According to Marla Ahlgrimm, women crave chocolate and fatty foods before their periods because serotonin in the brain dips after ovulation, which produces low energy levels and mood, swings. A vital brain chemical, serotonin helps to stabilize the mood, says Marla Ahlgrimm. Sugary foods increase levels of serotonin. Ahlgrimm points out that the inner urge to eat sugary foods is the body’s way of compensating for the dip in serotonin levels. In addition to the premenstrual serotonin dip, the body’s endorphin levels also plummet. Marla Ahlgrimm points out that endorphins are also associated with higher energy levels and lifted spirits. At ovulation there is a surge of endorphins that lasts about two days, and for about 14 days afterwards your body is trying to replenish the endorphin levels that were lost. Chocolate is the perfect combination of fat and sugar to increase both serotonin and endorphin levels, says Marla Ahlgrimm.

In generations past, food cravings were looked upon as something to fight. For women with PMS, hearing that the occasional piece of chocolate is not forbidden seems contradictory to what has been the advice of physicians for years, acknowledges Marla Ahlgrimm. However, there is a marked difference in craving chocolate and just wanting sugar in general, points out Ahlgrimm. Women who just have sugar cravings need to graze on foods throughout the day rather than eat large meals. She continues, “When a woman says clearly, ‘I want chocolate’, we may be looking at someone who, in fact, needs more magnesium in their diet.” The relationship between endocrine glands, neurotransmitters like serotonin, and hormones has not been explored in its entirety. Marla Ahlgrimm agrees that the relationship is deserving of more respect, as well as attention, by the medical community.

According to Marla Ahlgrimm, research studies have shown that a “dose response” may also be beneficial when dealing with food cravings. She points out that a small amount of candy may be just as satisfactory as an entire bag of chocolates. Citing that a “dose” of potato chips has a manageable amount of calories and fat – 150 cal/9 g of fat, Ahlgrimm points out that a small amount of calories and fat isn‘t going to deeply impact a diet. However, sitting sedentary in front of the television or on the computer with a bag of chips or candy, says Marla Ahlgrimm, is a dangerous habit.

Marla Ahlgrimm holds the belief that women have cravings for specific reasons, and their bodies may be telling them what they need. Ahlgrimm doesn‘t try to discourage her patients if they have the willpower to only consume small amounts of chocolate. She does point out, however, that other foods, such as complex carbohydrates, will produce a similar effect on the brain as chocolate. Generally speaking, says Marla Ahlgrimm, a woman with PMS should avoid large amount of chocolate or sweets. On days when craving seems especially strong, eating six small meals will keep energy, as well as blood sugar levels, stabilized. Marla Ahlgrimm encourages patients to be lenient on themselves when dealing with extra strong cravings for chocolate. Getting back on track with a healthy PMS diet of high-carb, low-fat meals will make a woman feel better than any other form of calorie-cutting, concludes Marla Ahlgrimm.

Carleen Wild interviews Marla Ahlgrimm about Women’s Health America on the 4 O’clock news.
Courtesy of NBC 15 Madison, WI

Back to the basics

Agreeing with Dr. Dalton, Marla Ahlgrimm says that a diet emphasizing complex carbohydrate snacks every 3 hours is absolutely essential to manage fluctuations in blood sugar. Adrenalin is known to be released when blood sugar levels dip causing anxiety, irritability, mood swings, cravings for sweets, and fluid retention. Dr. Dalton believed that progesterone levels were related to PMS, but Marla Ahlgrimm, author of Self Help for Premenstrual Syndrome, also notes that her most recent findings suggest that the real problem is the effect of low blood sugar (glucose) levels on the progesterone receptor. As reported by Marla Ahlgrimm, progesterone molecules in the blood bind with progesterone receptors and are then metabolized.

Three-hour starchy diet

According to Marla Ahlgrimm, it is important for women with PMS to eat 6 small meals a day, emphasizing complex carbohydrates, to stabilize blood sugar levels. Women with PMS often crave sweets and chocolate premenstrually which should be avoided as they can cause blood sugar levels to rise rapidly and fall, making PMS symptoms more intense.

