauce that was to be poured over the pieces of chicken. The flavor was there, but it would have been more delicious with the sauce to pour over the meal. Do not be afraid to make adjustments, print out your recipes make notes with your changes, decide how you liked your item and either make more corrections or make a note letting yourself know if you liked it or not. There will be some things that you will love the flavor, but maybe you will want a different texture. I'm still working on gooey brownies, I will be adding apple sauce to increase the moisture in my next batch.

Here are some helpful links to find recipes to begin your journey of cooking with coconut flour, and don't forget these three things when using coconut flour: always sift before measuring, extra liquid is needed, and it needs something to bind it all together.

http://www.freecoconutrecipes.com/gluten_free_coconut_flour_recipes.htm

http://www.kokonutpacific.com.au/OilSales/OilIndex.html?Health/CoconutFlour.php

http://www.simplycoconut.com/coconut_flour.htm

http://www.tiana-coconut.com/coconut_flour_recipes.htm

Reading the entry about the patient with an Flax allergy brought to mind a similar situation with a patient who had multiple allergies, including sesame and soy. I had recently suggested to her that she should take daily supplements of fish oil and vitamin D3. At our next appointment she reported that"there was no way that she could take any of these pills." Apparently she had tried several different brands and found that"most made her psoriasis worse. and several made her joints ache or gave her gastrointestinal distress." She said that additionally, she had tried a couple of fortified foods since the pills were bothersome and had reactions to several of the products. I asked her to email me the brands that she had tried so that I could do a bit of sleuthing. And what I found was quite interesting…
It was neither the fish oil (per se) or the VItamin D3 that was causing her distress but fillers in the pills, contents of the enteric coating of some of the pills and ingredients in some of the foods. Specifically several of the pills contained soybean oil and one contained sesame lignans. Sesame was also listed in the ingredients of some of the bars that she tried. At least 2 of the fortified products also included sulfites and sorbitol. Interestingly, most people know of the eight common allergens discussed here in the US (milk, fish, seafood, peanuts, tree nuts, eggs, soy and wheat.) But most are not aware that Canada recognizes nine common allergens with sesame included in this list. The point that I made to her and what I hope to emphasize here is the need to carefully examine the listing of the ingredients in these supplements — get out that magnifying glass if need be. Try to choose products without unnecessary fillers or ingredients! Check Consumerlab.com for the ingredients in their approved products. If you suspect that you are reacting to an ingredient in the product you can also check the manufacturer's web site or call the company to find out what you are really taking.
Hope all is well, Shelly

Shelly Sherman practices nutrition in Westport, Connecticut. If you would like to contact her for your own appointment, she can be found at smartnutrition@optonline.net.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

My post a few days ago about the effects of PCOS on the brain seems to have created some discomfort. We lost a few Facebook fans, and those who did respond, said that learning that PCOS was taking its toll on brain tissue and function was somewhat depressing to take. Theories of behavioral change state that until you know a problem exists, you will not act to change. So while the news can be uncomfortable to live with, the good news is, now you know why you need to make changes. You can't talk yourself out of those changes by convincing yourself that you're at peace with your body type, or that maybe you can live without having a baby. You're fighting for your cognitive life, and only you can make the changes that can make a difference. Here is a list of things you can do to help preserve brain and nervous system function. 1. Get sleep. You may think it's a badge of honor to cut yourself short in the sleep department. But it takes its toll. It is when you sleep, that your brain cleans out all the crud from the day before…spit shining neurons, so to speak. If you go too long without sleep, it's like you're letting rust accumulate all throughout your brain. Make it a habit to get to bed at an hour that allows you to get at least 7 hours of sleep a night. 2. Reduce stress. Every little thought, behavior, chemical reaction, that gets you through a day, requires a series of neurons to coordinate that activity. Every time a neuron is asked to work, it uses glucose to do so. Every time a neuron burns a molecule of glucose, it uses oxygen to do so. More neurons = more glucose = more oxidation. Make it a priority to give up the small stuff…and if you can't completely give it up…learn how not to sweat it so much. 3. Manage mental health issues. Most mental health diagnoses affecting PCOS (anxiety, bipolar disorder, PTSD, OCD, ADHD), involve processes that overwork the brain and nervous system. People with these disorders are fairly high energy, and that means they are using more neurons, more often, with far more intensity, than people who don't have to live with these conditions. Get counseling. If you need medication, take it. Health means MENTAL as well as PHYSICAL conditioning. Take it seriously. Do what you need to do. Slow down those neurons in any (legal) way available to you. 4. Exercise. Research is showing that regular physical activity slows down the development of brain diseases like Alzheimer's and helps to maintain brain tissue. How many times have you struggled with a problem at your desk, put it down, walked over to the post office, and had an inspiration while moving your body? Muscles and neurons are best friends. Be sure to give them plenty of play dates.

