Marissa Kent of Mission Viejo, California wrote a wonderful article about watermelon for her August newsletter. Be sure to check out the watermelon salad recipe at the bottom of the post!

In addition to being a dietitian specializing in eating disorders and a certified diabetes educator, Marissa loves food, cooking, and hanging out at her local farmer's market.

You can learn more about Marissa and her nutrition counseling services at http://www.marissakentnutrition.com/.

One of the most enjoyed fruits during the hot season is the watermelon (Citrullus lanatus), which originated
from Africa. Did you know a watermelon is 95% water, and there are more than 200 to 300 varieties grown
in the United States alone? Only about half a dozen of those varieties make it into your supermarket. There
is even a square shaped watermelon grown in Japan, so that it will fit into refrigerator shelves nicely and not
take up too much space.

Watermelons do grow from a vine, but the melon is on top of the ground. Growing a watermelon can be very demanding. They require a lot of sunlight, space, water, and nutrients.It takes about 90 days for a full mature watermelon. California’s peak season for watermelon is May – October, but in general you can buy watermelon throughout the year.

Picking a watermelon requires both talent and skill, or just pure luck. Ideally you want a firm, smooth melon
with a yellowish creamy-white underside where it touched ground. Ripe watermelons should have a healthy
sheen and a melon smell. One popular way of picking a watermelon is by knocking on the melon with your
knuckles and listening for a dull, hollow sound. The unripe melons have a higher pitched sound.

Most people prefer watermelons for the cool sweet refreshing taste, but little do they know a watermelon is filled with nutrition.

Nutrition values:

1 cup of diced watermelon:
50 calories
11 grams of carbohydrate
0.6 grams of fiber
9 grams of sugar
1 gram protein– (can you believe it!)
11 mg calcium
170 mg potassium– (helps you stay hydrated)
12.5 mg Vit. C
875 IU (International Units) Vit. A
6900 mcg (micrograms) lycopene — Wow!

Watermelon (as defined by its name) mostly consists of water. It’s a great source for keeping your body hydrated during this hot season. Most of the water will come out of your body through sweat or urination. This does not mean it is low in nutritional value!

The top 2 benefits of eating a watermelon are: 1) the values of vitamin A and 2) lycopene. Both of these are antioxidants. Antioxidants help protect the body from damage caused by free radicals (highly reactive and unstable molecules). Vitamin A aids in the building and strengthening of bones, soft tissue, skin, and mucous membranes. Lycopene is in the subcategory of Vitamin A, and has been shown in recent studies to have potential health benefits to reduce the risk of cancer! Watermelon contains potassium. Potassium helps trigger your heart’s squeeze of blood through your body. It also helps with reducing the amount of muscle cramps.

People with diabetes may be concerned with the sugar content of watermelon. However, other foods you eat with watermelon will reduce the impact on your blood sugar.

Glycemic index refers to how fast a specific carbohydrate (bread, rice, potato, fruits, etc… ) food raises the blood sugar within a given time. The glycemic index of a food can change when you eat a combination of nutrients (carbohydrate, protein, fat). Watermelon (as defined by its name) mostly consists of water. It’s a great source for keeping your body hydrated during this hot season. Most of the water will come out of your body through sweat or urination. This does not mean it is low in nutritional value!

The top 2 benefits of eating a watermelon are: 1) the values of vitamin A and 2) lycopene. Both of these are antioxidants. Antioxidants help protect the body from damage caused by free radicals (highly reactive and unstable molecules). Vitamin A aids in the building and strengthening of bones, soft tissue, skin, and mucous membranes. Lycopene is in the subcategory of Vitamin A, and has been shown in recent studies to have potential health benefits to reduce the risk of cancer! Watermelon contains potassium. Potassium helps trigger your heart’s squeeze of blood through your body. It also helps with reducing the amount of muscle cramps.

People with diabetes may be concerned with the sugar content of watermelon. However, other foods you eat with watermelon will reduce the impact on your blood sugar.

Glycemic index refers to how fast a specific carbohydrate (bread, rice, potato, fruits, etc… ) food raises the blood sugar within a given time. The glycemic index of a food can change when you eat a combination of nutrients (carbohydrate, protein, fat).

For example, if you are eating a hamburger and then a slice of watermelon, that will decrease the time it takes to rise the sugar level. You may want to work with a dietitian to learn more about combining and preparing foods to achieve the lowest glycemic index levels in your meals.

The glycemic index of a watermelon is 72, which is high compared to the chart below. Most nonstarchy vegetables, legumes, high fiber fruits and grains, have a low glycemic index.

Here is a chart of the levels of the glycemic index:

 Low (good) glycemic index levels: 55 or less

 Medium glycemic index levels: 56–69

 High (bad) glycemic index levels: 70 or higher

In conclusion, the glycemic index of watermelon is high. If you stay within the recommended portion size (1 cup diced), your blood sugar will not be significantly affected. In addition, if you enjoy watermelon with a meal this will further balance blood sugar.

Enjoy picking out and eating your watermelon while we are still in summer!!!

Watermelon Summer Salad

Dressing:

1/4 cup freshly squeezed orange juice
1/4 cup freshly squeezed lemon juice (2 lemons)
1/4 cup minced shallots (1 large)
1 T honey
1/2 cup olive oil
1 tsp salt
1/2 tsp ground black pepper

Salad:

6 cups of baby arugula, washed
1/8 of a seedless watermelon, rind removed and cut into 1 inch cubes
12 oz of feta cheese, 1/2 inch diced
1/2 cup whole fresh mint leaves, julienned

Directions

Whisk together the orange juice, lemon juice and shallots, honey, salt and pepper. Slowly pour in the olive oil, whisking constantly to form an emulsion. If not using within an hour, store the vinaigrette covered in the refrigerator.

Place arugula, watermelon, feta, and mint in a large bowl. Drizzle with enough vinaigrette to coat the greens lightly and toss well. Taste and serve immediately

Note: I've received quite a few compliments about this blog post. It was written and published without a single edit by Sarah Jones. Sarah is currently a nutrition student and Arizona State University and has been interning with me over this academic year. The attention to detail you see here is just how Sarah does things. I'm very lucky to have her, and glad she has shared such a timely topic in such a wonderful post. Thanks, Sarah!

