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


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.

Celiac Disease & Why the Gluten-Free Diet is No Joke

Earlier this month I had the pleasure of speaking with Shelley Case, RD, a dietitian from Canada who is an expert in Celiac disease and Gluten-free eating. I became interested in this subject due to the popularity of Elizabeth Hasselbeck’s book, The G-Free Diet: A Gluten-Free Survival Guide, and the way it had taken over the public by storm. In the hospital where I work, I noticed an increasing amount of people interested in Gluten-free options, and not because they had Celiac disease or a wheat intolerance.

I began to wonder why so many people were opting out of eating Gluten. I came to the conclusion that many people equated Elizabeth Hasselbeck’s physique with her Gluten-free diet. What people need to realize is that she suffers from a specific disease in which she cannot digest Gluten. The Gluten-free diet is not recommended for individuals that do not have Celiac disease or a similar intolerance to Gluten. Gluten-free eating can lead to nutritional deficencies, weight gain, more expensive groceries, and disordered eating habits.

source: WatchingTheView.com

Celiac disease is a serious disease that has many different consequences and varied symptoms that are hard to diagnose and treat. The majority of individuals have iron-deficiency anemia (approximately 66%), which is a non-GI symptom for a GI-specific disease. Sufferers of Celiac disease face certain issues that disappear once Gluten is removed from the diet. However, without the removal of Gluten, Celiac disease can cause many problems. Gluten is seen by the body as a foreign substance that the body attacks via antibodies. Celiac disease is an auto-immune disease and the antibodies attack the body, specifically the villi on the surface of the small intestine. This leads to problems with nutrient absorption and can also lead to intestinal lymphoma.

There is also non-Celiac Gluten intolerance and wheat intolerance – two disorders that are not Celiac disease and do not have the same long-term consequences. Individuals may feel better once they removed Gluten or wheat products from their diet. However, anyone who believes they may have Celiac disease should speak with their doctor about being tested for this disease before starting a Gluten-free diet. This is because once the Gluten is removed from the diet, the body stops making antibodies. The antibodies are used to determine through a blood test or gastric biopsy whether the individual has Celiac disease.

The bottom line is that Celiac disease is a major disorder that specifically responds to the Gluten-free diet. Those without this disease should not attempt to eat a Gluten-free diet, no matter which celebrities are endorsing it. It is also wise to do more research into a diet book and understand its message before diving headfirst into its recommendations; Hasselbeck’s book is for fellow sufferers of Celiac disease – not for every woman in America who wants to look like her.

Interview with Shelley Case, RD: Celiac and Gluten-Free Diet

I recently had the opportunity to speak with North America’s Gluten-Free Nutrition Expert,  Shelley Case, RD who is a dietitian in Canada  specializing in Celiac disease and Gluten-free eating. She is also the author of The Gluten-Free Diet: A Comprehensive Resource Guide. I had the pleasure of interviewing her about the Gluten-free “trend” and what it means for individuals who mistake Gluten-free eating as an effective weight-loss diet.

source: sgvceliac.org

  • Can you give a brief explanation for our readers of what gluten is and how it affects those with Celiac disease?

Gluten is a protein found in grains like wheat, barley. Celiac disease is an autoimmune disease in which the body recognizes gluten as a toxic substance and reacts by developing antibodies when gluten is consumed. The body attacks the lining of the GI tract and destroys the villi, which are responsible for absorption of iron, calcium, Vitamin D and other nutrients. Over time, more and more damage will occur, and gluten can also damage other organs in the body besides the GI tract.

  • What percentage of people currently have Celiac disease?

Currently 1 in 100 people have Celiac, but it is estimated that only 5-10% are officially diagnosed at this time. Many individuals are misdiagnosed with other conditions such as acid reflux, ulcers, fibromyalgia, irritable bowel syndrome (IBS), and ulcerative colitis. The current delay in diagnosis is approximately 12 years, according to research from 2007 in Digestive Diseases. Research by Peter Green from New York indicated that the delay is more than 10 years in the U.S. Doctors are not picking up this rare disease. Celiac is a multi-system autoimmune disease that affects other organs and is hard to treat. The most common non-GI symptom that presented in 66% of Celiac patients is iron-deficiency anemia. It is hard to treat and diagnose because it looks like other diseases.

