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My 3rd Trimester: COVID-19, PCOS, and more

My 3rd trimester was filled with so many ups and downs. It sure came at an interesting time. My 3rd trimester started mid-April 2020 when we were knee-deep in our stay-at-home order here in Michigan for COVID-19. The middle of my 3rd trimester was marked by civil unrest and protests breaking out across the country, including in my own backyard, Grand Rapids, over the death of George Floyd. Every OB appointment had a new flavor of the week in terms of COVID requirements, which always kept me on my toes. But sprinkled in there were so many wonderful things too, like finalizing names for Baby B, clients or followers getting pregnant with PCOS, the launch of my new e-book, adjusting to fluctuations in appetite, and feeling big, I mean BIG movements by Baby B in my belly.

COVID-19

I think we are all a little sick of talking about COVID-19, but it has been a serious milestone in both 2020 and my pregnancy. It seemed to have no rhyme or reason in terms of who got sick and how they carried their symptoms, making it quite stressful for a normal person, let alone a 3rd trimester pregnant person. 

I feel incredibly lucky that for the most part, my husband and I, as well as our families were not badly affected by the virus directly or indirectly. My husband and I work from home normally so not much changed there, but it is incredible how different you feel when you can’t even go the 2-3 places you were used to going daily. Or even just how isolated you start feeling from not being able to go to those 2-3 places daily or seeing close family and friends. My OB appointments started to get very interesting. Protocols changed every time I went in for a new appointment and my husband was no longer allowed to accompany me to any appointments. 

Although I felt relatively blessed throughout the whole process, I’d be lying if I said there weren’t times where I thought to myself ‘why this year?!’. A few times where I was at bigger appointments alone, I had a few moments of feeling sorry for myself and wishing my husband was able to be there with me during this new and sometimes anxious experience…both for me and for him. I’m a strong person mentally but sometimes you just want your person there with you, mainly to make sure you don’t forget anything you wanted to ask and catch every piece of information the doctor tells you. As I mentioned before, luckily my family’s health was not directly affected (meaning I think we all have been affected mentally in some capacity, but physically no one in my family has tested positive for COVID) and my husband was able to join me for my last OBGYN appointment before the baby arrives.

Civil Unrest

I was just starting to enter the 2nd half of my 3rd trimester when the riots started breaking out after George Floyd’s death. While I’m not going to use this time to take a political stance, I do want to mention that this certainly brought on some self-reflection on just how advantaged I have been throughout my life. This provided me with an interesting perspective considering I’m also due to bring a child into this world any minute. It made me reflect on how I was raised and what I might want to tweak to help create a human that is priivy to the world around her, understands the value of human life as well as the history of our country, but can also critically think about the information provided by (social) media and be able to come up with her own conclusions. Again, I’d be lying if I said this time in our history has not left me feeling uneasy with my own ignorance at times and just about bringing a child into this world at this time, but without uneasiness there is no growth. I’m going to leave it at that.

Ravenous Appetite and PCOS

I’ve touched on food cravings in my previous pregnancy posts, but I wanted to provide a few tips here. The 3rd trimester definitely left me hungry almost every 2 hours. There were often times that even despite having healthy food and snacks around, I would eat through those healthy foods and wonder ‘what else can I eat?!’. This was a little tricky at times in terms of trying to manage my PCOS and keep my blood sugar balance. 

Here are a few tips to help navigate this time: 

  • Pair your carbs with a protein or fat. This may sound redundant but it’s true! It helps keep your cravings to a minimum and keeps you full for longer
  • Consider inositol supplementation. Always consult your doctor and/or PCOS dietitian before starting any supplement but inositol, specifically myoinositol has been considered safe to use during pregnancy, can help keep your cravings under control, and has been shown to lower risk of gestational diabetes when used in combination with folic acid. Not to mention, it can help keep androgens (or male hormones) within normal levels. 
  • Keep ready-to-eat healthy snacks on-hand as much as possible. Having carrots, cucumbers, and spinach in the fridge is one thing. But having them washed, cut up, and ready-to-eat makes the decision to chose the healthy snack a lot easier. Even if you run out of your healthy snacks faster, all those vitamins, minerals, antioxidants, and fiber help keep both you and baby healthy! 
  • Listen to your cravings more often than you would when you weren’t pregnant. Now that’s not to say you can’t listen to your cravings when you’re not pregnant either, but during pregnancy our hormones are doing crazy things to help bring a healthy baby into the world. So often when you’re craving full-fat ice cream or pickles, your body (and growing belly) might be telling you it needs more salt, iodine, or calcium so LISTEN! Try your best to live a PCOS-friendly lifestyle 80% of the time, eat the food, and move on! 