You may have noticed that vitamin D has been a hot topic in the media lately and, at this point, it is likely that we as consumers are becoming overwhelmed by all the media hype. Recent studies have suggested that in prehistoric times, in addition to normal skeletal development, humans probably used vitamin D as a natural form of sunscreen. Before majoring in Dietetics, my basic knowledge of the role vitamin D played in the body is that it somehow worked with calcium to promote healthy bones. As it turns out, I had no idea how complex the relationship actually was between vitamin D and the human body! Let’s take a further look at vitamin D. Most of us may know vitamin D as the “sunshine vitamin.” We get it from the sun, right? Sure, but how? When ultraviolet light from the sun shines on a cholesterol compound in our skin, it is transformed into a vitamin D “precursor” (compounds that can be converted into active vitamins that the body can use) and is absorbed directly into the blood. The liver and kidneys finish converting the precursor to the active form of vitamin D. There are two major forms of vitamin D; these are vitamin D₂ (ergocalciferol), which is present in plants, and vitamin D₃ (cholecalciferol), which is present in the skin of animals. Vitamin D was discovered in 1920 and was originally classified as a vitamin. However, it has since been revealed that vitamin D is actually a hormone (steroid) since it can be synthesized by the body when exposed to sunlight. Essentially, the major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus in our bodies, which aids in the absorption of calcium and helps to form and maintain strong bones. Vitamin D₃ is the most active form of the vitamin, which is what you will see in most supplements. Obtaining vitamin D from sunlight presents no risk of vitamin D toxicity because the body is able to regulate the vitamin D precursor – see what I mean about complex! But, as we know, getting too much sun puts us at risk for skin cancer. Since moving to Arizona, I have started wearing sunscreen everyday to decrease my risk of skin cancer, but sunscreen can reduce or prevent the synthesis of vitamin D. And, because vitamin D is one of the most toxic of all the vitamins, taking supplements can put us at risk for toxicity. Now you may be thinking, I wear sunscreen, I am concerned about supplementing without first consulting my doctor, and I live in an area that does not get much sunlight during this time of year, what foods can I eat that have vitamin D in them? As far as foods are concerned, dietary vitamin D is provided primarily by foods of animal origin, especially liver, beef and eggs (mainly the yolk). You can also find vitamin D in dairy products such as milk, cheese and butter. Lastly, vitamin D is in some saltwater fish, including tuna, salmon, herring and sardines. Because few foods naturally have substantial vitamin D content, i n the United States there are pre-selected foods, such as milk, cheese, margarine and yogurt as well as some orange juice, bread, and cereals that have been fortified with vitamin D. If you are a vegetarian, you likely will not be obtaining vitamin D by eating liver, beef or fish, but you may still be eating eggs and dairy products. I mentioned yogurt as a source of vitamin D, but after a trip to the grocery store and looking at no less than ten brands of yogurt, I was stumped! I was hard pressed to find yogurts that have been fortified with vitamin D. However, it was not a complete loss, as I eventually spotted one (which also happens to be one of my favorite brands). Stonyfield Organic Yogurt has fortified most of their yogurt products with vitamin D₃. Here is a list from their labels of the “percent of daily values based on a 2,000 calorie diet”: Organic Fat Free Smooth and Creamy 6 oz (all flavors): 20% of D₃ Organic Fat Free Fruit on the Bottom 6 oz (all flavors): 15% of D₃ Organic Low Fat Smooth and Creamy 6 oz (all flavors): 20% of D₃ Organic Low Fat Fruit on the Bottom 6 oz (all flavors): 15% of D₃ Their soy and Greek yogurt’s do not have vitamin D, but they also make six and ten ounce organic smoothies that contain vitamin D. Additionally, they have two other products that are worth mentioning: “B-Healthy and B-Well.” B-Healthy includes omega-3 fatty acids, as well as three of the B vitamins ( B₃ or Niacin, B₅ or Panthothenic Acid and B12). B-Well contains vitamin B₆, probiotic cultures and vitamin D. According to their website, if you live in the Phoenix area, Stonyfield Organic Yogurt can be found at: Bashas’, AJ’s Fine Foods and Sprouts Farmers Market.

References

inCYSTer Christine Marquette recently gave a great, detailed webinar about supplements and PCOS. In it, she pointed out that there are certain nutrients women with PCOS may need more of because their metabolism is altered.

What I've been wondering ever since, is whether or not they need more because their intentional eating plans have thrown them out of balance…or would they need more even if they ate absolutely perfectly? The research does support these additional needs, but what the studies do NOT do, is provide women with healthy food for a period of time to discern whether those needs exist even when the diet has been brought back into balance. I suspect the needs would still be different, although not perhaps not quite as remarkable as they are when you're not eating well.

I thought, once a week, I'd introduce you to a vitamin or mineral and challenge you to see if you eat enough of it, regularly, over the course of the day.

Once you bring all of your vitamins and minerals back to baseline, then you can more accurately determine whether or not supplementation is going to work for you. If you want to check out how you're doing, check out http://www.fitday.com/, where you can enter all of your foods and check out how your own intake measures up to the recommendations for the vitamins and minerals.

Vitamin A
How do you do with the following foods?
liver carrots broccoli leaves (not the commonly eaten florets) sweet potatoes butter kale spinach pumpkin collard greens cantaloupe egg yolks
Keep this list handy over the next week and think of ways you can be sure you're getting enough vitamin A. Here are some suggestions.
1. If you make your own smoothies, be sure to throw a handful of leafy greens into them. Even if they're fruit flavored, a handful won't make a difference flavor-wise, but they'll make a huge difference nutrition-wise.
2. If you juice, which is the easiest way to get tons of vitamin A, be sure to balance all that carbohydrate with some protein. The biggest problem with juicing for people who tend to be insulin resistant is the huge carbohydrate load in comparison to the protein juice tends to not provide.
3. Always buy the darkest possible greens for your salad
4. Think kale chips, broccoli chips, etc. They're easy to make and tasty to munch on!
5. If that hour between arriving home and eating dinner is a problem, stock your refrigerator with baby carrots and hummous to snack on while you wait.
6. Try putting spinach leaves instead of plain lettuce on your sandwiches.
7. I'm a huge fan of omelets and frittatas. I never ate Swiss chard until I learned to put it into a frittata. It's also a great way to clean out the vegetable bin at the tail end of the week, it's a cheap dinner (it adds some eggs to your diet), and it's so easy on those nights when you come home exhausted and not wanting to think about anything complicated for dinner.
8. Boil up some eggs and keep them handy for snacks and to top salads with. We tend to be afraid of eggs because of the outdated information about cholesterol. They're actually quite healthy, quite convenient, and something that can make getting vitamin A…as well as protein…a little bit easier.
9. Still have an abundance of vegetables after eating the frittata? Why not make some soup! I have a slow cooker and it is the best appliance for making an easy dinner. A few minutes in the morning and I've got the house smelling great by late afternoon. If thinking about this in the morning while you're rushing out the door just isn't going to work…try putting everything in the slow cooker the night before and programming your smart phone to remind you to plug it in before you leave for work.
10. Stir fry! It's quick and it's easy. You can also buy chopped up vegetables if you want it to be even easier.
OK, let's do it! Let us know how you do with the challenge, or if you have new suggestions to add.

A lot has been talked about when it comes to skin cancer and its cause. Ninety percent of non-melanoma skin cancer is caused by sun exposure. Oddly enough one way we generate a very important vitamin (vitamin D) is from sun exposure! What to do? Expose skin to sun and risk cancer or become housebound avoiding all light from the sun and risk vitamin d deficiency?

Fact: Vitamin D is very good for you.

Fact: Sun is not.

First understand that I think the body is genius in the way it can take sun applied to the skin and start a biochemical process that makes us into little Vitamin D machines. It is photosynthesis like the plants! Without sun the machine does not work.

Without Vitamin D we experience a myriad of negative consequences. Vitamin D is necessary for healthy bones, good immunity and possibly in protecting us from diseases from fibromyalgia to multiple sclerosis, and cancers from prostate to colon. The NIH (National Institue of Health) has reviewed research on Vitamin D and found it to be very complicated. It is not just black and white (or in this case tan and white!). A lot of research is happening, just trying to figure out how much vitamin D we actually need for optimum health is an enormous undertaking (If you like data there is a good scientific review in the Journal of the American Academy of Dermatology, Feb 2006). Believe it or not we are still not sure how much Vitamin D is the correct amount.

