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

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.

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.

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.

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.

I recently blogged about Greek yogurt, and how most major brands contain no vitamin D. Given the realities that many women consider yogurt to be a nutritional equivalent to milk, and vitamin D is increasingly being recognized as a factor in PCOS and other health issues, this is a really important thing to know. I have become increasingly frustrated with the amount of nutritional advice encouraging Greek yogurt consumption without mentioning this.

Last night I noticed that Yoplait has come out with its own Greek yogurt, containing twice the protein of regular yogurt and 20% of the recommended Daily Value for vitamin D. I would strongly recommend going with the plain version and adding fruit to sweeten it, to avoid excessive added sugar, but otherwise, it's probably the best Greek yogurt out there for anyone who is concerned about their vitamin D levels.

If you go to the link above, you can get a coupon you can use when you try it, too!

Enjoy!

This past Wednesday, Sasha Ottey of PCOS Challenge interviewed Walter Futterweit, MD, a longtime PCOS researcher and advocate. He provided a great summary of the laboratory tests you should be getting and why. I'm providing that summary here.

If you'd like to listen to the interview with Dr. Futterweit in its entirety, please visit Sasha's Blog Talk Radio page.

Adrenal hormones--these test rule out an adrenal problem, necessary to do to be sure it's actually PCOS

17 hydroxy progesterone (drawn between 5 and 9 of a menstrual cycle)--rules out the diagnosis of nonclassic congenital adrenal hyperplasia.

(Normal levels are 15-70 ng/dl prior to ovulation, and 35-290 ng/dl during the luteal phase. )

DHEAS (dehydroepiandrosterone sulfate)

Typical normal ranges, according to NIH, for females, are:

•Ages 18 — 19: 145 — 395 ug/dL
•Ages 20 — 29: 65 — 380 ug/dL
•Ages 30 — 39: 45 — 270 ug/dL
•Ages 40 — 49: 32 — 240 ug/dL
•Ages 50 — 59: 26 — 200 ug/dL
•Ages 60 — 69: 13 — 130 ug/dL
•Ages 69 and older: 17 — 90 ug/dL

Prolactin levels, which rule out a prolactin producing tumor, as well as the effects of some medications such as Risperdal, which can elevate prolactin levels

•Non-pregnant females: 2 — 29 ng/mL

•Pregnant women: 10 — 209 ng/mL

Tests to monitor thyroid function

T4

A typical normal range is 4.5 to 11.2 micrograms per deciliter (mcg/dL).

TSH

Normal values are 0.4 — 4.0 mIU/L.

SHBG (sex hormone binding globulin) — helps to evaluate how much of your testosterone is bound/inactive and how much is free and available to cause androgen-related symptoms.

Normal values:

Follicular phase of menstrual cycle 24 — 200 nmol/L
Luteal phase of menstrual cycle 48 — 185 nmol/L
Contraceptive use 89 — 379 nmol/L
Postmenopausal 46 — 200 nmol/L

Insulin function

Fasting insulin level
Normal values: less than 13 mIU/ml

2 h glucose tolerance test
Depends on the laboratory's protocol. Typical values can be found at the link directly above.

*****************************************************************************
Dr. Futterweit did not mention vitamin D testing but since low vitamin D levels are commonly found in women with PCOS, I'd recommend that as well.

25-hydroxy vitamin D

Normal levels are 30 — 74 ng/ml

I don't know about you, but mushrooms just aren't my top priority when I'm writing my grocery list. They're fungus, right? They just can't have much to offer with regards to nutrition, with that neutral color and different texture!

Was I ever wrong! Last week I learned that mushrooms contain two nutrients with healing potential for women with PCOS. They contain chromium, a metal that can be helpful with cravings. You may have read earlier on this blog, chromium in large doses may damage DNA. So the wiser choice may be to include foods in your diet that provide this metal in a dose that Mother Nature has provided.

Mushrooms, surprisingly, also contain vitamin D! It's one of the few non-animal sources of this vitamin, so vegetarians take notice! Your pizza is a great place to sneak in some 'shrooms. You may have read that some mushroom producers are experimenting with a technology to increase the vitamin D content of mushrooms using light exposure. Even if you get the regular button mushrooms at the store that have not been processed in this fashion, they'll still contain vitamin D.

I spent last night looking at how different mushrooms vary in nutritional value. Regardless of what the type…portabella, shiitake, button…there was something valuable about each and every one of them.

So put them in your omelets, add them to your salads, toss them into your pasta sauce! Mushrooms, for PCOS, can be pretty marvelous!

