I've been a dietitian for 26 years now. I've seen, at this point, thousands of clients for dozens of reasons. And despite all of the new information available, medical advances, and my own experience, one thing has not changed.
Meal plans do not solve medical problems, they do not cause weight loss, and they do not improve your fertility.
If I had a dollar for every time someone called me, asked for an appointment, politely listened to everything I had to say, then changed the subject and asked for a meal plan, I wouldn't have to write this blog to earn a living.
Face it. If a meal plan was what you needed, you could buy one for $15 at Borders. Better yet, you could get it for free at the public library. By the time you likely asked for help, you'd probably tried several meal plans…and none of them worked.
Or, you tried the meal plan, and it worked, but you quit using it. And started looking for another meal plan.
The definition of insanity is trying the same thing over and over and over and over and over and over again…and expecting a different result.
If you are bouncing from meal plan to meal plan, and either not trying them long enough to see them work, or not following a meal plan that works and hoping that dropping money on a consultation with a nutritonist will produce results that you didn't get the last time you didn't try something…
…you are participating in insanity.
So for the benefit of women everywhere looking for help with their PCOS, here is a list of considerations. If you are honestly (and I mean honestly) looking to learn how to eat better, here is a list of what meal plans can and cannot do.
1. A meal plan can help you to get a handle on realistic portion sizes. No dietitian out there expects you to weigh and measure your food for the rest of your life, but our estimation of portion sizes tends to creep up over time. Getting back on track with portion sizes can be useful.
2. A meal plan can remind you to eat from a variety of food groups. My experience is that people eat best when they focus on what they CAN eat, rather than on what they CAN'T. Most people who are not eating well are not eating fruits and vegetables. A meal plan can remind them to get enough of these important foods, and most people who DO are full enough to not be hungry for foods that get them into trouble.
3. A meal plan can encourage you to try foods you weren't hungry for when your carbohydrate cravings were in control. This is an important one. Many women with PCOS are clueless when it comes what to eat, because they have spent so much time trying to satisfy cravings that originate from their hormone imbalance. Once those cravings are corrected, which our program is very good at doing, a meal plan can teach you what normal eating is like.
Now, here's what meal plans WON'T do.
1. Meal plans won't cause weight loss. Following a meal plan can correct a calorie imbalance and encourage weight loss. But you have to follow it. Buying one from a bookstore or a dietitian and letting it collect dust on your desk, won't give you results.
2. Meal plans won't make babies. We're pretty good at correcting hormone imbalances, but even so, we cannot make guarantees. We do know that women who have the ability to make changes over an extended period of time are more successful at correcting hormone imbalances that make it hard to have a baby. But the keywords in that last sentence are make changes and over an extended period of time. Buying a meal plan is not making changes. Following a meal plan is making changes. One week is not an extended period of time.
3. Meal plans won't teach you how to recognize hunger and fullness, and how to distinguish hunger from cravings. A dietitian, if you trust him/her, can guide you through that process. But you have to look up from your meal plan and listen…and try…what they're excited about teaching you.
4. Meal plans won't stop you from emotional eating or binge eating. If you have a history of yo-yo dieting and binge eating, a meal plan may actually set you off. You may rebel against it. But why? The only person you rebel against, when you rebel against a diet…is yourself. A meal plan is an attempt to impose superficial structure over chaos. Not all that different from putting a shiny new paint job on a rusted out old beater, hoping no one will notice the inside. And when you fail, you end up reinforcing with yourself that you do not deserve to succeed. A dietitian can help you succeed. But only when that is what you are ready to do.
Next time you ask a dietitian for a meal plan, be sure you have been able to verbalize, out loud, just what it is that you expect the meal plan to do for you. Better yet, go into your bathroom, look yourself in the eye in the mirror, and say out loud,"I would like a meal plan because it will help me with __________________. I commit to following the meal plan for __________ weeks before I determine that it is not working. And before I quit, I will ask the dietitian I asked to give me a meal plan for help in problem solving why it didn't work. I will ask her how to help me succeed."
Then write your commitment to yourself on two pieces of paper. Post one on your refrigerator and the other on your bathroom mirror.
If the thought of doing this leaves you feeling uncomfortable, it's time to be honest with yourself. Maybe a meal plan is not what you're looking for.
What is hopelessness? Simply, it is a loss of hope and optimism, and a failure of belief that the future will be brighter and better. Hopelessness takes your energy and trashes it. It contributes to and even defines depression to a great extent. When you’re feeling hopeless, that’s often a point at which you give up trying to do anything, and it all gets worse. Sound familiar?
Life in general is pretty stressful. We’ve all got a giant list of “shoulds” in our heads already, about family, romantic partners, children, work, religious and social commitments, and a myriad of other things. We’ve got bedrooms to paint, dinners to make, children to shuttle around, bosses to satisfy, cars to wash, craft projects to complete, vacations to plan, and chin hairs to pluck! My goodness, we are busy! The list is endless.
Add PCOS to all of that, with the reminders about proper eating, exercise, supplementation, fertility enhancement techniques, stress reduction, and everything else, and you’ve got a big old heap of overwhelm festering in your brain. That’s your brain, by the way, that’s already over-taxed by the hormonal imbalances caused by PCOS – so it’s a double whammy. You may already be feeling sluggish and lethargic mentally, and now there’s even more you’re supposed to read, understand, absorb, interpret, and apply. And it’s feeling like you can’t possibly master this condition, or ever really have a perfect plan (or even a half-way decent plan that’s effective) for managing it.
I want you to know that PCOS doesn’t just feel overwhelming, stressful, and depressing – it actually is overwhelming, stressful, and depressing. It’s entirely normal to get overwhelmed by it, be angry at it, ignore it, hate it and everything associated with it, and just want to wake up and find that it’s disappeared. It’s also normal to be bored, irritated, and not want to cope at all. And it’s normal to struggle with it, find some peace and balance, and then struggle some more.
In the struggle, you may find a place to focus on that actually has some positive aspects to it, and that will allow you to shift your attitude, and shift out of hopelessness. Your mind is a powerful thing, and a source for positive thoughts as well as negative ones. It’s pretty clear that focusing on negative thoughts produces more negative thinking – but the same is true of positive thoughts. That’s why it’s often recommended to focus on what’s good in your life, as a way of starting the shift toward the positive. In support of that concept, next week’s “Mental Health Monday” post will be about the upside of PCOS.
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 invite her to speak at your event, please visit her website athttp://www.drhousemd.com/, or e-mail her atGretchen@drhousemd.com. You can also follow her on Twitter @askdrhousemd
In my experience, dietitians tend to come from one of two schools of thought: (1) those who believe in structured meal plans and (2) those who promote a concept known as intuitive eating. It is very all-or-nothing. Which is ironic, since intuitive eating is supposedly about eliminating all-or-nothing thinking.
I've worked with both, and at this point in my career, in my chosen specialty, I am a blend of both. And that is what seems to work best with PCOS.
It would be nice if women with PCOS could be intuitive eaters. But it isn't a natural talent, and it often isn't possible out of the starting gate.
Here's a story from my caseload to illustrate.
A few years ago, I met with a young woman with PCOS. We met for an hour and half. I sketched out a meal plan for her and explained how it would help her cravings and make it easier for her to eat intuitively. She was very polite and accommodating, but at the end of the session she asked me,"But what am I going to do about my cravings?" I reminded her that her cravings would decrease. She asked the same question again. We went in this conversational circle several times, and it finally hit me, that my poor client had struggled with her intense carbohydrate cravings for so long that she no longer even knew what hunger was. She had also been let down by so many health professionals giving her bad advice that she didn't trust mine.
