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Sweating and breathing heavily after climbing up several sets of stairs, I opened the door to my apartment. It was absolutely boiling. Boiling!! The humidity in Boston last week was quite treacherous — it felt unbearable to purely exist in, let alone cook, clean, or even think about hiking up and down all the stairs to do laundry in an apartment with no A/C. I realize that it’s much hotter in other places, but for Boston it felt so hot!

I’d just gotten home from my second day of a new job at a hospital — my scrubs were sweaty, I was hungry for dinner but had no desire to turn on a hot stove or unload the dishwasher, and I was becoming easily annoyed at the littlest, most irrelevant things. Just as I was about to get some food going and, quite honestly, start complaining (to myself) again, a little thought popped into my head: “Ok wow. I’m actually so thankful I get to wear scrubs for this job. Yeah I’m super sweaty and need to take a cold shower asap. But…at least I don’t have to be in nice work clothes like my last job in this sweltering heat. I’ve never had an opportunity to wear scrubs to work before.” Even though it was hot and gross and I had been letting that get the best of my attention and attitude….for a moment, I felt lucky. I appreciated this new job. I appreciated that, so far, I’d had two really good first days. I felt happy to be able to wear comfy (and cute) scrubs + sneakers to work. In that second, I realized that while I couldn’t control the heat, I could change the way I was thinking amidst the gross temperatures. This sounded simple. Yet it was having a more-than-simple effect.

I was probably a bit dehydrated, and while being agitated is surely a normal, understandable part of being stuck in a humid heat wave, I was letting it affect an otherwise perfectly calm, lovely, and free evening for myself. There were so many more things to be grateful for than there were to be mad and pessimistic about: I have a job, an apartment to come home to, food, water, and supportive friends and family who I love and who love me.

This roasting day last week helped me realize something that I hope to make into a habit this summer. A habit that hopefully grows and evolves as I do: cultivating an attitude of gratitude and being in a state of thankfulness when I can be. I realize it isn’t always easy or our first inclination to be grateful. And I completely realize that we all have the right to be annoyed at things every now and again. That’s sometimes a part of being human! But here’s the crazy part — what I’m learning through trial and error is that when I practice more gratitude, I find myself becoming happier, more easygoing, and less bothered by things in daily life. I don’t know about you, but anything that provides an avenue to more happiness and love in my life is something I want to try and incorporate when possible.

‘Thank you’ is the best prayer that anyone could say. I say that one a lot. Thank you expresses extreme gratitude, humility, understanding. -Alice Walker

With that story being said, I wanted to pass along some tips for gratitude that I’ve tried recently — maybe they’ll help you too. And if you have any thoughts on thankfulness, or ways to add more of it into your life, I would love to hear them in the comments!

1.) At dinner, or as you wind down for the evening, jot down one thing that you’re glad or thankful for from that day.

I know, I know…everyone says this one. (I thought it was annoying at first, too.) BUT, I’ve actually realized how easy it is to do this, and how nice it feels to be winding down from a busy day and take literally five seconds to appreciate something good from earlier. There are many, many moments in each day to find gratitude in, and writing down just one is a positive step towards cultivating more thankfulness.

2.) If you’re not into any kind of journaling, set a “gratitude” alarm that goes off at a good time for you — you can make the alarm have a prompting label that’ll give you a little nudge to find thankfulness. Such as “what’s something good that’s happened today so far?”

Without exception, every person I interviewed who described living a joyful life or who described themselves as joyful, actively practiced gratitude and attributed their joyfulness to their gratitude practice. -Brené Brown

3.) Be grateful for something that you don’t have yet, but that you’re hoping to happen. This may seem woo-woo or “out there”, but I’ve actually come to love this so much. It’s one thing to cross your fingers and wish for that exciting thing in your future; it’s another thing to have the confidence that it’s going to happen — so much confidence, in fact, that you’re already thankful that it’s coming into your life. You might not think about it like this right away, but I think this way of thinking can be brave. Deeply hoping in something feels risky.

4.) Change your wording. If you find yourself complaining about XYZ, changing how you phrase your thoughts could be a first step towards gratitude. For example, if you’re upset about a grade you received or a project you have to work on that isn’t super up your alley, maybe try changing your perspective and see what happens. Instead of “I can’t believe I got that low of a score on this test”, try saying “that was hard. I studied a lot, and even though I didn’t do as well as I wanted to, hey at least I’m getting a college education and I’m still learning a ton of stuff that otherwise I wouldn’t be.”

Instead of “This project is the stupidest and most boring thing I’ve ever had to work on, why are they making me do this,” you could say, “Well it feels good to make money. This project might not be my favorite, but I know I like other things about this job that I appreciate, and I’m thankful to be receiving an income.”

And that’s what I have to share for this month! I hope you have a wonderful day. Today, I’m grateful for YOU, for Robyn + the RLWH team, for ED recovery, and for a new job that I’m finding so much fulfillment in.

The post Lessons From Gratitude appeared first on The Real Life RD.

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Being in a place where you want to learn intuitive eating and stop dieting, but also lose weight is pretty normal place to be in this journey. Desiring weight loss is mainstream in our culture, so if you desire to lose weight, that makes sense. In fact, expected. That doesn’t mean intuitive eating is a means to weight loss – it is not at all and if you see it marketed as that, that’s called a diet and not intuitive eating – but I think it’s normal for someone to be grappling with wanting to change their body, but also wanting to find freedom with food. You can be in that tough, tense space and wrestle with these concepts…that’s part of the process. And you can still want to change your body when you begin body image work. That’s normal. The tough part is coming to a place where you’re no longer actively pursuing weight loss or changing your body. Attempting to manipulate your body will get in the way of your IE journey and your ability to work towards body tolerance and acceptance. If you’re not there yet, that is okay. You’re right where you need to be and giving yourself time and space to wrestle through that is really important.

Body image work is hard. And it’s far more complex than, “love yourself.” It’s messy and uncomfortable and at times scary and there’s a large dose of uncertainty. In reality, many of us will never love our bodies. We can work towards acceptance and appreciation and caring of our bodies…but in order to have healthy body image you don’t have to love your body. That’s a high expectation that some will experience, but it isn’t a requirement for healthy body image.

A big part of the intuitive eating and body acceptance journey is letting go of and grieving the thin ideal. Or if you already live or have lived in a small body, letting go of your “thinner” body that once way or that is currently unsustainable. In order to find acceptance, we often have to go through a grieving process.

You might grieve the social events, relationships or other things you missed out on while dieting and being consumed with your body and weight. You might grieve all the time and energy you spent working toward an ideal weight or body size that wasn’t sustainable and that is now changing. You might feel grief over the possibility that yo-yo dieting increased your set point due to weight cycling. Maybe you’re grieving the physical harm done to your body through dieting, over exercising, laxative abuse, or other harmful behaviors. It can be really hard to come to terms with a medical diagnosis caused by these behaviors. I’ve had several clients share with me that after they became pregnant without the help of fertility treatments because their fertility struggles were caused by nutrition/exercise choices, they were really sad and angry about what they had put their body through with diet and exercise. Perhaps you’ve dreamed off all the things you would do once you got to ___ weight or body size or how you would feel when you were ___ body size. Maybe you have fantasized about life simply being better or your problems going away once you lost the weight.