If you'd like more specific help planning menus including mushrooms, our new inCYSTem menu planning/coaching program features mushrooms this coming week. If you sign up before October 23 and help us beta test this program, you pay half price ($7.50 for a month of ongoing menus and can continue to subscribe at that price for the following 5 months). Contact me directly at marika@google.com for more information.

Since we talk so much about the importance of fish oil for women's health, we get forwarded articles and studies from colleagues who'd like to know what we think.

Late last night, Minh-Hai Tran forwarded me an article entitled,"Healthy and Pregnant: Forget the Fish Oil".

The hairs on the back of my neck immediately prickled on seeing this title…knowing the potential for confusion this could cause with readers like ours, who've heard us talk so much about an opposing viewpoint.

Here's a closer look at what the article says and how it fits into our treatment model.

I've always followed the guidelines established by the International Society for the Study of Fatty Acids and Lipids (ISSFAL) when evaluating studies and formulating recommendations. Here are their recommendations, right off of their website. I comment on the current study's accommodation of these recommendations in italics below each item.

1. Dietary fat intake during pregnancy and lactation, as a proportion of energy intake, should be the same as that recommended for the general population.

I was not able to find if there was any standardization of diet during this study. This is a common error in study design when evaluating the effectiveness of a supplement. Any added chemical in any study is going to respond differently, depending on the biochemistry of the environment into which it is introduced.

The pre-pregnancy weights of the women in the study were not mentioned, either. I would imagine that this would potentially affect the outcome of the study.

2. The n-3 LC-PUFA, DHA, must be deposited in adequate amounts in brain and other tissues during fetal and early postnatal life. Several studies have shown an association between maternal dietary intake of oily fish or oils providing n-3 LC-PUFA during pregnancy and/or lactation and visual and cognitive development as well as other functional outcomes of the infants.Pregnant and lactating women should aim to achieve a dietary intake of n-3 LC-PUFA that supplies a DHA intake of at least 200 mg/d. Intakes of up to 1 g/d DHA or 2·7 g/d n-3 LC-PUFA have been used in randomized trials without occurrence of significant adverse effects.

It appears from the comment of the lead researcher that a dose of 200 mg DHA per day is what was used in the study. Our experience at inCYST is that it can take significantly more DHA than that to see benefit. This is especially true if the diet in which the supplement is included is high in omega-6 fatty acids, which interfere with omega-3 activity. The study size is large--around 2,400 women, which would have given these researchers an opportunity to collect dietary intake data and evaluate if there were different results in women whose diets were high in omega-6 fatty acids vs. those which were higher in omega-9 fatty acids. Huge opportunity lost, and important advice for anyone currently putting together any kind of study regarding omega-3 fatty acids. The entire diet, not just the dosed supplement, is important to standardize and measure.

I would have been interested to see various levels of DHA--200, 500, 750, 1000 mg, to see if the same results resulted. Using the lowest dose possible is going to be the treatment least likely to produce positive results.

3. Women of childbearing age can meet the recommended intake of DHA by consuming one to two portions of sea fish per week, including oily fish, which is a good source of n-3 LC-PUFA. This intake of oily fish rarely exceeds the tolerable intake of environmental contaminants. Dietary fish should be selected from a wide range of species without undue preference for large predatory fish, which are more likely to be contaminated with methylmercury.

I agree, that there may be more to this issue than DHA. For example, much information is coming out about the importance of adequate vitamin D for reproductive health. Is it the fish oil or the vitamin D in the salmon…or the interaction between the two that is important? Future studies need to separate out and explore these questions…in the presence of a controlled diet.

Intake of the precursor, a-linolenic acid, is far less effective with regard to DHA deposition in fetal brain than the intake of preformed DHA.

5. There is no evidence that women of childbearing age whose dietary intake of linoleic acid is adequate need an additional dietary intake of arachidonic acid.

This was not a concern with this study.

6. Some studies have shown that maternal intake of fish, fish oils or n-3 LC-PUFA results in a slightly longer duration of gestation, a somewhat higher birth weight and a reduced risk of early preterm delivery. The clinical importance of such effects with regard to infant health has not been fully elucidated.

This finding was confirmed in the new study. I look forward to future studies understanding why.

7. Screening for dietary inadequacies should be performed during pregnancy, preferably during the first trimester. If less than desirable dietary habits are detected, individual counselling should be offered during pregnancy as well as during lactation.

It does not appear that individual omega-3 fatty acid status was evaluated in the women in the new study. So if the women were deficient, a low DHA dosage likely would not have been enough to elucidate a treatment response. If the women had adequate DHA in their tissues before coming pregnant they likely would not have experienced a treatment response.