I finally asked her to tell me what she normally did when she had cravings. She motioned me to follow her into her kitchen, where she opened a drawer and showed me her stockpile of Snickers, 3 Musketeers, and Baby Ruth bars. I was completely humbled. I realized that since I don't have PCOS myself, I had no way of relating at all to the women who had the syndrome who I wanted to help.
I told her to do her best to follow my meal plan, and if the cravings got to be really bad, to have a candy bar.
The good news was…she never once needed a candy bar.
Lesson two for ME was…now that we'd eliminated the cravings, I was working with a completely blank slate, with a person who really had never had an opportunity to learn what foods she liked and didn't like, or what hunger and fullness really were. She had been at the mercy of cravings for years.
We had to start with a structured meal plan in order to learn what many of us learn as children. I literally had to put foods on the list for her to commit to preparing and trying. Gradually, she started to understand what hunger and fullness was, and a good chunk of the time, she was able to use some intuitive eating skills.
But the story doesn't end, even THERE!
As the layers of disordered eating peeled off, and food became less of a priority, my client now had to deal with the reality that she now had quite a bit of free time on her hands that once belonged to food procurement. She had to learn to deal with that time in ways other than boredom eating, or eating in response to emotions she was becoming aware of.
Something else that I've learned is that there are times when intuitive eating can be the primary tool a woman with PCOS uses, and there are times when it simply won't work. You may need to be a little bit more structured when you are under stress, when you've got a cold, haven't slept well, are pregnant, etc. When you are insulin resistant, and you're increasing activity and decreasing food intake, you may have times when you feel very hungry, to a degree that doesn't match what you observe about your routine. It can feel scary, and it can be tempting to binge. You may need to gently back yourself out of that corner with some simple structure.
Each one of you has a different story, a different PCOS presentation, a different hormone function, a different brain, and a different response to food. The most important thing you can look for in a dietitian, is not one who is going to tell you that you need to be an intuitive eater, or a structured eater, but one who empowers you to discover who YOU are and to help you design a lifestyle that accommodates what you need to do in order to maximize your potential.
Our inCYST dietitians are all trained to help you map out this path of discovery. If you've tried the"all or nothing" approach to restoring eating sanity, and no way seems to work well, consider engaging the help of someone who understands that you are unique. Our referral page is getting longer as professionals complete the training. Be sure to check in the next few weeks as I add names and contact information for options that might work for you.
I'm looking for some cysters to help beta test"The inCYSTem", a new eating program. It is a combination of PCOS-friendly menus and coaching.
Part of what I am testing is whether doing such a program will be self-supporting financially (and therefore feasible for me to spend time developing). I will be charging a fee for participation, but anyone who beta-tests the program during the month of October ($7.50, 50% projected normal price) will be able to sign up for the plan for the 6 months at this reduced price.
I hear all the time that women with PCOS want menus, menus, menus, and so I am developing a PCOS-friendly plan that you can follow independently, or discuss with anyone who is helping you with your PCOS.
The first unit will be available a week from today, October 3, 2009. To register, contact me directly at marika@google.com
I've never experienced infertility. I was overweight as a child/teen, but I've been the same weight for most of my adult life. I'm relatively healthy. I'm not saying this to intimidate anyone, but rather to share an insecurity I've had about what I do for a living.
I always wonder how in the world women who have those issues can even find me relevant and helpful if I've never had to experience them?
The last two months have presented me with a situation that, even though it may not be apparent on the outside, has very much changed me on the inside. I've learned a lot about control, gratitude, and what is truly important in life.
And I feel like this journey, challenging as it is, is molding me into someone better equipped to help the people who come to inCYST for help.
Regular readers of the blog will remember that I wrote about my sick kitty in October. I thought I was dealing with a simple urine crystal issue that a diet change would fix. I'm a dietitian, I know how to change diets. This was simple, or so I thought.
Well, Rodeo simply never recovered from the crystal incident. He would not eat. He became lethargic. About a month after the vet visit, I noticed, he just wasn't breathing well. Being the data fiend that I am, I started monitoring his respirations. They seemed stable, so I figured maybe he was allergic to the new diet he'd been prescribed for his urine crystals. I changed back to the old diet and waited to see if he responded.
Then he crashed. I got the last appointment on a Friday evening with his vet, and learned that he was dealing with one of four potential diagnoses. One was a fungal infection (no problem), one of those was a 100% fatal virus (that would require euthanasia), one was cancer (fatal over time), one was heart disease (manageable but life-shortening).
I had to wait almost a week for the pathology report to come back, and to get an appointment for an ultrasound with a cardiologist. (Yes, my cat has more specialists in his Rolodex than I do at this point).
The good news is, it's not the fatal virus, and it's not cancer, but it is heart disease, and it's a serious problem. There is no cure, but there is a lot I can do to manage the situation.
Sound familiar?
I told the vet,"If you can give me heart disease, I'll take heart disease. I can do that." Two sentences I never, ever envisioned coming out of my mouth at any point in my life.
I can tell you this. I have a reputation for being pretty even-keeled in even the most adversarial of situations. During my eating disorder treatment center gig, it was not uncommon for cans of Ensure to be flung my way after a tough counseling session. Nothing phases me after that!
But the night I came home from the vet with a couple of medications and no idea what was happening, I laid on my bed and cried my heart out. I didn't even notice that Rodeo had jumped up on the bed. He felt like crap, and he was sitting there trying to take care of me. I realized, of my two kitties, he is the one most affected by my emotions. And here he was, more concerned about me than about the X-ray, the aspiration, and all the poking and prodding he'd been through.
That was reality check #1. I knew I needed to allow myself to feel what I was feeling, but I needed to learn how to do it in a way that didn't turn itself back on the problem in a negative way.
As I imagine has happened with many of you, my life changed in a mere instant. I became hyper aware of respiratory rates, fluid intake, food intake, urine output, medication times…my life was filled with new details I had no choice but to learn to live with.
Even though I run a business, it's the holidays, and I had committed to coordinating vendors for a huge market here in Phoenix. Even though my five major plans for December revenue pretty much collapsed within days of getting the kitty diagnosis. Somehow, I had to figure out how to make it all work.
This is where I started thinking of all of you. How many of you readers are busy, successful women, juggling a million different responsibilities, happily living out your lives…when you're told you have to start monitoring what you eat, when you eat it, when you ovulate, when you menstruate, what your blood glucose number is…and on top of it all, every expert on the planet expects you to figure out when to work out, to plan the perfect meal combination, each and every meal, to buy the supplements, and on top of it, manage your anxiety, frustration, and anger over the situation?
Do these health professionals even have a clue? Did I ever have a clue with any of my clients I thought I was helping with inCYST? That's what's been going on in my head in the two months since Rodeo's diagnosis.
Reality check #2 for me was realizing what I was doing any time I had a free moment, especially during the week when I didn't know what I was dealing with. I found myself surfing the Internet, Googling symptoms, reading everything I could find about lymphoma and cardiomyopathy, looking for the worst in kitty, looking for anyone, anyone at all, who could tell me that there was a supplement or pill I could give him that would just make this all go away.
