Polycystic Ovary Syndrome: Diet Therapy

Polycystic ovary syndrome (PCOS) is the most common female hormonal disorder, affecting approximately 5%-10% of all females. PCOS is a hormonal disorder that involves multiple tissues and organ systems within the body, and is believed to be fundamentally caused by insensitivity to the hormone insulin Diet and Nutrition play a large role in treatment of this disorder, and food is medicine in this disease state. Registered Dietitians can help to maintain weight, and alleviate some of the symptoms by adjusting diet and lifestyle choices. Here are some important things to remember if you have been diagnosed with PCOS:

Signs and Symptoms:

According to MayoClinic the symptoms often begin soon after menarche, but it can also develop later in life. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. Additionally, PCOS is also the most common cause of female infertility.

Insulin resistance occurs frequently in those with PCOS, meaning the body cannot use insulin effectively to regulate blood sugar. This can result in high blood sugar and type 2 diabetes. The long-term complications are quite serious and include heart disease and stroke. Compared with women of a similar age who don’t have polycystic ovary syndrome, women with PCOS are more likely to be overweight or obese.

When to see a doctor

Early diagnosis and treatment of polycystic ovary syndrome may help reduce your risk of long-term complications. Talk with your doctor if you have menstrual irregularities — such as infrequent periods, prolonged periods or no menstrual periods — and have excess hair on your face and body or acne. Regular checkups are key to timely diagnosis. Find a medical professional that specializes in PCOS here

Treatment:

There is no cure to PCOS, but there are methods to control it and reduce the risk including:

• Weight control
• regular exercise
• healthy diet
• not smoking

Lifestyle modification through diet is an effective and important part of the treatment for PCOS. There is no doubt that making changes to your eating can result in weight loss, improved fertility, and overall improvement in health. Obesity makes insulin resistance worse, and weight loss can reduce both insulin and androgen levels and restore ovulation. Exercise also helps lower blood sugar levels, so should be part of your daily regime.  A Registered Dietitian would be able to help you create a meal plan for optimal health; find one near you!

While PCOS is a serious condition, through behavior and lifestyle modifications the symptoms can be treated and reduced. Registered Dietitians are here to help you become a healthier you! Newly diagnosed? Check out the MayoClinic or PCOS Support pages.

Do you or anyone you know have PCOS? What has been some of your experiences and what role did you find diet played?

Food and Health Survey Results Indicate a Change

’77′ seems to be a key number in weight management, according to the 2010 Food and Health Survey.  77% of Americans are currently attempting to lose or maintain their post weight loss bodies.  However, another 77% report not meeting the U.S. Department of Health and Human Services’ Physical Activity Guideline.

The Food and Health Survey’s goal is to assess the current population’s vision on eating and physical activity habits.  The organization responsible for producing the survey is the Nutrition and Food Safety at the International Food Information Council Foundation. The foundation’s senior vice president ,Marianne Smith Edge, MS, RD, LD, FADA, states that Americans continue to hear about the importance of overall health, but from a large variety of sources.  She states that there are organizations all over, from the White House’s Let’s Move campaign to similar smaller programs, which are all concentrating on reducing the obesity epidemic. But in order to do that, you have to take baby steps.

Edge is referring to proper calculations of ‘calories in’ versus ‘calories out’.  The same survey indicated that 58% of the population does not concern themselves with the balance of calories, therefore eliminating a key weight loss or weight management tool.  Another issue is the public’s estimation of those calories.  Unless you are relying on a very up to date program, it’s possible to get incorrect numbers.  In addition, portion size, and keeping track of snacks throughout the day need to be taken into account. Everything adds up.

Here are some more survey stats:

• 53% of the population is more concerned with sodium intake in their diets
• 72% are consuming more fiber
• 73% are consuming more grains
• 64% were concerned about money issues with foods while in 2010 it increased to 73%.
• When purchasing 86% of individuals buy because of taste, with price in second, health factor at 58% and convenience at 55%.
• Overall, 73% of Americans are pleased with the types of foods they have offered at their local supermarkets.

For more information about the foundation or the survey, visit www.foodinsight.org.

iPod App Review: Nike+

If you are a fan of Nike running shoes, and crunching the numbers from your run, this app is for you!  Just head to your local sporting goods store and purchase the Nike+ indicated shoes, then download the app!  Note that you’ll still need to buy  the Nike+ package sold separately which contains the pedometer piece to insert into your shoe, but from there just sync up and hit the trails!