Letting go of the person you have dreamed of being can literally feel like losing a close person in your life. Accepting that no matter your body size, you are still you and you still have to deal with the mental and emotional problems in your life no matter what your body size can be really hard. But letting go of these things allows you to actually begin living your life. It allows you to begin showing up for yourself. Contrary to what we think, we actually have very little control over our bodies – unless we are willing to do extreme things which sometimes people are willing to do for a short time, but not for life. Genetics are powerful. And our socioeconomic status, ethnicity, and race are a few of many other factors that greatly affect our body size and health, but that we actually have very little or no control over at all.

There is a level of uncertainty to the journey towards intuitive eating. I tell my clients that there are 3 possibilities with your body when you embark on IE and letting go of dieting – your body can get smaller, stay the same, or your body will get larger. There are no guarantees in the journey and that can be terrifying. But what IS worthwhile is choosing to engage in behaviors that honor your health and help you care for your entire self – body, mind and soul – versus choosing behaviors to manipulate your body size. It might get better before it gets worse, but in the long run it is so worth it.

I read a post a few months ago by my RD friend and colleague, Rachel Hartley  on moving through the stages of grief when it comes to body acceptance that I would highly recommend reading. This process is an ebb and flow. This ebb and flow is why I say we never really arrive. There’s no finish line. Life is always changing and there were be times in our lives when things happen that make us really vulnerable to negative thoughts about our body or make us want to go back to dieting or exercising unhealthily.

What I found to be really helpful in my journey and what many other women have found helpful is writing down all the things you lose by trying to control or being obsessed with your body size. Diet culture is really alluring and enticing. It shows you all the positives (that are often unrealistic and untrue) and none of the negative. That diet your friend is on sounds so good when you’re feeling uncomfortable in your body. But what would you lose or what would you have to sacrifice to get there? What would you miss out on? How would your relationships be affected? What do you want to remember in the years to come – obsessing about food and your body or living your life in a meaningful and purposeful way?

It’s okay if you aesthetically prefer your former body or if you aesthetically prefer a fantasized thin body you’ve never had. I think you can prefer that body, but accept and appreciate the body you do have at the same time. We can hold them both. I prefer my smaller body, but the sacrifices I would have to make to get there are 1000% not worth it to me and I much prefer the whole person that I am in the body I live in today. Nothing is worth the feeling of truly and fully living.

Maybe you’re on your intuitive eating journey, but deep down holding onto hope that one day you’ll fit back into those shorts you once wore. Maybe you’re eating more flexibly than you have in the past, so things are better, but you’re still thinking about your body often and terrified of it changing. Maybe you’re scared that you’ll never be able to stop eating if you fully embrace intuitive eating and walk that path, or maybe you’re terrified your body will never stop gaining if you truly let go of control. Those are real and honest feelings and you are not alone in that. I would really encourage you to dig deep into the Intuitive Eating and Health At Every Size (HAES) concepts.

The books, Intuitive Eating, Health At Every Size and Body Respect are great places to start. HAES and IE do not mean, “eat whatever you want and be happy” Both concepts are very concerned with physical health while also being concerned with one’s mental and emotional wellbeing…which ultimately impact physical health. In the same breath, I recognize that embracing IE and HAES for me, in a culturally accepted thin body, didn’t come with the added layer of stigma and oppression that it would have if I was living in a larger body. Embracing this concepts can be really hard so give yourself time and space and safe people to process this with.

Letting go is a key part of being able to come to peace with your body and food. It’s hard and it’s scary and it’s uncertain, but you’ll never know how full and meaningful life could be until you release the grip of diet culture and decide to give yourself the opportunity to experience what that life might look like.

I’d love to hear your thoughts and own experiences in the comments <3

The post Letting Go of the Thin Ideal or Your Thinner Body appeared first on The Real Life RD.

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1. Weekend with Alexis and Simi

Alexis and Simi came to visit Boston this weekend and saying it was a blast is a complete understatement. Friday we had lunch at Dig Inn and then explored Boston on bike and then ate dinner at Kava – an amazing Greek restaurant in the South End I highly recommend. Saturday was the greatest – we took a day trip to Portland, Maine. I’ve been wanting to go forever! We picked up donuts from Holy Donut when we got there and planned to take a ferry ride but then the boat got too full and we couldn’t get on which was a bummer. Oh well.

Instead we sat on the dock eating donuts and then spent the morning walking the Back Cove Trail along the water before stopping for lunch at Local Sprouts Cooperative. After lunch we went stand up paddle boarding (the water was choppy and the tide was strong – aka it was HARD) and then went to Urban Farm Fermentory – a really cool place that has all kinds of kombucha, hard cider and beer on tap.

We ended the day with dinner on the water at Portland Lobster Co. where we listened to live music, sat outside, and ate lots of lobster. I’ve never eaten a whole lobster and probably never will again – give me lobster already cleaned and stuff. But it was delicious and the atmosphere was so fun.

Sunday, we brunched over in Cambridge at Alden and Harlow and then strolled around Cambridge and then drove over to Jamaica Pond to walk and explore. We grabbed Whole Foods hot bar for a quick dinner on the way back and then sadly said goodbye. It was such a great weekend. I wish they lived here!

2. Pinterest Gem

I found this image on Pinterest and thought it hit the nail on the head. I love when you find words from someone else that articulate a thought so well. I hope this is encouraging or motivating or whatever you need it to be for some of you reading. <3

3. Update on my NP job

I had a few people ask for some updates on my NP job in one of last week’s post and so I thought I’d share some. I’m not intentionally withholding, I just forget/didn’t think about sharing. Oops! I mentioned back in May that I was starting a new NP job at an inpatient eating disorder hospital. For those of you that have stuck around long enough for the saga…essentially it took WAY longer for me to get licensed in Massachusetts than I ever anticipated (5 months vs what I naively thought would be 6-8 weeks) so the delay in job was partly my fault, some of MA Board of Nursing for being characteristically slower than normal, and quite honestly…finding a job in women’s health and/or eating disorders was slim pickings. It made me realize how lucky I was for the quick job search process after graduating in New York!

I’m about a month in now and really enjoying this new job. The biggest adjustment for me has been 1) not being in the outpatient setting and 2) not have the responsibility of also being a patient’s primary care provider. I have always worked outpatient as a nurse practitioner (and an RD) so being in the inpatient setting is a totally different environment and higher acuity (obviously) so that was an adjustment. I’m use to caring for people for months and months, but with inpatient it might be a few weeks to a couple months max. I do LOVE the collaboration, multidisciplinary environment and high quantity of clinicians and providers in this setting versus my old job where it was a primary care office with myself and the physician. There are A LOT of things I miss about my last job (the physician was amazing and thankfully we still collaborate since he medically manages some of my private practice clients, I loved being able to do a lot of eating disorder work but also bits and pieces of everything else – mainly women’s health and then anything else that walked through the door, I loved the family like feel of the clinic, and much more) but I am finding myself enjoying the unpredictability of the inpatient setting and the acuity of patients and everyone at this new job has been so kind and welcoming.