That behavior is known as magical thinking. It is a very common thing to do when faced with a situation that leaves you feeling cornered. Getting older. Cancer. Weight that won't come off. Infertility. It's about trying to find something, anything at all, that can give you the illusion that you're in control of something. Note that I used the word illusion. You're really not in control. You've transferred your need to be in control of outcome to a concrete, more manageable option. That's all. The only thing magical thinking succeeds at, is allowing us to avoid the pain of a situation. In many cases, it keeps us distracted from constructive and helpful things we can be doing.
So…knowing from working with all of you that this is what I was doing, I told Rodeo's vet what I do for a living, that I'm a real biochem nerd, and that I was probably dealing with my stress by reading waaay too much about cardiomyopathy. I told him at any time I was becoming annoying and intefering with his treatment plan and Rodeo's progress, he had permission to put me in my place. We negotiated a few things I wanted to try, one we're using, most we're not.
And I am adhering completely to what the doctor ordered. Even if it means staying up past my bedtime to get a med in, even if it means passing on a social invitation if it interferes with the treatment plan, even if it means using money I wanted to spend on something else to buy medication. The vet is not cheap. But he's incredibly smart. If kitty is going to get better, I can't be bargaining with him because of the inconvenience the instructions impose on my life as I wish it was.
Reality check #3 has been about how much control issues can be triggered when life throws a curve ball. We can do everything exactly perfectly. And Rodeo has a bad day. Or Rodeo can go dumpster diving, eat a fish head, throw it up, and be perfectly fine. At least for a day. How Rodeo feels today, is not at all about what I did for him this morning. It is about the consistency of what we do over time.
Oh, I'm so embarrassed to even be saying this, but this simple reality took me awhile to"get". I wanted him to always breathe perfectly. To eat when I gave him the food. To love the deli turkey. It doesn't happen that way. Some days he eats like he's the size of Zenyatta, other days, nothing strikes his fancy. I have had to learn to roll with it, and to not view one incident as failure, but as a challenge to figure out what another option might be.
On the days when things don't go as planned, I have to adjust my life. Yesterday morning, for example, meds did not go in at 8 am as scheduled. I spent 4 hours getting them in, but realizing that the four hours it took to make that happen was four hours I'd planned to spend making my contribution for a holiday potluck I was to attend tonight…I made the choice to cancel my attendance, focus on medication, and spend the evening tonight taking care of myself here at home.
Reality check #4. You know what happened when I stopped stressing about how I was going to do both the medications and the potluck and OMG what happens if I'm at the potluck and he bottoms out?!?!?! Rodeo settled in to one of the absolute best respiratory patterns and ate better for me than he did all week. I suspect he picked up on my more relaxed demeanor and was able to put energy into himself that he was putting into me. Some of the things I am inadvertently doing affect kitty as much, if not more, than the things I am supposed to be doing.
Reality check #5. I sometimes find myself getting annoyed at people complaining about things that now seem minor in the big scheme of things. All these people complaining about having to much to do for Christmas? In my eyes they are lucky they are able to participate. I have to remind myself, their situations are different and even though I might envy them, in their own scenarios are lessons from the Universe in action that may not include a cat. Still working on that one.
There are many early Christmas gifts this situation has brought me.
First of all, I have kitty happily sleeping on the bed today. He doesn't fit into a stocking and probably wouldn't consent to it if he did…but he's here compliments of two of Santa's finest elves…er…angels in elves' clothing, Dr. Oyan and Dr. Paige.
Secondly, my priorities, as healthy as I thought they were, needed some addressing. I have been able to let go of situations that I simply have no time to accommodate. I have more time to myself, since I'm home more, and that has given me quiet time to think about what inCYST will be for all of you in 2011. I hope you like the inspirations you'll see in the next 12 months.
Thirdly, I feel like I have a much better idea of what it is that you all need from inCYST in the first place. I am still at a disadvantage for not having experience every single thing you all have exactly as you have, but I have been humbled, I'm dealing with a challenge, and it cause me to consider every inCYST choice I make in an entirely different fashion. Humility is never a bad thing on which to base intention.
Fourthly, I've learned that it's not always bad if success has to be redefined. Of course I'd love it if there was a cure for cardiomyopathy. But there isn't. I can be angry about it, not follow the vet's instructions because I managed to find an obscure website on the Internet that contradicted them, turn to supplements which would put more control in my hands than his, or do nothing and hope the Calgon cardiomyopathy fairy will just swoop in and whisk us away to Kitty Tahiti.
None of that is going to happen. I got over it, decided to listen to the vet, and to redefine success as staying informed, being proactive and communicative with new information, and to the best of my ability, prioritize my life so that I can enact the recommendations I've been provided with. It's slowly turning things around. Not curing them. But, gratefully, allowing kitty to breathe. Oxygen in heart cells…is a lot more important than a complete and total cure. We have learned to think simply.
Finally, I still don't know what it is like to be infertile, not be able to lose weight, or live with insulin resistance. But at least I am more aware of how important it is to always remember that no matter who are you are, when you look to inCYST for help, guidance, support, inspiration, your story, especially the part we don't know about, or cannot immediately relate to, is important to consider in everything we say and do.
I hope all of you are enjoying your holiday season, whatever customs you practice.
One last thing. To all of my friends who are tired of hearing me talk endlessly about the cat, now that he's stabilizing I can get back to the gym and put the stress there. I appreciate all of your ears and support.
As women with PCOS, you've likely had troubles getting our health care system to work in your favor.
The information in this post was sent to me by inCYST provider Karen Siegel, and I wanted to share it with all of you. Specific issues are highlighted in the text below, and you can review the bill yourself at this link.
You may wish to go through this and consider how each of these stipulations would play out in your own personal PCOS situation. If you have suggestions for better ways to do things…get proactive and contact those who represent you in Washington!
I do my best to be nonbiased in this blog, but there are aspects of this legislation that disturb me.
Here are a few highlights of some problems with the healthcare bill.
These problems highlight the reason every bill must be read by the American people before they are signed. (if these points don't get you upset, please check your pulse and call 911):
Disclaimer: This summary was sent from a colleague. We encourage you to conduct additional research on your own.
• Page 16: Eliminates the choice to purchase private health insurance! • Page 22: Mandates audits of all employers that self-insure! • Page 29: Admission: your health care will be rationed! • Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process) • Page 42: The"Health Choices Commissioner" will decide health benefits for you. You will have no choice. None. • Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services. • Page 58: Every person will be issued a National ID Healthcard. • Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer. • Page 65: Taxpayers will subsidize all union retiree and community organizer health plans. • Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange. • Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans) • Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens • Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan. • Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter. • Page 124: No company can sue the government for price-fixing. No"judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed. • Page 127: The AMA sold doctors out: the government will set wages. • Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives. • Page 126: Employers MUST pay healthcare bills for part-time employees AND their families. • Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll • Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll • Page 167: Any individual who doesnt' have acceptable healthcare (according to the government) will be taxed 2.5% of income. • Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them). • Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected." • Page 241: Doctors: no matter what speciality you have, you'll all be paid the same (thanks, AMA!) • Page 253: Government sets value of doctors' time, their professional judgment, etc. • Page 265: Government mandates and controls productivity for private healthcare industries. • Page 268: Government regulates rental and purchase of power-driven wheelchairs. • Page 272: Cancer patients: welcome to the wonderful world of rationing! • Page 280: Hospitals will be penalized for what the government deems preventable re-admissions. • Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government. • Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies! • Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval. • Page 335: Government mandates establishment of outcome-based measures: i.e., rationing. • Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc. • Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals. • Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone). • Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia? • Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time. • Page 425: Goverment provides approved list of end-of-life resources, guiding you in death. • Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends. • Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT. • Page 430: Government will decide what level of treatments you may have at end-of-life. • Page 469: Community-based Home Medical Services. • Page 472: Payments to Community-based organizations. • Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage. • Page 494: Government will cover mental health services: defining, creating and rationing those services.