Pros:

• Multiple options for workout goal
  • Open-ended time, timed goal, distance goal, calorie goal
  • Allows customized setting if your goal is not indicated
• Allows the option for song choices during run
  • Shuffle all songs or pick a playlist
  • Include a Power Song, which you can press at any time to keep pushing through
• Can create custom workouts to include one or more the goal options
• Holds your history of runs
  • Includes goal chosen, date, distance, time, pace per mile and calories burned
• Shoe piece and ipod synched to create accurate pacing and distance
• With each resume of page, Nike+ Lady indicates distance traveled and time ran so far
• Updates during run when distance markers have been hit
• Very simple, just turn on and run!

Cons:

• Requires special Nike+ shoe to work, as well as package or ipod app
• If you have traveled past indicated time or distance, you only have a set amount of time to continue exercise before the program ends
• Indicates ‘best mile time’ at top of history page, but doesn’t update for all goals
• Only when you are on ‘basic goal’ does Nike+ Lady indicate pace of each mile as you’ve run, which would be nice in other training programs, like distance
• Music option not as fun to maneuver, starts each playlist from the beginning so very often I run to the same songs everyday.

Overall, if you’re a running, walker or just like a good pair of Nike shoes, this app is great.  There are constantly new updates for programs and if you’re an iphone user, the newest version also can track your running path!  I’ve never had a better running partner!  Happy trails!

Speaking on a Big Stage

Yes, it’s true. Public speaking is feared more than death. Now, for me, I come alive on a stage. But don’t get me wrong. I’m really nervous and want to puke up until I hear the “Please welcome…”

In two weeks, my speaking partner and I, Bernie Salazar (NBC’s Biggest Loser Season 5 at-home winner) will be headed to New Orleans for some shrimp po’ boys and a major talk with families living with hemophilia.

See Us @ “Living Fit” Summit November 12, 2010 New Orleans

Sponsored By:

Thanks to Bayer for bringing the Nurture Principles message to families attending the National Hemophilia Foundation’s Annual Meeting.

Check out the postcards Bernie will be signing at the booth!

 

We’re also doing food demos and exercising with the whole conference room! Looking forward to meeting hundreds of people and changing some lives. Love me job!!!!!

iPod App Review: LoseIt!

The LoseIt! App. is a handy dandy pocket dietitian! Well, not exactly.  Obviously you get much better and personalized information with a real RD, but this app would be a great thing to try out for a week or so before your visit. This way, you’ll have a clearer picture of where you are at right now when you go for your session.

The app allows you to input specific foods eaten during the day, exercise done and calculates your calories, all based on you weight loss or gain goals.  It is excellent to have on hand for those on the go but still concerned about their weight.  Simply create an account with your weight, height and current goals and the app will do the rest!

Pros:

• Breaks each day down with a daily calorie budget, including food consume and exercise burned, to tell how many more calories today you can eat
  • Can get weekly averages, as well a nutrient analysis for each day and each weekly average
• Food log allows for food input, with specific, brand name and restaurant food options
  • Also have the option to input and customize specific food if you can’t find a comparable
• Exercise log very detailed, to include walking up stairs or carrying in groceries
  • Also allows for an input for customized workouts
• Calculates your goals and presents them in an easy to read and  understandable fashion
• Ability to add pass-code lock if your iPod is often viewed by others
• Saves a log of My Foods for those you often eat to search through instead of entire database, as well as Previous Meals function if you often eat similar meals
• Has a motivator function and a connect with friends function to keep your spirits and interest level up
• Can input recipes you include in daily food log

Cons:

• Requires input of each food, including details of individual condiments and components of the meal
• Cannot transfer to metric units
• Takes time
• Can be a bad thing for those obsessed with tracking daily calories
• You can’t “track” at this level the rest of your life

So check it out, but don’t play too long. You don’t want to associate “tracking” positive behaviors (eating healthy and exercise) with negative ones (like the “need” to watch/input every single step you take and food you eat the rest of your life.) My advice is always use the technology as a tool in the short term to get some information, then focus on yourself and behavior changes that will help you live healthier. An RD can really help you with that — oh and if you have a condition from diabetes to high cholesterol to food allergies, the app just can’t do that (nor should it!)