All due respect to the well-intended researchers, some important aspects of study design were not incorporated, limiting the conclusions that can be drawn from this study. I hope they include a dietitian in future studies.

All due respect to MSNBC, please consider the damage and suffering you potentially inflict on women who could drastically benefit from a simple dietary intervention, on behalf of titling an article purely with SEO (search engine optimization) in mind. Post partum depression is a serious disorder, hurting many others in addition to the woman whose biochemistry produces it.

I was just provided a copy of The Art and Science of Low Carbohydrate Living by Jeff S. Volek, PhD, RD, and Stephen D. Phinney, MD, PhD. Knowing how many of you are leaning toward low carb eating in an attempt to pull your hormones back into balance, I figured this would be an important book to review.

Two very important issues to consider that may preclude your even needing to read the entire review.

1. This book advocates for ketosis. While there may be times in your life where ketosis might be something to consider pursuing (which I will cover in tomorrow's post), it has not been reported that a ketotic state in a mother is safe for the baby she is pregnant with. Therefore, if you are trying to conceive, or are pregnant, or are not trying to conceive but might become pregnant, I do NOT, repeat, do NOT, advocate that you follow this diet. The word pregnant did not appear even once in this book and I do not believe this was a consideration of the two male authors who wrote it. Reader beware.

2. I used two of the menu plans in the back of the book for diet analyses. I came pretty close to the total calorie, as well as protein/carbohydrate/fat breakdowns they listed. Both days I analzyed came up short. Day One was deficient in fiber, vitamin D, and iron.

Day Two was deficient in pantothenic acid, iron, calcium, vitamin D, and vitamin C.

I think the basic premise of the book, that fewer refined foods are better, is something most people would agree with. I actually think that be it vegan, raw, paleo, or low carb, advocates of each of these ways of eating are trying to say that less processing is better. They then frame it in a way of eating that makes the choices easier. In each case, however, when taken to extremes, the diets become unbalanced and potentially deficient.

The whole time I was reading this book, the words of my grad school statistics professor were on my mind. He used to always say,"If you torture the statistics long enough, they will confess whatever you want them to."

These scientists were able to prove that an extreme diet accomplished a counterintuitive effect. I won't deny that. However, I had the sense in reading the book they were so singluarly focused on proving that point, they forgot about the big picture, namely balanced nutrition. I'm on board with much of what the book says. But you can't throw out all vitamin, mineral, and pregnancy recommendations just because you proved one singluar point.

inCYST nutrition is very high liability nutrition. We are not just making recommendations for Momma. Baby (and in many cases, especially those of you undergoing IVF, multiple babies) is at the mercy of what we say as well. In this case, I felt very uneasy with what I read. If the authors were willing to take the time to do research on pregnant women, I'd be willing to listen to what they have to say. In the meantime, it feels like at the very least they should have provided a disclaimer for this population to protect themselves.

Because that was neglected in the spirit of demonstrating that bacon, meat, and ice cream are ok to eat, for inCYSTers, this book does NOT get a recommendation.

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

The primary problems with these alternatives are:

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

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

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

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

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

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

All information is for an 8 ounce serving.

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

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

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

FLAX MILK

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

Flax USA Flax Milk

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

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

Living Harvest Hemp Milk

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

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

OATMEAL MILK

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

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

HAZELNUT MILK

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

Pacific Foods Hazelnut Milk

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

COCONUT MILK

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

Regular Canned Coconut Milk

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

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

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

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

RICE MILK

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

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

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

Rice Dream Rice Milk

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

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

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

I finished up my nutrition education during the height of cholesterol phobia/low fat mania. The message we were taught to teach about egg yolks dies hard.

Several years ago colleague Susan Kleiner, Ph.D., R.D., shared in a presentation I attended, that there really isn't hard research that shows, without a doubt, that eating egg yolks increases cholesterol. Neither is there really evidence to show that removing egg yolks from your diet reduces cholesterol. Other dietary choices, such as the ones we teach on this blog, are far more effective at normalizing your blood lipid tests.

Eggs are such a cheap, easy source of protein. Scrambling them with vegetables is my favorite way to clean out my vegetable bin.

If you're trying to increase and maintain your vitamin D levels, keep in mind that it is found in egg yolks. And the levels of vitamin D in egg yolks, according to the US Agricultural Research Service, is higher than thought. Each large standard egg contains 41 IU.

If you're still not convinced and questioning, consider that this same analysis showed that the amount of cholesterol in eggs is 14% lower than previously reported, 185 milligrams per egg.

