Читать книгу Healing PCOS - Amy Medling - Страница 11
ОглавлениеI was raised in the 1980s and 1990s, the era of margarine, diet soda, and fat-free everything. As a teen, I wouldn’t have been caught dead with a package of Oreos, but a fistful of fat-free Snackwells cookies sounded like a good choice. Wash them down with some Diet Coke, and I had a good “skinny” snack. Looking back, it is no wonder I felt terrible. Not only was I not getting the nutrients I needed, but I was filling my body with artificial chemicals and inflammatory foods that wreaked havoc on my hormones.
The pattern continued into college. My body was crying out for protein, and I was answering the cry by secretly binging on peanut butter. I should take this moment to apologize to my old college roommates. I admit it. I was the Peanut Butter Bandit. All those jars of peanut butter that went missing—that was me and my PCOS. I’m sorry. I didn’t understand what my cravings were trying to tell me, and your stores of peanut butter paid the price.
To make matters worse, being a vegetarian was trendy and sounded like a healthy option, so I jumped on the bandwagon. Unfortunately, I wasn’t a particularly good vegetarian. I ate almost no protein. Tofu sounded weird, and beans were not glamorous. I filled in the space where lean protein should have been with carbs.
Later in college, when I no longer had to eat in the cafeteria, I gave up vegetarianism and discovered both that I actually liked to cook and that I was pretty good at it. I began hosting dinner parties and cooking for myself and friends on a regular basis. I didn’t put it together until much later, but I started feeling better. I was finally giving my body what it craved—lean, clean meats and vegetables!
A Healthy Relationship with Food
Let’s talk about the second most important part of the PCOS Diva lifestyle: food. Many (dare I say most) women with PCOS have an adversarial relationship with food. In fact, a startling number of us have some level of eating disorder. Whether it is occasional binge eating, bulimia, or anorexia, our dysfunctional relationship with food may come from any number of sources, including:
Struggling to conform with societal expectations for the perfect body.
Unhealthy foods available to us in our youth that became our go-to or comfort foods.
Emotional eating.
Biological issues, such as chemical imbalances in the areas of the brain that regulate appetite, digestion, and hunger.
Psychological issues, such as low self-esteem, feelings of inadequacy or lack of control in life, depression, anxiety, anger, stress, or loneliness.
Interpersonal issues, such as troubled personal relationships, difficulty expressing emotions and feelings, a history of being teased or ridiculed based on size or weight, or a history of physical or sexual abuse.
PCOS Divas must approach their diet using the proper mindset. PCOS Divas do not engage in the three Ds: deprivation, denial, and diet. We feed ourselves (including our cravings) mindfully and with care. Our diet isn’t a fad diet. It isn’t restrictive, extreme, or punishing. It is a way of eating that springs from the PCOS Diva mindset. We eat foods that our bodies deserve, that make us feel strong, healthy, and energized. We are aware of how different foods make us feel, and we make mindful choices accordingly. Our PCOS Diva mindset means that we nurture ourselves, and having a healthy relationship with food and choosing foods that heal, nourish, and taste delicious are an important part of that. During the Healing PCOS 21-Day Plan, you will develop a healthier relationship with food. It will become an enjoyable part of your daily self-care.
“Three years ago, I tried the ‘next thing’ after years of diets, medicines, and exercise programs. My ‘next thing’ was the PCOS Diva Jumpstart week. I never looked back. Feeling stronger and more in control of my choices, my body, and my PCOS, I began eating like a PCOS Diva all the time. So did my family. I lost thirty pounds in the first three months of living the PCOS Diva lifestyle. My three sons started requesting specific recipes and began reading labels on food products. Amy’s research and information have transformed my life, my mood, and my family’s dinner table. Her holistic approach is both achievable and down to earth, addressing habits, emotions, and roadblocks. Hundreds of tasty recipes, pages of tips to make and change habits, and prepared shopping lists equipped me for success.”
—HEATHER G.
Treat Food as Medicine
Many diet books tell you to look at food as fuel for your body. Although this is true, food is much, much more than fuel. It doesn’t just give us energy. The food we eat has the power to heal or harm us. It can make us feel energized and focused or sleepy, bloated, and constipated. We need to consider food medicine. The right foods can regulate insulin, control inflammation, regulate cardiovascular health, improve gut health, and help manage stress and PCOS symptoms. The nutrients, phytonutrients, antioxidants, fiber, vitamins, and minerals contained in the foods you choose can be the difference between healing diseases and disorders and making them worse. In fact, nutrigenomics is an entire field of research exploring the link between the food we take in and how those nutrients communicate with our genes to trigger or reduce the risk of certain diseases such as heart disease and diabetes. These interactions may even play a part in your cravings, fitness, and overall health.