Right now I do admissions on the inpatient unit and then also cover when the attending physician is out – I also see some patients in residential when they’re admitted. One perk, the flexibility! In the outpatient setting it’s normal business hours and you have to stay on time with patient appointments. I suck at staying on time, so I found that really stressful. In the inpatient setting, I can spend more than 15 minutes with a patient. Because there aren’t “times” you meet with patients, you can spend as much time as you need. If a consult comes in, acuity is prioritized and I see the patient as soon as I can. All new admissions must have a history and physical and initial assessment within 24 hours. Before that, they are seeing other important people like the RD, therapist, nurse etc. So for me, not being on that “only 15 minutes for each patient” time crunch is less stressful and my work feels more thorough. I also really love the non conventional hours – sometimes I work 7am to 2pm and sometimes 10am to whenever all the patients are seen. Some people thrive in a structured, regular schedule. I’ve learned over the years that I really work best with a lot of flexibility. That’s that for now!

4. Tips and strategies for eating foods once “off limits”

I think one of the most frustrating and misleading things when beginning your IE journey is this idea of “if you give yourself full permission to eat ____ food you’ll stop binging, overeating or having negative experiences with that food.” That idea is a lot of times false and can possibly make someone feel a lot of shame and like they’ve failed if they give themselves permission to eat a food, and then they aren’t able to eat that food intuitively right off the bat. Maybe that resonates with you? If so, I 100% hear you and you aren’t doing anything wrong. Think of intuitive eating as a skill. You have to learn the fundamental skills in order to move onto more advanced skills. If I came home tired and stressed from the workday and was feeling really hungry and there was a pizza leftover in the fridge and I was by myself that night…I’d probably overeat that pizza too. I’m really vulnerable in that situation! I’m having a human experience. So when we are working with clients, we get strategic about introducing previously “off limit” foods to bring down as many vulnerabilities as possible so you’re in the best position to have a positive experience. Here are some things to consider that might bring down some of those vulnerabilities..

  • start with a low anxiety food not with a food that you feel most anxious about (for example, a homemade granola bar versus a cookie)
  • make sure you’re not super hungry before eating – if you’re eating ice cream or a cookie, maybe you eat that after a nourishing lunch or dinner, if it’s pizza maybe you have a slice when you’re about a 5 (neutral) on the hunger/fullness scale
  • eat with safe people – sometimes eating alone can make us more vulnerable to negative food experiences, but eating with a close person (parent, spouse, friend, etc) can make it easier
  • eat in a calm environment, not when you’re feeling really stressed or highly emotional
  • plate the food and have a plan for what to do afterward finishing the portion – will you go on a walk, do deep breathing, journal or do some painting or coloring?

Then once you build some skills around that food you can move onto more vulnerable situations because you have more skills to deal with that.

5. We’re having a baby boy!

Saturday, I let the cat out of the bag on instagram that we are having a BABY. That feels nuts to type out. I didn’t have a plan for when I’d share, but as the weeks went on it felt really special to be sharing in this with just our closest people and family for the first half of this pregnancy. We will be halfway to 40 weeks this weekend and now time is flying by! It’s been a wild mix of emotions over the past several months – surprise, shock, deep gratitude, fear, sadness and guilt, excitement and anticipation all mixed into one. As we were planning to try for a family this summer, I was prepared to face fertility struggles. My mom had fertility challenges and I struggled with 10 years of hypothalamic amenorrhea. I also work with so many women who walk the painful path of infertility and have friends and family struggling to conceive right now and friends who have lost babies.

When we found out we were pregnant, knowing all that loss in the midst of our gift was really hard for me to process. I was excited we were pregnant, but also felt really sad and guilty that we had the gift of a baby when others wanted that gift too and had been through so much pain and heartache. It felt too good to be true, so for the first trimester I was terrified something would go wrong. I’m still fighting anxiety and fear which I think some of that is normal based on what other women have told me. I was all over the place emotionally. I was also nauseous most of the time, exhausted and just blahhhhh. Seeing human life form within my body though, has given me a deeply rooted sense of gratitude for pregnancy that I didn’t have before hand. It is nothing short of a major miracle. If seeing baby announcement is hard for you, my heart is in both places and I’m thinking of you. And know that this will not be a space filled with pregnancy posts. If there are topics that people would like to hear about related to pregnancy, you can email me or share in the comments and I’ll make a note of them, but I won’t be posting regular updates. And lastly, THANK YOU SO SO MUCH for all the love you showed us on social media – I was BLOWN away by all your caring comments and read every single one. You are so incredibly kind. Thank you for celebrating with us in this new adventure!

Have a wonderful week!

The post 5 Things on My Mind appeared first on The Real Life RD.

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Hey everyone! Connie, one of the RLRD interns here again. As I was thinking about what I would like to share with you today, I thought about the upcoming eating experiences I’m going to have this summer and what those experiences will look like. I thought some of you might resonate with eating less than perfect food on long airplane rides, a road trip fast food or hole in the wall food stop and finding some peace in that.

I have a really wonderful family trip to Croatia that I am so looking forward to with many eating experiences that I’m sure will be surreal and filled with authentic and unique food accompanied with a view! I will also have my last week as a camp director with food that is meant to feed almost 300 people from one kitchen in about one hour which means the eating experience is going to be less than ideal some of the time. What’s cool about both of these experiences is that I can still find nourishment and satisfaction in each, they just might present themselves in different ways.

I wanted to talk to you about camp food because I’ve learned a lot from it. The camp I volunteer for and have for several years is called Camp Fox, a beautiful place tucked in a cove on Catalina Island off the coast of California filled with self growth, new experiences, and getting to support and shape some young middle schoolers that fill that space for one wonderful week. It really is a magical place but camp food and I have been through our ups and downs. It hasn’t always been smooth sailing with camp food.

The first year at camp I was still very much in diet mindset and was the one member of the director team who brought far too many refrigerated snacks for fear of foreign food that wasn’t deemed “healthy” enough. There’s nothing wrong with snacks or packing snacks, but snacking out of necessity and/or pleasure is different than snacking out of fear. I was scared to let go of the rules I had made for myself and was scared of letting go and fully embracing camp food. I remember that being really stressful for me and it took away a lot of my mental energy that I could have been spending on building relationships, fearlessly embracing new experiences, and just doing something as simple as feeding myself. Whether it’s a vacation, family bbq or time away at a camp, maybe some of you can relate to stressing about food that will be served somewhere?