Egg yolks also contain choline, the precursor for acetylcholine, the neurotransmitter involved in memory. It's not easy to find in food…if brain fog and memory are problems your PCOS has brought you, perhaps rethinking your relationship with egg yolks could be helpful.

I'm not sure what the change is, perhaps farmers have been changing the composition of poultry feed in response to the dietary concerns of their customers.

Whatever it is, I'm hoping the new results in a few more egg yolks showing up on diet diaries I review here in the office!

I love blueberries. And recently they've gotten a lot of press, making practically every nutritional top ten list for their antioxidant content. Even so, it's always bothered me a little that they're not the most sustainable choice for someone like me, living in the desert, far from any blueberry farm. So I've been in search of alternatives that might be more logical choices when blueberries are not in season, and for people who do not live where blueberries are cultivated.

A few weeks ago I was excited to learn that hibiscus contains the same anthocyanins as blueberries. It's a popular tea here in the desert, and I've begun to ask for it in coffeehouses and restaurants.

Yesterday, on behalf of a reader living in the Netherlands who posted that she was looking for good teas over there, I looked up rosehips, a popular tea in Europe. And bingo! They contain anthocyanins as well. They also contain twice the daily recommendations for vitamin C, another powerful antioxidant.

Rosehips are readily available in Europe and the United States. They were popular with Native Americans in their cooking. Supports my"big picture" theory that if you are knowledgeable about local foods, you can often find the essentials right in your backyard. No need to import expensive foods from exotic locations in order to eat completely.

Plus, you can use hibiscus and rosehips teas while managing the overall carbohydrate content of your diet more effectively than you could eating large amounts of fruit. (Not that fruit is bad, it just needs to be consumed with respect.)

Interestingly, one reference I found described a rosehips-hibiscus tea that I'm interested in…that would definitely be a find for my suntea collection!

An interesting note, several places on the Internet mentioned that rosehips contain vitamin D, but I have not been able to find credible references to verify that. You'll best insure good vitamin D balance if you include other foods for that nutrient.

Source: Uploaded by user via Monika on Pinterest

I was asked by one of our readers (who happens to also be my dear cousin Susan), if there was anywhere on the Internet, a checklist for vegetarians to follow to be sure their diet is complete. Her pretty exhaustive research found nothing really practical for meal planning.

So in response to that, and knowing that a very high percentage of our own readers are vegetarian, I put something together. Please let us know if it needs refining or detail, so that we can make this as practical as it can possibly be.

There are five main things to attend to. All of them are important, but I ordered them in the way I look at them when planning a vegetarian meal for myself.

1. What is my protein source and how much of it do I need to truly give me enough protein?

Here are your goals based on the number of calories you eat. This will make 30% of your calories protein, which will help to fight insulin resistance.

1200 calories 90 grams
1300 calories 93 grams
1400 calories 95 grams
1500 calories 98 grams
1600 calories 100 grams
1700 calories 103 grams
1800 calories 105 grams
1900 calories 108 grams
2000 calories 110 grams

2. Where is my vitamin D coming from, and have I had enough? You will have to make a very conscious effort to get enough of this vitamin. With regard to whole foods, mushrooms are pretty much the only vitamin D-containing food. With regard to vegan milk alternatives, beware. Most are so low in protein, they are more accurately thought of as juices rather than milks. If you choose to drink them you will need to find other ways to meet criteria nu,ber one above. I blogged about
this in detail not too long ago.

3. Are my fats healthy? If your definition of vegan is primarily not eating meat, and you are eating a lot of packaged, processed, prepared, or baked food…be extra sure you are not inadvertently letting the pro-inflammatory fats sneak in. Remember, they tend to begin with the letters"s" and" c" — soybean, safflower, sunflower, sesame, corn, cottonseed. (Canola is the exception.). Vegans are often blindsided here with salad dressings, baked goods, cookies, and chops. Read your labels--as much as I love Whole Foods, their entire snack food aisle only has a handful of choices you can bring home if you follow this rule! Good fats include olive and organic canola.

4. Am I getting DHA and EPA (marine omega-3)? Yes, flax, green veggies, and other foods contain omega-3, but the conversion rate is not high. You will need to find a marine algae supplement to be sure your intake of these two essential fatty acids is adequate. InCYSTer Chris Marquette found one that is not genetically modified; look for it next time you shop.

5. Am I getting enough fruits and vegetables? Ideally, these should be the vast majority of what you eat. I am surprised at how many vegans I know who do not like vegetables! You should be aiming for 2-3 1/2 cup servings PER MEAL. Beware of juicing; it is a great way to get in large volumes of fruits and vegetables…BUT…the carbohydrate to protein ratio is not going to help reduce insulin resistance. Make a smoothie out of your juice with your favorite protein powder.

