Quinoa confusion - Paleo or not? Healthy or not?

What an exciting week it has been! In case you missed it, I had the amazing honour of sharing my journey with hypothalamic amenorrhea and body image on The Huffington Post! Seriously a dream come true! 

OK back to quinoa. It’s the high-protein darling of the vegan and vegetarian world. It’s the hip new pseudo-grain (it’s actually a fruit). And it seems to be somewhat of a grey area for Paleo folks – some love it (using said “fruit” defense, because God-forbid they eat a grain), and some are downright against it (if it walks and talks like a duck, (or grain), then…).

So who is right? Is quinoa the super-food it’s made out to be, or is it just another dodgy grain-like cereal?

Apparently Quinoa is a girl on pinterest who is well
 into her fashion…and hates pleather.
Just a little weird.

About 4 years ago, I was diagnosed with coeliac disease. My symptoms were not pretty – fat and protein malabsorption (which translates to chronic diarrhea, that kind of also feels like constipation – fun, right?), nutrient deficiencies, low energy and a rash that was spreading all over my body. The treatment for coeliac disease is simple – follow a gluten free diet.

So I switched my beloved oat-based porridge to quinoa porridge. It was a simple switch, and tasted pretty good, too. Unfortunately, just going gluten free didn’t cut it. I still had my symptoms some 6-9 months later. That’s when I decided to try this crazy “Paleo” thing that my hubby was doing (despite my dietitian brain being completely against it). Lo and behold my symptoms disappeared…..quite rapidly, in fact, with the high fat, low carb diet I had adopted.

Fast-forward to last year when I was diagnosed with hypothalamic amenorrhea and hypothyroidism, which my low carb diet probably played a large role in. I was tasked with adding in more carbs, and there is only so much sweet potato a girl can eat, especially with the exorbitant prices in NZ! Cue quinoa. I thought – why not throw it back in the mixer and see what happens?

This time, however, I made sure that I soaked my quinoa seeds overnight, rinsed and rubbed them in the morning, THEN cooked them (more on why I did this later). Success! No adverse reaction, no tummy upset. I felt great. Hurrah! Quinoa porridge is now a regular breakfast for me, and I love it!

I tell this story to highlight the fact that there is no one diet for everyone, and what might be right for you now, might not have been OK a while ago, or in the future. It’s all about experiementation!

So why does quinoa get such a bad wrap? Well, the quinoa seed contains a few “anti-nutrients”:

Check out those soapy saponins after soaking quinoa overnight

• Saponins – as the name suggests, these are soap-like substances, which can cause problems with digestion and potentially increase intestinal permeability (AKA “leaky gut”)
• Phytates – or “phytic acid” can bind up minerals, such as iron, zinc and magnesium, preventing their absorption and utilization by the body
• Protease inhibitors – “proteases” are enzymes that break down proteins into their smaller constituents, amino acids, which can then be absorbed through the intestinal wall and used by the body to build new proteins. The body is clever, right? Protease inhibitors, as you might have guess, can inhibit the action of these enzymes, thus disrupting the ability to digest proteins 

Well crap. That all sounds pretty unhealthy. Why would I even consider eating such a food?

Here’s the thing – soaking, rubbing, rinsing and cooking reduces the content of these anti-nutrients by 50-100%, making them less problematic, and the vitamns and minerals contained within (think calcium, magnesium, folate, iron, phosphorus, vitamin Bs and vitamin E), more bioavailable. Brilliant!

All that said, if someone is suffering from a health condition, especially if it is digestion-related, I would suggest cutting out quinoa and going quite strict Paleo for a period of 30 days. Then you can start to reintroduce foods and see how you go. That sounds fair, right?

Now just because I love you, I have decided to share my yummy brekkie recipe. Enjoy!

