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PCOS Part III: treatment

Pills spilledOnly recently have doctors begun to recognize and diagnose PCOS (Polycystic Ovarian Syndrome), and research is being conducted as the medical community realizes how prevalent this condition actually is. The biggest challenge doctors face in prescribing treatment is that PCOS affects every woman differently, so there is no one-size-fits-all approach. The best that can be done at this point is treat and manage symptoms. Some of the most common treatments are ones that I’ve tried and listed below.

Birth Control Pill: This is usually the first line of treatment for women with PCOS because it regulates your menstrual cycle, lessens heavy bleeding, and some pills contain Spironolactone which helps with hormonal hair growth. I started on Yasmin when I was diagnosed by my OB/GYN in 2006 because I had irregular periods. It did regulate my periods, but after 8 years taking it, I decided to try a more holistic route. After being off of the pill for 2 years, I attempted it again (for the purpose of birth control), and it sent me spiraling into a pit of depression and wacky mood swings. It’s important to notice how your body reacts to the addition of synthetic hormones; especially with PCOS because I believe we are more sensitive than most. It may take a few different pills to find one that works for you, or you may opt not to use one at all. Just because you are diagnosed with PCOS does NOT mean you have to treat it with a birth control pill!

Metformin: This is a diabetic drug that is also used to help women with fertility issues, however, I don’t believe it’s necessary to treat PCOS if you are not trying to conceive (unless your glucose levels are out of control). I started on Metformin in 2006 at my next stop to an endocrinologist that supposedly specialized in PCOS patients. She prescribed me 2000mg, and if you know anything about Metformin, you know that’s a high dose even for a diabetic. I started with 500mg and slowly increased the dose as instructed, only to spend every morning at my work desk feeling dizzy and nauseous. I decided that figuring out how to eat properly for PCOS would be a better choice for my body than Metformin.

Acupuncture: I haven’t seen any research on the direct effects of stress on PCOS, but my body tells me that stress makes my symptoms worse. After dropping the birth control pill, I decided to try acupuncture. My stress levels happened to be very high at the time, and I can’t tell you for sure that acupuncture did much for my PCOS, but I can tell you that slowing down and laying on a table for 30 minutes was help enough to lower my stress levels. I can also tell you that since I went off the pill and had acupuncture treatments for 3 months, my menstrual cycle has never been more regular in my life.

Diet & Exercise: Let’s face it, nobody likes this as an answer for treatment for any condition because we are a culture that likes to pop pills to fix problems. I can tell you from experience, though, that you can resolve the majority of your symptoms by taking care of your body. You don’t have to run 3 miles and live on chicken and broccoli, but doing something that gets your heart pumping every day and eating natural foods will benefit you most in the long term. I no longer take any medication to treat my PCOS symptoms; I treat them solely with diet and exercise, and I’ve never felt better!

Ashley Brodeur, MS, CPT
Exercise Physiologist
Owner, Active Lifestyle Fitness, LLC

The Truth About Weight Loss

Weight-Loss-PlateauWeight loss is a tricky beast, and sounds easier in theory than it is in reality. Many people have misconceptions about weight loss and set themselves up for disappointment by not understanding what it actually looks like. Here are some of the key points to keep in mind on your weight loss journey:

1) You have to be ready to reach your goal. Are you willing to give up ALL of your excuses? Really? Weight loss takes a lot of focus and dedication, and excuses are obstacles that will hinder the process. Before you set your sights on a big goal, make sure that you are really ready to take on the challenge and accept no excuses from yourself. Giving up the excuses will clear your path to the finish line.

2) Don’t expect a running start. Expect your body to do weird things in the first 6 weeks of starting a new training program. Some people lose weight, some stay the same and lose inches, and some lose weight and lose inches. The reality is, your body is trying to figure out WTF you’re doing and how to respond to it. After 4-6 weeks, it will respond to your brain’s mojo, and the scale should start trending downward.

3) Even as you’re losing weight, you will have “fat days.” Yesterday you were svelte and defined, and today you feel like a bloated sausage. That is perfectly normal, and does NOT mean what you’re doing is not working! One day of bloated sausage is just that – ONE DAY. Do not throw in the towel and invite your friends Ben & Jerry over for a pity party. Tomorrow is a new day, and you may feel even better tomorrow than you did yesterday!