Eating like a PCOS Diva means embracing a plant-based diet that includes healing foods: wild-caught fish, organic poultry, grass-fed meat, gluten-free whole grains, healthy fats, and tons of produce. You’ll move out of the processed food aisles of your grocery store and into the produce section, where you’ll discover fruits and vegetables that are low on the glycemic index, which means they will blow your mind and heal your body without spiking your blood sugar. No, you will not be eating crazy, exotic foods you have never heard of. That’s not sustainable. But you may encounter new foods and learn new ways to prepare and appreciate some you already know. You will learn how different foods can work as medicine and help soothe your symptoms. For example:
Apples: Apples are low on the glycemic index and high in vitamin C, potassium, antioxidants, and fiber. Studies demonstrate that adding apples to your diet can reduce your risk of diabetes and weight gain.
Avocados: Avocados are packed with vitamins, minerals, and heart-healthy fatty acids that help quell systemic inflammation, promote healthy endocrine and immune system function, and make your skin glow. Adding an avocado per day to an already well-balanced diet has been shown to lower risk of heart disease, lower LDL cholesterol, and reduce oxidative stress.
Berries: Berries are packed with immune-boosting, cancer-preventing, heart-protecting, obesity-preventing antioxidant components, including specific polyphenols, flavonoids, and other phytocomponents that fight inflammation and disease. Researchers are learning that phytonutrients in raspberries may prevent obesity and fatty liver by regulating certain enzymes.
Brown rice: Unlike its nutritionally stripped white cousin, brown rice is a gluten-free whole grain containing vitamins, minerals, fiber, and protein to balance its carbs. Brown rice contains magnesium and selenium for heart health and manganese for bone and thyroid health, regulation of blood sugar levels, metabolism of fats and carbohydrates, and absorption of calcium. Fiber lowers blood glucose (and, as a result, insulin) and estrogen levels, all while flushing toxins.
Cinnamon: Rich in antioxidants, cinnamon can help stabilize blood sugar and reduce insulin resistance. Some studies indicate that it may also help regulate menstruation.
Dark chocolate: Chocolate containing 70 percent cacao or more reduces hypertension, increases circulation, aids in preventing atherosclerosis, improves glucose regulation by preventing blood sugar spikes, and may promote weight loss by controlling hunger and promoting satiety. It can also improve mood, soothe nerves, prevent memory decline, and improve overall cognitive function. As an added bonus, it contains all-important magnesium, which can help regulate insulin, relieve anxiety, boost energy, and support bone health.
Green tea: A zero-calorie beverage, green tea is considered one of the world’s healthiest drinks. Green tea contains a high concentration of powerful antioxidants that improve blood flow, lower cholesterol, improve hypertension, and may prevent other heart-related issues, including congestive heart failure and stroke. Because of its circulatory benefits, green tea also nourishes and stimulates the brain by boosting brain activity and memory and helps block the formation of amyloid plaques linked to Alzheimer’s disease.
Leafy greens: Romaine and red leaf lettuce, kale, chard, spinach, collards, beet greens, dandelion greens, endive, basil, parsley, and arugula are the very best low-calorie, high-fiber, low–glycemic index food sources of essential vitamins and minerals. They improve digestion, absorption of nutrients in the gut, glucose regulation, and overall endocrine function and reduce the risk of metabolic, cardiovascular, and autoimmune diseases, as well as cancer. Leafy greens are also a good source of many B vitamins, especially folate.
Maple syrup: With fewer calories than honey and a lower glycemic index than cane sugar, maple syrup is a great natural sweetener choice. It contains water, protein, fat, carbohydrates, antioxidants, calcium, iron, magnesium, phosphorus sodium, potassium, zinc, thiamin, riboflavin, manganese, niacin, and B6.
Nuts and seeds: Eating nuts and seeds in combination with fruit or other high–glycemic index foods lowers the total glycemic index and improves glucose and insulin regulation. Seeds (especially pumpkin seeds, sesame seeds, and cashews) contain essential fatty acids (EFAs) and zinc, which our bodies need. EFAs help regulate hormone function; improve hair, skin, and nails; lower insulin levels; stabilize blood sugars; and help regulate periods. These may also help with hirsutism.
Oats: Both rolled and steel-cut oats are nutritional powerhouses, though steel-cut oats are lower on the glycemic index. These gluten-free whole grains contain fiber, protein, antioxidants, and tons of vitamins and minerals, including manganese, phosphorous, magnesium, copper, iron, zinc, B1, B5, and folate. Thanks to the high fiber content, oats keep you feeling full while helping to lower your blood sugar and improve insulin sensitivity.
Buying Organic
When choosing meat, poultry, fish, fats like butter, fruits, and vegetables, consider organic, grass-fed, and wild-caught options. These are likely to contain fewer of the toxins that creep into conventional foods through pesticides, antibiotics, water, and feed. Some fruits and vegetables are especially prone to contamination; others are more resistant. The Environmental Working Group (ewg.org) keeps list of the “Dirty Dozen” and “Clean Fifteen” as well as a seafood guide on its website.