Warming Quinoa Porridge

• ¼ cup quinoa
• ½ cup water (plus extra for after cooking)
• ¼ cup coconut milk (plus extra for after cooking)
• 1 ripe banana, mashed
• 1 tsp cinnamon
• 1 tsp maca powder (optional, but is great for hormonal balancing)
• 1 small handful of nuts (chopped) and/or seeds
• 1 small handful of coconut flakes (optional)
• Sometimes I also add a sprinkle of Great Lakes Beef Gelatin (flavourless) for extra gut-healing goodness

Method

1. Soak the quinoa overnight and rinse thoroughly in the morning, massaging the seeds as you rinse. This removes “saponins” and improves the digestibility of the quinoa
2. Add quinoa, water and coconut milk to a small saucepan over med-high heat until just boiling
3. Turn the heat down to low and put a lid on the saucepan for around 10 minutes or until most liquid is absorbed
4. Meanwhile, mash the banana and chop the nuts
5. Add everything together (quinoa, banana, nuts, maca, coconut flakes, cinnamon) and add extra water and/or coconut milk until it reaches your desired consistency
6. Enjoy slowly!

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Hypothalamic Amenorrhea and How To Exercise

I get asked this question A LOT. Especially since Sarah Wilson kindly posted my story on her blog. I think, inherently, we are all a little voyeuristic. A little pervy. Wanting to know the intricate details of other peoples’ lives. Or perhaps we just want a little guidance or confirmation that we are doing the right thing. Either way, I have decided to share how I approached exercise as I was healing from hypothalamic amenorrhea.

Peeping Toms in Tokyo, 1951. Image via pinterest by sahua d

First, know this: hypothalamic amenorrhea (also referred to as the Female Athlete Triad) is often a result of over-exercising and/or under-eating, which leads to an overall negative energy balance for an extended period of time. The body senses that you are, essentially, starving and says “Righteo, no energy for reproduction, then” and bids farewell to your monthly lady holiday.

So, taking this into account, you can see that exercise is perhaps contraindicated in the treatment of hypothalamic amenorrhea. Right? Right! 

Chronic exercise = no good. BUT movement = good!

Prior to actually deciding to do something about my infertile situation, this is what my exercise looked like: 

• Monday: Body Attack (1hr) followed by Body Pump (1hr). I might have walked ~1/2 -1hr too
• Tuesday: Maybe a walk, maybe a weights session (maybe both), maybe a cardio session
• Wednesday: Body Attack (1hr)
• Thursday: Body Step (1hr), ½-1hr walk
• Friday: Body Attack (1hr), weights (1hr)
• Saturday: Body Step (1hr) – every second Saturday
• Sunday: Body Step (1hr)

Holy crap. I am exhausted just looking at all of that! So much time wasted in the gym! Granted, it was my job, which made it more “legitimate”, I suppose, albeit no less damaging to my health and fertility.

I realised that this was unsustainable and would leave me in my infertile state if I were to continue. 

Yes, thank you for your wisdom, Albert. For a while, I was insane. I thought I could just throw herbs and vitamins at the situation and it would sort itself out. But, after spending thousands of dollars (literally), I realised this approach was no bueno. So here is what I did…

I progressed quite gradually, and it helped that it coincided with my dietetics placement, so I had an excuse to no longer teach a lot of my classes.

Stage 1

• Monday: Body Pump
• Tuesday: Walk
• Wednesday: Weights (functional training 1hr)
• Thursday: Yoga
• Friday: Weights (functional training 1hr)
• Saturday: Body Step (every 2^nd weekend)
• Sunday: Body Step

 A considerable change, but probably not enough. Cue stage 2.

Stage 2

• Monday: Body Pump
• Tuesday: Walk/yoga
• Wednesday: Weights (8 minutes – YES, you read right EIGHT minutes – 8 sets of 3 clean and presses; sets 1 min apart)
• Thursday: Walk/yoga
• Friday: Walk/yoga, maybe a Tabata session (4mins of cardio)
• Saturday: REST
• Sunday: REST

Although it was tough (mentally), I stuck to this routine for quite some time (until my period returned), gradually adding in more yoga (vinyasa/yin/hatha NOT bikram/ashtanga) and taking out the Body Pump. As I have previously mentioned, I found the yoga incredibly beneficial to the healing process as it allowed me to focus more on my body’s ability, rather than its aesthetics.