We can all agree that we need at least some Vitamin D and we have three ways to get it; sun, food and supplements. Start with food; not a great source unless you eat a lot of fish (tuna, salmon, mackerel and fish liver). Beef liver, cheese and egg yolks have small amounts, but think for the cholesterol! Milk and bread are fortified which is helpful but many Americans still seem to be lacking.

So, supplement or sun? The reality is that if you have light skin and don’t live in a submarine you get about 15 minutes of sun on your hands and face just from living every day. The human body maxes out its Vitamin D producing capacity in 5 minutes (sunny day, hands and face unprotected). Anything more is not helping Vitamin D but is helping skin cancer. Shut-ins and dark skinned people are another story. Rolling grandma out to the sun porch everyday is an option but supplements are more practical. With very dark skin more sun time is needed to penetrate the natural advantage in sun protective color but how much time depends (I know, I hate that answer, too).

Bottom line, sun causes cancer; supplements are available to supply vitamin D, so why risk it? Until we know exactly what we need for perfect Vitamin D health perhaps we should go for the sunscreen and a pill. How much? 200 IU a day, 400 IU for over 50’s and 600 IU for over 70’s.

Note from Monika: One of the aspects of inCYST that I absolutely love is how because of our interdisciplinary team we can look at health issues in new and different ways. Dr. Van Dyke has been teaching me so much about skin issues and how the relate to PCOS. She has been very active this month on Twitter for melanoma month. It seemed like the perfect time to have her write about vitamin D from her specialty's perspective. Thank you so much for taking the time!

For more information on Dr. Van Dyke's practice please visit http://www.vandykelaser.com/. She can be found on Twitter at @drvandyke.

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.

One of the more frequent searches bringing readers to our blog is"vegetarian" and"fertility"…and"vegetarian" and"pcos". I've also noticed when doing Fertility Friendly Food Tours at Whole Foods, that a disproportionate percentage of women attending these classes, are vegetarian. And, in my individual counseling, it's not uncommon to learn during an assessment that if a client is not currently vegetarian, she was at some point in her life.

So I wasn't surprised to find this study reporting that women with PCOS tend to be deficient in vitamin B12.

I often teach that PCOS is a counterintuitive illness. By that, I mean that what often needs to be done is the opposite of what you might think. In this case, rather than immediately assuming that the most important strategy is to restrict food choices because your appearance suggests overnutrition, it may actually be to add foods back into your diet to correct underlying deficiencies.

This B vitamin is found almost exclusively in animal products, including fish, meat, poultry, eggs, milk, and milk products. It is also found in some fortified breakfast cereals, but if you're avoiding carbohydrates as well as trying to be vegetarian, you're likely not getting enough vitamin B12 in your diet.

Some fermented soy products, namely tofu, tempeh, miso, and tamari, may contain vitamin B12, if the bacteria, molds, and fungi used to produce them were vitamin B12 producing. This is a project I'll look into and blog about in a later post.

Finally, some nutritional yeast products also contain vitamin B12. Lucky for you Aussies reading this blog, that means Vegemite and Marmite, made from yeast extracts, can be excellent choices to include in your diet!

It is possible to obtain vitamin B12 by taking a vitamin supplement, but the amount of the vitamin that is actually absorbed through the digestive tract may be very low. For this reason, physicians who note a low vitamin B12 level may recommend an injection, to bypass the digestive tract.

Women over 14 years of age, if not pregnant, should be consuming 2.4 mcg of vitamin B12 per day. They should aim for 2.6 mcg per day when pregnant, and 2.6 mcg per day when breastfeeding.

It's clear, if you don't do vegetarian eating in a thoughtful, proactive way, it carries considerable health risks. As you've seen before in this blog, inCYST believes that healthy vegetarian eating is about what you DO choose to eat, more than what you DON'T choose to eat.

It is a good idea, if you're vegetarian, or ever have been, to ask your physician to check your vitamin B12 levels. A low status is easy to correct and that can be part of your strong foundation for managing your PCOS and improving your mood, insulin function, and fertility.

Kaya C, Cengiz SD, Satiroğlu H. Obesity and insulin resistance associated with lower plasma vitamin B12 in PCOS. Reprod Biomed Online. 2009 Nov;19(5):721-6.

I was asked to clarify some comments I recently made about chia, as they were questioned for their accuracy. I'm all for revisiting and making sure my information is accurate, so here is my response.

First of all, while the information on this blog should be helpful to anyone regardless of whether or not they have PCOS, it IS targeted toward women who have this hormone imbalance. So some of the information I provide is more geared toward their specific nutritional needs and not the apparently healthy population. This should always be kept in mind when reading what I write.

One of the questions about my post was that I stated that taurine is an essential amino acid. There is actually some debate about this. Some experts say no, we can synthesize it. Others call it a conditional amino acid, meaning in some situations it may be essential.

Women with PCOS seem to have something going on in their brain and nervous systems that interferes with everything from mood and appetite regulation to speech and language function. (Simply read the responses to my question last week about the symptoms I listed and you will see what I mean.) Much of the dietary protocol we have developed is actually derived from epilepsy research at Johns Hopkins University, with the premise that calming nervous system excitability makes it easier for the brain and nervous system to function as they should when not under duress. Taurine is an amino acid showing promise as an anti-seizure compound, which makes me wonder whether or not a hyperexcitable brain blows through available taurine much more quickly than a brain that does not have to live under these conditions.

That being said, I am more comfortable with the premise that for the population for whom this blog is written, as well as anyone living with any kind of condition that places stress on the brain (migraines, epilepsy, OCD, anxiety disorder, bipolar disorder, PTSD, schizophrenia, etc.), taurine may actually be an essential amino acid. Research to support my claim still needs to be done, but I am more comfortable being conservative on this one, especially given the responses to last week's questionnaire and the severity of some of the diagnoses I just listed. Better to be safe than sorry.

Secondly, even if the amino acid profile of chia is complete, the total protein content of chia is relatively low. So if we're advocating for a 30% protein diet in a woman who is being advised to consume 1500 calories a day, she is going to need to consume about 113 grams of protein. That translates into your needing, at this protein level, to consume 700 grams of chia per day, just to get your protein needs. That is also 3,430 calories' worth of chia, more than twice your daily calorie needs. And while its amino acid profile is nearly complete, its nutritional profile is not. It contains no vitamin A, vitamin C, vitamin D, vitamin K, thiamine, riboflavin, niacin, vitamin B6, folate, or iron, to name a few.

From an omega-3 standpoint, I did invert the numbers. There is no consistent order by which omega-6 and omega-3 ratios are reported, and though I usually check to be sure I did not flip them, I did not this time. I do apologize for that.

According to http://www.nutritiondata.com/, chia seed contains an omega-6 to omega-3 ratio of 3.03, which is actually quite good.

The caveat is that the omega-3 this food contains is alpha-linolenic acid (ALA), not EPA or DHA. Most omega-3 experts will contend that in the most perfect of conditions conversion of ALA to DHA is at best 5%. Again, the women this blog serves seem to need a much higher level of DHA than average for a variety of reasons. We find that they seem to do best on 1000 mg DHA daily, the level recommended by Dr. Artemis Simopolous for treating depression. Calculated out, if you are depending on chia seed to get all of your omega-3 fatty acids, from ALA through EPA and DHA, you're going to need to consume about 115 grams of chia seeds per day. Just be forewarned.