In the years to follow, I graduated college, started grad school, and discovered this thing called intuitive eating and fully living all while coming back to camp almost every summer. Last summer was by far the best year I’ve ever had at camp because instead of critically analyzing the food served, I just accepted it as fuel that I very much needed, and moved on. It was incredibly freeing to just accept that the food provided was all that was being provided- no special orders- no fancy food- just food. Side note –> of course, if you have a true allergy or medically indicated diet that’s a different story

Sure the eggs probably aren’t cage free, theres no Ezekiel bread – just regular old white bread – and who knows where the meat comes from, but I realized it’s actually pretty good! It was my fear that told me I didn’t. I found I really loved many of the things I previously denied like the crispy potatoes at breakfast in the morning. I found that along with eggs and some fruit, that breakfast holds me for a few hours so that I CAN take that 2 hour kayak without thoughts of food. I can 100% focus on my task at hand until a snack is needed because I’m hungry. I found that I could use camp food as a small nutrition education opportunity for my kids. I love teaching them how to balance a simple plate. They find pride in showing me their protein, carb, fat, and fiber in every meal and we all enjoyed our fun food together as a group after meals too.

This process wasn’t fast, nor was it glamorous. I didn’t just magically arrive one summer at camp sans my food rules. It took asking myself hard questions, working through and accepting my body, focus on what really mattered and moving forward with my life. All these things are hard, but know that you can do hard things.

During this process, I realized a few things that were helpful in getting me to this point. Maybe they will be helpful for you too.

1. There’s a lot that goes into food. Nourishment, taste and preferences, quality, and experience – just to name a few. Not every eating experience has all of these! I’m sure some experiences in Croatia will, but camp, no. I realized that if you don’t have all these components at the end of the day you still have food. That is a gift and a privilege that not everyone has. You still have nourishment that you can attempt to make work. Where can you get all the macronutrients together and maybe find some fiber that keeps your GI system healthy and move on. Where can you find satisfaction with what you’ve got?!

2. There will be opportunities for you to choose your food and have it in an ideal setting in the future and what a privilege that is! Just because I’m not having ideal eating experiences for a few days doesn’t mean I won’t have them in the future.

3. I will be ok without my “normal” food. In fact it will just taste that much better once I get home! A day without kale and days with some extra cake (or camp cookies) isn’t going to throw my or your body out of equilibrium.

4. Use this as an opportunity to try something new and focus on another enjoyable part of the meal. Why not experiment? I absolutely love the dining hall experience. The kids have cheering matches, play with cups on the table to the beat of the music, and we are all enjoying life together. What a wonderful thing. Carpe diem!

I share this with you because I think this is something many people struggle with when moving forward with intuitive eating. Making intuitive eating decisions when you have all the food and finances available is different than making intuitive eating decisions when you have limited choices and resources – that can be hard. I hope this post encourages you to try and embrace that hole in the wall restaurant or those baked beans on a camp fire. Food isn’t always the most gourmet and satisfying experience, but at the end of the day, it’s still food. And that’s something to be thankful for.

The post Tips To Not Fear Food That Isn’t “Healthy” Enough While Traveling appeared first on The Real Life RD.

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Happy 4th of July!! I actually ended up not having to go into work yesterday since they didn’t need coverage anymore. That meant we headed to Cape Code yesterday morning instead of evening and hit some traffic, but avoided most of it which was awesome. Nick’s grandma sold her cottage that she’s had for decades so I’m so glad we were able to make it here to visit her – hopefully we’ll be able to make one more trip before she moves out in August. I’m seeing a few clients this morning, but will be done by 9am and plan on relaxing on the beach all day, eating a lobster roll and doing nothing productive. What are your fourth plans?

Hopefully it involves lots of delicious food and relaxing whether you’re traveling or not. I love July 4th because we get to celebrate America and that’s really great and also because it feels like the epitome of summer. Being in New England this year makes it feel even more historic and celebratory. In addition to all the delicious eats I hope you enjoy this week, here’s a roundup of some meals and snacks I’ve eaten over the past couple weeks that I found on my camera roll. I hope these posts inspire you in your own journey with food – I’d love to hear what meals and snacks you’re loving lately in the comments!

Breakfasts

I haven’t had overnight oats in a jar in forever so I was pumped about this breakfast that I brought to work on Monday. Also this almond butter from Target is amazing – they also have a chocolate version I highly recommend. You can’t see what’s in there, but the night before I stirred together about 1/2 cup each of whole milk greek yogurt, almond milk and rolled oats plus a big spoonful of chia seeds to make it extra thick, vanilla and a pinch of sea salt. Then I added a bunch of strawberries that we picked over the weekend and poured it into this AB jar to sit overnight in the fridge. In the morning I just grabbed it as I was running out the door. I got to work a little bit early (shocking for me) so I ate this in the parking garage while I finished talking to my friend Jess on the phone. I think I overestimated how much almond butter was leftover in this jar because by the time I got to the bottom I couldn’t finish and left a few big bits in there.

For the past couple weeks breakfasts have been either toast or yogurt in some form. We had so many cheeses in our fridge leftover from Nick’s birthday dinner so I melted a bunch of goat gouda over scrambled eggs that we ate with buttered + jammed sourdough toast and cantaloupe. These kinds of breakfasts always make it feel like the weekend during the week.

We had a rainy, colder morning last week so hot oatmeal actually sounded good- that never happens during summer. I made enough for two using a heaping cup of oats, a couple cups of almond milk and a spoonful of chia seeds plus a pinch of salt and cinnamon. Stirred in frozen blueberries at the end and topped with banana and sunbutter. I hate mushy bananas in my oatmeal (I know, everyone loves them like that) so I slice them on top.

I went on a bagel spree for a week and a half where I was eating a Trader Joe’s whole wheat bagel every morning with whipped cream cheese on both sides or cream cheese + jam on half and almond butter and banana on the other. It’s quick and easy, satisfying and keeps me full for a few hours.

Lunches

We had a meeting after church last week and they provided lunch. As we were walking into church that morning I told Nick we needed to go our for pizza because I was craving it. And then they ordered pizza for lunch – perfect timing! I had two slices of the white pizza with veggies, which was delicious, along with ceasar salad and lemonade. Craving crushed.

We had Tatte for lunch this past weekend when Nick’s mom was in town. Their halloumi salad is my favorite salad there – it’s perfect for summer. Halloumi cheese is one of my favorite foods. The salad is a mixture of greens, apples, raisins, carrots, radishes and a tahini dressing. And the roll is also salty and doughy and perfect.

I wrote on Monday about how I’m into snack plates lately for lunch. This variation had leftover rotisserie chicken, hummus + crackers + veg, apple with cinnamon and two TJs peanut butter cups.

This is one of my favorite go to frozen meals – Trader Joe’s black bean and corn enchiladas. If you like doughy tortillas and super saucy enchiladas, buy these! And they’re like $2. They wouldn’t be filling on their own so I added some avocado for more fat and ate them with carrots + hummus.

I picked up lunch while grocery shopping one Sunday. My favorite salad combo has been romaine + shredded beets and carrots + feta + corn with olive oil and balsamic. I think I added a stuffed grape leaf in there too because those are tasty. Plus a salmon sushi roll.