Talk to Your Family, Friends, Neighbors & Co-Workers
You must talk to people about this. We need to get as many people informed about this as possible. Here are a few key points:
This issue is not Republican vs. Democrat. It is government vs. individual rights. "What's the proper role of Government in our lives?" "Do we really want the government making decisions for us that should be between me and my doctor?" "Should the government be eliminating personal health insurance plans?" "Should the government be requiring seniors to attend 'end of life counseling'?"
‘Tis the time of year when blogs, magazines, and radio broadcasts are full of tips for combating overeating, over-drinking, and the kind of carousing that leaves you tired, bloated, overly full, and generally disgusted with yourself. They’re often repetitive, and not all that useful. I’m full of tips, techniques, and strategies myself, actually! One that I DO think is useful and easy to remember is HALT, which stands for Hungry, Angry, Lonely, and Tired.
If you’re one of those things – hungry, angry, lonely, or tired – the risk of over-indulging rises. If you’re two, three of those things, the risk of losing control is much greater. And if you’re all four of those things, watch out world, because almost nothing’s going to stand in the way of the oncoming binge, bad behavior, or acting out.
But what’s the first aspect of change? Awareness. HALT is a way to bring yourself back to a place of awareness, so you can reign in your behavior before it becomes self-destructive. Let’s talk about the specifics:
Hungry: When you’re hungry – really hungry – your blood sugar starts to drop, and you feel tired, confused, and irritable. And did we mention, hungry? Really, really hungry. Like, so hungry you could the entire contents of a small refrigerator. Or the buffet table. Or as much as you can load up on at the drive-through. Yeah, that kind of hungry. Women with PCOS are more subject to the vagaries of blood sugar dysregulation (it’s the insulin resistance thing, AGAIN) than other people. We’re more vulnerable. Accept it, and plan for it.
Strategy: Have a little healthy snack with you at all times. Know that shopping is hard work and frequently results in blood sugar drops because you’re walking more than you think. Plan ahead. Decide: “If I get hungry, I’m going to Subway for a turkey sandwich loaded up with vegetables and skip the mayo.” This will prevent you from going to McDonald’s and getting a Big Mac, large fries, and a shake.
Angry: The traffic, the crowds, the prices, the shopping for people you don’t even care about, the time pressure, and the social obligations, your spouse who still expects home-cooked meals when you’re in the middle of SHOPPING!, can all lead to a build-up of anger.
Strategy: Do not shop when you’re angry. Do not expose yourself to challenging foods or social situations when you’re angry. Take five to twenty minutes to meditate, walk around the block, drink a glass of cool water, and practice forgiveness and compassion. Now engage in your usual activities.
Lonely: So often, it’s assumed that we’re off with our friends, families, and other loved ones at the holidays, but some of us are sitting home alone, without an invitation, a thought, or a concern.
Strategy: If you’re alone, embrace it. Don’t take a shower until 3:00 p.m. Spend all day on FaceBook. Eat breakfast for dinner. Revel in your ability to live precisely how you want to live today, without judgment or interference. It can be utterly rejuvenating. If you don’t like being alone, and really do feel lonely, make a point of issuing invitations to other people, or showing up at every group event you know about, and don’t tell me it’s unfair that you have to do all the asking. Life is like that sometimes, and if you want to undo this loneliness, you will have to take action. Tell people you don’t have any plans for Christmas, and you don’t have any invitations either. Quite often, one will be forthcoming. People are feeling generous this time of year. In any case, again, avoid whatever triggers you to behave uncharacteristically. This is not a good time to shop the web, bake a cake, or order enough take-out for six people. Remind yourself that this is a temporary, and repairable, condition.
Tired: Tiredness connects to hunger quite often. Drops or dips in blood sugar can leave you feeling exhausted, confused, and overwhelmed. When you’re tired, your decision-making capacity is impaired. See where I’m going with this theme?
Strategy: If you’ve been running around like a maniac, trying to get it all done (The shopping! The cooking! The baking! The cards! The decorating! The parties! OH MY!), slash and burn. You are NOT Superwoman. I repeat, you are NOT Superwoman. No one will notice. Seriously. I used to send upwards of 100 handwritten (and often handmade) greeting cards. A few years ago, I only sent a few. Now I don’t send any, except to my mother, and that’s a maybe. Not one single person has called me out for it. Wow, what a relief!
If you feel strongly, pick a few critical priorities (i.e., my husband will definitely die, or at least pout for days, if he doesn’t get a homemade peppermint cake by Christmas, my children will be ostracized if they don’t get Chanukah gifts like everyone else, and my staff assistant is going to “lose” my messages for the rest of the year if I don’t buy her a great present) and lose the rest. Children are important; adults will have to understand. Your budget, your sanity, and your ability to get the rest you need are the most important things. The rest is not. HALT. And be well.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. 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 AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
Our attitudes control our lives. Attitudes are a secret power working twenty-four hours a day, for good or bad. It is of paramount importance that we know how to harness and control this great force. -Tom Blandi
I have a friend who likes to say “I (heart) my attitude problem” – she loves her attitude problem, she’s proud of it, she parades it in front of anyone who will listen. She’s got a bad attitude, and she doesn’t want to fix it – and that’s one form of attempting to control. She alienates a whole lot of people with her bad attitude, thereby proving to herself repeatedly that she’s unlovable and unacceptable. Maybe you have that kind of twist on control issues, or maybe yours looks more like this:
• “Don’t worry; I’ve got it handled.”
• “If I follow this specific diet and exercise plan, I will lose weight, and everything will be okay.”
• “If I can schedule it, I can plan for it.”
• “I’ve mapped it, scheduled it, programmed it, imagined it, and now it’s going to happen exactly that way.”
• “Sure, I can do all of this by tomorrow.”
• “If I could figure out what to do to prevent him/her/it from acting that way, I wouldn’t be suffering.” How often have you said one or more of the above, all the while thinking distressing secret thoughts that go more like this:
• “I’m a liar, liar, pants on fire – but maybe I won’t get busted – this time.”
• “What am I thinking?! This is insane!”
• “If I talk enough, or move fast enough, no one will notice that this is a disaster spinning out of control.”
• “Who am I kidding? I can’t even control what I put in mouth for 24 hours, let alone anything else.”
We all have illusions of control, to varying degree. That’s fine – sometimes it’s even protective. But the problems occur when you don’t realize your illusion of control is actually an illusion, you believe your own phony story about precisely how in charge you are, or you slip over to the opposite side, believe you have no control over anything at all, and stop taking charge of what you can control.
Awesomely enough, however, your attitude IS within your control. You cannot control the weather, your mother, most of your hormonal fluctuations, or the state of the economy. You can’t even control the emotions that flow through you. But you can control your response to those emotions (getting stuck in them vs. letting them flow freely), your attitude towards life in general (pessimism vs. optimism), a goodly number of the people you hang out with, the influences you expose yourself to, and a host of other things. How about focusing your energy on the few things you truly can control?
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.