Bottom line, I actually think chia is a healthy food--as part of a varied diet. I especially think that for vegans reading this blog it can be a great addition to your diet. However, I do not believe in superfoods. There seems to be a trend toward wanting to find one perfect food that has it all. I have yet to find it. It's understandable when we're surrounded by a lot of confusing information and we live in a culture where over 10,000 new products hit the grocery shelves each year (I saw half of them in Anaheim last month and it was overwhelming!) that we'd want to have just a few foods and a small nutritional comfort zone. Unfortunately that is not really how human nutrition works.

This is an especially important philosophy to stick to on this blog, given the fact that we're learning that a very high percentage of the women we're helping have some kind of history of"veganism gone wrong"…in other words, overzealous veganism with a focus on eliminating foods rather than on learning how to eat to be nutritionally complete with no animal products on the menu. We discourage fanaticism and encourage food curiosity and variety!

We were designed to be omnivores and to eat a variety of foods from a variety of sources. I encourage you, rather than arguing for why you should narrow your choices down to feel more comfortable around food, to learn to negotiate a wider variety of foods you are willing to include in your diet.

Gaby AR. Natural approaches to epilepsy. Altern Med Rev. 2007 Mar;12(1):9-24.

I recently received a newsletter from one of our network members that I wanted to share with you. Karen Siegel, in addition to being a registered dietitian, is a licensed acupuncturist and herbalist. Her practice is located in Houston, Texas. She writes a wonderful newsletter entitled,"Qi Mail", which some of you might really enjoy. I am pasting the contents of her most recent newsletter for you to sample. Karen's contact information is listed below, if you'd like to schedule an appointment, or sign up to personally receive these wonderful newsletters. The actual layout is much more beautiful than what I can reproduce here, I can only paste the content in Blogger's format. As many of you are likely rushing around this weekend to get the last few holiday gifts, foods, and details taken care of, I thought this topic was especially pertinent. Enjoy!

REST, RESTORE, REVITALIZE

In nature, winter is the season where all living things slow down, conserve their energy and prepare for the outburst of new life and energy in the spring. Our bodies are instinctively expressing the fundamental principles of winter – rest, restoration and revitalization.

The Nei Ching, one of the earliest surviving medical books on acupuncture, advises:
“During the winter months one should refrain from overusing energy. Retire early and get up with the sunrise, which is later in winter. Desires and mental activity should be kept quiet and subdued, as if keeping a happy secret.”

Eating warm hearty soups, dressing warmly, and refraining from cold and raw foods is also recommended.

Element: Water
Nature: Yin
Organs: Kidney, Urinary Bladder, Adrenal Glands, Ears and Hair
Emotion: Fear and Depression
Flavor: Salty

Seasonal acupuncture treatments in winter serve to nurture and nourish kidney Qi (the organ associated with winter) which can greatly enhance the body's ability to thrive in times of stress and aid in healing, preventing illness, and increase vitality.

Call now for more information or to schedule your seasonal tune-up

De-stress this Winter with Acupuncture

While optimal health and well-being in the winter season calls for rest, energy conservation and the revitalization of body and spirit, your holiday activities may have a different agenda. This year can be filled with a mad scramble of visitors, family get-togethers and frantic shopping trips. Compound the usual seasonal pressures with the constant barrage of bad economic news and you may find this to be one of the most stressful times of the year.

Stress, frustration and unresolved anger can cause a disruption in the flow of qi or energy through the body. These energetic imbalances can throw off the immune system or cause symptoms of pain, sleep disturbances, mood changes, abnormal digestion, headaches, and menstrual irregularities, and, over time, more serious illnesses can develop. Acupuncture treatments can correct these imbalances and directly effect the way you manage stress.

Studies on Acupuncture and Stress

Numerous studies have demonstrated the substantial benefits of acupuncture in the treatment of stress.

A 2008 study published in Anesthesia & Analgesia found that acupuncture point alleviated preoperative anxiety in children while a 2003 study conducted at Yale University showed that ear acupuncture significantly lowered the stress level of the mothers of children that were scheduled for surgery.

A German study published in Circulation found that acupuncture significantly lowers both systolic and diastolic blood pressure. The extent of the blood pressure reductions by acupuncture treatments was comparable to those seen with antihypertensive medication or aggressive lifestyle changes, including radical salt restrictions.

Another study from the University of New Mexico measured the affects of acupuncture on 73 men and women with post-traumatic stress disorder (PTSD). The researchers found the acupuncture treatments to be as helpful as the standard treatment of cognitive behavioral therapy.

Needless to say, if the stress in your life is throwing you off balance, consider acupuncture therapy to regain peace of mind, regulate your immune system and stay healthy.

Miso Soup with Scallions

Did you know that Miso Soup with Scallions is actually an ancient herbal remedy for colds?

In 300 AD famous herbalist, Ge Hong, writes about Miso Soup with Scallions in a book called, Bei ji zhou hou fang or Emergency Formulas to Keep Up One’s Sleeve.

The soup is indicated for the onset of a cold when a person is just beginning to feel a headache, stuffy nose and a slight fever. So, the next time you feel a cold coming on, be sure to have your miso!

Miso Soup (Serves 4)

Ingredients:

* 6 cups water
* 3-4 Tablespoons Aka Miso or red soy bean paste (usually sold in the refrigerated section)
* 3-5 green onions stalks, chopped

Directions:

* Dissolve the miso in a little bit of boiling water (about 2 tsp.)
* Bring water to a boil in a saucepan and add the miso & scallions.
* Simmer for 5-10 minutes.
* Remove from heat top with green onions and serve.

Variations: you can add various other ingredients to make a more substantial soup, such as tofu, seaweed, fresh mushrooms, cooked shrimp, snow pea sprouts, cooked rice noodles, or paper-thin slices of fresh ginger.

Be a Good Friend
Refer someone you know for acupuncture and get $10 off your next acupuncture treatment.

Stress Busting Foods

The foods that you eat play a crucial role in your overall well-being as well as your ability to handle stress.

Over 1400 chemical changes occur as stress hormones, such as cortisone, sap important nutrients such as B vitamins, vitamin C and magnesium from the body.

Here are three foods that can replenish your supply of these nutrients and enhance your ability to manage stress:

Cauliflower – Cauliflower and other cruciferous vegetables, such as broccoli, cabbage, and kale are chock full of stress-relieving B vitamins. Cauliflower is also one of the very best sources of vitamin B5 or pantothenic acid.

Pantothenic acid helps turn carbohydrates and fats into usable energy and improves your ability to respond to stress by supporting your adrenal glands. Fatigue, listlessness, numbness and tingling or burning pain in the feet are all indications that you may need more vitamin B5 in your diet.

Salmon – Salmon is a healthy and delicious way to get your dose of B vitamins and omega-3 fatty acids. Vitamin B12 supports production of red blood cells, allows nerve cells to develop properly and is essential to the synthesis of the “happy” brain chemical serotonin.

Among the many benefits of omega-3 fatty acids, a 2003 study published in Diabetes & Metabolism found that a diet rich in omega-3 fatty acids significantly reduced the stress response and kept the stress hormones cortisol and epinephrine in check.

Blackberries – Blackberries are jam packed with Vitamin C, calcium and magnesium. Vitamin C has shown to be a powerful stress reducer that can lower blood pressure and return cortisol levels to normal faster when taken during periods of stress.

Magnesium and calcium act together to help regulate the body's nerves and muscle tone. When there is too little magnesium in your diet, nerve cells can become over activated and can trigger muscle tension, muscle soreness, muscle spasms, muscle cramps, and muscle fatigue.