Postpartum Meal Prep

Postpartum meal prep

 

In my final weeks of pregnancy, I tried my best to prepare a handful of PCOS-friendly meals and snacks to have on-hand to make postpartum life a little easier. Although my husband said he’s happy to cook (he’s a keeper!), I also know that this will be a new journey for both of us and it will be helpful to have some freezer meals and snacks to fall back on if he decides he wants a week off. I find it hard to cook for just two people anyway so cooking extra of some of my favorite go-to meals was not all that difficult for me. Plus, I’m planning on breastfeeding so I know my appetite might be a little larger than normal depending on how that goes. Some of these recipes are mine, but some are also from other fertility-friendly resources which I will link accordingly. For any pregnant mamas out there considering postpartum meal prep, Lily Nichols’ book, Real Food for Pregnancy, and website are great resources for recipes and nutrients to focus on throughout pregnancy and postpartum regardless of whether you have PCOS or not. 

I’m a dietitian and I seriously learned SO much about both prenatal and postpartum nutrition that I didn’t know beforehand by reading Lily Nichols’ book. It is no surprise to me that nutrition plays a HUGE role in postpartum healing and breastfeeding. An important tidbit of information that I found particularly helpful as it pertains to PCOS in her postpartum nutrition chapter was where she discusses carbohydrates. She explains that while it may be tempting to immediately go back to a low carbohydrate diet to help drop the baby weight, the immediate postpartum period is not the time to do so (or at least not until your milk supply is fully established). She states that this type of undereating can negatively impact your milk supply, put you and your baby at risk for dehydration as extra fluids are needed when creating breastmilk, and lead to inadequate electrolyte intake. 

What I made:

  • PCOS-friendly Apple Spiced Granola
  • Pork Carnitas (I followed Lily Nichols’ recipe from Real Food for Pregnancy book-check out her website here)
  • Beef Chili
  • Chicken & Veggie Coconut Curry (recipe from my ebook bonus items, but here is a similar recipe I use)
  • Brownie Protein Bites (recipe from my ebook bonus items)
  • Oatmeal PB Energy Bites
  • Venison and Veggie Egg Muffin Cups
  • Oatmeal Breakfast Bars (I used @fertility.with.pcos recipe from Instagram here)
  • Chicken Enchiladas (here is a similar recipe I use (feel free to sub out black beans for chicken and other veggies you have on hand for the sweet potatoes)-I did both gluten-free and regular tortilla options for me and my husband)

Recommendations for Storage: I’m not going to lie. I was in a pinch and needed to make this food fast so I used the standard disposable aluminum freezer containers. We are all human here. I will adjust for next time and plan accordingly, but here are some lower toxin strategies for freezer food storage:

*Tip: Depending on how many will be eating with you, portion out accordingly. For example, I portioned mine out into 2-4 serving portions for both my husband and I, but if it’s just you or more you’re feeding, you’ll want to modify as needed.

Launch of my Restore Your Fertility E-book!

Restore Your Fertility Ebook

This was definitely a highlight of my 3rd trimester! The launch of my Restore Your Fertility E-book on May 27, 2020 was so fun! It was a labor of love and what I hope to be a great resource for any woman with PCOS trying to get pregnant. I poured information I wish I would have known during my fertility journey, as well as other evidence-based information on how to get synced with your cycle, how to optimize your nutrition for fertility, and how to build a healthy, fertile mindset (a crucial part of any infertility journey!). Not to mention, it provides 2 weeks of PCOS-friendly meals to help get you started. It’s bound to get you one step closer to getting pregnant with PCOS! For more information on the ebook, click here

The day is almost here!