It was 1975, and my father had a powder blue polyester double-knit “leisure suit,” a weight-loss plan disguised as a plan to single-handedly re-roof our house, and a keen interest in alternative nutrition and well-being. The latter took the form of upside-down eating, in which we had our smallest meal at dinner and our largest meal at breakfast. My friends thought it was very strange that we ate steaks and pork chops for breakfast, along with huge salads.
We were also eating texturized soy protein, roughly ground grains made into coarse earthy breads, spoonfuls of lecithin, mung bean sprouts, and a whole lot of strange things that you could only get out of the bulk food barrels at Elliot’s Natural Foods. We had a copy of “The Whole Earth Catalog” on the coffee table, and there was also a well-worn copy of my dad’s new bible, Adelle Davis’ “Let’s Eat Right to Get Fit.” There was some new thinking going on in this middle-aged straight-laced German guy, and I was curious about it. Extremely curious. I read the books, and ate whatever weird stuff I was supposed to be eating.
Things got even more curious when my father signed the entire family up to learn Transcendental Meditation (TM), which was developed by the Mahareshi Mahesh Yogi in the 1950s. Although it started elsewhere, by the 1970s, it had penetrated as far as “The Big Tomato,” my hometown of Sacramento, California. He went to a couple of introductory lectures, and the next thing we knew, all five of us were learning TM! It sure seemed exotic at the time, but it’s a technique I have practiced off on and on for over three decades. It’s so simple, I find it the easiest place to return to when I’m most stressed.
TM is a mantra-based meditation technique that has been scientifically validated for stress reduction, blood pressure reduction and, most recently management of the symptoms of Post Traumatic Stress in veterans. The National Institute of Health has spent in excess of $20 million validating the benefits of TM. It increases mental clarity, creativity, and overall health, and decreases stress by decreasing the activation of the sympathetic nervous system. When the sympathetic nervous system’s activity decreases, so do adrenaline, noradrenaline, and cortisol levels. Therefore, it is quite effective for stabilizing mood and even controlling appetite, because your appetite tends to go out of control when you’re feeling stressed.
Technically, it must be taught through an authorized trainer (see www.tm.org), but a great deal of introductory information can be gleaned online. I’ve written previously here about the benefits of meditation, and I’d love to introduce you to this technique.
Simply sit quietly and comfortably. This is essential to all forms of meditation. The mantra would be assigned by your teacher, but you can choose a syllable or sound with no inherent meaning (other forms of meditation might focus on a word with a meaning, such as “love” or “peace.”). The act of focusing on the mantra draws your mind out of its normal state of anxiety, chatter, and activity. If your mind drifts, return your attention to the mantra gently and repeatedly, for a period of 20 minutes per day. Results have been verified with as little as eight weeks of consistent daily practice. Optimally, practicing twice a day for twenty minutes each time is the goal, but benefits can be derived from as little as five minutes a day.
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: Dillbeck M.C. and Orme-Johnson D. W. Physiological differences between Transcendental Meditation and rest. American Psychologist 42:879–881, 1987. Jevning R., et al. The physiology of meditation: a review. A wakeful hypometabolic integrated response. Neuroscience & Biobehavioral Reviews 16(3):415-24, 1992. Orme-Johnson D.W. and Walton K. W. All approaches of preventing or reversing effects of stress are not the same. American Journal of Health Promotion 12:297-299, 1998.
Today is National Splurge Day, a concept I absolutely love. While I believe in adhering to schedules and having as much consistency in our lives as possible (it eases stress, creates predictability, and soothes the PCOS brain), I think there’s not only space for splurging in our lives, but a mental health necessity for it as well. Splurging is a verb defined as: 1. To indulge in an extravagant expense or luxury. 2. To be showy or ostentatious. 3. To spend extravagantly or wastefully. Personal definitions of what constitutes a splurge may vary widely. If you’ve got an Oprah-sized budget, maybe nothing in the world qualifies as a splurge anymore. If you’re pretty prosperous, it might mean flying first class everywhere you go, even though business class is more than adequate. And if you’re kind of average, it might mean buying berries when apples are the most fiscally prudent fruit choice, or springing for tickets to the play-off games for a once-in-a-lifetime experience. For some, splurging can be a dangerous lifestyle – they buy whatever they want, whenever they want. They don’t worry about saving for the future, or how bad their credit card debt might be. They indulge all the time. Not only are there financial risks to this approach, there are the risks of burning out, of having the splurge lose the quality of the splurge, and becoming mundane and unsatisfying. Don’t you appreciate your $5 latte a whole lot more when it’s a payday treat instead of an everyday indulgence? On the flip side, we have the under-splurgers. They’re so frugal, you can hear the pennies squealing as they pinch them ever-tighter. They risk food poisoning on a regular basis because they don’t want to waste anything that’s looking or smelling a little questionable. They wear their clothes far past the point of fashionability, and into a state of disrepair, even when they can afford to replace them. Or they can’t imagine ever spending THAT kind of money on themselves, for a treat. Even the idea of eating a meal outside the home may seem to reek of over-indulgence. I find that a lot of us are feeling stressed, overworked, and overwhelmed most of the time. We don’t take time for rest and relaxation. We don’t allow ourselves enough time to get to place from place in peace, or to plan for and cook homemade meals. We end up engaging in minor indulgences on a daily basis, or even multiple times a day. No time to check e-mail at home? No problem, get a data plan for your phone. No time to make coffee in the morning? No problem, grab a cup at your favorite gourmet coffee place. No time to stop by the store and try on a shirt? No problem, pay $13.50 in shipping charges – both ways if it doesn’t work out. We don’t think of these things as indulgences, but they are. They’re indulgences in the wrong way, indulgences that have become necessities. We think we can’t exist without them. But they degrade the true meaning of indulgence, which is to treat yourself or someone else to something memorable, special, desirable, and pampering or self-nurturing. I think we can’t get enough self-nurturing. It doesn’t have to come in the form of money we spend, although that’s one way to get it. And I don’t think we have to be wasteful with our money to define it as a splurge. We can be prudent, yet achieve great satisfaction. That being said, if you want to do something wasteful on this National Splurge Day, go for it. Maybe it means you actually get enough sleep, for once (and wasted time you could have used for housework – hmph!). Maybe it means that you take yourself out to lunch, instead of skipping it altogether. Maybe you treat yourself to fresh cut flowers, just because you can. Those would all be great splurges that affirm that you like having fun, you like beauty and pleasure, and you like yourself enough to practice a little shameless splurging. It’s a great way to say, “I’m worth it, and I deserve it,” and when you give yourself those messages in an external way, you reinforce them internally as well. Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. 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 AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
Network member Dori Zerlin posted this as a comment to a post and I wanted to be sure readers didn't miss it. Thanks for taking the time to write, Dori!
I also would love to share my daily eating habits and recipes since I feel that my diet is pretty tasty even though it is quite healthy too. However, I do practice what I preach quite closely. And what I mean by that is as a dietitian working at Cedars-Sinai Medical Center, consulting with pre-and post-op lapband and gastric bypass patients, I teach them the importance of planning their meals ahead of time and eating balanced meals that contain a lean source of protein, a complex carbohydrate, and some heart-healthy fats. I do plan out most of my meals ahead of time and prepare them over the weekend or the night before since my weekly work schedule is tight and I have very little time for preparation let alone petty cash to spend on eating out. Therefore, this meal plan is what works for me and my lifestyle and my body type. I would not expect everyone to follow it or to enjoy it. My menu varies from day to day as well, but I am going to give 2 variations of what I might eat on any given day. I also take the following supplements with my meals spread out over the day: Krill Oil (contains omega 3-fatty acids), Calcium, Magnesium, Vitamin D (2000 IU), Basic Multivitamin, and Vitamin C.