4) The road to success is not a straight line. You will have times that your body will plateau for a week or two, especially if you have a lot of weight to lose. Your body needs time to readjust and balance itself out every once in a while, and you should let it. If you still have a lot of weight to lose and your weight plateaus for more than 2 weeks, you should re-evaluate what you’re doing, because it’s probably time to make some changes.

5) Your body has a “happy weight,” which you may not agree with. I don’t like to set final weight goals with my clients because, the reality is, nobody knows what that’s going to be. If you’re 45 y/o, you are not likely going to weigh what you did at your best shape at 25 y/o, but you may be able to wear the same size jeans! Your body will eventually reach its “happy weight” and plateau. It may not be at the number you want, but who cares? You will be happy with your accomplishments at that weight, and it will have been worth all the hard work!

Ashley Brodeur, MS, CPT
Exercise Physiologist
Owner, Active Lifestyle Fitness, LLC

PCOS Part II: symptoms & diagnosis

It’s important to understand that every woman experiences PCOS (Polycystic Ovary Syndrome) differently. I’ve met many women with PCOS across the spectrum when it comes to symptoms. Thus, the following list is simply an idea of what you may be experiencing, and not necessarily the requirements for diagnosis. Symptoms may also worsen/appear with weight gain and stress, and may change throughout your lifetime.

As I mentioned in PCOS Part I, my inability to lose weight and excessive mood swings are ultimately what drove me to the doctor’s office. I also experienced irregular periods, but have since been able to regulate them with diet and exercise. Here are some symptoms that women with PCOS may experience:

Irregular periods
Excessive weight gain or difficulty losing weight
Hair loss on the scalp
Hair growth on hormonal areas (face, chest, stomach, etc)
Excessive acne
Fertility problems
Skin tags or patches of skin discoloration
Depression or mood swings

Women with PCOS have higher than normal androgen levels (male hormones) which is the cause of some of the symptoms above. Your doctor will order a blood test to examine your hormone levels as part of the diagnosis. I was also sent for an ultrasound that showed multiple cysts on my ovaries. It is important to have an open conversation with your doctor about what you are experiencing, and to advocate for yourself when it comes to a proper diagnosis. While there is no cure for PCOS, your doctor may be able to help you manage your symptoms, and you will have peace of mind knowing that symptoms such as “difficulty losing weight” are not all in your head!

Ashley Brodeur, MS, CPT
Exercise Physiologist
Owner, Active Lifestyle Fitness, LLC

PCOS Part I: my story

PCOS I’ve been wanting to write about PCOS for a long time, but wasn’t sure how to start, because it’s such a huge part of my life. PCOS is what inspired my career path, and to learn everything I could about health and fitness, especially for women. I intend for this to be an on-going discussion in my blog so that I can do the topic justice. First, I will start with a brief overview and my personal journey.

What is PCOS (Polycystic Ovarian Syndrome)? In simple terms, it is an imbalance of hormones caused by insulin resistance in females. This imbalance of hormones causes eggs in the ovaries to become stuck as cysts and never release into the fallopian tubes, making it the number one cause of infertility in women (though many women with PCOS are able to have children when the condition is properly managed or with fertility treatments). The current statistics are that 1 in 10 women have PCOS (I believe there are MANY more that don’t know they have it), and over 60% of women that have PCOS are overweight or obese.

I was diagnosed with PCOS in February 2006. I went to my OB/GYN because my mood swings were out of control, and no matter what I did, I couldn’t lose weight. Doctors don’t really understand how to treat PCOS. Trust me, I’ve been to several of them. They usually tell you that you need to eat well and lose weight and it will get better. But this condition makes it twice as difficult to lose weight than it is for a woman without PCOS, so that’s easier said than done. Sometimes they prescribe Metformin (a diabetic drug) and the birth control pill. Both are just band-aids for the underlying issues.