Listen to Your Body
Partnering with your body and listening to its signals will provide you with a wealth of valuable information on your healing journey. During the 21-Day Plan, you’ll learn:
To identify the foods that heal and those that hurt you. Do you need a nap an hour after eating a salad? What if you add chicken or a healthy fat like avocado or olive oil? Does adding croutons make you crave more carbs and feel logy later? For the next few weeks, you will use a journal to log what you eat and how you feel after you eat it. How do you feel an hour after your morning smoothie? Energized? Hungry? How do you feel after snacking on crackers and cheese? Bloated? Grouchy? Some effects can be felt in the short term while others may not present until hours later. Keeping a food journal will help you to spot the patterns and develop a personalized eating plan that nurtures your body. When you stop listening to fad diets and their one-size-fits-all promises and start listening to your body, you will be surprised by what you hear.
To recognize what your body needs. Cravings are your body’s way of telling you it needs something. No, it is not telling you that it needs some chocolate ice cream. Are you craving chocolate? You may need magnesium. Are you craving salty snacks? Your diet may be missing certain minerals such as calcium or magnesium. Are you craving sweets? Your blood sugar may be low. Are you craving carbohydrates? Your hormones are probably fluctuating. Sometimes, you aren’t really hungry at all; you may just be dehydrated. Is the craving emotional? Many of us eat reflexively when we are bored, sad, or tired. What we think is a craving is really just a habitual reaction to our state of mind, or we may use food to fill hungers in other areas of our lives.
Sometimes I just want a potato chip. There is something about the salt and crunch that my body craves. When I get this feeling, I ask myself what’s going on. Maybe I need more minerals and crave the salt. Sometimes I find that I am frustrated, and crunching on something like chips helps me take out my frustration. Sometimes I find another way to do this, and sometimes I decide to mindfully indulge. The important thing is to recognize what drives your craving.
Sometimes when a craving strikes (especially for a food that I know makes me sick), I tell myself, “I can have this food anytime. This is not the last time I will ever see it. I choose not to eat it right now.” This mindset helps me get some distance from the immediacy of the feeling.
Try to follow the 80/20 rule. Eat exactly what your body needs 80 percent of the time. The other 20 percent is for those times that you indulge, slip, or otherwise fall off the wagon. You will notice that, as you upgrade your everyday diet and start to crowd out processed foods, you will start to crave nourishing rather than unhealthy food.
Sugar-Craving Busters
Typically, we should listen to our body’s cravings and try to supply the nutrients it is signaling for, but with sugar our craving is often an indication of an addiction. Until we break the addiction, feeding this craving is not helping. Here are four Sugar-Craving Busters that may help:
1 L-glutamine is an amino acid that has been found to reduce or even eliminate sugar and carb cravings. Try a 500 mg dose up to three times a day when sugar cravings occur. This dose should rid you of sugar cravings within a month or two.
2 Coconut manna (also called coconut butter) is pure coconut flesh blended until it reaches the consistency of peanut butter. Eat a spoonful of this healthy fat straight from the jar or spread it on a piece of dark chocolate when you are dying for something sweet.
3 Mineral deficiencies can cause cravings, so drink a glass of high-quality mineral water, like San Pellegrino, to replace the trace minerals you may be lacking. Try this especially if you regularly drink filtered water.
4 Drink licorice mint tea with a little coconut oil to curb cravings. I also like Good Earth Organic Sweet & Spicy Caffeine-Free Tea for sweet cravings at night.
During the next 21 days, we will talk more about what to do when you have a craving. Until then, don’t fight your body. When you are craving something, first ask what your body may be telling you. Then try to give it what it needs. Remember, nothing tastes as good as feeling good feels.
Listening to your body takes practice. Be patient with yourself. By the end of the 21-Day Plan, you will be much more in tune with your body’s signals.
Choose Foods That Heal the Root Cause of Your Symptoms
Anti-inflammatory Foods
Chronic inflammation is the root cause of many of your PCOS symptoms, such as insulin resistance and acne. Every time you consume a food to which you are allergic or sensitive, your body reacts as though it is under attack, and inflammation results. This inflammation is recognized by your adrenal glands as stress. With your body under attack, the adrenals go into overdrive producing cortisol to get you through the emergency. As a result, they produce less estrogen, progesterone, and testosterone, causing hormonal imbalance. If inflammation in your digestive tract is left unchecked, it can result in leaky gut syndrome, causing inflammation throughout your body and leading to a variety of autoimmune diseases.
Removing inflammatory foods from your diet is imperative. Determining which foods to eliminate from your diet is a process. Just as every woman with PCOS has a different set of symptoms, we each have different food allergies and sensitivities. A food allergy triggers an immune-system reaction, resulting in a range of symptoms such as hives, swelling, and trouble breathing. You may know almost right away if you have an allergy, but it could take four hours or more. A food sensitivity is an adverse reaction to a food that does not involve the immune system. Symptoms, including bloating, gas, diarrhea, nausea, and indigestion, may emerge hours or days after consumption.
The nine most common food allergens are:
1 Peanuts
2 Tree nuts
3 Milk
4 Eggs
5 Wheat and other grains containing gluten, including barley and rye
6 Soy
7 Fish
8 Shellfish
9 Corn
Over the next three weeks, you’ll begin to pinpoint your food sensitivities. Your food journal will help you to identify the foods that make you feel miserable, and as part of the 21-Day Plan you will limit or eliminate three inflammatory foods that commonly affect women with PCOS: gluten, dairy, and processed soy.