  • Can you differentiate between Celiac disease and wheat intolerance?

There are 3 different conditions that must be differentiated. There is Celiac disease, non-Celiac gluten sensitivity (with similar symptoms but patients do not develop seizures, infertility, or intestinal lymphoma), and then wheat allergy. Gluten sensitivity and wheat allergies are not auto-immune and do not damage the villi in the small intestine. Patients should be thoroughly tested for Celiac if they present with conditions such as anemia, bone issues, thyroid and liver dysfunction, and arthritis.

  • What implications or affects are there for individuals who eat a gluten-free diet? Is there a risk of nutritional deficiencies or disordered eating with this diet?

There are many challenges with the Gluten-free diet. Many products on the market are not enriched with iron and Vitamin B. They are made with white rice flour or tapioca flour, which are low in nutrients. There are many fiber issues and deficiencies in trace minerals on the Gluten-free diet as well. Those on a Gluten-free diet should look for enriched products as well as using nutrient-rich sources of gluten-free grains, such as amaranth, sorgoum, flax, quinoa, and brown rice. Also be conscious of fiber intake, getting Gluten-free whole grains, flax, and iron-rich foods. It can be difficult for vegetarians on a Gluten-free diet because of the lack of iron.

  • What tips can you give to individuals who want to begin a gluten-free diet?

First of all, the diet is very overwhelming. You should shop the perimeter of the grocery stores and work your way into the middle aisles wisely. Read all labels and work with a Registered Dietitian. Gluten-free products are approximately 2-3 times more expensive, which can be very frustrating for Celiac patients.

  • Do you have any thoughts or concerns about individuals without Celiac disease who adopt the Gluten-free diet? Can it be helpful or detrimental for weight loss?

Many who start a Gluten-free diet will gain weight. Once you remove the Gluten from your diet your body is able to absorb nutrients and gain weight again. Gluten-free items also have twice the amount of carbohydrates from added sugars as well as extra fat. Many of the Gluten-free products you see are items like cookies, brownies, and desserts that are already high in fat and sugar, and which Celiac patients used to avoid because they contained Gluten. Eating these again, with additional fats and sugars than their Gluten-containing counterparts, can easily contribute to weight gain.

  • Have you noticed an increase in consumer interest in using Gluten-free eating as a way of dieting or restricting calories? In your professional opinion, does a Gluten-free diet guarantee weight loss? Why or why not?

Due to Elizabeth Hasselback’s book and celebrity endorsement, it seems to be the latest trend. But many gluten-free products are high in fat and sugar, and unless you have Celiac disease this is definitely not an ideal way to reduce calories or weight. A lot more people are interested in Gluten-free dieting, either from the publicity from this book or because they have noticed that they feel better when they remove Gluten from their diet.

The problem is that if a potential Celiac patient was to get on the Gluten-free diet before being tested and diagnosed, the test will not return positive. Once you remove Gluten from the diet, the body does not attack itself they way it does when Gluten and the antibodies produced from Gluten consumption are present. Blood tests to test for Celiac disease are 90% accurate, and only if the person is consuming Gluten, because the antibodies will be in the blood. A gastric biopsy is 100% accurate but more invasive.

Those who suspect they may have Celiac disease or an intolerance should first be tested to be sure. And those interested in Gluten-free diets for weight loss should be careful about what they are consuming. Because of celebrity endorsement, the diet has become more popular, but it is not recommended for weight loss or people who do not have Gluten sensitivity of Celiac disease.

Adult “Picky Eaters” May Have Unusual Eating Disorder

By: Alison Brewer, Intern

As a child, I had the traditional outlook of “macaroni and cheese is good, broccoli is bad.”  When you’re young, it’s almost like you are supposed to be picky.  As I grew, I became more open to new foods so that I now have a very short list of ‘I Don’t Like You’ foods.  However, the title of picky eater doesn’t outgrow everyone and has recently been identified as a potential eating disorder.