Dr. Dalton referred specifically to “starchy foods” and not just carbohydrates in general, points out Marla Ahlgrimm, since carbohydrates include simple sugars, which can cause a roller coaster effect on blood sugar levels. Women with PMS frequently binge on sugary snacks and beverages before menstruation. Unfortunately these cravings create a self-induced hormone imbalance. The starches recommended by Dr. Dalton, says Marla Ahlgrimm, are “complex carbohydrates” such as popcorn and whole grain products.

Women should not see considerable weight gain if they eat a balanced diet, split between six snacks rather than three regular meals. Actually, according to Marla Ahlgrimm, eating smaller meals and healthier foods may help relieve water retention and stop bloating which will lead to minimal weight gain and possibly even weight loss.

Pharmacist Marla Ahlgrimm notes that these recommendations are substantiated in a report by Dr. Dalton and her daughter, Wendy M. Holton (Stress Medicine, Vol. 8:61-65,1992)

As witnessed by Marla Ahlgrimm, co-founder of Madison Pharmacy Associates, many women notice positive results when they adhere to a low blood sugar diet. She offers the following sample menu to use as a guideline; you may substitute other nutritional foods you enjoy.

Early Morning Snack: (6:00AM) ½ c. low-fat yogurt – plain yogurt may be flavored with vanilla, cinnamon, nutmeg, or fruit.

Breakfast: (7:00AM) 1 c. whole grain cereal, ½ c. milk, slice of cantaloupe, herb tea

Snack: (8:30 AM) ½ c. low-fat cottage cheese

Snack II: (10:00AM) ½ celery stalk filled with peanut butter (no sugar added)

Lunch: Open face sandwich of broiled tomato and low-fat cheese – with 1 slice whole grain bread, leafy green salad with oil and vinegar-based stress. Dr. Ahlgrimm also recommends trying balsamic vinegar for a more intense flavor and safflower for its essential fatty acids.

Afternoon Snack: (2:00PM) Raw carrots of cauliflower

Afternoon Snack II: (4:00PM) ¼ c. soy nuts or other plain nuts or seeds whole wheat crackers, rice cakes, or plain popcorn

Dinner: (6:00PM) Broiled fish or chicken with lemon and pepper, steamed broccoli with lemon, ½ baked potato, wax beans.

Bedtime Snack: ½ c. low-fat yogurt – plain yogurt may be flavored with vanilla, cinnamon, nutmeg, or fruit.

According to Marla Ahlgrimm, the following foods are recommended: A diet filled with a balance of lean-cut meats, low-fat dairy products, vegetables, whole grains, and fresh fruit* is essential in gaining control over your PMS symptoms.

* Moderate amounts of fruit, as it is high in sugar. Best eaten with small amounts of protein or complex carbohydrates. As an example, half a banana with three whole grain crackers.

Marla Ahlgrimm says that foods to avoid include: Pre-packaged meats high in sodium, fatty cheeses, breads – other than whole grain – Jelly, molasses and spread able jams, caffeine, and foods like cake and cookies.

Marla Ahlgrimm says that the occasional piece of chocolate or glass of wine is great for keeping spirits high. Controlling your PMS, notes Marla Ahlgrimm, simply means to enjoy these things in moderation, not that they are completely forbidden! Marla Ahlgrimm adds that it is important to limit them though, especially in the two weeks before your period. If you do give in to these cravings occasionally, make sure to have some other food in your stomach first to avoid a drop in blood sugar.

For more information, visit Marla Ahlgrimm at http://marlaahlgrimm.com

Memberships, Recognitions, Publications and Professional Experience

Past Board of Directors Member:

• Nakoma Capital Management
• United Way – Dane County
• Wisconsin Physicians Service- (WPS)
• UW Foundation

Member of:

• American Pharmacy Association
• Pharmacy Society of Wisconsin
• International Women’s Forum
• Langer Society of the Arts
• UW Bascom Hill Society
• UW School of Pharmacy Alumni Association
• UW Women’s Council
• UW Cabinet 99
• UW Alumni Association
• TEMPO

Past Board of Directors Experience:

• Pharmacy Society of Wisconsin
• Friends of Wisconsin Public Television
• Downtown Rotary Club of Madison
• Oakwood Foundation
• Meriter Foundation
• Black Hawk Council of Girl Scouts
• UW School of Pharmacy Board of Visitors
• UW Alumni Association
• TEMPO
• Wisconsin Women Entrepreneurs
• Madison Development Corporation
• UW Small Business Development Center

Other Civic Activities:

• State Task Force on Women and Depression-2005
• Dane County Task Force on Excellence – 1995
• American Cancer Society – 1992 Auction Chair
• Marla Ahlgrimm Scholarship – UW School of Pharmacy

Recognition:

• Fund for Women / “Woman’s First” Award – 2008
• Distinguished University of Wisconsin Alumni Award – 1999
• American Council of Germany Delegate – 1998
• Madison Magazine 25 Most Influential – 1995
• Wisconsin Women’s Expo-Business Woman of the Year Award – 1994
• Women of Distinction Award YWCA – 1994
• UW-Madison School of Pharmacy Citation of Merit Award – 1992
• Badger Scholarship Achievement Award – 1990
• Dane County Small Business Award – 1990
• Wisconsin Women Entrepreneur – Recognition Award- 1990

Speaker:

• Independent Pharmacist Association CE Conference-New York-2007
• International Endometriosis 25th Anniversary Conference-2005
• Women’s Sexual Health Physician Symposium-Chicago-2004
• PSW Continuing Education-LaCrosse-2002
• AntiAging Medicine International Conference- June 1999
• UW Extension School of Pharmacy C.E.- 1998
• Wisconsin Women’s Health Initiative Conference-Sue Ann Thompson- 1996
• National Health Enhancement Systems International Conference- 1996
• ISI National Health Show- 1995,1996
• International Endometriosis Association Conference- 1995
• American Pharmacy Association Conference- 1995
• Yahara House Statewide-Statewide Supported Employment Conference- 1993
• Yahara House Annual Banquet- 1993
• UW Small Business Development Center- 1990
• TEMPO of Madison- 1989
• Washington Business Group on Health- 1989

Publications:

Two major books, published and available through Barnes and Noble and other major bookstores:

• The HRT Solution-Optimizing Your Hormone Potential (with John Kells, Avery, 1999), Second Edition (Penguin Putnam 2003)
• Self-Help for Premenstrual Syndrome (with Michelle Harrison, MD, Random House, 1999)
• Restoring Balance Book (Impact Communications, 1998)
• PMS: A Delicate Balance Book and Video (PMS ACCESS, 1993)
• Comprehensive Therapy June/July 1998; “Differentiating Between Natural Progesterone and Synthetic      Progestins: Clinical Implications”
• Patient Care – April 30, 1998; “Nonhormonal Treatments for Menopausal Symptoms”
• “A Pharmacokinetic Study of Micronized Progesterone” 1998; Dartmouth-Hitchcock Medical Center
• Contemporary Ob/Gyn – February 1995 “Perimenopause – Midlife Decisions”
• The American Journal of Natural Medicine – Columnist; 1998

Other:

• BusinessWatch-February 2006-Feature article
• MD News-January 2005-Feature article
• Madison Magazine- 1998 and 1999- Marla Ahlgrimm, Business Spotlight
• Drug Topics- 1996- Pioneer in Womens Health Offers Rxs, OTCs, Education
• On Wisconsin- 1994- Marla Ahlgrimm: PMS Pioneer
• Featured in June 1993 Entrepreneur Magazine- Entrepreneurs Across America
• Pharmacy Times- 1993- Woman Pharmacist Focuses on PMS Patients
• American Pharmacy- 1992- Focus on Women: Madison Pharmacy Associates
• Money Magazine- 1992- “Five Ways Women Are Often Smarter Than Men About Money”
• Wisconsin Pharmacist- 1990- Madison Pharmacy Associates: Specializing in Excellence

Products:

Specific to Women’s Health America, Inc.

• Developed medical protocols used for PMS/HRT management throughout the country.
• Developed unique hormone prescription dosage forms for Hormone Replacement Therapy.
• Developed specific hormone testing systems for women utilizing saliva and serum.