Last but certainly not least, enjoy this time! For me, I fluctuated frequently between excitement and anxiety over what I didn’t know or do yet. Did I read enough books or do I know what the hell I’m doing?! My take? Nope. There will never be enough books to read, videos to watch, recipes to make, or articles to read that will appropriately prepare you for becoming a parent. The most I can do? Allow myself some grace during such a momentous transition in my life. And I encourage you to do the same! I hope you found this helpful! The next time we chat, I will have a baby 🙂 Happy almost 4th of July friends!

-EAB

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PCOS-Friendly Apple Spiced Granola

PCOS-Friendly Apple Spiced Granola

Course

Snack
Keyword

dairy free, gluten free, granola

Servings 3 mason jars
Author Liz Bissell

Ingredients


  • cup
    pumpkin seeds, raw
  • ½
    cup
    pecans, chopped

  • cup
    hemp seeds
  • 1
    cup
    gluten-free old-fashioned oats
  • 1
    cup
    macadamia nuts
  • 1
    tbsp
    cinnamon
  • ¼
    cup
    apple butter
  • ¼
    cup
    coconut oil, melted
  • 1
    tsp
    vanilla extract
  • ¼
    tsp
    ground cloves
  • ¼
    tsp
    all-spice
  • ¼
    tsp
    coarse sea salt

Instructions

  1. Preheat oven to 325 degrees. Combine the cinnamon, cloves, all-spice, and sea salt in a small bowl. Stir to combine. Set aside.

  2. Using a gallon ziplock bag, add the oats, pumpkin seeds, pecans, hemp seeds, and macadamia nuts. Close the ziplock bag and lay flat evenly on a hard surface, such as the kitchen counter. Using the bottom of a small saute pan, hit the bag several times to slightly break down the nuts. You can also chop manually or add to the a food processor and pulse 1-2 times if you prefer. Shake to evenly distribute and pour into a medium size bowl.

  3. Add the spices to the nut mixture and stir to combine. Add in the melted coconut oil and vanilla extract, stir. Heat the apple butter for about 20-30 seconds in the microwave and add to the nut mixture. Stir to evenly combine.

  4. Spread parchment paper or aluminum foil on a baking sheet and spray with cooking spray. Spread the granola evenly on the baking sheet. You want to make sure the granola is not spread too thin so you get some good clusters. I spread mine while maintaining some shape to it and then pressed down with my fingertips to reinforce the cluster creation.

  5. Bake for 25-30 minutes. Let cool for 5-10 minutes then break into smaller clusters. I stored mine in mason jars in the refrigerator but it can also be frozen for later use. Enjoy!

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8 Facts about Alcohol and Fertility

Reducing alcohol intake for potential mama’s and dad’s can be tricky. I don’t know about you but I find that most social events I go to involve some form of alcoholic beverage, which can make it very difficult to avoid alcohol or avoid attention for NOT drinking. Because there in lies the next question, “OMG you’re not drinking, are you pregnant?” This specific question is especially uncomfortable when you are trying to conceive but have not yet had success.

I’m going to be perfectly honest, I enjoy drinking alcohol! Wine, tequila, white claws, and high noon exactly in that order…not on the same night of course 😉 I have no shame! I am human just like the rest of us. Therefore, reducing alcohol intake for me is a purposeful action and takes some work. This may not be the case for everyone, but for me, it is. For this reason, it can be a huge challenge to be socially happy while trying to reduce your alcohol intake to promote optimal fertility, which led me to ask myself, does reducing or avoiding alcohol entirely really help with fertility? I decided to dive into the evidence and see what the science says.

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Here are the 8 facts about alcohol, fertility, and managing PCOS.