I ate this veggie wrap when we were in Vermont for a wedding a couple weeks ago. We were in the middle of nowhere, but there was a couple general stores nearby that had an awesome lunch and breakfast menu and you could also take out. I ate lunch just an hour or so before the wedding began and I knew cocktail hour (which we knew would have an incredible spread – seriously some of the best wedding food I’ve ever had!) would be soon, so I didn’t want to fill up too much. Along with lots of fresh veggies, this tortilla was also stuffed with local goat cheese, hummus and avocado and was super tasty. I want to remake this at home.

Dinners

For dinner on Sunday and Monday we kept it easy and simple before leaving town for the Cape. I sautéed up zucchini and summer squash in a mixture of olive oil and butter along with some garlic. At the end I added a squeeze of lemon juice and lots of grated parmesan cheese. This is my favorite way to eat summer squash! Nick cooked up chicken sausages in the cast iron and his Mom threw these baby potatoes into the Instant Pot to cook. The salad with simply mixed greens, sliced strawberries, feta cheese, sliced almonds and honey dijon dressing. Everything was delicious and I think took 15 minutes to throw together.

While Nick’s mom was here, we went to The Salty Pig on Friday night for pizza. Nick and I tried to go in the winter and it was PACKED so this time we made a reservation. We started with charcuterie – the prosciutto was amazing as was the buttery grilled bread.

And then we shared two pizzas – a margarita with pepperoni added and a sausage onion arugula pizza that was also really good. I love chewy crust versus crispy so that was the only thing that could have been different. Other than that, we’d definitely go back!

There are lots of fast casual places popping up on Bolyston which is only about a 15 minute walk from our apartment. Last week we tried out Minigrow which is like an Asian noodle place where you pick your base, protein, toppings etc. This was spicy! But I loved the thick noodles (that you can’t see buried underneath there) and all the fresh veggies. It is a bit pricier than other fast casual places, but it was fun to mix it up.

We’ve also been on a mexican kick lately because throwing together tacos takes minimal cooking and I don’t have to turn on the oven. I just cook up ground beef in a pan, add a can of black beans and a packet of taco seasoning and that’s it. Then I put out a bunch of toppings and shells. I picked up some tortillas that where a wheat and corn mix from Trader Joe’s and I really liked them – they still had the nutty corn flavor I love, but were chewier and held together well – unlike 100% corn tortillas that unless used in enchiladas, I find are dry and crackly.

Not to toot my horn, because I did zero cooking here, but the above taco salad with the BOMB. If I cook a bunch of taco meat, we’ll rotate between tacos, taco salads and nachos throughout the week to mix it up. On a bed of romaine and the taco meat, I added chopped bell pepper + tomato, grated cheddar, sour cream, avocado, lime juice, salsa, hot sauce and crunched in a bunch of tortilla chips. I’ll be eating this all summer. It’s all about the toppings.

And continuing the mexican theme, Nick picked up Qdoba one night before we left town and we split a steak burrito bowl and chicken quesadilla. Except I mainly ate the quesadilla because it tasted way better to me than the burrito bowl.

Snacks

Almond croissant shared while we were waiting for our order to come out at Tatte. Not the best almond croissant I’ve ever had, but it was still pretty tasty.

I was on a walk with a friend and we walked by the Copley farmer’s market one afternoon and I spotted what looked like amazing baked goods so I picked up a whoopie pie and snickerdoodle cookie. THE COOKIE was epically doughy, buttery and soft and everything I’d ever want in a cookie. It sounds dramatic I know, but the drama is appropriate. The whoopie pie was the size of my face and also very very good.

I ate a big chunk of the whoopie pie with Breyer’s mint chocolate chip ice cream a few nights in a row for a snack.

Other ice cream snacks were leftover birthday ice cream cake…

And the last bit of chocolate coconut ice cream with crushed Oreos and chocolate syrup.

Ate a couple cookies before bed one night when we were out of town.

And beyond cookies and ice cream, I also ate Larabars and crunchy apples for snacks.

Along with juicy peaches and banana bread muffin tops.

And dark chocolate sandwiched between a date with peanut butter –> this is super tasty.

Have an awesome day and holiday week!

The post Meals and Snacks I Ate appeared first on The Real Life RD.

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Hi friends! It’s Hannah, one of the RLRD interns. Happy Friday!! I hope your week has so far has been wonderful. A couple weekends ago, I took a mini trip to Colorado with my mom and sister. We had such a blast (well, I did once I got over some altitude sickness) hiking, exploring, trying new restaurants, and spending time with each other in the sunny outdoors. The weekend made me think about my past experiences with travel a lot, and how my previous, disordered eating habits changed and shaped the way I travelled for multiple years.

As a kid, travelling was so easy and simple for me when it came to food + movement. I feel very lucky and privileged that my family and I were able to take trips together. We’d wake up early and eat something that we’d buy at the airport, and once we were at our destination, I’d just order whatever sounded good to me in the restaurants we’d find. Even if it was a warm, beach trip, I wouldn’t worry about how certain foods would make me “look” in a bathing suit — I was an intuitive eater (like many of us were) as a child, and selecting my meals wasn’t a big deal. If something sounded appetizing, that’s what I’d pick. As for exercise, it was never about going to the hotel gym on vacation or squeezing in time to work out when it really didn’t fit naturally into the day’s schedule — movement was naturally incorporated through playing and swimming in the pool, skiing, hiking, or walking through the town to explore. Travelling, like regular life, was intuitive for me as a child before I was roped, like you might’ve been too, into the world of diet culture.

In the throes of my disordered eating period, I distinctly remember family and friend vacations feeling very different — because for me, they mentally were. I was stuck in the need to try to control my food and my exercise while in a new place or in the place of transit (airports were so stressful for me because I could never find food that fit within the way I was restrictively eating). I was quite distracted from the actual trip as well — the place, the people I was with, the culture, the new foods, because I was hyper-focused on keeping my rigid eating and exercising habits the same as the ones I more easily kept control over at home and at college. If right now you are in a similar situation as the one I used to be in, I feel you. I hear you. It’s tough; I totally get it, and you are not alone. What I can say now though, is that with time and a concerted effort on supported recovery, travel can and will get a whole lot better. And a ton more fun.

I’ve been on a few trips here and there since feeling fully recovered from my disordered eating thoughts and habits, and I still feel just as lucky and privileged (if not even more!) to be able to travel – to see friends who live far away, to explore new places, and to afford flight and train costs. I am very thankful for these opportunities and adventures. I’m taking even more advantage of them now because I embrace vacations and travel experiences in ways that are very similar to how I enjoyed them as a child: intuitively. Naturally. Happily. I no longer get anxious about needing to keep up with an exercise routine while travelling; I now realize that airports and train stations have lots of food, and that I have permission to eat whatever I’d like — nothing is off limits anymore. It took a while to get to this point in recovery, but I can promise you that it is SO possible. It just takes a lot of time, discomfort, patience and grace with yourself. Being able to travel freely without a diet leash around my neck has been one of the best parts of recovery for me. It’s beyond liberating to be able to go to new places and not feel anxiety about keeping up with the mechanisms that I thought were helping me “control” my body, weight, and hunger.