Of course, you can take supplements to make up many of these deficiencies…but if your solution in more than one of these categories is a supplement, I challenge you to consider why you do what you do. The true definition of a vegan is someone WHO MEETS THEIR DAILY NUTRITIONAL NEEDS without using animal-based food to make it happen. If all you have done is remove animals from your diet, you are simply a picky or misinformed eater.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

They're all tasty ways to include mushrooms in your diet.

Earlier this week, Christine Marquette mentioned high vitamin-D mushrooms in her radio interview. I wanted to give you more information if you're vegan and looking for a way to increase your dietary vitamin D intake.

Check out the Monterey Mushroom website for nutrition information, recipes, and where to buy them.

As I mentioned when talking to Christine, I wasn't a big mushroom fan for a long time. Then I realized they had a lot of nutritional benefit. They're so easy to add to a lot of your already favorite foods.

It is so much easier to eat well when it tastes good!

Hello everyone, we have so many new people coming to us through Twitter and Facebook, asking what our diet and exercise recommendations are, and then when they come, they are faced with a tremendous task of plowing through hundreds of blog posts I promise I will better organize in 2012…I thought I would summarize what we stand for and what we don't stand for.

If you ever hear differently from anyone in our network, I do need to know. The goal of building a network is to know what our non-negotiables are that we all stand for, and then let each individual network member use their creative talents to make it happen in your life.

Here goes.

1. We do not believe in a one-size-fits-all diet, exercise, or lifestyle prescription for PCOS. That means that while some of you may learn that you are gluten intolerant, we do not recommend that all women with PCOS refrain from eating gluten. While some of you may benefit from running, others may find that another form of activity is going to work better. We believe in creating a set of recommendations that are personally relevant to your own situation, biochemistry, likes, and dislikes. We are not out to create an army of Stepford cysters!

2. We do not advocate for any one type of diet. We choose to honor your own personal food religion, be it vegan, Paleo, low glycemic, raw…whatever…and assist you with understanding what choices you need to make that honor both your food religion and your biochemical nutritional needs. It's about how to be complete, not which is the best way to be complete. Only you know what works best for you.

3. Put another way, we do not advocate for eliminating large categories of foods (gluten-containing, dairy, meat, cooked) unless we see that there is a genuine, medically-indicated reason for doing so.

4. We believe that PCOS does not respond to extremes of any kind. Extreme calorie restriction, extreme exercise participation, extreme dependence on medication, extreme dependence on supplements. Managing your PCOS is entirely about balance in all of those departments. Our job is to show you how to achieve that balance.

5. We believe that nutrition and exercise can be as counterproductive to your health as not pursuing them. Overzealous dieting and overtraining are as harmful to your hormone balance as are overeating and not exercising. Anyone who tells you that you're simply not dieting hard enough or not exercising hard enough…has not taken the time to study what PCOS is about, and they are running the risk of encouraging you to layer yet another inflammatory condition on top of the tangled hormone web that is already in place. We will never endorse that approach.

6. Some things we do know: Women with PCOS tend to be vitamin D deficient, they tend to have an imbalance in dietary omega-6's and omega-3's, and they often have food sensitivities. But those are factors that can be clinically tested. Your physician can do the vitamin D testing. The omega-3 balance is a home-administered test we can set you up with at inCYST. Food sensitivities can be tested as well, through one of the many inCYSTers who is also LEAP-certified.

7. We believe that PCOS is a generalized inflammatory syndrome. But each woman's core source of inflammation is completely unique and different than every other woman's. We encourage that you invest in a comprehensive consultation to help determine what factors are most important for you. If you try to follow every piece of advice that every person on the Internet tries to give you…you're going to be able to follow it for about 3 days before you run out of money, time, and energy. We're here to help you sort through the information and decide which is relevant to your personal situation.

8. We believe that the main issue is not that there is not information to help your case, but that for whatever reason, you've given up on believing that it can work for you. We're committed, through our research institute, to understanding the physiology and psychology of that resignation so we can work to break through it and motivate you to try things that actually work. (We've knocked a lot of women up! I promise!)

I know there's no secret recipe here, but that is because everyone's recipe is different. Just like my mother's potato salad has bacon and mayonnaise in it, and I adjust mine to include turkey bacon and Greek yogurt…you each are going to have your own recipe for success. To settle for a blanket recommendation, is to accept that you are not unique and special. We simply do not believe that.

Hope this helps, and I hope you take advantage of the incredible knowledge and expertise of the experts who have taken the time to learn as much as they can about PCOS so they can help you chart your course through the haze and maze.

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