Here is a sample with a variation for each meal or snack:
Breakfast 1 cup of nonfat plain sugar-free Greek Yogurt (by Trader Joe’s brand) 1/2 cup high fiber cereal (Organic Heritage Heirloom whole grains) or 1/3 cup of Trader Joe’s High Fiber Cereal. 1/2 cup frozen organic blueberries or strawberries Cinnamon and stevia to taste 1 tablespoon of Salba seeds ground
or
1/2 cup yogurt (same brand as above) 1/2 cup organic non-fat cottage cheese (by Nancy’s) 1/4 cup of raw oat bran hot cereal + a little bit of water to moisten it 1 Tbl. Salba 1/2 cup strawberries I use liquid stevia vanilla flavor to add a natural sweet vanilla flavor (Let this chill in the fridge over night and it is delicious the next day!)
Lunch 2 slices Turkey Bacon on 2 slices of Ezekial bread 2 slices of tomato or roasted red peppers spinach mustard With a salad on the side
or
Egg-white omelet w/ spinach, onions, and mushrooms, hot sauce I cook it with 1/2 cup of wild rice or two corn tortillas and salsa and a ranchero sauce
Snack A sugar-free dark chocolate protein bar called a Paleobar/or 10 raw nuts (almonds, pistachios, brazil nuts, etc.) with an apple or 1 cup of strawberries
Pre-workout snack 1 cup of the greek yogurt with 1/2 cup of cereal or fruit
Dinner (I don’t measure that much during dinner since I always end up taking double or more of the serving size on days I workout, so I go with my hunger here) Usually is a large stew made up of the following ingredients: Steamed veggies (asparagus, cauliflower, mushrooms, cabbage, etc.) Some sort of protein (fish, chicken, turkey, etc.) Either Corn tortillas, wild rice, brown rice, or ezekial bread I use marinara sauce a lot to season my stews or salsa or other spices for variation I also have a large salad with it and use some store bought salad dressings from Trader Joe’s or Whole Foods.
Snack 1 cup yogurt 1/2 cup of frozen berries 1 oz. of raw nuts Sometimes I will also have a cup of unsweetened non-fat almond milk (vanilla or chocolate) and mix in some stevia, cereal, fruit, and nuts.
I generally do weight training 4 days a week and use the elliptical machine at the gym for about 30 minutes as well. I do a pilates class once a week if I can make it. Staying active and physically fit help me to stay in shape and is very important to me. I schedule it into my days the same way that I schedule my meals ahead of time. Therefore it goes to show you that it does take consistent hard work for even myself to get the results that I have achieved thus far. (Although it does become second nature after awhile: ).)
When you’re first diagnosed with PCOS, it seems overwhelming. Depending upon how you were diagnosed (with or without sensitivity, by someone knowledgeable or someone clueless, in the midst of an infertility crisis, etc.), you might not have been able to absorb any helpful information that was given to you. You might have been overwhelmed, and felt hard pressed to simply do what the doctor was telling you to do in that moment. Or maybe you got into fighting mode, and immediately ordered a bunch of books, read all the medical pamphlets, and found every website dedicated to educating you about PCOS.
Either way, you may have gotten caught up in being too macro or too micro in how you manage your PCOS. By macro, I mean, seeing the big picture, like knowing you need to lose weight, prevent heart disease, and try to stave off diabetes, but not really getting the details of how exactly you’re supposed to achieve those goals. By micro, I mean, you found information of evidence of some details of PCOS treatment – tidbits of information like: eat low glycemic, take fish oil, maybe inositol helps, soy can be a thyro-toxin, etc. You dutifully apply these bits and pieces as you find them, and you may or may not feel better, but still, you don’t really have a clear concept of why you’re doing all these things. You’re just doing them because someone, somewhere, suggested they might be helpful. So step back a bit to see the big picture if you’re caught up in details, and drill down a bit for more detail if you can’t seem to get a grasp on what you need to do, or are caught up in a panic of possibilities.
Self-care is like the financial world. You’ve had a meeting with a financial advisor, or you’ve read enough articles to get the concepts: slow but steady wins the race; your financial future shouldn’t be based on just one investment but should be multi-pronged; a little bit is better than nothing, it pays to watch for hidden fees; and so on. Translating this into self-care terms, I’d say almost the same things: slow but steady wins the race; one supplement or one exercise isn’t the cure-all; doing as much as you can, even if it’s just a little bit, is better than doing nothing; and it’s important to watch out for people who aren’t motivated by your best interests, and who just want to make a buck from your suffering.
PCOS self-care is a life-long project. If you don’t have a solid base, the structure will topple (kind of like the financial structure in this country and many other parts of the world). You need a good plan, and good advisors for creating a personalized nutrition plan, taking care of your mental health, getting enough of the right kinds of exercise, and getting plenty of sleep. If these basics aren’t in place, it won’t matter how many stress management techniques you practice, or which supplements you take, or which specialists you see. Meditation can’t fix five hours a night of sleep. Supplements can’t fix a steady diet of junk. A naturopath can’t re-regulate your body if you’re smoking or doing drugs. It’s pretty simple – build the foundation first, then the rest of the structure will follow naturally. Embellish later, when you’re feeling pretty good with the whole situation. You don’t decorate a house before it’s built. And so it is with PCOS self-care.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. 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 AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
Several years ago I wrote a booket about post-traumatic stress disorder and how it can affect eating. I have been asked about the booklet several times in past weeks so I pulled it out of the archives and put it back in my store. It is an… e-booklet that I mail as soon as you process your order. For those of you who do counseling, if you purchase it, you also get the rights to copy as many times as you wish. Reviving it since it seems there might be a need and use for it again. I originally wrote this right after September 11, because I was feeling helpless and wanting to do something. I originally had a concept that I wanted to include pictures of all people from all cultures in my graphics, but not find any graphics of Middle Eastern people that were not stereotypical and insulting. So I moved to plan B, and asked my nephews if they wanted to help me illustrate the booklet. So they did, and their art seems to be a huge part of what made this booklet so popular and therapeutic. Things always work out the way they should if you don't resist the process! Anyway, here is the link to purchasing. Know that I do remove the shipping fee before processing any orders, I am not tech-savvy enough to figure out the programming to do that. Hope this is helpful to those of you who need it.
This past spring I was on a committee to plan events for our local Earth Day celebration. I advocated for our catering to, as much as possible, follow the guidelines taught on this blog, and for our vendors to be locally owned (at least) and organic (whenever possible).
In the process, I came to know Chef Elizabeth, house chef at the Phoenix Downtown Market. She whipped up a delicious chicken/walnut/rosemary salad that was the hit of the party. Chef Elizabeth mentioned that several of our local City Council representatives are frequent patrons of the farmer's market, which I was excited to hear.
I thought it would be fun to contact each of our City Council members to learn more about their thoughts about food and local and organic eating. Our first installment is here, and I will post followup installments as they return.
Michael Nowakowski, representing Phoenix District 7, is a lifelong resident of Phoenix. He holds a Bachelor of Liberal Arts in Religious Studies from Arizona State University. He is married to Delia and is a proud parent of 5 children.