In 2007, I challenged myself to learn how to live with this condition without being obese, as my body seemed to want to gravitate toward obesity. I signed up for a figure competition in June 2008, and the experimenting began. What I found was that I needed to treat myself like a diabetic. All processed carbs were out: my body swells like a balloon when I eat a piece of bread. My body loves a high protein diet with moderate fat intake. I limited carbs to only 2 servings daily; before and after my workout. My body likes rolled oats and quinoa, but sweet potatoes and rice make me hungry an hour later. I can’t eat fruit, even when accompanied with a fat, because I will have a blood sugar crash. I was able to lose 30lbs, and though I wasn’t as lean as the rest of the women on stage, I was damn proud of myself, and I learned everything I needed to know about how my body processes food.

Losing weight didn’t resolve this issue for me, but it did make managing my weight a lot easier. PCOS can be self-inflicted through poor eating habits and lack of exercise, or it can be genetic and it never really goes away (as in my case), but you can learn to manage it. With PCOS, there is no slipping up, being lazy, or “just having one piece of candy.” It’s a battle every day just to maintain your weight, and losing weight is an entirely different story, but it is NEVER an obesity sentence. I know this because I fight this battle every day of my life.

As the obesity rate continues to rise, I believe we will start hearing more about self-induced cases of PCOS, and women using it as an excuse as to why they can’t lose weight. PCOS is not an excuse to be obese. You have to work twice as hard as everyone else, and it is a difficult journey, but your health is worth it.

Ashley Brodeur, MS, CPT
Exercise Physiologist
Owner, Active Lifestyle Fitness, LLC

Crock Pot Mexican Stuffed Bell Peppers

Ingredients:
• 4 bell peppers
• 1lb lean ground beef (90/10)
• 1c canned enchilada sauce
• 1/2 yellow onion, diced
• 1c shredded mexican cheese
• salt and pepper

Directions:
1) Soften onions over medium heat in a skillet with enchilada sauce about 5 minutes.

2) Cut off tops of peppers and remove seeds. Dice tops of peppers to mix with beef.

3) Pour 1/3c water into bottom of crock pot and place 4 peppers in, open side up.

4) In a large mixing bowl, combine beef, onion/enchilada sauce mixture, diced pepper tops, cheese, and salt/pepper.

6) Cook on low for 6 hours.

9 guilt-free foods at the Big E

I decided this would be the year I tackled the Big E in all its junk food glory to find food items our members could eat without ruining their hard work. I can’t say this was an easy task, but I did come out with a few gems for you. The main criteria for my search was that these items would not encourage a blood sugar spike causing junk food cravings after the food is digested, ultimately leading you to a dark place where deep fried Oreos live. To those that mentioned baked potato, fruit, corn, or any sort of sandwiches involving white bread, that is why they are not included in this list. Stay away from simple carbs and sugars if you’re trying to keep yourself under control!

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1) Smoked Salmon (Maine Building)
A great source of protein and healthy fat, I would agree with their claim that this is the healthiest food at the Big E. Wicked convenient, too, since you can carry around your salmon on a stick.


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2) A Cup of Chili (Massachusetts Building)
A plain cup of chili (not chili cheese dogs) should keep you satisfied and provide a good source of protein if you get turkey, beef, or emu (what?) Kielbasa didn’t make my list because I’m not sure if it’s marinated. Marinades are usually full of sugar.


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3) Shrimp Cocktail (Rhode Island Building)
There are lots of other seafood items at this stand that I found questionable, but plain shrimp cocktail is a safe bet. It’s a great source of protein; just don’t load up on the cocktail sauce!


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4) Tomato, Basil, and Mozzarella Salad (Connecticut Building)
This looked very fresh and easy to eat! Cheese is not high on my list of “healthy” things to eat, but it is portioned out for you in this dish.


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5) Chop Chop Salad (Delaney House Tent)
There are several tents where you can sit and have a salad if you have time; this is not the only one. Just make sure the toppings are not saturated in sauces or marinades and that you ask for a dressing on the side. Ceasar, Greek, Blue Cheese, or Olive Oil-based dressings are higher in fat but are more satisfying and produce less of a blood sugar spike, so I would opt for those.


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6) Greek Salad (Everywhere!)
There are a lot of tents and stands serving Greek food. While I might stay away from the white bread gyro (or just eat the guts and throw away the bread), Tzatziki sauce and other Greek dressings have a yogurt and/or olive oil base which isn’t bad for you like a lot of the dressings and sauces on American food. I might opt for a place that looks somewhat authentic, though, than a random food truck that’s also serving donuts.