Find an RD at www.eatright.org

Are you #RD to Chat?

By Carlene Helble

The ultimate Twitter chat is ready to launch this November and it’s something you won’t want to miss! Registered Dietitian Janet Helm (@JanetHelm on Twitter) created #RDChat to help dietitians, students, and others interested in nutrition and health connect on fresh, hot button topics.

#RDChat will occur as a moderated conversation on Twitter the first Wednesday of the month from 8-9 pm ET in an hour long session. Things like headlines from newspapers, as well as new studies, and controversial topics will be covered with the help of special guests.

New to Twitter chats? Janet provided these step by step instructions to get you ready to go!:

• The chat happens live on Twitter and you can jump in at any time during the hour.  Simply log on to your Twitter account and you can use any of these options to help you manage the conversations.
  • One option,  go to http://www.search.twitter.com and type in #RDchat.  Only the  tweets that include that hashtag (#) will appear.  You may have to refresh the page to get new results.
  • If you use Tweetdeck, start a column for #RDchat.  Only tweets that are tagged with #RDchat will appear in that column for you to respond to.
  • There are several other programs you can use that are specifically designed for chats on Twitter:   http://www.tweetchat.com http://www.tweetgrid.com http://twubs.com All you have to do is log on to one of those programs.  When prompted, type in #RDchat and you’ll only see tweets that include that hashtag.  It allows you to see the fast-paced conversation happening in real time.  You use just like Twitter;  reply, comment, retweet, etc.  All of your tweets will automatically be tagged with #RDchat.

See you for a #healthy #nutritious and interesting @Twitter chat in November!

There’s an App for That! The Top 14 Fitness Apps

By Carlene Helble- Elite Nutrition Intern

We are all permaninatly attached to our phones, but are you using  yours to help you stay healthy? Rebecca helped find 14 of the best apps to support healthy eating and exercise that you can download now! The article she is featured in is from the LifeScript website and has a variety of apps including Six Pack Abs, Run Keeper, and Exercise TV.

Have you downloaded some great healthy living apps yet? Ready, set, go!

Time To Taper

If you’re running a fall marathon like me, most likely your long runs are now behind you and it’s time to taper! Tapering is both an exciting and scary concept for most runners. By decreasing your mileage you are letting your body rest and recover before the big day, but at times it can feel like you aren’t doing enough. But tapering is a tried and true part of training that I urge you to incorporate prior to your race.

First of all, what is a taper? This is the period in training when weekly and long run mileage is reduced, usually 2-3 weeks before the race. If you are already following a training plan, like Hal Higdon’s this should be incorporated in the plan. If you would like to check out some more tapering schedules, check out this link.

So while reducing mileage may seem easy, often times runner develop not only a physical addiction to running, but also a psychological need to iron out any life kinks on the road. Without those long runs, it is important that you find other ways to occupy your time. Surround yourself by those who love and support you, take the time to watch a new movie, and enjoy some of your other hobbies. Don’t let Taper Madness grab hold of you, race day will come, and your training will shine through. Research has shown that those who taper properly perform better than those who train right up until race day.

Here’s a few more tips I have found helpful while tapering:

• Runner’s World suggests sticking to your training log. No matter how short and easy your runs get during the taper, keep recording your workouts in your log to reinforce the feeling that you are studiously sticking to the plan.
• Listen to your body. Last minute workouts the week of the marathon are not going to improve your time. Trust your previous training and if you are feeling either physically or mentally tired or your leg muscles are fatigued, give them rest.
• Make Sure you are stretching! Check out these great stretches for runners
• Keep your nutrition at it’s peak! In the week before the race, gradually increase your carbohydrate intake. Chose high quality, nutritious foods to fuel your race-day. This article has some great nutrition tips for the week before the big day!
• Drink up!! Make sure you are hydrate well the week before the marathon and in particular, during the carbohydrate loading period.
• Don’t fret over weight gain! If your weight fluctuates a few pounds, don’t panic. Because of reduced activity, and increased hydration, this is mostly water weight! I assure you it will disappear immediately post-race.
• If you are traveling to your race, make sure to pack some of your favorite foods, and foods that you are used to using on your training runs. If you have been using a specific source of carbohydrates during your long runs, now is not the time to switch it up! Save yourself some headaches (and tummyaches!) by planning ahead and packing what you’ll need!
• Catch your ZZZZZs! Make sure you are getting plenty of sleep the week prior to the marathon.