So, now that my cycle is getting back on track, how do I exercise? Well, it depends. I try and get outside as much as possible for a gentle walk/hike, as I now live in the nature-lover’s playground:

Image by Lake Wanaka Tourism

But if it is raining outside, and I feel really good, and my stress levels are low, my week might look like this:

• Monday: Weights (1hr - 10 min mobility warm up, 30 min weights, 20 min stretch/yoga)
• Tuesday: 1hr yoga
• Wednesday: Body Pump
• Thursday: Tabata
• Friday: 1hr yoga
• Saturday: Hopefully the rain has stopped by now and I can go for a hike!
• Sunday: Rest

Note: I do at least 30 minutes of yoga every day in the morning. It grounds me and sets me up for an awesome day.

Now please note, this was MY journey. This gives you a general idea of what worked for me. It may or may not work for you. Listen to your body. If you have exercise/stress/lack of food-induced amenorrhea, then you probably need to pull right back on the exercise to start with, then take baby steps along the way, depending on how everything is tracking along.

If this is all too overwhelming for you, I get it. My hubby (who is a PT and peak performance coach) helped keep me on track. Everyone needs someone. Feel free to shoot me through an email via my website if you would like to book a consultation for some more structured, personalised guidance that will help you get your sexy back.

Final note – as always, be kind to yourself. x

How I got the body I've always wanted

This past weekend, I turned 30. Officially in the dirty thirties now. And I feel great. Fantastic, in fact.

My awesome hubby took me on a helicopter flight for my b'day!

It has been 1 year since I wrote my postabout putting on weight to restore my fertility. It has been 3 years since I lost my period due to under-eating, over-exercising, taking the birth control pill and being a stressed-out, maniacal perfectionist. It has been an interesting 30-year journey of progressing from someone who was constantly trying to change her body to meet some unrealistic ideal, to someone who actually loves the skin she is in. And I am not just saying that. For the first time in my life, I actually really love my body.

I have been wanting to write this post for a while, but putting it off. Not sure why. I guess we all have a fear of being judged in a negative light. So I ask you to please, if you have nothing nice to say, then say nothing at all. OK here goes...

For reference purposes, here is my before and after pic to show my progress. Please excuse the hair in both shots – one was scraggly beach hair and the other sweaty post-workout hair. But it’s not about the hair (although it is thicker and more lustrous nowadays). Let’s take an objective view here, simply looking at the change in body shape.

On the left, you will see “Check out my 8-pack, you think I'm healthy and fit , but my fertility is in the shitter” Kate. I showed this to a friend the other day and she said “Oh wow! What were you training for?”. Nothing. I was training for my illusive “dream body”. Pfft.

On the right, you will see “Check out my boobs, I look healthy and feminine and my internal state reflects this” Kate. There are just two things that I do not like about this pic – 

1)My lack of tan (although I have that many layers on here in Wanaka that a tan would not even get noticed) and 

2)The selfie pose. I hate bathroom-half-naked selfies. It makes you look like such a wanker. I apologise. I am doing this for reference purposes, not to show off or entice more Instagram followers.