Gluten: Many women with PCOS have a gluten sensitivity. For those with celiac disease, an autoimmune disorder, gluten must be avoided entirely. Most of us have a sensitivity that results in constant low-grade inflammation.
Gluten-free doesn’t mean healthy. There are tons of gluten-free products available now. Many of them are terrific alternatives for foods that make us sick. However, a gluten-free cookie is still a cookie. It is loaded with sugar and other ingredients that are not good for you. “Gluten-free” on the label is not a free pass to consume junk.
Dairy: Most humans stop producing the enzymes needed to properly digest and metabolize milk (and foods containing milk, such as cheese and yogurt) after they have been weaned. In fact, much of the world’s adult population may be unable to digest lactose, a sugar found in milk. Those who are lactose intolerant experience digestive issues whenever they consume dairy products. Others may react poorly to the casein and whey proteins found in milk. According to Dr. Amy Myers, 50 percent of people who are gluten intolerant are also casein intolerant due to the similar molecular structures. In addition, your body may struggle to manage the acidity, hormones, and antibiotics that are often present. Grass-fed butter and ghee are allowed as they contain no or very minimal amounts of casein or lactose, and provide multiple health benefits.
Soy: Women with PCOS should limit their exposure to soy, not only because it is one of the most common allergens, but also because it interferes with hormones. Soybean protein naturally contains phytoestrogens called isoflavones that may mimic the activity of the hormone estrogen in your body. Soy is also a goitrogen, a substance that suppresses the thyroid gland and interferes with thyroid hormone production. If you must consume soy, please choose organic and/or fermented products in small amounts.
When Not to Eat: Intermittent Fasting
Intermittent fasting is a hot topic right now. The truth is, it is nothing new. Our ancestors went for long stretches between meals due to scarcity. Our bodies are designed to rest and digest between meals. Modern intermittent fasting refers to stretching out the time between your evening and morning meal or greatly reducing the amount of food you consume a couple of days each week. Research tells us that intermittent fasting can help cellular regeneration, lower insulin levels, boost weight loss, and fight stress and inflammation as well as reduce depression and improve brain health.
Intermittent fasting isn’t for everyone. If you have an eating disorder, diabetes, or an impaired metabolism, skipping meals may be more than your body can handle. Finally, if you notice dizziness or you stop getting your period, stop fasting.
I suggest trying to fast four days a week. On these days, create a twelve-hour gap between dinner and breakfast (for example, 6 p.m. to 6 a.m.) in which you don’t eat at all. Experiment and see if this works for you.
Eliminating these three allergens during the 21-Day Plan will reduce inflammation and help you determine if you are sensitive to gluten, dairy, and/or soy. Later, you may want to try reintroducing them into your diet one at a time and watching closely for signs of trouble. Experience tells me that you’ll notice a difference right away.
I use tree nuts, fish, and eggs in many PCOS Diva recipes because they offer fantastic health benefits. Please skip those if you know you are sensitive to them! If you’re feeling better after eliminating milk, gluten, and soy, consider removing the other common allergens one at a time and paying attention to your body’s response in order to identify other inflammatory foods you should avoid.
Foods That Balance Your Blood Sugar Level
Sugar and carbohydrates can throw your insulin off balance, setting off a cascade of cravings, fatigue, moodiness, and hormonal imbalance. Avoid processed foods and experiment with low–glycemic index carbohydrate choices, such as berries.
Symptoms of Falling Blood Sugar
Sweating (especially at the back of the neck below the hairline)
Nervousness, shakiness, and weakness
Extreme hunger and slight nausea
Headache
Fast heartbeat
Irritability and mood swings
Sleep disturbances (night sweats, confusion upon waking, nightmares, waking suddenly)
Dizziness
Blurred vision
Anxiety
If you have trouble recognizing how different foods affect your blood sugar, try using a glucometer, a tool that measures the approximate amount of glucose in your blood. When I began experimenting with my diet, I realized that I had become totally disconnected from my body’s blood-sugar signals. I didn’t connect the pizza I ate to the energy crash two hours later. The glucometer helped me connect the dots. Though not required, I encourage you to give a glucometer a try, adjust your food choices, and talk to your doctor about your findings next time you visit.
The PCOS Diva Plate
Two of the biggest challenges fledgling PCOS Divas face are discerning serving sizes and eating the right combination of protein, carbs, and fats at each meal. The PCOS Diva Plate will help you quickly determine how much to eat of each food and eliminate calorie and carb counting. That can take the pleasure out of a nice meal fast.
Every PCOS Diva is unique, so experiment with your combinations. You will know you have the right combination when you feel satisfied immediately after your meal and energized for hours afterward. Here is the formula that works for me and thousands of PCOS Divas. Based on a medium-size dinner plate:
Fat Is Your Friend
Well, some fats are your friend. Among the many benefits, good fats aid nutrient absorption and improve satiety. Try these healthy fats:
Avocado and avocado oil
Grass-fed butter
Extra-virgin olive oil
Virgin coconut oil, coconut manna
Nuts and seeds and butters made from them
Fish and fish oil
Fill ½ of the plate with leafy greens or nonstarchy veggies.