Need more guidence? Marathon Training.com has a great  Race Countdown and Marathon Strategy section for additional information about final preparations before the race.

By listening to your body and giving it time to rest and recovery, you’ll be more than ready when the starting gun goes off! Best of luck in your race!

Let’s here from my runner readers! Have any tips for other racers? What do you do before a race? Any superstitions or lasting traditions? What fall races are you running?

Eat What You Love, Love What You Eat

Is it possible to eat what you want without gaining weight? Many people, especially those who are chronic dieters are afraid this is not possible. Breaking away from the rigid set of dieting rules feels scary, and dieters are comfortable with the “restrictive” state diets teach. How can we learn to reshape our relationship with food, and respect our hunger?

Michelle May, MD is the  author of “Eat what you love, love what you eat: How to break your eat-repent-repeat cycle.“ Her website Am I Hungry? describes many of her eating philosophies. In her own words:

“Most diets are restrictive and unsustainable, leaving the dieter feeling guilty and disappointed. My goal is to help people recognize and cope with their triggers for overeating, rediscover joy in physical activity, and effectively nourish their body, mind, heart and spirit.“

After reading her article on the blog “Dieting and You” entitled Paint-by-Numbers or a Masterpiece, I decided to reach out to her for an interview. Michelle was kind enough to take the time out of her busy schedule to answer some of my questions. Eloquently and kindly she spoke about how we can turn our relationship with food around and answer the question “What are you hungry for?”

Q: You don’t advocate “Dieting,” So tell us, Why don’t diets work?

A: They do work-temporarily. But they fail to address the root cause, and for many people, result in feelings of deprivation. This causes them to crave food more, and feel more out of control when they are around food. Restriction drives overeating. People think they don’t have enough willpower. Restriction also leads to obsession which is bad. Our body is wise, but people are skeptical because we are so diet-focused as a society. we think that we need to diet chronically to maintain are weight. But, we are all born with the instinctive ability to eat what our body needs. Instinctive eaters eat what they love, when they’re hungry, stop when they’re full and don’t worry about food in the between times.

Q: It can be very difficult and scary for chronic dieters to look at this approach to eating. They believe being intuitive is impossible and they will never know when they are really hungry and full. How do we separate cravings/hunger for love etc. from real biological hunger

A: This is a deceptively simple step. Ask yourself the question “Am I hungry?” Before you eat. Before starting to eat, focus on what’s going on inside. Do a Mind-body scan for the physical sign/symptoms (such as a drop in blood sugar) and also notice emotions/feelings. If your not sure you’re hungry, you’re probably not. If you decide to eat even if you are not physically hungry, notice this, and try to gain insight on why you want to eat. This question, “Am I hungry” must not become a rule to abide to, instead look at it as a way to pause, and reflect, being more mindful of your eating habits.

Q: So if we learn to appreciate and respect our hunger we can end yo-yo dieting and the eat-repent-repeat cycle?

A: Instead of a yo-yo I like to think of this as a Pendulum between excess and restriction.  Find the flexible arc in the middle of the pendulum where you still have freedom. We need to get away from this hopeless pursuit of trying to be perfect. Accept where you are. Everyone overeats, undereats, over exercises, underexerises sometimes. Its just important that we find a Balance.

Q: How can we move away from the “perfect” “skinny” mindset and learn to appreciate ourselves and our bodies, our health?
A: For too long now, we’ve tried to measure things by physical attributes-health is just a trophy that everyone seeks.
We need a balance of body, mind, health and spirit.  Health is  more than a number on a scale. Numbers like BMI, blood pressure, are easy to get obsessed with, and we need to take a step back and look at the whole picture of health.

Q: How can we fit fitness into this pictures without it becoming obsessive?

A: Often we look at exercise as punishment for eating or we need to exercise to earn the right to eat, which creates a very negative relationship with exercise. It turns into a penance for eating a “bad” food, and often you feel guilty if it is missed. This becomes an obsessive behavior which strips all of the joy from exercise. I think we need to not discuss exercise at the same time as weight loss. Exercise is good for everyone! Not just for those people that need to lose weight. It is also important to pay attention to the positive aspects of exercise, and find something you love doing.