My family’s recent weekend adventure to Colorado inspired me to reflect on some tips that I have for you about traveling. Navigating the experience of travel, which involves leaving your physical (and probably mental as well) comfort zone, can be daunting for some of us, and these are some tips that I wish someone had told me a few years ago. I hope they are helpful for you.

1.) Feed yourself on travel days

I don’t know about you, but I often find that travel days throw off my hunger, especially if flying into a different time zone, or if I’m waking up really early to get somewhere. It’s totally okay that travelling does this — travel days are weird! But, what I think is important is that we remember to care for ourselves in these times of transit and not judge ourselves if we’re hungry at weird hours and want to eat. Our bodies know what they’re doing.

With that being said, I think packing snacks for travel days is cool because you can save some money at the station/airport, or maybe you had some perishable snacks that were going to go bad at home if you didn’t eat them, so you bring them with you. However, I don’t think packing snacks and meals needs to be obsessive — if you forget snacks at home, it’s okay! You’ve got permission to get something in your place of transit. I used to be so scared to eat food at the airport because I thought it was all “junk” and didn’t fit within my eating plan.

What I wish I could tell this old self of mine is this: Hannah! pleaaase take care of yourself and feed yourself food while at the airport/on the plane or train. Don’t go hungry just because you forgot your ‘compliant’ snacks at home — you have permission to eat airport food. It’s not “bad”. It’s food, it macronutrients and energy and therefore your body knows how to use it. This is just food, and you deserve to be taken care of. You deserve to be well-fed.

2.) Strive to go with the flow while out to eat

Vacations often prompt more opportunity for going out to eat than regular life does. This can be stressful for some of us. I’ve completely been there; it was anxiety-inducing, especially if my meal came and it wasn’t exactly what I had expected or ordered. I’ve come to enjoy going out to eat a lot now, but of course there are still those times where the food that arrives isn’t what I’d been anticipating, and that’s where practicing going with the flow comes in handy. For example, this past weekend in Colorado, I ordered this tasty-sounding roasted chicken — it came and was slathered in some creamy and savory sage butter. It looked delicious, but I know that my GI system and dairy don’t always agree. I’m learning that sometimes dairy feels totally fine, and sometimes not so much — it really just depends.

In this type of situation, something that I’ve found to be helpful in ‘flowing’ is thinking about my options. I quickly thought about the choices in my head before making a decision — one option was to send it back and ask for the chicken without the sage butter. Another option was to try and enjoy the meal with my family, and see what happens (this is very individual, but for me I’ll either get a bad stomach-ache from dairy, or nothing at all). I went with the latter option because I was really hungry, wanted to eat a good meal eat after a long day of traveling, and was willing to risk the stomachache. Now, if you’re someone who has a severe allergic reaction to a food that your meal comes with, of course I wouldn’t recommend this to you! But for people like me, who in the past have been scared to eat any “off limits” foods, I’ve worked these past two years to truly, mindfully introduce all foods and get to a place where no food is considered fearful and scary. I’d rather not have a stomach-ache in an ideal world, but sometimes it happens and I’m learning that I’ll be okay, that the situation is totally fine, and that whatever is happening will pass. (As a side, so happy that I kept the meal at that restaurant because it was very good with that savory butter!)

3.) Work to be adaptable with exercise

Travel doesn’t always lend itself to a rigid exercise routine. I used to try and “force” a strict exercise regimen onto vacations and while I studied abroad. Now,I’m learning it’s better and way easier to simply find ways to incorporate happy movement into the trip. If it feels constricting and not intuitive to be running on the treadmill at the hotel’s gym all the time, but you still would like to move while travelling, maybe explore other types of activities that involve getting your blood flowing. Kayaking, walking through the city, going for a hike or a sunset walk, swimming, snow-shoeing…what’s cool about travel is that you can experiment and find new ways to move, ones that you might not be able to do at home. If you can get outside, I recommend that! Fresh air and nature are things I’ve come to appreciate as much as possible since I reside in a city right now and don’t always have access to quiet, fresh outdoor spaces.

4.) Use travel as an opportunity to try new foods

I studied abroad in Greece my freshman year of college and my friends and I were lucky that we got to travel to a few various countries in the EU while living in Greece. I was in the throes of disordered eating during my time abroad, and I didn’t try the fun or traditional foods in any of the places we visited. I never had a gyro in Greece, a Belgian waffle in Brussels, or pasta in Italy. I know, I know. I didn’t have pasta in Italy. I was scared of gluten at the time. It’s sad now to think about.

It’s because of this that now, when I go places, I make an effort to try new, fun foods – ones that I haven’t had before but, that sound delicious to me. I empower you to try doing this too. We can be in it together. Of course there will always be the days, even when traveling, that you just want to eat something familiar and comforting and classic, and there’s nothing wrong with that. But if I’m you’re traveling somewhere and something new on the menu sounds appetizing, why not go for that? When you look back on your travels, you don’t want to remember calories, you’ll want to remember the experience. 

One small example is that on a family trip last year, I experimented with peanut butter and honey on a blueberry bagel for breakfast at the buffet. I’d never mixed PB and honey before. This was a little, non climactic moment, but it was SO good and slightly transformative for my breakfast situations. Now, I love to drizzle honey on top of my PB-slathered bagels on a regular basis at home because of what I experienced on that particular vacation. I learned I really liked that!

Those are some small tips about travel based on my experience in the past and present. Hopefully they help! I hope you have a lovely week and holiday and if you’re traveling anywhere in the near future, I want to hear about your experience — safe travels! 

The post Learning to Let Go of Rigid Food and Exercise Rules on Vacation appeared first on The Real Life RD.

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1. June Birthdays

June always flies by, feels super busy and is full of celebration! Between five family birthdays, a friend birthday and Nick’s birthday there’s birthdays every week. I feel like June is a popular birthday month? Cheers to June birthdays! Nick turns 29 tomorrow and so we celebrated this weekend with a progressive dinner party – progressive meaning, the wine paired with the food progressed from lighter to fuller bodied throughout the meal. Our favorite wine store, Urban Grape, is based on this philosophy and we have found it not only really fun to learn about wine this way, but so much less confusing and way more approachable. We went to a wine tasting event back in February where the owners walked us through this progressive philosophy and it was the best tasting I’ve been too because I felt like I really learned – if you’re interested, here’s more about the progressive scale and their book!