Blackberries have more than double the amounts of vitamin C, calcium and magnesium than their popular cousin, the blueberry.

Karen Siegel MPH, MS, RD, LD, L.Ac.
9660 Hillcroft, Suite 202
Houston, TX 77096
713-721-7755
karensclinic@gmail.com

This is to address some great questions about fish oil that Katie sent in.

Katie asked:
after reading about fish oil and its obvious benefits, I finally bought some Carlson Super Omega-3 Fish Oil Concentrate soft gels yesterday at Whole Foods.

I have several questions I have tried to get answered via this site and the Internet, but can't seem to find clear answers, so I am throwing them out here, in hopes you can help.

1. The bottle says"Each Carlson Super Omega — 3 soft gel contains 1000 mg (1 gram) of a special concentrate of fish body oils from deep, cold-water fish which are especially rich in the important Omega-3's EPA and DHA." However, the Supplemental Facts read EPA 300 mg DHA 200 mg Other Omega-3's 100mg. I believe that adds up to 600mg. Right? There is no mention of the other 400 mg. Where are they? I'm very confused about this. Can you explain this to me? There is also Natural Vitamin E — 10 IU…incase that means something.

2. How many pills/mg am I supposed to take? I read between 1000 mg and 3000 mg. Which makes me confused again because even though the bottle says 1000 mg in each pill I can only find 600 of them! I want to make sure that I am taking enough, but not taking too much! How much do you take? Also, do I work up to that or just dive in?

3. Last question…is there anything else I should be taking with the fish oil? I know that sometimes if you take something you need to supplement with something else. Is that the case here?

Thank you in advance for your advice and information!

My response:
Katie, these are really great questions and something that I am often asked by my clients. Here's the scoop:

1. The dosage on the ingredient list can indeed be very confusing and frankly I believe it is a way in which some supplement companies try to give the impression that you are getting a better product with higher potency, but it can be misleading. When the label states something like…"contains 1000 mg marine oil", you are not getting the complete information.

The critical ingredients and the amounts you need to know about are — how much EPA (eicosapentanoic acid) and DHA (docosahexaenoic acid) are contained in each capsule.

EPA and DHA have been shown to support healthy functioning of the cardiovascular, immune, gastrointestinal, and musculoskeletal systems. EPA is also an excellent anti-inflammatory and helpful in conditions such as insulin resistance, diabetes and auto-immune related inflammation.

DHA is an important factor for those with PCOS as it supports many aspects of health including pregnancy, fetal development, and healthy neurological function.

The other"marine lipids" are simply the total fat of the fish, where the EPA and DHA are the active portions of that fat. It is the"actives" that are providing the therapeutic value. The vitamin E in the capsules is for preservative purposes and helps prevent rancidity of the fat.

2. Regarding the dosage you should take, that is a harder question to answer because it will depend on what you are trying to target. Those with PCOS should be targeting anywhere from 500 — 1000 mg. DHA. So you need to know how much DHA is in each cap, for example if the capsule has only 200mg. of DHA, you'll need to take 3 of them to get approximately 500mg. You can then work up to a higher dose, always start with the lower dose and work your way up. Sometimes it is easier to get a liquid version that is high potency versus taking handfuls of pills to achieve the same dose.

I do not recommend that you take a liquid fish oil that is derived from Cod Liver Oil as the source as it usually has a high amount of Vitamin A and it is possible to get toxic doses of vitamin A. Another thing to note is that in a combination EPA/DHA cap, the dosage EPA will usually be higher than the amount of DHA, that is no problem. The EPA will only be of additional benefit.

Don't hesitate consulting with a registered dietitian knowledgeable both in PCOS and supplements in order to have your supplementation tailored to your specific health needs — remember we are all different, with unique physiology, medical history and requirements.

3. Fish Oil does not have to be taken with anything else to enhance its function. It can be taken all at once, with meals, between meals — it is very flexible this way.

Here are a couple of additional tips:

- if you tend to"burp" back fish oil, make sure to buy a brand that comes in an"enterically coated capsule", they might cost a few cents more, but it's worth it.
- refrigerate your fish oil to protect it and this also can help reduce"burp back".
- contributes to creating beautiful, healthy skin.

One last fun fact about fish oil. Most of it actually comes from the southern hemisphere not as you might think from the deep waters off Norway!

Here's to fish oil!

Carmina McGee, MS, RD, LE
Ventura, California
805.816.2629
info@carminamcgee.com

Many of you remember Amber, who had been recording her journey with us here and who helped us out with a segment for ABC-LA. Well, since that time, she has gone back to culinary school. (Go Girl!) She recently shared a report that she wrote about quinoa, and has agreed to let me post it as a guest blog. So excited to see someone with PCOS working in a place where she can have a significant impact!

This ancient grain has many nutritional properties, as it also possesses many universal uses as stated by, Daniel Fairbanks, Ph. D., a professor of plant and animal sciences at Brigham Young University.

“It has about twice the protein of regular cereal grains, fewer carbohydrates, and even a dose of healthy fats.”(D.Fairbanks)

Plus"it is considered a 'complete' protein, which means that, like meat, eggs, and dairy, it packs all of the essential amino acids your body needs
to build muscle.”(Matt Goulding Men’s Health 2007)

Despite its many qualities, until recently, the last fifteen years or so, it has not been a popularly widespread grain. “It has been cultivated in the South American Andes from around 3000 B.C.” (K. Railey) and is claimed to be a staple food, like corn, or rice. “Quinoa is not specifically a true grain, but rather a seed of the Chenopodium or sometimes called the Goosefoot plant.” (D. Johnson, S. Ward) What classifies this as a grain is its culinary use, or the cooking technique used to prepare it. “The Incas believe quinoa to be a sacred grain, planting it each year is done first by the chief with a solid gold shovel.” (K. Railey)

Quinoa grows best in cool arid climates at higher elevations. The plant grows six to eight feet in height and has several angled branches; the flower produces clusters of seeds at the end of a stalk. The greens of the plant resemble that of a goose’s foot, hence the name"goosefoot," and are edible, similar to spinach greens. The seeds or quinoa, are very small, only about a quarter of the size of one grain of rice. They vary in color they can be red, brown, white, or pink and have a nutty flavor when properly cooked.

Attempting to cook the quinoa for the first time it became clear that this little seed is relatively unique in such a way, that when cooking it, the seed’s outer casing peels outward forming into a tail shape. The grain itself is a lot like rice, but the tail creates a crunchy and unique texture. Upon further research of this super grain, I became aware that “the seed when picked has a resin like coating; called saponin” (botanical.com) that rinses off easily. This outer resin'like “coating is of use as a detergent and a topical antiseptic in South America.” (K. Railey)

“The protein in quinoa about 12% to 18% about one cup a day could provide you with the proper amount of protein daily.” (D. Fairbanks) It also contains calcium, and iron and a substantial amount of vitamin E, and several of vitamin B complex, however it does contain a 6% to 7% o fat ratio (considered healthy fats). It has lower sodium content; it contains albumen, is gluten-free and it contains eight essential amino acids. Other grains come close to containing as much protein as that of quinoa but it is only about half the protein levels.