Fill ¼ of the plate with starchy root veggies or a gluten-free whole grain.
Fill ¼ of the plate with a lean protein.
Add a generous portion of healthy fat.
As you eat, be mindful about how full you feel. At some meals, you may clear your plate; at others, you will eat less. Despite what your grandmother told you, there is no need to clean your plate at every meal. That may leave you feeling overstuffed and logy. What’s the point?
If you choose to have seconds, keep the PCOS Diva Plate in mind. If you take more grains, have more protein and veggies in proportion.
Eating on the Go
You’ve heard the old adage, “Breakfast is the most important meal of the day.” At least, that’s what cereal companies want us to think. For women with PCOS, though, breakfast really is critical. A solid breakfast can help to keep our blood-sugar levels even. Please don’t skip it because you are running out the door or feel nauseous when you wake up. This nausea may be attributed to low blood sugar and eating will usually help.
During the next 21 days, you will experiment with the kind of breakfast that works best for you. You will find a few favorites and establish a routine that basically automates breakfast. Try to incorporate some protein and greens every morning. I do this by having a protein smoothie almost every day. I can take it with me in the car, and it will give me sure-fire energy until lunch. Steel-cut oats travel well too. Make some protein bars, and eat one in the car if you must. The point is to find something that nourishes you first thing and keeps you fueled throughout your morning.
Lunch is our chance to refuel, and PCOS Divas have a secret to the perfect lunch—automation. I have two tricks to help you accomplish this. First, as you clean up dinner, package up the right PCOS Diva Plate combination of leftovers for your lunch tomorrow. Your coworkers will envy your gorgeous lunches, and it will save you time in the morning. Second, salad in a jar can be made days ahead. Just grab and go!
Tips for Dining Out
Use www.findmeglutenfree.com or the app to help identify restaurants.
Visit a restaurant’s menu online before you go, so you can plan what you’ll order.
If all else fails, request grilled or broiled chicken or fish and then ask for whatever fresh veggies they have in the kitchen.
Have the bread basket taken away, so you’re not tempted (even if it is gluten-free).
Choose dishes that have a lot of veggies and some lean protein, and ask if the veggies can be lightly sautéed or steamed.
Ask the server to bring you some olive oil or real butter and fresh lemon to flavor the veggies.
Request a double serving of vegetables to replace the white potatoes or rice that often accompanies dinner.
Order sparkling water with a squeeze of lime or lemon.
Snacks work much the same way. We will plan snacks ahead of time, so that you have them on hand when you need one. Try to keep emergency snacks stashed in convenient places, like your purse, car, or desk. No more trips to the vending machine for you!
Every PCOS Diva deserves a night off. Once in a while, go out to a restaurant and let someone else cook for a change. It is also a chance to strengthen your PCOS Diva muscles. Remember my story at the beginning of this book about ordering a sweet potato? Many restaurants now have gluten-free and/or healthy options already on their menus. If they don’t, just ask! Trust me, you will not be the first person to ever ask them to “hold the bun” or whether there is dairy in a sauce. It’s not rude to ask. They want you to be a satisfied customer as much as you want to feel good. If you find that isn’t true, find a different restaurant next time. Be a PCOS Diva! You deserve to eat well and feel great.
Can I Be a PCOS Diva and a Vegetarian/Vegan?
In my experience working with women with PCOS, it is difficult to manage PCOS on a vegetarian/vegan diet. Women often trade animal protein for processed soy (which throws hormones off balance) and large quantities of beans (which can spike blood sugar). That doesn’t mean you can’t have meatless meals during the week; it’s just difficult to be completely exclusive without intensive help from a nutrition professional.
Drink like a PCOS Diva
Americans each consume roughly 66 pounds of added sugar per year. That’s about 20 teaspoons per day! Much of that comes from our beverages. Sodas and other soft drinks like lemonade and iced tea are the main culprits. Also, watch your coffee. You might be shocked to know how much sugar is in the latte from your favorite coffee shop. As PCOS Divas, we don’t drink our calories. Diet-soda lovers, don’t think you are off the hook either (see below).
The problem isn’t just the extra calories. The sugar in these drinks kicks off the unhealthy insulin cycle that we are working so hard to get under control. These sugary and often caffeinated beverages can also overstimulate the adrenals as well as cause anxiety and oxidative stress. Upgrading your daily beverages may mean changing a very ingrained habit, but if you are mindful about your choices, it will soon become second nature.
PCOS Diva Beverages
PCOS Divas drink:
Warm water with lemon in the morning. Lemon water is a great way to hydrate and energize first thing. It also will reduce bloating and help you better absorb nutrients all day.
Infused water. Experts say we need 64 ounces of water every day. I find that women with PCOS need more. Make 64 ounces your minimum and adjust up from there. Jazz it up and make it even better for you with these add-ins, but don’t feel limited to these. Get creative! Just try to use low–glycemic index fruits.