We started with a mega charcuterie board. We eat cheese boards often, so I wanted to make this one feel out of the ordinary. Bacon wrapped dates, prosciutto wrapped cantaloupe (sounds weird, tastes fab), a variety of cheeses and jams and nuts and dried fruit, artichoke bruschetta and lots of other things. The charcuterie was paired with a Lambrusco – a sparkling red wine that I have never had before but was very good. For dinner I searched Pinterest and made this arugula, cucumber and feta salad to start that we drank with a Venica Pinot Grigio from Italy and then the main course was this garlic basil chicken with tomato butter sauce over linguine that we drank with a red wine – a Cerasuolo di Vittoria. Lastly, for dessert I made up a “recipe” for a homemade ice cream cake because ice cream cake sounded awesome. I made a box of TJs brownies, layered on vanilla ice cream, then crushed up TJs version of Oreos (aka Jo Jos) + caramel sauce, more ice cream and then topped with whipped cream and chocolate shavings. I think everyone left with full bellies. I love to throw dinner parties and this was a fun way to mix it up – the recipes were simple to put together too so highly recommend those if you’re looking for easy meal ideas!

2. Nourishly

You may have seen this swirling around the internet. Recovery Record is an app used by a lot of RDs and clients to help in ED recovery. I have clients that use RR and I think it’s a great app. They recently released another app called Nourishly which is a more general nutrition app that helps people become healthier with features like tracking hunger and fullness, stress levels, sleep, meals, digestive problems and other symptoms. There was some uproar because it was being marketed as a “weight management” app and had diet centric features. Given that Nourishly and Recovery Record are under the same business umbrella, the messaging was conflicting and harmful. Marci Evans and Christy Harrison led the way with speaking out and the CEO of Recovery Record was so receptive! Everyone is going to make mistakes (I’ve made plenty!) …we are all human. The CEO responded with such humility and openness to feedback – I thought her response was really admirable. It was really encouraging to see the changes and to have an app now that promotes true health and helps people with health problems and chronic disease focus on getting well by emphasizing health promoting behaviors and not weight loss. Here’s a screen shot from their webpage that I think is fantastic.

3. This quote

This is something I feeling like I’ve been learning for the last six years and I’m going to keep learning for the next six+ years. Everything doesn’t matter. It’s hard to let stuff go. But letting go of stuff that doesn’t matter feels sooooooo good.

4. What if that thought wasn’t just true just for other people, but for me too?

A client emailed me some things that were clicking for her and one of them was this question. It seemed simple, but was rather profound. For myself when I was going through my own journey, and for many women I talk to, they are able to believe things for other people such as…. “their body won’t get out of control if they stop calorie counting” or “that person can be ___ size and they aren’t less valuable” or “my friend can eat ice cream and that doesn’t make her a bad person..” or “they can practice intuitive eating, that works for them” …but believing that for themselves seems impossible. But what if you asked yourself, “What if that wasn’t true just for them, but for me too?” This way of thinking is like an “exception effect” where things apply to everyone else except ourselves. I just made “exception effect” up, but there are probably areas in life this applies to outside of food too.

5. Freezer stash

I forgot about these for a hot second and I never will again. Who else picks up a package of these goodies for 99 cents every time you check out at Trader Joe’s?

Have a great week!

The post 5 Thoughts appeared first on The Real Life RD.

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For the past two weeks, we’ve been in a PCOS series. In Part 1 we talked about what causes PCOS, how a diagnosis is made, the different types of PCOS and what is happening in your body if you do have PCOS. In Part 2 we talked about reasonable and evidence based lifestyle modifications you can make (including many that go beyond food) to improve your PCOS…no diets involved. My hope is that these posts are informative, but they are certainly not prescriptive. Nutrition and medicine are highly individual – everyone has different genetics and biology, so it’s really important to work with your health care provider and dietitian to figure out what combination of treatment modalities will work best for you.

Everyone is at a different place in their lives so your treatment will take into consideration all those things – there is no one size fits all. The optimal treatment approach for PCOS in multifactorial – lifestyle modifications, psychological treatment, supplements, and medications all play a role. I think the most important thing is that you as the patient and woman feel empowered in your decisions, that you feel well informed on the pros/cons of everything and that you know your treatment is 100% a personal decision and whatever works for you, works for you. You are not better or worse or doing things right or wrong for choosing or not choosing something to care for yourself.

In this post, we’re going to talk about supplements that have been well researched and shown to improve PCOS. Often, supplements can be a really powerful tool in helping women with PCOS along with lifestyle changes and other treatments that might be necessary too. I’m not one who throws around supplements and suggests taking supplements just to take them. I think that can end up being really expensive and stressful. And the supplement world can get confusing very fast. While supplements are different than medications, are still powerful and change endocrine and metabolic pathways in the body; therefore it’s really important to take supplements appropriate for your body. Work with a dietitian or health care provider who is knowledgable around these supplements before taking them so you know what is best for you.

Supplements are meant to support lifestyle choices, but they certainly aren’t a replacement. Just like taking certain supplements to lower cholesterol isn’t a replacement for eating nourishing foods and moving in an enjoyable way or taking supplements to recovery from amenorrhea isn’t a replacement for giving your body the rest and nourishment it needs…same goes for PCOS. All these tools whether some of all of them – lifestyle, psychological treatment, supplements, and medications – they all play a role.

There are many more potential supplements that you can take for PCOS than what I’m going to share in this post. Some have more research than others. The ones I’m sharing below are what I would consider the basics to start with and then if things still need some tweaking after implementing lifestyle changes and other tools, you could consider trying other supplements in partnership with your dietitian and/or HCP. These ones I’m sharing below have also been well researched. When purchasing supplements, make sure you are taking FDA approved supplements – this ensures quality, purity and accuracy.

Inositol

Inositol has a large body of evidence when it comes to it’s efficacy in the treatment of PCOS. Out of 9 total, the 2 stereoisomers well researched in particular are myo-inositol and d-chiro-inositol. It’s been demonstrated that women with PCOS experience dysregulation of inositol metabolism which affects fertility, insulin and many other factors – this could actually be why women with PCOS experience insulin resistance in the first place. Research has shown that myo-inositol has the most profound effect over d-chiro, but these two sterioisomers work best in the ratio of 40:1 myo-inositol to d-chiro-inositol which is what is found naturally in the human body. They help in restoring hormonal and metabolic parameters which includes things like improving egg quality and ovulation, dyslipidemia, improving insulin sensitivity, leveling out androgens levels, increasing insulin sensitivity, and decreasing inflammation.

What’s really cool is that there is good research showing the effect of this 40:1 ratio in comparison to metformin. You may have heard of metformin before because it’s a common medication used to treat type 2 diabetes. It also works in women with PCOS to increase insulin sensitivity, improve ovulatory function and menstrual regularity. The drawback for some women is that is causes unpleasant gastrointestinal symptoms, while inositol is quite well tolerated although some women, although uncommon, do experience low blood sugar. There is still more research needed, but there are studies I’ve referenced at the bottom that have shown inositol to improve PCOS symptoms better than metformin. In a more recent study, women took either 1500mg of metformin OR myo-inositiol and d-chiro-inositol in a 40:1 ratio every day for 12 weeks. What did they find? Inositol supplementation showed significantly better improvement in ovulation and conception rates (46.7% and 11.2%) versus the 1500mg of metformin at 13.5% and 3%. Inositol also showed significant improved in progesterone levels and weight loss. **Weight loss unrelated to diet, rather inositol helps improve hormonal imbalances that cause the challenging metabolic dysregulation in women with PCOS.