7) Beef Jerky (Better Living Center)
Jerky is usually a safe bet as long as you make sure it wasn’t heavily marinated. It can be high in sodium, but unless your doctor has placed you on a low sodium diet for medical reasons, it’s not going to hurt you.


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8) Dill Pickles (Craft Marketplace)
There isn’t much to dill pickles, except a little bit of sodium. It may not be completely satisfying, but it will take you a while to munch on it, so it will keep you occupied while your friends/family are eating ice cream!


9) Roasted Nuts (Rhode Island Building)
Nuts are a healthy fat source that will keep you satisfied and provide energy during your trek across the junk food jungle. Just make sure you count out a serving and don’t eat the entire bag because the calories add up quickly! Some other stands also have nuts, but they’re coated in sugar. Opt for plain, salted, or roasted!


After hustling through the Exposition and finding myself parched, I also thought it would be helpful to list some drinks in addition to water:

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Sugar-Free Lemonade (Outside the Better Living Center)
I was disappointed to find that most of the lemonade stands (even in the state buildings) were pouring syrup and sugar into their drinks. I asked a few if I could get fresh squeezed lemon in water and this was the only stand that would do it. It was very refreshing! Del’s in the Rhode Island building has a sugar-free lemonade option, but there is some kind of artificial sweetener in it that I wasn’t too sure about.


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Coffee (Everywhere!)
When all else fails… coffee! As long as you don’t fill it with sugar or order a mochalatte coffee-flavored sugar bomb, a plain iced coffee will provide some hydration and also serve as a mild appetite suppressant!


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Vodka/Seltzer: no cranberry (V1 tent, Delaney House tent)
I get it, some of you go to the Big E to drink alcohol. Your best bet is to stop by the V1 tent (not for the deep fried martinis) and get a vodka/seltzer (you don’t really need a sugar splash of cranberry). The Delaney House tent also has Spiked Seltzer if you want something more convenient in a can. Just keep in mind that alcohol consumption can lead to poor choices, and poor choices can include mini donuts.

 

Lastly, you may decide to use your visit to the Big E as your cheat meal for the week, and there is nothing wrong with that. Just make sure to eat in moderation and not drag the junk food out over the course of a day. Cheat meals are fine, cheat days can easily erase a whole week of hard work!

Muscle vs Fat Myths

musclevsfatweb-300x300In the quest for good health and fitness, it’s important to understand what your body is actually doing while you’re watching it change. There are a few myths regarding muscle and fat that are still circulating. Here is some info about these common myths:

1) Does muscle weigh more than fat? I always answer this question with a question. What weighs more: a ton of bricks or a ton of feathers? Answer: they weigh the same. Which takes up more space: a ton of bricks or a ton of feathers? Answer: a ton of feathers. Muscle, like bricks, are more dense and take up less space. If you gain 5lbs of muscle and lose 5lbs of fat, you will weigh the same, but your body will be smaller!

2) When you lift weights, you turn fat into muscle. Fat and muscle are two entirely different tissues, so there is no converting one into the other. When you first start a resistance training program, you are building muscle and losing fat simultaneously, which causes the change you see in your body shape.

3) I just want to “tone” my muscles. The word “tone” when used in reference to exercise is a marketing term to sell fitness programs to women that are scared of looking like a bodybuilder in a magazine. “Toning muscle” by that definition is not an action that your body can perform. You can build muscle and lose fat to get visible muscle definition, which is usually the look women want when they use the word tone. And, it takes years of focus and dedication to look like a bodybuilder in a magazine. It doesn’t happen to anyone by accident!

Why Exercise Isn’t Making You Skinny

bigstock-Tired-Woman-Sweating-After-Run-52155052-1How many times have you had a particularly active day and said to yourself, “Well, I walked a lot today, so I can eat this burger and fries.” Do you go on bike rides in the summer and the end goal is the ice cream stand? Have you run 3 miles or more, and then indulged in the pizza you’ve been craving? I hate to rain on your parade, but, you will only gain fat with this behavior.

You’re not burning as many calories as you think you are. Calm down with that calorie counter on your wrist – it’s usually lying to you. A common misconception is that, because you feel exhausted after a workout, you burned a lot of calories and need a big re-feed. This is not usually the case.