5. Eat less carbohydrate. Because your brain uses glucose, and because it's going to want more glucose when it is stressed, you're going to want to eat more carbs when under pressure. Remember what I said in number 2. The more carbs you eat, the more oxidative stress you impose on your brain. The more easily your brain rusts out and breaks down. I want you to think of this picture every time from this point forward you see a donut, order of french fries, or bottle of soda. Look less appetizing? Good. That was my point. 6. Eat antioxidants Antioxidants, those chemicals with the funny names nutrition experts love to impress people with in their blogs…hate oxidation. Eat them. Don't worry if you can pronounce their names, just know if the food in your hand (1) doesn't have an ingredient label, (2) has color, (3) and rots if left too long in your fridge, it's good for you. Put it on your plate and into your body. 7. Use fish oil. Fifteen percent of the dry weight of a healthy human brain is DHA, one of the primary omega-3's found in fish oil. It has to be fish, it can't be nuts, or flax, or greens. Eat the fish or take the capsules. I don't care if they come up a little bit. You have a choice…burps or brains. Just do it. 8. Reduce omega-6's. All those oils beginning with the letters"s" and"c"…break down brain tissue. Read labels. Get them out of your diet. Two exceptions. Organic canola is fine and coconut oil is fine, provided you're not eating it by the tablespoonful. 9. Yoga. Yoga tones the nervous system. It chills you out. It improves circulation in your spinal column. It improves your flexibility. It helps to manage mental health issues. It pretty much takes items 1 through 8 and makes them work even more effectively for you. It's worth the time. 10. Cut the high-fructose corn syrup. Recent research suggests that HFCS affects memory. Get it out of your diet!

Fatty liver is a common problem in women with PCOS. In this study, EPA, an omega-3 fatty acid and a fish oil, was shown to improve the symptoms of nonalcoholic steatohepatitis (fatty liver). EPA is the fish oil that you cannot get when you rely on vegan sources of omega-3's--it's not in flax, and it's not in marine algae. Some research shows that when you've eaten enough marine algae to completely saturate your tissues, what's left can be used to make EPA, but it's not the way of getting it that the body prefers.

This is important to understand, because the vast majority of foods that are labeled as supplemented with omega-3 fatty acids either contain ALA (primarily in the form of flax) or DHA (primarily from marine algae).

The other advantage to eating fish is, that if you've put a fillet on your plate, you've likely removed another (fattier) kind of protein. That's the positive double whammy you get in seafood choices.

In my training I was always encouraged to develop good negotiation skills. In other words, if a client didn't like a certain food, to have a few other options up my sleeve that would provide equivalent nutritional value. Only when I got into omega-3 chemistry, inflammation, and PCOS, did I realize that in this one crucial area, I would have to dig my heels in and advocate that this essential nutrient was simply non-negotiable: if you don't eat fish, you miss out on total health.

Over the weekend I had an animated discussion with another dietitian who was adamant that her clients (mainly with eating disorders) simply were not going to accept this. I told her they simply would not achieve total health…and possibly total recovery. I got some resistance, but hopefully at some point this colleague will come to understand that we're here to guide our clients where they have the potential to go. We're not here to tell them what they want to hear, with the hopes that somehow health will just magically appear.

Tanaka N, Sano K, Horiuchi A, Tanaka E, Kiyosawa K, Aoyama T. Highly Purified Eicosapentaenoic Acid Treatment Improves Nonalcoholic Steatohepatitis. J Clin Gastroenterol. 2008 Apr;42(4):413-418.