Lemon stimulates the liver and helps release digestive enzymes. Lemon water contains useful antioxidants and electrolytes (potassium, calcium, and magnesium) and is a rich source of the immune-boosting vitamin C.
Ginger is a great pain reliever for many things from menstrual cramps to headaches. It’s also energizing and smells fabulous. Make a pitcher of ginger tea to drink throughout the day. Grate a 1- to 2-inch piece of ginger root. Add 3 to 4 cups of water and a squeeze of lemon. Strain and serve over ice.
Strawberries are packed with vitamins, minerals, and other antioxidants. They contain potassium, vitamin K, and magnesium, which are important for bone health, and biotin, which is good for your hair and nails. They also can help ease inflammation.
Coconut water contains antioxidants, amino acids, enzymes, and minerals like iron, calcium, potassium, magnesium, manganese, and zinc as well as vitamin C and B vitamins. Add a splash!
Herbs, such as mint, lavender, or basil, can be refreshing.
Mineral water or seltzer. Bubbly beverages like mineral water and seltzer are great replacements for soda. Add a splash of fruit juice or real fruit for added flavor.
Tea. Studies have shown that green and spearmint teas can reduce androgens, but there are health benefits in all teas (see box on here). If you need a sweetener, try a little stevia or honey.
Apple cider vinegar. Full of enzymes, good bacteria, and acetic acid, apple cider vinegar has been shown to drop blood sugar levels by 6 percent. Studies have shown it works as effectively as metformin in people with insulin resistance. Drink the following beverage before each meal to improve insulin sensitivity and prevent blood-sugar spikes:
To a 12- to 16-ounce glass of water add:
2 teaspoons apple cider vinegar
2 teaspoons lemon juice (balances blood sugar levels and contains vitamin C)
A sprinkle of ground cinnamon (a fat-soluble antioxidant that lowers blood sugar)
A dash of cayenne pepper (optional; can reduce blood sugar)
If you are on metformin, consult your doctor. Combining apple cider vinegar and metformin may make your blood sugar too low.
PCOS Divas Don’t Drink Diet Soda
During my Discover Your PCOS Diva Jumpstart Program, I ask participants to eliminate soda, especially diet soda. Since many women switched to diet soda from regular soda to save calories, they are shocked to find that the swap does them no good. It may even make things worse. And now they’re addicted. So why is diet soda a big PCOS Diva no-no?
It confuses your body. The artificial sweetener in diet soda is so sweet that it dulls your senses over time, so you will eventually not recognize when you are consuming sugary things. The result is that you consume sweeter and sweeter things to get the same sensation; natural sugars in fruit will no longer sate your sugar craving. In addition, according to the Harvard School of Public Health, “By providing a sweet taste without any calories . . . artificial sweeteners cause us to crave more sweet foods and drinks, which can add up to excess calories.”
It raises your risk of diabetes, stroke, and heart disease. A recent study shows that people who drink diet soda every day increase their risk of metabolic syndrome (high blood pressure, abnormal cholesterol levels, excess body fat around the waist) by 36 percent, which raises the risk of diabetes, stroke, and heart disease.
It doesn’t help you lose weight. Typically, people who drink diet soda make up for the calories they “saved” somewhere else. I’m sure you’ve seen people order a Big Mac with a Diet Coke. In fact, many studies show that diet-soda drinkers have a larger waist circumference than those who do not drink diet soda. People who consume two or more diet sodas per day have an even greater increase in weight around the middle—what researchers called “a striking dose-response relationship.”
It is associated with depression. Studies show that people who consume four or more cans of soda per day (diet or otherwise) are 30 percent more likely to develop depression than those who do not consume sugary drinks.
It increases your risk of osteoporosis. Tufts University researchers found that female cola (caffeinated or decaffeinated) drinkers had lower bone mineral density in their hips than women who didn’t drink soda regardless of age, body mass index, physical activity, alcohol intake, and other factors. Again, frequency of consumption matters. “Women who drink cola daily had lower bone mineral density than those who drink it only once a week,” explains lead researcher Katherine Tucker.
It has no nutritional value. Other than a small amount of water, soda is made entirely of artificial ingredients that, at best, offer no nourishment.
Phasing out diet soda is an act of self-care. I understand the deep psychological attachment and know that it can be a hard habit to break. Start small. First, decide that you want to stop. Then slowly begin upgrading to healthier beverages until diet sodas are crowded out and your taste buds return to normal.
PCOS Divas Sometimes Drink Wine
One of the world’s favorite indulgences is wine. Many of my clients like a glass at the end of the day to help unwind. That’s totally fine. If you are a wine lover, I encourage you to savor a glass of red wine with a meal, but no more than three times a week. Why so infrequently?
Wine weakens resolve. You are much more likely to make PCOS-unfriendly choices if you have more than a glass.
Wine depresses the function of your adrenal glands. Inadequately functioning adrenals can lead to issues with inflammation and sleep patterns.