Uncommon Disorder

Eating disorders are more common than people think. One out of 100 kids will struggle with one. We’ve heard of bulimia and anorexia, but these are not the only eating disorders in existence. Doctors have changed the term of the condition ‘picky eating’ to ‘selective eating’ when it seems we do not outgrown it. The Diagnostic and Statistical Manual of Mental Disorders, will now contain ‘selective eating’ in the 2013 edition.

Researchers from Duke University and the University of Pittsburgh have started a registry of picky eaters, allowing individuals to input habits and characteristics of eating patterns online.  They hope through this connection, identification, support, a potential treatment will be produced.

Habits of Selective Eaters

It seems the major habit for those with selective eating is not based on calories or health issues, but more on a mental block for allowing certain foods to contact their tongue.  Some doctors hint there may be a  connection to obsessive-compulsive tendencies while others indicate it may be more connected to attention deficit disorder.  The true reason is unknown, but is probably more accurately decided  on an individual basis.  Yet, because of the general habit, doctors can agree that nutritional issues will arise or continue to persist without proper balanced diets.

One participant of the research registry stated that she had a list of ten foods she had consumed since the age of three.  She stated that putting certain foods in her mouth caused her to gag and her body would not physically allow her to swallow.  The same participant avoids any social eating situations, which cause anxiety, and fears that her habits have been passed to her 5 year old who is already exhibiting similar behaviors.  The client also shared that during family Thanksgiving dinner, she hides in the playroom with the kids or washes dishes during the entire feeding process to avoid more awkward situations.

If you have a food aversion and worry about the severity, talk to someone about it. You can get therapy and work though it.

For more information on the research registry, visit eatingdisorders.mc.duke.edu.

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!


  • 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!


  • 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!

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!

Weight Loss Advice: Don’t Eat Like a “Typical American”

As a nutrition expert, people are always asking me for my “weight loss secrets.” The truth is, I don’t have any secrets. I think the credible information that would help most people is already out there. Things are changing ever so slowly. I see a growing trend toward simplifying weight loss strategies. Many people are saying that they aren’t dieting (yay!), they’re just making healthier food choices and only eating when hungry. (That’s a big one. Try it for one day and you will realize, you really don’t know what hunger and fullness feels like.)

One simple tip I can offer is to avoid eating like a typical American – the SAD diet(Standard American Diet). I recently appeared on TV with a client to show how she is losing weight – and inches – by avoiding the SAD eating habits of typical Americans.

Here’s the low-down on the typical American eating habits from the 2005-2006 National Health and Nutrition Examination Survey (NHANES a.k.a. the Census of food habits).

  • About 70% of Americans do not meet recommendations for fruit and vegetable intake. I like to crunch on veggies between meals and check my plate at lunch and dinner for fresh, steamed, or broiled non-starchy veggies. Looking for something new? Try fennel, jicama, and kale. Aim for 2-3 fruits a day. I like having one fruit with breakfast and one with lunch or dessert after dinner. Fruit is nature’s candy and really should form the foundation of sugar intake.
  • Americans get nearly 30 grams of saturated fat per day. Some saturated fat is fine. You may find it in coconut milk, coconut oil, or lean animal meats. The recommendation is less than 10% of calories. Since we all eat different calories, our limits are different. If you focus on adding in plant foods and limiting meats, animal skins, solid fats like butter, and cheese you should be in your range. Most healthy adults need 2,000 calories or less, which puts the upper level of saturated fat at 22 grams a day. Replacing a fast food burger meal (about 14 g saturated fat) with a home cooked vegetarian meal will help you slash it way down.
  • The average American consumes about 22 teaspoons of sugar a day. It is most important to get naturally occurring sugars from fruits and dairy products. Watch the added sugar found in flavored drinks, yogurts, and desserts. Check labels. The American Heart Association recommends limiting sugar to 6 tsp/day for women (100 kcal) and 9 tsp/day for men (150 kcal).
  • Cut way back on salt intake. The typical American gets more than 3500 mg of salt a day. The recommended range is 500-2100 mg per day. Ask for “no salt” when ordering at restaurants. You can also split an entree and a large garden (veggie) salad. Pile half the plate with veggies and the other half with “anything else.” It’s a quick way to eat less of the salty prepared food and get in veggies, which are naturally low in salt. You should also read labels of sauces and marinades you buy for the quick and healthy meals you’re trying to make at home.