While shopping at Trader Joes the other day, I stumbled upon an amazing product!
Trader Joes Five Seed Almond Bars
They are made with flax, poppy, sunflower, sesame and pumpkin seeds and combined with almonds, cinnamon, vanilla, brown sugar and honey to create these soft, chewy and delicious cookie bars
They taste amazing, but what is so wonderful is that each 110 calorie bar has 53mg EPA and DHA. The omega 3 sources seem to be from the flax as well as Omega-3 refined menhaden fish oil (with tocoperols)
If you live by a Trader Joes you just have to try it!

Hello everyone,

I want to take a moment to introduce you to our new sponsor, Green Mountain at Fox Run in Ludlow, Vermont, and explain how this partnership came to be.

Here is an introductory note from Robyn, Green Mountain's dietitian:

Women working to manage PCOS know first-hand that making lifestyle changes to promote better health is often easier said than done. To say nothing of the confusion about what's best to eat. At Green Mountain at Fox Run, you can begin to sort out the confusion and find what works best for you in terms of eating and physical activity with the help of professionals who understand the needs of women with PCOS, and who truly care about helping women take control of their health. Green Mountain offers a comprehensive program that allows women with PCOS to get a taste of how good they can feel while eating healthy and being active.

Here you'll practice healthy living that features foods you like and physical activity you enjoy. Our meals are comprised of high-quality choices such as fruits, vegetables, whole grains, lean meats, fish, legumes, lower fat dairy products, nuts & seeds, and healthy added fats such as flax seed, olive oil & canola oil. We also leave room for “fun” foods to illustrate how healthy eating can be flexible and delicious. Our chefs strive to create exciting meals out of whole foods, with most menu items made from scratch. We offer a conservative level of carbohydrate as part of our balanced meals & snacks for better management of blood sugar and insulin levels. Generous amounts of fun fitness classes offered throughout the day encourage better insulin sensitivity as well.

Our strong focus on education not only guides women in practicing healthy habits while with us, but prepares them to integrate these new habits into their routines back at home.

First of all, I want to tell you that I'm very, very picky about who inCYST partners with, and who it accepts sponsorships from. Companies with products and services to sell see women with PCOS as a very lucrative demographic. That includes fertility centers, diet centers, supplement companies…you name it. With one in ten women in this country having PCOS, that's an awful lot of dollar signs.

It could mean an awful lot of money for a well-visited blog like this, to accept advertising from all of these companies wanting your attention, but that's not how this business is operated. I actually discontinued Google Ads because no matter how hard I tried to filter, I kept getting ads on here that were counterproductive to the message I wanted to project. And more opportunities are declined than accepted.

I also am very selective about who inCYST promotes as a PCOS expert. It's not just anyone you see here, it's someone who has been willing to invest time and money into the inCYST training. A training that is as much about the facts of PCOS, as it is about understanding what it means to go through a health care system with the syndrome and be treated poorly by doctors, dietitians, etc., who give counterproductive advice.

I know I've probably offended a few colleagues who wanted to be included in what we do here, but didn't want to participate in the training as I've outlined it. But this program is about women with PCOS, first and foremost, not about the many entities that want to profit from them.

What that means to all of you is, that you can be assured that professionals listed here and on my website are of a different breed, and that sponsors I choose to include in the inCYST mission have quality services and products, delivered with integrity.

Which brings me to our newest sponsor, Green Mountain at Fox Run. I love them! I actually had an opportunity to spend a week at their Vermont resort a few years ago, and wish that all of you had an opportunity to spend time there. Alan Wayler and Marsha Hudnall, the owners of this fitness retreat, work hard to provide quality programming that incorporates the principles you regularly read about on this blog. Marsha actually took the time to come to one of our professional trainings a few years ago.

Sometimes it helps to just get out of your personal situation and have some time to experience what healthy living actually feels like. Eating well. Moving your body. Sleeping well. Lower stress level. I know there are many people coming to this blog with the search words,"pcos""program". For you and anyone else who simply didn't know this program even existed, I encourage you to check out their website. Their logo will be up on the right if you ever want to come back and click through for information.

Welcome, Green Mountain at Fox Run! I'm so excited that our readers get a chance to learn about your wonderful program!