OK, so aside from having boobs (seriously, I’m still obsessed with them), what is so great about my new body? Probably best if I list out the reasons, as I tend to do. As always, feel free to just read the bolded text to get a general gist:

1. I have unbelievable energy. I used to have to take regular naps throughout the day, just to make it through. Now, I can soldier through, completely sans-caffeine. Funny what happens when you start to eat enough
2. The whites of my eyes are crystal clear. They used to be constantly bloodshot and my vision was blurry. I relied on ClearEyes, and I wasn’t even getting stoned!
3. My skin is clear and wrinkle free. Previously, it would look kind of dry and lackluster
4. My nails are thick and strong. For the first time in my life, my nails are not snapping off as soon as a little bit of white appears. I used to have vertical ridges (signs of adrenal fatigue) and horizontal ridges (signs of thyroid issues). These ridges are almost non-existent now
5. My gray hairs have disappeared. Now this one I find quite odd, and did not think it possible. I used to have quite a few gray hairs, and my hairdresser can vouch for this – she kindly pointed out a patch of grays on my head that I would have otherwise been unaware of. Thanks Leigh. Those grays – all gone! Bizarre, right?
6. My cycle is getting back on track. Thank God, because that’s the whole reason I headed down this road. It’s not perfect – about 40 day cycles, but compared to the nothingness of about 6mths ago, this is a pretty significant improvement
7. I can do crazy yoga shit. Seriously – handstands and backbends and balances and all sorts of awesome stuff. I am loving it! I would never have gone down the yoga path if I wasn’t forced to sort out my stress and pull back on the chronic cardio that I was doing
8. I am so much more in tune with my body now. I listen to how it feels and I respond with understanding and respect, rather than saying “Harden up! It’ll be worth it”, because more often than not, it won’t be worth it.
9. My hubby thinks I am sexy and tells me this all the time. I know what you are thinking – he has to say that. Maybe, but he could just say nothing at all. I asked him if he preferred me the way I used to be and he said “Honestly, you were almost too skinny for me”. Interesting. I find the male response to this whole thing very intriguing. Any males out there who want to chime in on this, please do – obviously not telling me I’m sexy (unless you want to), but just commenting on the whole female body thang.
10. I am now in the position to be a positive role model for other females, both young and old. My previous body was unrealistic and unattainable for most. It took a lot of hard training and strict eating, and wasn’t even healthy. I was practically a male! No boobs, no period, no hips. Sounds pretty masculine to me!

So how did I do it? How did I go from hating my body at 57kg (172cm tall, 'cos I know you were wondering) to loving it at around 62-64kg (not exactly sure what my weight is – I broke up with the scales a while ago)? Well, it wasn’t easy. I didn’t just suddenly wake up and go “Hurrah! I am woman, hear me roar!”. These are the things that were invaluable to complete body image backflip:

1. Support. Lots and lots of it. From loved ones, and from you folks through the interwebs – thank you!
2. The knowledge that I might be helping others in a similar situation – this was a massive driver! I truly hope I can help others, even if it is just one person
3. The realisation that menstruation is a sign of fertility. Fertility is a sign of health. Body fat is needed for menstruation. Ergo body fat is healthy.
4. Self-love. I know this sounds really woo-woo, but it truly helped me understand the underlying thoughts I had about my body and how to change them. Gabrielle Bernstein’s May Cause Miracles, and Louise Hay’s You Can Heal Your Life are invaluable resources. Get them both. NOW!
5. Yoga. Yes, I am well and truly a hippy now. I even have crystals throughout my house. Candles too. But back to yoga. Aside from being able to bend and balance my way into poses that I was once only dreamed of doing, yoga taught me how to focus on my body’s ability, rather than it’s aesthetics.
6. The realisation that those who really matter in your life could not give a flying fuck (sorry - I was overdue for a swear word) if you are a size 8 or a size 14

Image via care2.com

This is my body. In your eyes, it may not be perfect. I have cellulite. I have stretch marks (in fact, I had cellulite and stretch marks before putting on weight). I don’t have abs. Or a thigh gap. But in my eyes, what I see and how I feel, for the first time in my life, I am completely and unashamedly happy. This is 100% me. I am not a replica of someone else, nor am I trying to be. I am confident and I am healthy, and I hope that I have sparked the desire in you to love, accept and appreciate your body exactly as it is. xx

Amenorrhea and bone health

I know a lot of chicks who do not have their period. Most of whom aren’t looking to get pregnant yet, so they don’t really see it as much of an issue. Some even see it as a blessing.  I get that. Periods are a little inconvenient. They are messy. They hurt. BUT they play an important role in our health. As women, getting a regular, monthly period signals that our menstrual cycle is healthy, our hormones are working as they should be and we are capable of reproducing, if we so wish. Our period, in a way, is the canary in the coal mine. 