  1. Alcohol intake can affect your quality of sleep, which can ultimately alter your cortisol and melatonin levels making your PCOS worse.
  2. Studies related to alcohol intake and fertility are limited and not always reliable due to the unethical issues with testing this and the retrospective nature of many studies.
  3. Moderate intake of alcohol has not shown negative impacts on semen quality and in some cases, moderate alcohol consumption has shown positive health effects due to the antioxidant content found in red wine. However, excess alcohol intake (>14 servings) has been correlated with decreased fertility.
  4. Excess alcohol intake can increase inflammation in the body. This inflammation can cause worsening gut health and central obesity.
  5. Alcohol intake causes a burden on the liver. If the liver is sluggish due to frequently detoxing alcohol intake, it may not be as efficient at clearing estrogen levels, causing hormonal imbalance.
  6. Many alcoholic beverages are high in sugar due to the simple syrups, sodas, and juices used for mixing. Excess sugar intake can lead to worsening abdominal obesity, which can further deteriorate your insulin resistance. Women with PCOS are also more likely to develop non-alcoholic fatty liver disease even without alcohol intake! Drinking alcohol on top of this disease can further worsen your liver function.
  7. Because of the high sugar nature of some mixed drinks, your blood sugar will spike quickly and drop rapidly. This can lead to increased hunger and binge-eating late at night or in the morning.
  8. Limiting or keeping your alcohol intake within the recommended levels is safe. For women, this includes 1 alcoholic beverage daily and for men, 2 drinks or less.

Lime cocktail

What to do with this information?

  • If you like to drink alcohol, drink in moderation! And that includes your partner 😉 If you’re not a drinker, don’t start drinking now.
  • Plan to have your drinks with a meal to avoid low drops in blood sugar.
  • Include high fiber foods in your diet regularly to keep your estrogen levels at normal levels.
  • Avoid cocktails with high amounts of added sugar from juice, soda, or syrups. Utilize diet sodas or flavored water to mix with your alcohol instead.
  • Keep a water bottle or glass of water near you while you drink. This is a good reminder to keep yourself hydrated while you drink.
  • Enjoy a mocktail! A little bit of fresh lime juice with your favorite zero-calorie flavored water and a few sprigs of fresh mint…yes please! Just as refreshing as a regular cocktail.
  • Similar to caffeine, start cutting back on your alcohol intake slowly. Rome wasn’t built in a day! This will improve efficacy for longer term behavior change as well. If you normally drink 2 drinks at night, try to set a time limit on when you can allow yourself a drink or have your favorite zero-calorie flavored water on hand to substitute that other drink.
  • Don’t use alcohol as a social crutch. You are more than capable of having a good time with or without the use of alcohol. Don’t depend on alcohol to make you more social or outgoing. Be yourself!

-EAB

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Dairy-free, Gluten-free Chocolate Pumpkin Dessert Bars

OCTOBER! How the hell are ya?! I’ve missed you so! By this point, my husband is already wondering when I’m going to stop cooking with so much pumpkin. But after he tastes whatever I’m making, he quiets down and remembers how delicious pumpkin really is. I have no idea why I don’t cook with it more throughout the year, but I guess that’s what makes it so damn special.

Y’all know my kitchen is a no-baking zone when it comes to desserts so this is another easy frozen dessert that can be made pretty quickly with some no-fuss ingredients. Much of what I used I already had in my pantry or fridge. These little babies will satisfy your sweet tooth while offering a powerful nutrition punch.

IMG_7923-2

These bars are very PCOS-friendly! Here are some reasons why:

  • Low in added sugar: no huge spikes in blood sugar and better insulin sensitivity
  • High in dietary fiber and healthy fats: aids in satiety and weight management and reducing cravings and estrogen dominance
  • Loaded with antioxidants and important vitamins/minerals from the pumpkin and cocoa powder
    • Vitamin C: aids in improving progesterone levels (for women with low progesterone) in the luteal phase to improve chances of pregnancy
    • Vitamin A: supports the immune system to help fight inflammation
    • Flavanoids: reduces inflammation in the body to improve egg quality
    • Magnesium: relieves PMS symptoms, improves mood and insulin resistance
  • Good source of tryptophan: may aid in improved sleep quality

A common misunderstanding with PCOS is that we have to completely eliminate desserts or sweets because of the sugar or refined carbohydrate intake, but remember the key is enjoying desserts that are lower in added sugar AND offer nutritional benefit. As you can see, this sweet treat offers so many nutritional benefits! Not to mention, it’s so yummy! I hope you guys enjoy!