In conclusion, in my research of quinoa, I have found that it truly lives up to its superior qualities in that it has amazing protein levels, vitamin complex, and amino acids all packed into a rather small package. I love that you can use the whole plant, not just the seed and that it possesses medicinal qualities. It has replaced rice, and flour in my home due to its many benefits, and its universal cooking techniques. Since it contains higher amounts of fat and oil, it is necessary to store quinoa, in glass jars in the refrigerator in seed form it can store for up to one year, flour about three months. This super grain can be found at local health food stores, and on – line.

Recipe courtesy of epicurious.com

Yield: Makes 4 servings
Active Time: 5 minutes
Total Time: 30 minutes

Ingredients:
1 cup quinoa (all red or a mix of red, white, or black)
1 1/2 cups water
2 cinnamon sticks
1/4 teaspoon salt

Accompaniments:
Broken or chopped walnuts, pure maple syrup or honey, milk, and flaky sea salt

Wash quinoa in several changes of water in a bowl, rubbing grains and letting them settle before pouring off water (if quinoa does not settle, drain in a large fine-mesh sieve after each rinse), until water is clear. Drain washed quinoa well in a large fine-mesh sieve. Combine all
ingredients in a heavy medium saucepan and bring to a boil, covered. Reduce heat to low and cook, covered, until water is absorbed and quinoa is tender, about 20 minutes. Remove pan from heat and let stand, covered, 5 minutes. Fluff with a fork and keep covered to keep warm. Remove
cinnamon sticks. Divide quinoa among bowls and top with walnuts, maple syrup or honey, milk, and sea salt.

Bibliography

http://www.botanical.com/botanical/mgmh/c/chenop53.html. (2012, March 7). Retrieved March 7, 2012, from http://www.botanical.com: http://www.botanical.com/botanical/mgmh/c/chenop53.html

http://www.menshealth.com. (2012, March 6). Retrieved March 6, 2012, from http://www.menshealth.com: http://www.menshealth.com/nutrition/quinoa

Johnson, Duane L. and Ward, Sarah M."Quinoa". (2012, March 7). http://www.hort.perdue.edu/newcrop/proceedings1993/v2-222.html. Retrieved March 7, 2012, from http://www.hort.perdue.edu:
http://www.hort.perdue.edu/newcrop/proceedings1993/v2-222.html

Railey, K. (2012, March 8). http://www.chetday.com. Retrieved March 2, 2012, from http://www.chetday.com: http://www.chetday.com/quinoa.html

www.epicurious.com. (2012, March 7). Retrieved March 7, 2012, from www.epicurious.com: http://www.epicurious.com:80/recipes/food/Cinnamon-Scented-Breakfast-Quinoa

Someone on our Facebook page recently asked how you cook kale. And she asked at a perfect time, since we've been getting it almost weekly at Chow Locally, and I've been the one who's been curating recipes and techniques to keep our customers excited!

First of all, a bit about kale. It is actually a type of cabbage that never gets around to forming into a head. In this photo you see curly kale, which is one of the more popular kinds, what you often see used to make kale chips. It comes in a variety of colors and leaf shapes, all of which can be enjoyed!

Here are some of the great things kale can do for you.

1. It can lower your cholesterol.
2. It can lower your risk of cancer.
3. It is a great food for detoxification.
4. It is extremely high in antioxidants — over 45 have already been identified.
5. One cup cooked kale has 1328% of your RDA's for vitamin K, 354% for vitamin A, and 89% of vitamin C. And only 36 calories.

Now that is what I call nutrient dense!

For the longest time, I thought kale was just the pretty gray-green curly stuff you used to decorate party platters, but didn't really eat. Then antioxidants were discovered, and kale topped the charts, and people started deciding, maybe they should figure out how to eat it. It can be a bit of a challenge because it is bitter. Unless you are Kitty, who loves raw kale (this is white peacock kale here), it's best to know a few cooking techniques!

Here are some of the easiest ways to enjoy kale.

1. Juice it. There are a bazillion recipes for juicing kale on the Internet. I am linking you to just one here.

2. Massage it and eat it raw. Interestingly, kale's bitter flavor dials back a bit if you chop it, and massage it with some type of oil until the color pops green. Here is a great blog post with three massaged kale salad recipes, along with more ideas (colcannon, which is mashed potatoes and kale, is a recipe I sent to our customers with this week's box.)

3. Saute it. Super easy, as you can see in this recipe!

4. Make pesto with it. One week we got gorgeous purple peacock kale in our boxes, and it intimidated some of our customers. It's the same vegetable, just a different color, and to demonstrate, I made a purple pesto. You can make this exact same pesto with any kind of kale…curly, dinosaur, peacock, Toscano…because it's still kale!

5. Steam/wilt it. This is one of my all time favorite kale recipes, by Rachel Ray, steamed kale with portobello mushrooms. I often make this dinner!

6. Kale chips. This is all the rage right now. I'm giving you the recipe and I encourage you to try this with any sturdy greens you might have available — kohlrabi and beet have worked very well in my kitchen.
7. Braise it. Braising is a way to slow cook and infuse the flavor of a wine, vinegar, alcohol, broth, or other liquid. I just found this great salsa-braised kale recipe while surfing for this post…it is on my list to try!
I hope this gets you started! Let us know how you end up cooking yours!

I just returned from the Natural Products West Expo in Anaheim, California. This show is where companies providing products to health food stores, Whole Foods, etc., bring their information and samples to introduce to buyers. I came home with enough trends and food ideas to keep me blogging until next year's conference! It was really exciting to see the many possibilities for people who want to eat healthier but who do not want to sacrifice taste.

One of the trends was snacks from the sea. I wasn't fond of a lot of them, but one I really loved was the toasted seafood snacks made from nori. Nori is the seafood used to wrap sushi with. It's now becoming popular on its own, for its nutritional value, including calcium, magnesium, potassium, zinc, iron, vitamin A, vitamin E, vitamin K, thiamin, riboflavin, niacin, vitamin B6, vitamin B12, folic acid, and vitamin C. There's even a little bit of DHA, the kind of omega-3 that is primarily found in fish. Those are a lot of the things you hear me writing about here. For you vegans out there, take note of the vitamin B12!

Toasted nori is very much like the kale chips many of you told me you are now enjoying. It's very light and probably not something that would cure a case of the munchies, but crumbled onto salad or into a seafood salad, into soup, or on top of a pizza, they would be a great and tasty way to add nutrition to your diet without having to take yet another supplement. I will say that the type of fat is not the one you see us recommend here, but the amount you are likely going to get in the way I envision most of you eating this, it's not going to be the food that makes or breaks your fatty acid balance.

This product is so new the website listed on their package is not even up yet. For those of you who read this down the road, you will eventually be able to learn more at http://www.jayone.com/.

For now though, these nori snacks are available at amazon.com. Here is the order link for the salted flavor., and there is a sweet flavor to try as well.

If you're a frequent traveler, chances are you have already had an opportunity to experience the new security measures at the airport, which include the new full body scanner.

One of the biggest concerns about this scanner has been the radiation exposure these scanners emit. Because radiation can affect fertility, a concern of many readers of this blog, I did some fact checking.

What is interesting to note is that before these scanners were even in existence, anyone stepping on an airplane was already increasing their exposure to radiation! In a 1998 study published in Aviation, Space, and Environmental Medicine, scientists concluded that an airline captain is exposed to 37% more radiation per year (219 millirem) than a nuclear power plant worker in the same period of time (160 millirem). For the pilot, that is the equivalent to 22 chest x-rays, for the power plant worker, 16 chest x-rays.