Image by Manita Brug via Pinterest 

I often refer to my period problems as “hypothalamic amenorrhea” (HA), which is basically a diagnosis of exclusion. I don’t have PCOS. I don’t have a tumour on my pituitary gland. I don’t have a physical problem with my ovaries. I do have a problem with the message getting from my brain to my ovaries to produce sex hormones. Another term for this whole biz is the “Female Athlete Triad” – FAT (or lack there of it, in this case). FAT refers to a constellation of 3 clinical entities:

1. Menstrual dysfunction
2. Low energy availability (with or without an eating disorder). When I say “energy availability”, I am referring to the amount of energy left over for all of your bodily functions after taking exercise into account. If you are eating 2000 calories per day and "burning" 2000 calories per day, you're in trouble!
3. Decreased bone mineral density

Today I’m going to focus on the third point as this applies to all females, regardless of whether they want to make babies or not. I am pretty sure none of us wants a fractured hip before they hit their 40’s (which, scarily, is a more common occurrence than one would think). It's a bit of a long post, but incredibly important (and filled with loads of fun science. You know you love it). If you're time-short, just read the bold points and then take some action. 

Image by Alec Paloumpis via Pinterest

In February last year, I had a DEXA scan, which revealed my bone mineral density (BMD) was less than optimal. My response: Oh. Fuck. Considering my peak bone mass had already been obtained and I would start to lose BMD in less than 2 years, this was not the easiest thing for me to process. So I didn’t. I focused more on the infertility side of things instead, because that was what I was more concerned about at the time.

Let’s back up a bit. Why does amenorrhea cause bone loss? It’s a little bit sciency, but I think you can handle it. Maybe a picture will help? Here you go. Just look at the right hand side. The left hand side is a talk for another day.

 

Image via www.sfu.ca

In a normal, fully-functioning, female, part of the brain (the hypothalamus) will release something called Gonadotropin Releasing Hormone (GnRH). You can think of this in 2 parts to make more sense: “gonad” = ovaries, “tropin” = increase/stimulate. So GnRH signals to the pituitary gland (also in the brain) to “release” gonadotropins. These are Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH). FSH and LH then stimulate the ovaries to produce and secrete sex hormones (namely estrogen and progesterone) in a cyclic manner.

In someone with HA/FAT, the GnRH secretion is thrown all out of whack due to stress, too low body fat and/or not enough food to play with. As a result, down yonder in the ovaries, no message comes through to produce sex hormones, so they go on vacation. Ergo no estrogen. No progesterone. And, often, no testosterone. Boo. While all of this is pretty crappy, the bone complications come about due to the lack of estrogen, termed “hypoestrogenism”. Big words today, people. Are you still with me?

Why is estrogen important in bone health? I am going to simplify this with a list, given that your brain might be overloaded a bit already:

1. Estrogen stimulates bone formation
2. Estrogen suppresses bone resorption (whereby bone is broken down and the minerals are released, resulting in a transfer of calcium from bone to blood)
3. Estrogen inhibits osteoclast activity (osteoclasts break down bone, as opposed to osteoblasts, which build bone)
4. Estrogen is responsible for the expression of vitamin D receptors i.e. it plays a role in vitamin D actually doing its job in helping to build bone

Now, the process of bone breakdown and formation is incredibly complex, but this hopefully gets my point across – estrogen is important for bone health. No estrogen, no bones. Well, not really. You probably won’t turn to mush.