IMG_7920-2

Dairy-free, Gluten-free Chocolate Pumpkin Dessert Bars

Course Dessert
Keyword chocolate, healthy dessert, PCOS, PCOS friendly, pumpkin
Author Liz Bissell

Ingredients

Base

  • 1 cup walnuts
  • 5 dates, sliced
  • 2 tbsp cocoa powder

Filling

  • cup raw cashews, soaked overnight or for at least 2-4 hours
  • ½ can coconut milk
  • ¾ can coconut cream
  • 2 tbsp cocoa powder
  • 1 tbsp pumpkin pie spice
  • ¾ can 100% pumpkin puree
  • 3 tbsp maple syrup
  • 1-2 pinches coarse sea salt

Topping

  • Handful of dark chocolate chips, chopped

Instructions

  1. For the base, pulse the walnuts in a food processor until finely chopped.

  2. Add the cocoa powder and pulse until evenly combined. Next, add in the dates and pulse until dates are completely blended.

  3. Using a 9 by 9 freezer-friendly dish, spread the date mixture along the bottom of the pan and press firmly down covering the entire bottom of the pan. Freeze for at least 15 minutes.

  4. While the base is freezing, add the cashews, coconut milk, coconut cream, maple syrup, pumpkin puree, cocoa powder, pumpkin pie spice, and sea salt to a food processor or blender. Blend until smooth. Add additional salt as needed.

  5. Pour the filling over the frozen crust and sprinkle the chopped chocolate chips on top. Freeze for 2-3 hours.

  6. Remove from the freezer about 30 minutes prior to eating. Cut into squares and enjoy!

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Top 10 PCOS-friendly snacks

Hey cysters! This past weekend, my husband went on a wonderful long weekend getaway to northern Michigan for our 1-year wedding anniversary. Travel can sometimes stress me out with all the planning, packing, and prepping, but one of the many things I’ve learned from my lovely husbands’ type A personality is that planning ahead does pay off.

Having certain things, such as healthy snacks and my supplements from home keep me on track and honestly allow me to have a better time on vacation. When I plan to have my favorite healthy snacks available to me, I don’t stress about when and where I’m going to find healthy snacks if I get hungry between meals or if we have to hit the road around mealtimes.

Although my cravings and insulin resistance have improved, I still am a cyster who generally needs a snack or mini-meal every 2-3 hours. For me, I’ve found that if the right snacks are in my purview, I tend to do a better job with making sure my snacks are PCOS-friendly and overall healthy. Noshindietitian-20

Now what does it mean when I say “PCOS-friendly” snacks? This means I try to keep the snacks high in protein or as a kick-ass combo of nutrients. The best option is to pair complex carbohydrates with protein or fat. This combo allows for a slower rise in blood sugar and ultimately better insulin control. Not to mention, these snack combinations generally keep you full for longer and helps avoid overeating or binge-eating at your next meal. Trail mix

Here are some of my favorite PCOS-friendly snacks!

  1. Fresh fruit (apples or bananas) with individual nut butter packets. If you’re traveling by car, you can also pack your own nut butter of choice in a small tupperware if you don’t have the individual packets.
  2. Trail mix with dark chocolate (I like mixing dark chocolate with cashews and pumpkin seeds)
  3. Biena dry roasted chickpeas
  4. Chomps or other grass-fed beef jerky
  5. Hummus with veggies (broccoli, carrots, cucumbers) or whole grain crackers
  6. Half PB sandwich with sliced bananas on whole grain bread
  7. Seapoint Farms dry roasted edamame
  8. Individual (low-added sugar) yogurt topped with pumpkin seeds and cocoa nibs
  9. Hard-boiled egg with handful of pistachios
  10. Protein bars, such as Kind bars or RX bars, or homemade energy bites (check out my Matcha energy bites or pumpkin carrot energy bites!)

Be sure to comment below with some of your favorites!

-EAB