The recommended dose of inositol (in that 40:1 ratio of myo-inositol to d-chiro-inositol) is 2000mg to 4000mg of myo and 50 to 100mg of d-chiro. You can also take inositol with metformin if you’re already taking metformin and your HCP suggests that and it works for you. You could purchase each supplement separately and take it in that ratio, or Ovasitol is an FDA approved supplement made in that 40:1 ratio for about $25/month.

Omega 3s

Omega 3s are essential fatty acids that the body cannot make on its own so we have to get them from food or supplements. Fish oil, either in supplement form or found in food, contains both EPA and DHA which are building blocks for cell membranes and hormones. They have been well researched and have been proven to help decrease inflammation, improve insulin resistance, and improve the lipid profile by increasing HDL (your “happy” cholesterol that you want to be high), lowering triglycerides and lowering LDL (your “lousy” cholesterol that you want to be low). Omega 3s have also been shown to improve mood and women with PCOS experience higher rates of anxiety and depression. If you’re eating omega 3 rich fish (such as salmon, tuna and sardines) 2-3 times a week along with other omega 3 rich foods you might be getting your needed dose. But most of us, including myself, don’t do that. So a supplement can be helpful.

Along with improving lipid profiles, there’s also research showing omega 3s shorten the length in between menstrual cycles so cycles become more regular in women with PCOS. Omega 3s have also been shown to reduce testosterone levels. Check with your health care provider first, but an optimal dose for women with PCOS is 2-3g of fish oil per day. Look for high quality brands (which have been purified) with a good amount of EPA and DHA per dose. Nordic Naturals is a good brand that’s not too expensive and Eukonic is another brand that’s high quality and a touch cheaper per daily dose. Food sources have better health benefits than supplements, so while including frequent sources of omega 3 fats in your diet is good and something to aim for, sometimes taking a supplement is necessary and can make life a bit easier.

Vitamin D

I’ve found in my nursing practice, especially when I was working in primary care, that the majority of people are deficient in Vitamin D. That’s just my observation, but something I noticed as I practiced. Particularly for women with PCOS, more often than not they are deficient in Vitamin D. Vitamin D (which is a hormone) plays many roles in the body, including that key word again, inflammation… in addition to bone, cardiovascular and immune health, muscle function, fertility and menstrual regularity, depression, cognitive function, metabolism, blood sugar regulation and insulin metabolism. For women with PCOS, Vitamin D has a significant impact on fertility, glucose and insulin metabolism, androgen levels and the underlying inflammation. It’s been shown to lower testosterone levels, improve egg quality and development, and reduce inflammatory markers – C-reactive protein (CRP) being one that is found to be higher in women with PCOS.

Your health care provider can easily check your Vitamin D levels with a quick blood test. When you see your lab results, you’ll notice that the lower range of “optimal” is 20-30 ng/mL but that’s actually often too low and often a level of at least 50 ng/mL is optimal. Since Vitamin D is a fat soluble vitamin, you don’t pee it out, so your levels can get too high. I’d recommend getting a blood test to assess your current levels before taking any supplementation and then getting your level checked every 3-6 months to ensure you’re in a good range. Also keep in mind that pregnancy and breastfeeding deplete Vitamin D levels, so even more reason to make sure your levels are adequate. Your health care provider should be checking Vitamin D levels at your annual physical exam. There’s no known “optimal dose” of vitamin D for women with PCOS, your health care provider can suggest a dose based on your current level. And they can prescribe a 50,000 IU dose that you take once a week for 8 weeks to get your levels up rather quickly. For women with PCOS, typically 2000 to 4000 IUs/day is a helpful “maintenance” dose to keep Vitamin D levels optimal if you are often low, but again check with your doctor and then get your levels checked regularly. You’ll want to make sure you’re taking Vitamin D3. Fortified foods, sunshine and fatty fish like salmon are good food sources as well.

There are other supplements that can help with PCOS, but these are a few that have been well researched with compelling benefits. In addition to lifestyle changes, supplements can be really helpful in managing PCOS and significantly improving symptoms. And sometimes, women need lifestyle changes and supplements, in addition to medications to help manage their PCOS and that’s okay too. Everyone is different and the best thing is to do what works best for you. My hope is that women feel empowered, knowledgable and advocates for themselves. Two other RDs who are really great resources you can check out for further info is the work of Julie Duffy Dillon and Angela Grassi. Angela lives with PCOS herself and has dedicated her entire career (20+ years) to the research and treatment of PCOS. Highly recommend both! Also Rachel has a great post on disordered eating and eating disorders in women with PCOS that I think is so very important to read. I hope this has been helpful! If you have more questions, leave them in the comments and perhaps I’ll do a Q&A style post answering them the best I can.

References

Vittorio Unfer, John E. Nestler, Zdravko A. Kamenov, Nikos Prapas, and Fabio Facchinetti, “Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials,” International Journal of Endocrinology, vol. 2016, Article ID 1849162, 12 pages, 2016. https://doi.org/10.1155/2016/1849162.

Benelli, E., Del Ghianda, S., Di Cosmo, C., & Tonacchera, M. (2016). A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women. International Journal of Endocrinology, 2016, 3204083. http://doi.org/10.1155/2016/3204083

Hamid, A. M., Madkour, W. A., & Borg, T. F. (2015). Inositol versus Metformin administration in polycystic ovary syndrome patients. Evidence Based Womenʼs Health Journal,5(3), 93-98. doi:10.1097/01.ebx.0000466599.33293.cf

Khani, B., Mardanian, F., & Fesharaki, S. J. (2017). Omega-3 supplementation effects on polycystic ovary syndrome symptoms and metabolic syndrome. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 22, 64. http://doi.org/10.4103/jrms.JRMS_644_16

Nadjarzadeh, A., Dehghani Firouzabadi, R., Vaziri, N., Daneshbodi, H., Lotfi, M. H., & Mozaffari-Khosravi, H. (2013). The effect of omega-3 supplementation on androgen profile and menstrual status in women with polycystic ovary syndrome: A randomized clinical trial. Iranian Journal of Reproductive Medicine, 11(8), 665–672.

Mehri Jamilian,Fatemeh Foroozanfard, Elham Rahman. Effect of Two Different Doses of Vitamin D Supplementation on Metabolic Profiles of Insulin-Resistant Patients with Polycystic Ovary Syndrome. Nutrients. 2017 Dec; 9(12): 1280.

Divyesh Thakker, Amit Raval, Isha Patel, and Rama Walia, “N-Acetylcysteine for Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials,” Obstetrics and Gynecology International, vol. 2015, Article ID 817849, 13 pages, 2015. https://doi.org/10.1155/2015/817849.

The post Understanding PCOS [Part 3: Evidenced Based Supplements] appeared first on The Real Life RD.

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