Healthy Living Summit 2010

This weekend marks the start of the Healthy Living Summit (#HLS on Twitter), taking place in Chicago this year. For those not familiar, HLS is a gathering of healthy lifestyle bloggers who come to share their knowledge on their respective topics.

Rebecca will be one of the amazing speakers, focusing on nutrition for casual exercisers and athletes in her presentation with fellow RD Heather “Fueling for Fitness: : Perform Well and Recover Quickly from Your Workouts – Body”. They will cover new sports nutrition products, super new research on metabolic efficiency training, as well as disordered eating and eating disorders (especially how we can avoid contributing to them!). Just some of the topics you won’t want to miss!

This year’s keynote speaker is  Christine Palumbo RD who will be presenting “Eating Well for Feeling Fabulous”  where she will talk about the latest health trends and their impact on the food industry as well as health policies like Let’s Move. Another great speaker is Anne P from fANNEtasticfood.com who will cover everything you want to know about the blogging community in a panel discussion. There are many more great presentations whose topics include ethical cooking, healthy entertaining, and more. If you want to find out more about HLS and the schedule, check out the website.

How Fit is Your City? D.C. is Healthiest City in America

The American College of Sports Medicine (ACSM) recently published their 2010 list of the fittest major cities in the United States. The full list ranks 50 major metropolitan areas in America – where does your city fit in with fitness?

The ACSM has listed the following cities as the top ten healthiest in the United States: Washington D.C., Boston, Minneapolis-St. Paul, Seattle, Portland (Oregon), Denver, Sacramento, San Francisco, Hartford, and Austin.

According to the press release from ACSM, “characteristics of the D.C. area that helped it achieve the top ranking are a relatively low smoking rate, a higher-than-average percentage of folks eating the recommended daily serving of fruits and vegetables, and lower-than-average rates of chronic health concerns such as obesity, asthma, cardiovascular disease and diabetes.”

The press release also goes on to say that “D.C.-area residents also use public transportation regularly, meaning they are likely to walk to and from their places of work or transit stations. Also, the area of parkland as a percentage of the city’s land area is significant, providing residents with lots of space to run, bike, play sports or take a leisurely walk.”

ACSM ranks metropolitan areas based on their AFI – or American Fit Index – which takes into consideration access to healthcare, health insurance coverage, education, parks and recreation systems and programs, prevalence of chronic disease (such as cardiovascular disease, cancer, and diabetes), public policy dedicated to healthcare and prevention, and economic situations.

The lowest cities ranked on the list were New Orleans, Houston, San Antonio, Indianapolis, Las Vegas, Louisville, Detroit, Memphis, and Birmingham, with Oklahoma City ranking last. These cities have traditionally higher rates of obesity and high unemployment rates in the recent economic climate.

Regardless of where you live, you can make the most out of your health and fitness goals by following the tips below. While it may be inspiring to those of you residing in one of the top ten fittest places in America, do not be discouraged if your city ranks at the bottom of the list. Here are some tips for staying healthy despite your living conditions.

1. Take advantage of annual medical physicals and preventative healthcare. If you are insured, make sure to visit your doctor annually and follow through with any preventative measures he or she may suggest for your age group

2. Use your environment to your advantage. Bike along forest trails, climb mountains, stroll along the beach, run along the city streets, kayak in the river, or walk your dog at the park. Utilize whatever you can in your environment to get and stay active – whether you live in a bustling city, a small rural town, a mountain village, or down by the beach.

3. Eat a healthy and nutritionally-balanced diet. You are what you eat, and you have the power to control what you consume. Your eating habits and body weight play a major role in the onset of chronic disease such as – but not limited to – cancer, diabetes, metabolic syndrome, cardiovascular disease, and hypertension.


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