Councilman Nowakowski also is the General Manager of a non-profit radio station, coming from previous work with the Catholic Diocese of Phoenix where he served as Assistant Director of the Office of Youth and Young Adult Ministry. He currently serves on the Downtown and Aviation, Public Safety and Veterans, and Seniors, Youth and Families subcommittees. He also currently chairs the Housing and Neighborhoods subcommittee.
As you can see, Councilman Nowakowski, between his elected position, his radio station, and being the father of a growing brood, has plenty of reasons to not prioritize food. Sound familiar? Let's see what he says about how it really plays out!
LOCAL BUSINESSES
1. Do you have a favorite locally owned restaurant you enjoy patronizing? A favorite item on their menu?
I have many favorite locally-owned restaurants, such as China Chili on 3rd Street, MacAlpine’s on 7th Street, and My Florist on McDowell. The Mac Cheese Burger at MacAlpine’s is one of the best things on their menu and is always a good choice.
2. Do you have any favorite locally owned restaurants in your council district that you'd like us to mention?
My staff have told me that other restaurants they like, such as Carly’s on Roosevelt and Cibo’s on 5th Avenue, and Thaiger on Central are expanding what you can expect from restaurants in Phoenix and where you can find them.
3. When people visit you from out of town, do you have"Arizona Must Eat" experiences you like to share?
A restaurant I believe everyone should visit in Phoenix is Los Dos Molinos on Central and Dobbins. The food is amazing and unique to Phoenix.
LOCAL AND ORGANIC FOOD
4. Do you have a favorite Arizona-grown food?
Arizona green chili peppers are my favorite Arizona-grown food.
5. Have you had a chance to visit the Phoenix Downtown Market? If so, any favorite booths?
I’ve visited the Phoenix Downtown Market many times, and the food vendors always surprise me. I and many people have gone to the market intending to buy raw food, but wind up leaving with a full stomach from the tamales, Italian food and fresh fruit sold alongside what we bring home to prepare.
SOME BRIEF COMMENTS
There's a lot of variety in the listed choices, which means less possibility for losing out on important nutrients. And, clearly, a love of food! I especially love how the Downtown Market started out as a simple shopping excursion for the Nowakowski staff…and has become an enjoyable culinary experience. If you're not enjoying what you eat, you certainly aren't going to care about your choices!
Our legislators are in a position to be creating laws with impact on what we eat at home and in restaurants. I read this New York Times article last night about the food being consumed in Washington, DC, at the table where our health care plan revision is being hammered out. It left me wondering how nutrition could even be considered as an important component of those revisions. So nice to see, at least within our local government, that an appreciation for simple healthful choices and the local vendors working to create better choices that does show up on our representatives' radar.
JUST A FEW NOTES ABOUT CHILI PEPPERS Chili peppers are a wealth of antioxidants! Red chiles contain higher amounts of vitamin C and carotene than yellow and green ones, but all colors of chilis are a good source of most B vitamins, and vitamin B6 in particular. They are very high in potassium and high in magnesium and iron. If you're a regular reader of this blog, these nutrients should sound familiar, since they've all been mentioned as important to maintaining fertlity.
Vegetarian readers take note! The high vitamin C content of chili peppers can help increase the uptake of iron from other ingredients in a meal, such as beans and grains. Sounds like an authentic bean burrito with a side of rice (maybe from the farmer's market?) could be a great Nowakowski choice for dinner tonight!
With some breathing room and time to think, I've had a chance to start to plan the next round of couples infertility spa days. These are intended to teach the information you want and need, as well as remind you why you are in the fertility process in the first place! Sometimes that gets lost in the medical office.
If you'd like to be notified of these events when they are planned and ready for registration, sign up here to receive our blog via email, and/or join our Fertile Intentions Facebook group:
… only a “bad” choice. At least that’s the way I choose to look at it these days. I find that I’ve been able to maintain good health and normal weight the past few years after adopting a more realistic approach to the way I eat.
In the past I was a slave to the “all or nothing” mentality, and in the long-term it got me nowhere, though in the short term it seemed to produce results. If I was seeking fat loss, sure, the fat came off if I ate 100% “clean”, no treats, no cheats. Ever. Eventually, once I’d reached a goal (or a breaking point!) I’d end up overdoing it with whichever foods I’d declared off-limits. And after that, well… I would feel like I failed, and these things became part of my daily habits seemingly overnight once more. Sound familiar?
The truth is, foods like these were only “bad” for me when they were the foundation of my diet. These days, I choose to approach my eating habits in a more realistic way. I live in the real world, not some “perfect eaters Utopia” and, I love burgers, cookies, chocolate, and wine (among other foods commonly found on dieters’ Do-Not-Eat lists). At the same time though, I understand that these foods are not always the most nutritionally sound choices, and too much of any of them not only leads to less-than optimal health, they can provide way too many calories, possibly pushing my weight/body fat in the wrong direction.
So, I focus on having a strong and healthy foundation by eating primarily lean proteins, plenty of vegetables and fruits – essentially, foods that are more nutritionally balanced and promote good health. I re-labeled these other foods from bad foods to treats. The definition of the word"treat" in the Merriam-Webster dictionary is:"an especially unexpected source of joy, delight or amusement."
How do I do this? If there is a special occasion coming, and I know there will be something there that I consider an indulgence rather than the foods that make up my foundation, I will plan for that by keeping the rest of my meals leading up to that special occasion particularly healthy. If there is no special occasion, I will take note of my cravings throughout the week, and based on what my body is asking for, that weekend I’ll go out for a treat. Sometimes it’s as simple as a little frozen yogurt, or a cookie at Paradise Bakery. Sometimes I really want some pizza or a hamburger. Whatever it is, I make sure to honor that craving, enjoying the meal and then continue with my usual healthy diet. I guess you can call it a “common-sense” diet.
I can understand that this approach may not work for everyone, but it works for me more than any restrictive diet ever has. I was initially afraid to give this a shot, thinking I’d be tempted to just keep eating the “junky” stuff. Yet, here I am, pleasantly surprised that I was wrong. I have chosen to live a healthy life, and everything else has fallen into place around that choice.
We’d love to hear from those of you who have been successful at managing your weight while still being able to enjoy some of those foods that have a bad reputation…
Since vitamin D deficiency has been identified with a long list of health issues, including PCOS, I've been hearing readers, clients, colleagues, and friends talk about loading up on this nutrient with supplements. They're going about it in a not-so-scientific fashion, and I've wondered if that wasn't going to introduce a whole new spectrum of health issues.
A friend and colleague recently mentioned that she had just had a cholesterol test taken, and the LDL (bad cholesterol) reading had increased since her previous test. One of the changes she could identify was between the two tests, she had started to supplement with vitamin D.
I did a pretty thorough search both on the Internet and Pub Med to see if this was a common problem and didn't find anything. I then went to a listserve of about 1,000 nutrition colleagues to see if they'd seen it. Turns out, a few of them had also seen their cholesterols increase with vitamin D supplementation.
There is a tendency with nutrition, to adopt an"if a little is good, a whole lot is better" attitude. Unfortunately, imbalance in either direction, be it deficiency or excess, can be problematic.
The old recommendations for vitamin D were 200 IU per day. All of a sudden, a website popped up recommending 5000 IU per day. I couldn't find any research to support this magnificent dosage leap. I would have thought, given that magnitude, that some kind of dosing study that had ruled out that 500, 1500, 2000 IU were not sufficient. But no, the recommendations simply jumped without explanation.