The National Institute of Standards and Technology, in an independent study, reported that the average scan with the TSA backscatter x-ray scanner provides 0.0024 millirem of radiation exposure. Meaning, you would have to have 4,000 TSA scans to equal one x-ray. The people at greatest risk for increased radiation exposure from these machines is most likely the TSA workers themselves, who conduct their work in the presence of the scanners for hours at a time.

Bottom line:

1. Your biggest dose of radiation exposure is actually coming from the time you spend on the airplane at altitude, not the short amount of time in the scanner.
2. If you are a pilot, flight attendant, or frequent flyer with concerns about fertility, it certainly is a good strategy to start being more diligent about your intake of antioxidants. I've listed the important ones below that are consistently recommended as cancer fighters.
3. If you are a reporter researching the scanner issue, instead of scaring travelers, perhaps the more relevant issue is why TSA is not requiring its employees to wear dosimeters to be sure their own exposure over time is not an occupational risk. It might also be a very quick way to identify a machine that is malfunctioning and exposing flyers to unnecessary additional radiation.
4. Flight crews and TSA employees might want to consider packing their bags with more fruits and vegetables. Especially since these are not items commonly available in airport food courts.
5. In addition to the standard security questions TSA members should ask for your 24 hour diet recall to be sure you're sufficiently protected for your flight. (Couldn't resist that one…just KIDDING!)
6. For our specific population most likely reading this post, I strongly recommend you discuss your travel strategy with the appropriate caregiver if you have a history of cancer, are in the middle of infertility treatment, or have a history of sexual abuse. It's best to know what choices are most appropriate for your personal situation before standing in the TSA line.

So if you're heading home at altitude for Thanksgiving, consider that the broccoli, cranberries, and sweet potatoes (even a small extra sliver of pumpkin pie) aren't all that bad if you're going to have seconds. Enjoy them, as well as your family.

BEST ANTIOXIDANTS FOR COUNTERING RADIATION

Vitamin C parsley, broccoli, bell pepper, strawberries, oranges, lemon juice, papaya, cauliflower, kale, mustard greens, and Brussels sprouts.

Vitamin E mustard greens, chard, sunflower seeds, turnip greens

Vitamin A carrots, sweet potatoes, pumpkin, spinach, beef, collards, kale, turnip greens, beet greens, winter squash

Lutein and Zeaxanthin kale, spinach, turnip greens, collard greens, romaine lettuce, broccoli, zucchini, garden peas, Brussels sprouts

Proanthocyanadins apples, cinnamon, cocoa, grape seed, grape skin, red wine, cranberry, black currant, green tea, black tea, and chokecherry.

Selenium button mushrooms, shiitake mushrooms, cod, shrimp, snapper, tuna, halibut, calf's liver, and salmon.

Lycopene tomatoes, pink grapefruit, watermelon, and guava

Greek yogurt is all the rage these days. Are you missing something by not eating it?

Yes…and no.

This dairy treat is popular with consumers because it's thicker and creamier than regular yogurt. Nutrition experts like it because it is higher in protein. That, for PCOS is something to look for in foods.

Before you jump on the bandwagon, however, consider a couple of things.

Greek yogurt is made by straining out the water to make it thicker. In the process of straining, calcium leaches out into the water that is strained and discarded. This means that its calcium content tends to be lower.

Greek yogurt also doesn't contain vitamin D, a vitamin that is increasingly being found to be deficient in women with PCOS. I personally checked all major brand labels (Fage, Oikos, Chobani, and several other lesser known options) in the store to verify this, and unfortunately, not a single one is fortified with vitamin D.

So if you're using Greek yogurt as your dairy choice for the day, and you're assuming it's a good source of calcium and vitamin D, you're selling yourself short.

Fortunately, if you love Greek yogurt and you have a few minutes of time, the problem can easily be solved. It turns out, it's fairly easy to make Greek-style yogurt from regular, vitamin-D fortified yogurt! All you need to do is strain the regular yogurt with a cheesecloth. Here are the directions, with pictures.

Here is a list of yogurts that DO contain vitamin D. My recommendation is to stick with plain in order to keep the sugar content low. Also, to consider a low-fat rather than a non-fat version. Researchers have found that if only one of your dairy choices a day contains fat, you tend to increase your fertility.

If you want to, you can even save the liquid you've drained off and include it in smoothies--thus recapturing the calcium and the whey protein that's been drained off in the straining process.

Bottom line--don't assume that because yogurt is a dairy product that it is the exact nutritional equivalent of milk. And don't get caught up in the hype, and assume that Greek yogurt is automatically your superior choice.

There is a lot of demand for milk alternatives, for a lot of reasons. Some of you are lactose intolerant or have tested positive to a dairy allergy. So I wanted to compare the alternatives for you, if you fall in either of these categories, to give you some facts on which to base your personal decision.

Before I move on to milk alternatives, a word about cow's milk.

I'm not pro- or anti- cow's milk. I simply want you to have the facts about all of your options and base your decisions on facts. Much of what is said about cow's milk is personal opinion, not based on peer-reviewed evidence. In fact, there is not a single peer-reviewed article in the National Library of Medicine database even mentioning any kind of relationship between PCOS and cow's milk.

What IS found in that database, is a study I often cite, written in part by respected Harvard researcher Walter Willett, in which it was reported that women who consume one fat-containing serving of dairy a day were actually more fertile than those who did not. The statistics used to evaluate this relationship were derived from data obtained in the Harvard Nurses' Health Study II, from 18,555 registered nurses over a period of 8 years. Those are pretty impressive credentials! So I find the conclusions to be worthy of your consideration. Keep in mind, these women were not advised to change the type of milk they drank, so they were not steered toward raw milk, organic milk, or any other variation. They were most probably drinking plain milk you get from the corner grocer.

The researchers corrected for vitamin D and lactose, meaning vitamin D and lactose in the diet in the millk drinkers was NOT the explanation for this finding. In their words, their conclusion was this: "High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk."

If you've been avoiding cow's milk and vitamin D supplementation isn't doing the trick for your vitamin D levels, I strongly encourage you to consider a second reason for drinking cow's milk. If you've been eating yogurt assuing it's an appropriate substitute for milk, it's not. Most yogurts do NOT contain vitamin D. Try switching to milk (at least 1%) and see if it makes a difference.

For those of you drinking milk, I'd like to encourage you to consider antibiotic, hormone-free, organic, grass-fed. It's not something that is readily available (many organic brands are not grass-fed), but keep your eye out for it and grab it when you see it.

Like I said, I don't care if you do or don't drink milk. I just want to be sure of two things:

1. That your choice to drink or not drink cow's milk is based on fact and not on someone else's opinion who may not have a handle on YOUR personal physiology. Every single case of PCOS is different and it is not clinically sound for anyone to make a blanket recommendation about milk to all women with PCOS.

2. That if you choose to drink cow's milk, you know what kind is most supportive of hormone balance, and if you choose not to drink cow's milk, you know what adjustments you need to make to your overall diet in order to make up for deficiencies that eliminating an entire category of foods may be creating.

On that note, tomorrow I'll summarize the pros and cons of milk alternatives.

