Nutrition

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A healthy diet is critical to women and men seeking to conceive.  Multiple studies support that it makes it easier to conceive[1] and is one of the ways to enhance your child’s health.  I recommend a whole food diet, rich in vegetables and fruits, abundant in omega 3 fatty acids (choosing low-mercury fish such as wild salmon and sardines), eggs, and vegetable sources of protein.  The diet should be low in processed foods, meat, and rapidly digesting, high glycemic index carbohydrates.   The Mediterranean diet is one such whole food diet and in two recent studies – one of women trying to conceive naturally, another in those using IVF – it was associated with a 40% reduced the risk of infertility. [2],[3]

Many women avoid fish entirely due to the 2004 FDA/EPA warning.   In it, pregnant women, and women who might become pregnant, were advised to eat no more than 12 ounces per week of seafood, to entirely avoid eating shark, swordfish, king mackerel, and tilefish and to limit albacore tuna to 6 ounces or less per week.  These big predatory fish have accumulated large amounts of mercury that can be neurotoxic to a developing fetus.  In response to the warning, however, many women have cut out fish entirely.  In fact, the National Health and Nutrition Examination Survey showed that 90 percent of women are consuming less than the FDA-recommended amount of fish.

The problem with not eating fish at all is that it is the best source of omega 3 in our diets.   Omega 3 fatty acids are essential in our diets, meaning our bodies cannot synthesize them, and so we must consume them in foods.  The Avon Longitudinal Study of Parents and Children, which began in 1991, showed that babies whose mothers avoided fish tended to have lower verbal IQs. [4]  The ideal fish to eat is low in mercury and high in omega 3s such as wild Alaskan salmon, sardines, herring and trout.  For a chart reviewing commonly eaten fish and their mercury content see the Monterey Bay Aquarium list .

Surprisingly, it’s soda that we need to watch out for.  Two studies have shown the more soda consumed, the longer the time to conceive. [5],[6] Sodas are a form of high glycemic index carbohydrates; these carbs were found to interfere with fertility in the Nurse’s Health Study (NHS). [7]  Also beware of breakfast cereals with flour or sugar as the first ingredient.  Even if it says whole-wheat flour, all flours are rapidly metabolized into blood sugar leading to spikes of insulin with subsequent inflammation, and a corresponding reduction of fertility. We also need to avoid trans fats. While they are gradually being removed from the American diet, a significant amount persists in products that use partially hydrogenated oils; the Nurse’s Health Study revealed that trans fats increase the risk of ovulatory infertility by 73%. [8]

Our food and beverages are the primary way that we absorb environmental toxins into our bodies.  Shockingly, the average baby at the time of birth has more than 200 chemicals in their bodies. [9]  These environmental chemicals can increase a child’s risk of ADHD, autism, diabetes, and heart disease.  While frightening, careful lifestyle changes will reduce your baby’s exposure to environmental toxins.

It is worth purchasing organic vegetables and fruits as well as meats and poultry if you can afford them. It is the best way to reduce pesticide exposure and genetically modified organisms (GMO). The pesticide residue in conventionally grown vegetables and fruits and in animal feed can distort our normal hormonal function and increases the risk that your child could suffer from learning disabilities and childhood cancers; later, in adulthood, these early-life exposures can increase the risk for diabetes, heart disease, and cancer. When the cost is prohibitive, choosing from the least contaminated vegetables and fruits on the Environmental Working Group (EWG) list is a smart alternative. The EWG has calculated that you can reduce your pesticide exposure by 92% when you eat from the clean fifteen rather than the dirty dozen.

Many resources are now available to guide you to safer choices and practices. The EWG website (www.ewg.org) addresses food, water, cosmetics, and cleaning products.  Companies using cans with liners free of Bisphenol A (BPA) can be found at www.treehugger.com.  Rather than feeling overwhelmed, adopt a few doable environmental strategies around your food, water, food storage containers, personal care, and cleaning products.

When you avoid environmental chemicals you can significantly reduce your body burden of many of these toxins.  Studies show, for example, that when children are fed organic food, they dramatically reduce the amount of pesticides in their bodies in five days .[10]  In just 3 days, adults can lower levels of BPA by two thirds, when they avoid canned food and plastic containers. [11]  For further information about how to do an environmental self-assessment please go to: http://victoriamaizesmd.com/environment

Choose multivitamins and supplements with care.  Because this is a relatively unregulated industry, it is important to read labels carefully.  You will want your preconception multivitamin to contain folic acid 400-600 mcg, iron 18 mg, and iodine 150 mcg among its various ingredients.

**Celiac disease is one of the hidden causes of infertility. 90% of people with it are undiagnosed.  It can be diagnosed with blood tests (or biopsy)  Check a total Serum IgA level and an IgA endomysial antibody. Treatment involves dietary avoidance of wheat, barley and rye.

 


[1]Chavarro JE. Rich-Edwards JW. Rosner BA. Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstetrics & Gynecology. 110(5):1050-8, 2007 Nov.

[2] Toledo Estefania, Cristina Lopez-del Burgo, Alvaro Ruiz-Zambrana et al Dietary patterns and difficulty conceiving: a nested case–control study Fertility and Sterility, Vol 96, No.5, November 2011, 1149-1153

[3] Vujkovic M, de Vries JH, Lindemans J, Macklon NS, van der Spek PJ, Steegers EA, et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertil Steril 2010;94:2096–101.

[4] Hibbeln JR. Davis JM. Steer C. Emmett P. Rogers I. Williams C. Golding J. Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. Lancet. 2007 Feb 17;369(9561):578-85

[5] Hatch EE, Wise LA, Mikkelsen EM, Christensen T, Riis AH, Sørensen HT, Rothman KJ. . Caffeinated beverage and soda consumption and time to pregnancy. Epidemiology. 2012 May;23(3):393-401

[6] Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Caffeinated and alcoholic beverage intake in relation to ovulatory disorder infertility. Epidemiology. 2009;20:374–381.

[7] Chavarro JE. et al.  A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. European J of Clin Nutrition. 63(1):78-86, 2009 Jan.

[8] Chavarro JE. et al. Dietary fatty acid intakes and the risk of ovulatory infertility. American Journal of Clinical Nutrition. 85(1):231-7, 2007

[9] Peter Fimrite, “Chemicals, Pollutants Found in Newborns,” San Francisco Chronicle, December 3, 2009

[10] Chensheng Lu, Kathryn Toepel, Rene Irish, et al., “Organic Diets Significantly Lower Children’s Dietary Exposure to Organophosphorus Pesticides,” Environmental Health Perspectives 114, no. 2 (February 2006): 260–63

[11] R. A. Rudel, J. M. Gray, C. L. Engel, et al., “Food Packaging and Bisphenol A and Bis(2-Ethyhexyl) Phthalate Exposure: Findings from a Dietary Intervention,” Environmental Health Perspectives 119, no. 7 (2010): 914–920