Q: How do we create an atmosphere where food is not viewed as an enemy but can be savored and enjoyed without going overboard?

A: We need to put food back into perspective. When you are eating, EAT. Eat with abandon and joy, not to pay penance or seek to be virtuous. When you are not eating, let it go. Don’t think about it. Enjoy what you are doing at the time. Approach life fully engaged in the present moment. Mindfulness is not only a form of eating, but also a life skill.

Thank you Michelle for your wonderful insight and tips! Check out her website Am I hungry?, read her new book “Eat what you love, love what you eat” and follow her on twitter @eatwhatyoulove

Book Review, Part 2: Nutrient Timing for Peak Performance

In this second part of my book review, I wanted to  highlight some interesting points that I learned about how to refuel and energize your body using carbohydrates, protein, and fat. Each macronutrient plays a vital role in nutrient timing for before, during, and after your workout. Read below to see how what and when you eat can affect athletic performance.

Carbohydrates

As the primary fuel used for energy, carbohydrates can serve specific purposes in the body if they are strategically eaten before, during, and after exercise.

• Carbohydrates can be stored and utilized for energy anywhere from 24 hours ahead of your exercise up until about 15 minutes before you begin.

• Eating a good meal in the day previous to exercise ensures that your muscles will be full of glycogen, or stored glucose, that your body can tap into for energy.

• Carbohydrate intake during exercise spares the use of muscle glycogen so that your body can use those last reserves for the end – your last sprint toward the finish line, final moments of the game, or your break-away for a game-winning goal. This is because the carbohydrates that you eat during an event go straight into your bloodstream where your muscles can use it instead of using their stored energy.

• After exercise, it is important to “refuel, rehydrate, and rest” – what Skolnik and Chernus call the three R’s in sport.

• Refueling quickly after exercise is important, because it is within the first 2 hours that your muscles store glycogen at the fastest rate.

• It is most effective to start with a high-Glycemic Index food or beverage as soon as possible, because these carbohydrates are quickly absorbed, digested, and delivered into your bloodstream as glucose.

Protein

Protein is another nutrient that is essential for sport and performance. It provides many vital functions, but excessive protein intake can creat excess ammonia in your body as well as lead to the dehydration of muscles. It is important to refuel on protein following an intense training or weightlifting session so that the muscle fibers that were destroyed can be rebuilt. Follow these tips for proper refueling.

• The  maximum effective dose of protein your body can handle efficiently at one time is 20-35 grams. Eating any more than this at one time is simply a waste.

• Your body cannot efficiently use any more than 2-2.5 grams of protein per kilogram of bodyweight in a single day, so it is important to calculate your protein needs and not eat in much more excessively than what your body needs.

• Protein is utilized differently by all individuals, but more specifically on the type of exercise: endurance or resistance.

• For endurance training, many researchers find that it may be helpful to mix protein and carbohydrates for your post-workout meal to aid in muscle recovery and immunity protection.

• The addition of protein can result in less muscle protein breakdown and reduced muscle soreness, according to studies done on athletes.

• For resistance training, protein is an important nutrient that aids in protein synthesis which must be greater than muscle breakdown in order for muscles to grow in size and strength.

• Adequate carbohydrate and fat are needed to spare protein for muscle repair.

• Consuming a snack following a weightlifting session will help with recovery – limiting the tissue breakdown as well as promoting muscle building.

Fat

Dietary fat intake plays a major role in athletic performance with both direct and indirect effects.

• Eating too much fat right before working out can slow you down.

• Not eating enough fat can inhibit testosterone production and muscle building.

• Fats are very calorie dense and are great sources of calories for athletes that require a high caloric intake

In this section on fat, the authors describe how our body uses fat and burns it for fuel. This section is extraordinarily interesting and useful for all individuals. Since there are many misconceptions regarding the “best” exercises for fat burning and weight loss, I found this section of the book to be very informative. The authors address properly fueling your body before exercise. Many people workout on an empty stomach because they think they will burn more fat that way. Though exercising without eating would technically burn more fat, you will hinder your athletic performance and fatigue much earlier than if had you eaten. The authors also discuss the trend of dietary periodization as well as a high-fat diet and its affect on performance.

For more information about Nutrient Timing for Peak Performance, check out the Facebook Fan Page or my interview with one of the authors, Andrea Chernus MS, RD, CDE, on her book and other relevant topics in sports nutrition!