And every time I tried to find out what the basis for this jump was, I kept being referred back to the website making the recommendation.
My points are:
1. Know your vitamin D and your cholesterol levels. 2. Start out with 200 IU or even 400 IU per day and see how that affects both your vitamin D levels and your cholesterol levels. 3. Consider that the reason vitamin D levels may be deficient is more complex than the simple fact that dietary vitamin D is low…did you know that many of the same health issues associated with vitamin D deficiency are also related to omega 3 fatty deficiency as well as omega 6 fatty acid excess? Most nutritional problems, if they are related to imbalance, cannot be corrected with a supplement. The overall balance of the diet needs to be considered in the plan of correction.
Not long ago a woman with PCOS handed me a diet diary for analysis. She had eaten a burger without the bun and a sweetened ice tea for breakfast. Lunch didn't happen until 2 pm, and it was a brownie with ice cream. And finally, she recorded a bowl of cereal for dinner.
One of the things that jumped out at me was that there were no fruits or vegetables in her meal plan. When I asked her about it…she told me she was avoiding carbs!
Fruits have somehow gotten a bad rap because of their carbohydrate content. But they're not the culprit in an unhealthy diet. In fact, fruits are very high in antioxidants, which can help to repair the damage that life stress and the stress of having a chronic disease can create. In my opinion, you can't afford NOT to have fruit.
I chose oranges this week, because I live in Arizona and I have an orange tree off of my patio. It is the most wonderful treat to wake up, pick a few oranges, and have a glass of fresh squeezed juice. Or, when I need a break in the afternoon, to pick a fresh snack for myself. Nothing tastes better than fruit right from the source. I recently made a great salad vinaigrette using orange juice and olive oil as the base. Even with all these oranges, I'm not making a dent in my supply!
If your diet diary mimicks the one I described above, challenge yourself to try the following. Be sure to have a serving of fruit the size of a tennis ball at each meal, or the total equivalent of 3 servings that size of fruit in the course of a day. Challenge yourself to not eat any sources of refined sugar until you've met your daily quota of fruit. See if, when you focus on fruit, your appetite for other sugars diminishes. And in the process, if changing the kind of sugar you eat doesn't help stabilize your energy levels and help you to feel better.
Last month I had the opportunity to spend a week with 5 women with PCOS at Green Mountain at Fox Run's first ever PCOS week. I learned a tremendous amount from them, maybe even more than I went to teach to them, about the syndrome.
One of the most important insights I gained, was why it can be so difficult to lose weight once you've decided to change your eating and exercise habits.
Insulin has a lot to do with it.
Your body is constantly taking in data, recording the temperature, the light level, energy levels, etc., and adjusting itself to be able to meet the demands of the situations it's recording. When it comes to hormones, it often records and hangs on to information from weeks before. It's as if it wants to be sure it's ready to handle the worst case scenario it's going to have to be asked to deal with. So…if you've been binge eating, and you've changed your habits, information it's taken in about that binge, if it occurred in your recent past, is still in the database. Your body is likely to want to make more insulin than it currently needs, just in case it's asked to have to handle a binge session like one it remembers you engaged in.
If you continue your new eating habits, consistently, that will register positively, your body will trust that it needs to make less insulin, and your lab values will improve.
The challenging part is being patient with your body while the new data has a chance to be recorded and acted on.
If you've got high insulin levels and all of a sudden you decide to go on a diet, or exercise at high levels, the insulin levels won't automatically adjust. It can be very easy to create a hypoglycemic state if you take on too much too soon. And, as your blood sugar levels drop, your hunger and carbohydrate cravings are likely going to be triggered to correct the situation.
Hypoglycemia is a stressful situation for the body, so when this scenario kicks in, it also triggers the release of stress hormones. Cortisol, one of the major stress hormones, is made with cholesterol. As are estrogen, testosterone, and progesterone. If choices you are making are demanding of the body that it makes more cortisol, it's going to be hard for it to make the other three hormones in the proper proportions.
The other thing that is common with PCOS is an intelligent, driven, all-or-nothing tending personality. When you decide to take on diet and exercise, it can be in an extreme fashion. When weight doesn't come off as planned, you can be very hard on yourself, raising your stress levels, possibly bingeing out of frustration.
And thus the cycle starts, all over again.
Hence the title of this post. How do you back yourself out of such a situation?
Ohhhh…you all are going to hate this, but the key word is"moderation". Be gentle with yourself. Rather than taking on an extreme exercise plan and a rigid diet, focus on small simple changes and working to turn them into habits. Be patient. Understand that the changes you're implementing on the outside take time to be registered by your internal hormone control systems.
Probably key? Remember this: THE DAYS YOU FEEL THE LEAST LIKE STICKING WITH YOUR NEW HABITS ARE THE DAYS IT IS MOST IMPORTANT TO DO JUST THAT. It's tempting to blame a bad day on something you've done, to take it personally, rather than let your body do what it does best when it's not interfered with. By bingeing and not exercising on a day you feel badly, you prolong the time it's going to take to get things back into balance.
Yesterday I reviewed a book entitled,"The Art and Science of Low Carbohydrate Living". I started with the negative part of the review because years of reviewing blog statistics has taught me that people don't stick through much of what I write to get the main idea. Because avoiding ketosis is such a crucial concept I felt like that point needed to be made before getting to something I really liked about the book.
What this book discussed that I did like, was the concept that human brains, even though we're taught that they depend on glucose, can learn to live on ketones for energy. I immediately thought of the many of you who comment here and elsewhere that you feel as though you're addicted to carbohydrates. It's certainly going to feel that way if your brain has become so used to using glucose as its only fuel source that when it's not there it feels as if it's run on empty.
I tend to think of an addiction as a chemical reliance on a nonessential substance. A dependence is a reliance on something we need. We're not addicted to oxygen, for example, we're dependent on it. So I prefer to think of the relationship many of you have to simple sugar as a dependence, not an addiction. You can teach your brain to use low-glycemic carbohydrates and protein as sources of low-glycemic sugar, and you can even learn to use ketones.
If you've tried to jump from a simple carbohydrate-dependent diet to a carbohydrate-deficient diet overnight, chances are it felt like you were going through withdrawal. It is possible to gradually learn to use ketones over time, but if your experience in getting there is so miserable, you're likely to not stick with it. There are a lot of options between all and nothing.
As I mentioned yesterday, the extreme carbohydrate restriction described in this book proved a point, but in the process it also created some other potential nutrition deficiencies.
Instead of jumping to that extreme, why not try gradually removing the simple carbohydrate from your life and replacing it with protein and low-glycemic carbs? It will help the carbohydrate you DO eat distribute itself more evenly over the course of a day (just like your carburetor does for your car), and you might potentially (and gently) teach your brain to be less dependent on one source of fuel, pure sugar.
Be scientific about it. Use an analysis program such as http://www.fitday.com/ to track what you're doing and plan how to experiment with other ways. Record how you feel. Feel what feels best. You'll know when you've hit that place because that next drop in carbs will leave you feeling hungry, moody, and low in energy.
Let us know what you learn about yourself! Everyone is different, and therefore everyone's carbohydrate needs are different. The concept underlying the book is not unsound, it's just likely not necessary for everyone to restrict carbohydrates to that extreme.
The beauty of nutrition is that there are many paths to the same destination. Be it raw, vegan, Paleo, low-carb, low-glycemic, we prefer to show you how, once you've decided which food philosophy best fits your personality, to make it work on your behalf.