45-50% of our peak bone mass is formed during puberty. By the time we are 18, we will have reached ~90% (unless you have HA/FAT when you’re a teenager – then the picture ain’t so pretty). From the age of 30, if all is working well, we will lose ~1% of our BMD per year. HOWEVER…

If you have HA/FAT, the rate of bone loss is similar to that seen in menopausal women: ~5% per year. That is 5 times greater bone loss than we should be losing! 

If that doesn’t scare you, then I do not know what will. Maybe go and hang out at a geriatrics ward and take a look at what recovery from a hip fracture looks like.

One study found this: “The lumbar (lower back) BMD of [runners with amenorrhea] was found to be lower than the BMD of an average 50 year old woman”

Shitballs. Here are some more scary findings, just in case that is not enough to get you out of your whole “it’s convenient to not have a period” funk:

The bone loss that occurs in women with amenorrhea is most likely irreversible. I repeat – irreversible. You can take all of the calcium supplements you want, but you probably won’t get it all back. You might get some, if you are very serious about making some changes.

Another study on 27 women with an average age of 21.8 years with functional hypothalamic amenorrhea had reduced bone mass throughout the whole skeleton.

The length of time that someone has amenorrhea is negatively correlated with BMD. Read: the longer you have no period, the shittier your bones will be. Read: go and do something about it NOW!

Exercise is not sufficient protection. When I had my DEXA, the lady said “you should do some more weight bearing exercise”. No shit Sherlock. I’m a personal trainer, group fitness instructor and I have been doing weight bearing exercise all of my life. But thanks for your input.

Hormonal therapy (e.g. the oral contraceptive pill) is not sufficient if satisfactory nutritional status is not achieved. There is no magic bullet, ladies. You have to do the ground work and fix the underlying cause.

So what’s a gal to do?

Well, firstly, don’t ignore it. It will only get worse with time. If you have had amenorrhea for more than 6mths, get a DEXA scan to see how your BMD is looking. Then get another one every year after.

Secondly. Fix it. This is more complicated than I like to admit. I am in the process of writing a book about this now, which will take some time, but I am committed to the cause.  Read my other posts on hypothalamic amenorrhea as a start - HERE, HERE, HERE and HERE. Yep, there are a few of them. And there will be more, but I am moving from focusing about me to focusing about YOU!

Start with eating more (and eating well), exercising less, but still do some exercise. Yoga is great for bringing everything back into balance. Weight training, in small to moderate amounts, is good for helping with bone and muscle strength.  Don’t run. Don’t do more than 30mins of cardio at any given time. Just don’t. Research has shown that just 20 minutes of quiet standing on a vibration platform can decrease and prevent bone loss. And it feels pretty good – it shakes your body awake!

That’ll do for now. Thanks for hanging in there, friends. Please share this with anyone who you think might benefit from it.  Our skeleton is pretty important. Let’s make sure we don’t lose it before our time. PS have you checked out the Thyroid Sessions yet? They are pretty awesome, and free for a limited time. Fun fact: thyroid problems can cause amenorrhea. Click HERE to watch now. 

Studies used in writing this post:

• Constantini, NW. & Warren, MP. (1994) Special problems of the female athlete, Bailliere's Clinical Rheumatology, Vol 8, Iss 1, pp199-219
• Ackerman, KE. et al (2012) The Female Athlete Triad, Sports health, Vol 4, Iss 4, pp 302 - 311
• Deimel, JF. & Dunlap, BJ. (2012) The Female Athlete Triad, Clinics in Sports Medicine,  Vol 31, Iss 2, pp 247 - 254
• Nissenbaum, JT. (2013) Long term consequences of the female athlete triad, Maturitas, Vol 75, pp 107-112
• Pludowski, P. et al (2012) Skeletal status and body composition in young women with functional hypothalamic amenorrhea, Gynecological Endocrinology, Vol 28, Iss 4, pp 299-304