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!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

*****WE INTERRUPT THIS BLOG POST FOR AN IMPORTANT ANNOUNCEMENT***

So excited to announce that starting this week, the Nutrition 101 series will be co-written in conjunction with PCOS Diva Amy Medling, of Nashua, NH. Amy, a professional health coach, is currently completing the inCYST training. She also loves to cook, and has a great series on her own blog with a week's worth of menus. You all are always asking for those, so I like that Amy likes so much to take the time to prepare them. The theme in her menus will be the nutrient I feature over here. It's so fun to see what she did with this first round…and I like that you get suggestions more diverse than what I would eat myself. Increases the likelihood that you'll find something between both blogs that works for you.

OK. Back to what I was saying about riboflavin.

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Riboflavin is my favorite vitamin. Not for any nutritional reason, but because in my senior year of college I was lucky enough to work in renowned nutrition researcher Daphne Roe's laboratory, as a lab assistant for a riboflavin study. I was one of the people who prepared the food for female subjects in a study evaluating whether riboflavin requirements increase with increased activity (turns out they do).

It was a most unique job, because riboflavin is destroyed by ultraviolet light. In order to keep it stable to increase the accuracy of the experiment, my entire work shift was spent weighing and measuring all of the subjects' food IN THE DARK. Yes, for a semester, I dished out rice and poured milk with the shades pulled and the lights out.

As you can see in the bio I linked to, Dr. Roe was highly intelligent, hugely curious, and very high energy. She completely intimidated many of her students, as she loved the Socratic method and thought nothing of stopping midlecture, looking a student straight in the eye, and asking their opinion on the subject of the day's lecture. It is in her class that I developed a keen ability to avoid eye contact and feign complete focused interest on the notepad on my desk.

I was so very fortunate to be able to work side by side with Dr. Roe, because I had the honor of seeing her other side, that of someone who was intensely curious about problems affecting real people. She had questions she needed to answer, and did her best to do that. She didn't have patience with messing around, because she had important things to do. It is because she was an MD (a practicing dermatologist of all things!) that I become somewhat impatient with physicians who do not appreciate or take the time to understand solid nutrition principles. Sorry guys, Dr. Roe set a very high standard. It would serve you well to follow in her footsteps.
(On the flip side, I do my very best to work well with those who DO appreciate nutrition, like our own dermatologist, Dr. Van Dyke, who took time out of her busy schedule to take our training, much of which is not directly related to her personal medical specialty.)

I love riboflavin because by the end of the study I hated the tedious work so bloody much I decided I never wanted to be a researcher. BUT…I also gained such an appreciation for people who have the capacity to think about those questions and piece together the details of such a study to get answers that make the world a better place. I credit Dr. Roe for planting the very first seed of the inCYST Institute in this college senior's heart.

And since you all are working to increase your activity level, it's important that you benefit from Dr. Roe's research on the influence of exercise on how much riboflavin you need.

If you're vegetarian, vegan or dairy-free, be sure and take the time to analyze your diet to see how you measure up with this vitamin. You may be falling short.

Got milk? That's a good start.
Look for the following in your next shopping trip.
asparagus
popcorn
bananas
persimmons
okra
Swiss chard
Cottage cheese
Yogurt
Meat
Eggs
Fish
Green beans

Thanks, Dr. Roe, for all of what you did that rubbed off on me. I was pretty humbled by your presence and am grateful for your passion and enthusiasm for instilling excellence in budding nutrition experts like myself. I hope if you're looking down on your students, like me and fellow classmates and researchers Valerie Duffy at the University of Connecticut, and Karen Parfitt at Pomona College, you're smiling. You laid the foundation for many professional passions and successes.

Belko AZ, Meredith MP, Kalkwarf HJ, Obarzanek E, Weinberg S, Roach R, McKeon G, Roe DA. Effects of exercise on riboflavin requirements: biological validation in weight reducing women. Am J Clin Nutr. 1985 Feb;41(2):270-7.

Sadly, I need to use my blog to retract a post I put up a few months ago, because as information surfaced, the product I thought I had pretty thoroughly researched turned out not to be what I thought it was.

The product is green tea, or camellia oil, sold by Steven Frenzl of Bien Padre Foods.

I actually think the product itself is a good cooking oil, and I like some of the minor effects I've seen on my skin.

But Steve sent me a product information statement saying it contained vitamin A, which it turned out, it did not. He also told me it contained EGCG in higher amounts than green tea, and it turns out it has none.

More troublesome to me is that Steve has a very bad habit of recommending his oil for any and all kind of skin problem. He has diagnosed problems over the Internet and made recommendations. Some of his dietary recommendations for internal dosing encourage a consumption of oil that exceeds current recommendations for health, which I was very explicit about telling him. When he's gotten in over his head with his advice, he's referred them to me. Multiple times I told him this was not appropriate and it was practicing medicine without a license. I am not even a physician.

He did acknowledge to me that he was in some kind of trouble with the state health inspector. I told him I would no longer sell his product, and that I did not wish to have any kind of communication with him unless he could produce papers proving he was square with them.

He emailed me yesterday, without any such proof, but saying the following.

Nevertheless, despite the absence of the anti-cancer compound, there are still other significant health/wellness beneits I have discovered recently.

Last week I slipped while stepping into the shower and struck my shin hard on the side of the tub. Instant tear-producing pain and a welt that immediately swelled to the size and shape of a walnut. I quickly massaged oil into the injury and felt nearly immediate relief. The swelling disappeared within the hour--and I have yet to see a bruise. Normally, after an injury like that, I sport a bruise that lasts a month. I have applied the oil just once since the incident last week just as a precaution-- the effect of the oil on the injury is surprisingly long-term.

Another experience. Recently I have noticed dark bags under my eyes (nope, I can't be getting older) when I stare at that ugly mug in the mirror early every morning. So last month I started massaging a few drops of oil into the skin under each eye before bed each night. Now the sagging skin and dark color are both gone. Very cool.

I have told him if his product truly is this magical, he needs to back up these claims with clinical testing, and that science will support his observations.

I've also initiated proceedings for a formal complaint to the FDA.

That is likely to take awhile, so in the interest of protecting anyone from these business practices, I am using my blog to get the word out.

I am sorry I misled anyone. I've removed the original blog post and hope when Steve finds this, he'll learn that it's important to listen to people when they say no.

If Steve invests in the clinical testing and can show that his product really is a magical and powerful as he's claiming, you'll see it here first on the blog. Until then, beware.

I've written about this before, but wanted to revisit the topic since our network member Lesli Bitel-Koskela of Harmonic Nutrition just sent me a new study reinforcing the importance of vitamin D for fertility. The study Lesli sent is nice, because both the test and control groups were on metformin. That means the results reinforce that you can't give up on good nutrition simply because your physician has scripted a medication. Nutrition and medicine are not either/or options; they are important to use together in order to achieve their maximum effect. One hundred women with PCOS who had not been able to conceive, when given calcium and vitamin D supplements, lost weight, improved menstrual regularity, and had improved follicle quality and fertility. When the study started, 83% of the women studied had a measurable vitamin D deficiency; 35% of these women were rated as"severely deficient". After treatment, 74% of the women had normal vitamin D levels. I cannot reinforce enough; if you are pursuing infertility treatment, and your physician has not ordered a vitamin D level, s/he may be missing a crucial part of the puzzle. Demand it. It is relatively inexpensive, and may save you a fortune in infertility treatment. Firouzabadi RD, Aflatoonian A, et al. Therapeutic effects of calcium & vitamin D supplementation in women with PCOS," Complement Ther Clin Pract, 2012 May; 18(2):85-8.