That said, there are health benefits to wine. It is widely understood that, in moderation, wine can support cardiovascular health. We now know that red wine (pinot noir especially) contains resveratrol, which has noted anti-inflammatory, antioxidant, anti-aging, and cardioprotective properties. In addition, new research indicates that resveratrol may “help moderate the hormone imbalance that is one of the central features of PCOS.” Unfortunately, in order to metabolize enough resveratrol to make an impact, supplementation is needed. It is not feasible or safe to drink that much wine.
So go ahead and indulge in a glass of wine, but be sure to enjoy it with a meal to lesson your blood-sugar response.
Tea
Tea is an important part of my self-care. The ritual of preparing tea is calming, and the unique flavor of each infusion is one of my “sweet treats.” Beyond these benefits, tea can be used medicinally by women with PCOS to help with some of the toughest and most common symptoms.
Insulin resistance. Studies show that regular consumption of tea can reduce insulin resistance, a precursor of diabetes and weight gain. Black, green, ginger, turmeric, and cinnamon tea are all effective.
Androgen excess. Tea’s anti-androgenic effects and ability to modulate estrogen production make it a popular treatment for PCOS. Spearmint, red reishi, licorice, Chinese peony, and green teas all have androgen-lowering effects.
Mood, stress, and anxiety. Tea is an excellent stress reliever. Tea contains an amino acid called L-theanine, which studies show creates a state of deep relaxation and mental alertness. In addition, researchers have found that tea promotes a sense of calm distinct from its chemical impact on our body and brain. In this way, drinking tea is an act of self-care. I especially like matcha and chamomile teas when I’m stressed.
Inflammation. Tea has been used for centuries to fight inflammation, and modern science has finally verified its analgesic and anti-inflammatory properties, particularly in green tea varieties. This means relief for PCOS symptoms such as acne, headaches, and fatigue, and it may lessen weight gain and decrease your risk of diabetes.
Use Supplements to Fill in Gaps
There is no “perfect” diet. Even a well-balanced diet will have nutritional gaps. Women with PCOS often benefit from herbal supplements to help with specific symptoms such as insulin resistance, inflammation, hormone balance, or stress.
So why can’t we simply upgrade our diets and get the nutrients we need? The following are the main reasons women with PCOS may find themselves to be nutrient deficient.
Deficient diet. The Standard American Diet (SAD)—a diet high in sugar and refined carbohydrates and low in lean meats and vegetables—seems an obvious reason for nutrient deficiency. Many Americans are overfed and undernourished as a result of SAD. For women with PCOS, this diet induces high levels of insulin, which stimulate androgen receptors on the ovaries and cause many of the most common symptoms, such as hirsutism, thin hair on the head, and acne. Our bodies signal this lack of nutrients with increasing intensity as the problem goes on. Eventually, diabetes may develop. Studies specifically find that zinc, magnesium, chromium, and vitamin D are commonly deficient in patients with diabetes and women with PCOS.
Even if you have upgraded your diet to include lots of vegetables and lean meats, the foods available to the general public no longer contain the high levels of nutrients they enjoyed historically. Modern agricultural methods have stripped nutrients from the soil. The blueberries you eat today probably do not contain the same amount of nutrients that blueberries did when your grandmother ate them.
Nutrient conversion issues. Research demonstrates that many women with PCOS are unable to convert vitamins and minerals into the forms needed in the body.
Methylenetetrahydrofolate reductase (MTHFR). This gene instructs the body to make an enzyme that converts folic acid (B9) into a useable form, folate. When this occurs, we say it has been methylated. If you have the MTHFR mutation, your body is less efficient at making the conversion and therefore utilizing the folic acid in multivitamins and prenatal vitamins, which is important in preventing serious birth defects. A lack of folate may also result in lethargy, mood disorders, and impaired cognitive function. MTHFR is also responsible for converting homocysteine into methionine, which you need for growth, cell repair, and metabolism. High levels of homocysteine in the blood may negatively affect mood and mental health and are associated with cardiovascular disease, high blood pressure, depression, migraines, and more. A high-quality supplement containing folate instead of folic acid can help. I suggest all women with PCOS be tested for the MTHFR mutation.
Delta-6-desaturase (D6D). Foods such as flaxseed, leafy greens, and walnuts are high in an omega-3 fatty acid called alpha-linolenic acid (ALA). Omega 3s are widely recommended for their many health benefits, especially for the brain, eyes, and heart. For women with PCOS, sufficient amounts of omega 3s can improve fertility, regulate hormones, improve insulin sensitivity, stave off inflammation, reduce hirsutism, and reduce the risk of fatty liver and heart disease. Unfortunately, for ALA to be used in the body, it must first be converted by an enzyme called delta-6-desaturase (D6D) into one of two other omega-3 fatty acids, docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA). This transformation is very inefficient and is further inhibited by elevated cholesterol, caffeine or alcohol consumption, saturated fat or trans-fat consumption, vitamin and mineral deficiencies, and hormonal abnormalities, insulin resistance, and hypothyroidism. Even when D6D functions normally, only about 8 to 20 percent of ALA is converted to EPA and 0.5 to 9 percent to DHA (this may be slightly higher in women of childbearing age or who are pregnant). The omega 3s found in fish (and fish oil) are already in the form of DHA and EPA, so they do not need to undergo this conversion and are more bioavailable. Still, it is hard to safely eat enough fish to meet the daily requirements.