You’re eating back more calories than you actually burned. Let’s say, in reality, you burned 350 calories running a 5k race. One small slice of pizza will add back about the same number of calories… but did you really eat just one small slice of pizza?

All “calories” are not created equal. I wish fat loss was as simple as calories in, calories out, but it’s not. By eating junk at the end of your workout, you’re putting an immediate halt on your fat burning process. Your body is looking for specific nutrients at that time to repair and restore. Feed it quality calories, and your metabolism will reap the benefits later.

In summary, please remove any thoughts from your mind that equate exercise with junk food! It’s not about “how much exercise do I have to do so I can eat this?” It’s about how you can most effectively build your metabolism and optimize your body functions. This process starts with a mindset of exercise as a benefit, not a justification!

Managing your fitness goals with PMS

keep-calm-it-s-only-pms-2If you have female anatomy, chances are you have succumbed to the PMS demon that has overcome your body and controlled your soul at some point in your life. You want to eat all of the “bad” foods you shouldn’t have, you don’t want to exercise because you feel like a walking blimp, and you’re ready to throw in the towel and give up on your fitness goals (for this week, anyway). PMS affects every body differently, so it’s unreasonable to think there are specific anti-PMS methods that will work for everyone, but here are some of my thoughts about PMS and staying on track during your fitness journey:

1) This, too, shall pass. Keep reminding yourself that PMS doesn’t last 365 days of the year even though it feels like forever. The scale may frustrate you, but emotional eating won’t help either. Focus on maintenance during this time period rather than losing weight. If you can talk yourself into exercising and not eating everything in the house, count that as your success for the week!

2) Your symptoms will be worse with PMS if you eat poorly throughout the month. If you are someone that feels completely out of control with PMS, consider the rest of the month as your “prep” time. You will find that your cravings and other symptoms are dramatically lessened with PMS if you don’t consume sugary, processed foods on a regular basis.

3) Keep exercising, no matter what! Exercise will help to relieve cramping and headaches, lessen cravings, and keep you focused. Throwing in the towel and not showing up to your workout will also increase the chances of you ending up on the couch with a pint of Ben & Jerry’s. Get up and get moving even though you don’t want to – keep yourself mentally in the game!

The dumbest thing I’ve done

Many fitness professionals have a difficult time looking at their own bodies as objectively as they do with clients. I have fallen into this category on several occasions. We have the knowledge, we put together a plan, we do corrective exercises, and we push beyond our limits. But, like 16 year olds with license to drive, we think we are invincible… until our bodies remind us that we are human, just like everyone else. To date, one of the dumbest things I’ve done to my body as a fitness professional was that I stopped deadlifting when I started running. If you are a runner that battles with cross-training, you will understand my case.

deadliftI had never been interested in distance running, but I decided to start training for 5ks about 3 years ago. I didn’t want to be sore or in recovery from a workout when I had to run, but I knew it was neglectful to cut my lower body training, so I put some “maintenance leg work” in my weekly workouts. I didn’t know at the time that my 1″ leg length discrepancy with this type of training program would result in sacroiliac joint dysfunction, which led me to 3 years of lower back pain.

In 2009, before I started running, I had my best deadlift PR at 305lbs. I spent a little over a year training for that and I loved every minute of it. My body and my mind love deadlifting. In hindsight, when I was deadlifting regularly, the muscles surrounding my SI joints were strong and capable of stabilizing my pelvis. When I finally figured out this new non-deadlift training program was causing me damage, and hours of sitting at a desk in grad school exacerbated the issue, I was stuck in a cycle of back pain I couldn’t get out of. It has taken 2 months after graduation to finally report that my back pain is gone and I started deadlifting again. I had spent a lot of time on my Rumble Roller, stretching, getting deep tissue massages, and seeing the chiropractor over those 2 months.

The moral of this story is not to tell you not to run, or that you have to deadlift. The moral of this story is that everyone’s body is different, and each body has its own quirks and kinks. Your body will tell you what it likes and what it doesn’t like, and you should always listen! I do not believe we are all built to be runners, nor do I believe we are all built to be weight lifters, for example. If you are doing something that your body is not responding positively to, stop doing it. Just because Jane Smith loves her xyz workout doesn’t mean it’s going to make your body happy. Find what your mind and body agree on, and love your workouts!