Inositol. Inositol is a vitamin found in whole-grain foods and made by your body from glucose. Myo-inositol and D-chiro-inositol are two of the nine naturally occurring inositols that people need. These two inositols help with insulin sensitization, and women with PCOS commonly benefit from supplementation.
Found in meat, myo-inositol is critical for properly functioning insulin receptors. It has also been linked to the activation of serotonin (a “feel good” hormone) receptors, which could relieve depression and improve appetite, mood, and anxiety. Supplementation may help with inducing menses and ovulation and reducing acne and hirsutism. Myo-inositol is found in food, but women with PCOS often have a defect in their insulin pathways, which are heavily reliant on inositols. Adding myo-inositol supplementation seems to alleviate the problem.
Not abundant in our diets, D-chiro-inositol (DCI) needs to be converted from other inositols (myo-inositol and D-pinitol) by the body in order to be used. Studies suggest that women with PCOS may not be able to efficiently convert other inositols to DCI. Low levels of DCI have commonly been observed in women with impaired insulin sensitivity and PCOS. DCI increases the action of insulin, improves ovulatory function, and decreases serum androgen, blood pressure, and triglycerides. It may also help decrease testosterone and improve IVF outcomes.
Check Your Vitamin D
Three out of four women with PCOS have a vitamin-D deficiency. This may exacerbate the symptoms of PCOS and increase the risk for multiple sclerosis, inflammation, type 1 diabetes, osteoporosis, high blood pressure, heart disease, insulin resistance, and breast and other cancers. A vitamin-D deficiency may be caused by a genetic variation or a nutritional deficit.
Vitamin D works to inhibit inflammation. In a recent study, researchers at National Jewish Health found a DNA receptor specifically for vitamin D. They discovered that a lack of vitamin D will cause suboptimal activation of the receptor and put patients at risk for inflammatory diseases. Moreover, they discovered improvement with vitamin D supplementation. Since vitamin D is critical to the absorption of calcium, a deficiency causes a cascade of related issues.
I encourage all women to have their vitamin D levels checked right away. It is a simple test, and a deficiency is usually a straightforward thing to fix and can make a world of difference throughout your body. If your doctor does recommend a supplement, choose one like PCOS Diva Super D, which combines a high-quality vitamin D with vitamins K1 and K2 to facilitate absorption.
Medications. Many medications sap your nutrients. Women with PCOS are almost always prescribed either the birth control pill, metformin, or both. Each of these depletes important nutrients, which must be replaced.
Studies show that women who use the birth control pill have lower levels of B2, B6, B12, and folate compared to women who do not use oral contraceptives. This is of particular concern, because the body needs these critical B vitamins for metabolizing fats, proteins, and carbohydrates, and deficiency can cause anemia and depression. In fact, low levels of B6 may explain the increased risk of blood clots in women who take the pill. Low folate can cause birth defects. Other studies indicate that the pill may deplete vitamin C, vitamin E, magnesium, selenium, zinc, and coenzyme Q. Unfortunately, zinc and magnesium deficiencies are a common cause of unexplained infertility and recurrent miscarriages. Hair loss is often an indicator of a zinc deficiency.
Meant to lower insulin levels, metformin also depletes the body of Vitamin B12 and other nutrients in 30 percent of patients. B12 has recently taken center stage, and rightly so, as a shortage of B12 is associated with nerve pain, cognitive dysfunction, and anemias. B12 is also critical for many of the detoxification pathways and for DNA stability.
Recommended Supplements
There is no “PCOS supplement.” Every woman is unique. That said, there are a few supplements that I strongly advise women with PCOS to try. These supplements are certainly not the only ones that can help, but they are a good place to start. For a more complete list of supplements appropriate for women with PCOS, visit PCOSDiva.com/supplements and download the Complete Supplement Guide. Before beginning any supplements, natural or otherwise, check with your doctor for any possible interactions.
A multivitamin: A highly bioavailable multivitamin, like my PCOS Diva Essentials multivitamin, containing methylated B vitamins and insulin sensitizers such as chromium, vanadium, alpha-lipoic acid, zinc, and magnesium will support your metabolism. I take six capsules of PCOS Diva Essentials per day, three in the morning and three at lunch.
A prenatal vitamin: If you are thinking about getting pregnant, already are pregnant, or are breast-feeding, you need a high-quality prenatal vitamin. Be sure it contains folates (not folic acid), calcium and magnesium (for healthy bone development), iron, zinc (for reducing the risk of preterm birth), and iodine (for reducing the risk of birth defects).
Fish oil (an omega 3 with EPA and at least 1000 mg DHA): Most important for us, fish oil promotes normal insulin production and a healthy inflammation response. It can also support healthy hormone balance, reproductive functions, cholesterol and blood pressure levels, mood stability, and heightened brain function. Also critical is fish oil’s role in our natural detoxification process by supporting the liver. If you are allergic to fish, consider an algae-based DHA supplement. I take two capsules of PCOS Diva Ultra DHA a day.
