THE blog

If you want to listen to the full episode head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome back to the Healing infertility Podcast. I’m your host, Anabelle Clebenar, registered dietitian, functional nutritionist and your new fertility bestie. In this episode, I’m going to talk about the importance of nutrition in your fertility journey me why cutting out your favorite foods isn’t going to be the magic bullet and the real deal on weight loss and fertility. Let’s dive in. So, you may have heard that nutrition is especially important in the preconception period, and if you haven’t heard that before, I’m going to tell you right now it is. So your nutrition directly impacts egg quality, ovulation hormone health, and even the health of your baby. In fact, a 2012 study showed that a methyl deficient diet so a diet that was deficient of methylation nutrients such as B, twelve B, six B, two folate, methionine choline, and betane. So having this methyl deficient diet around the time of conception resulted in significant changes in methionine cycles within ovarian follicles, which were tied to offspring being higher weight, more insulin resistant, having altered immune responses, and elevated blood pressure.

So this study was specifically looking at how these nutrients, namely like the B vitamins and folate choline, how these specifically not only impacted fertility, but how they impacted the health of the offspring in 2020. A more recent study from researchers at the Harvard School of Public Health and Harvard Medical School published a review of past studies that looked at the impact of diet on fertility. So they found that for women trying to become pregnant naturally without IVF or any assistive reproductive technologies, that there were certain vitamins and nutrients that were linked to positive effects on fertility, namely folic acid, vitamin B, twelve omega three fatty acids, and eating an overall healthy diet such as the Mediterranean diet. In this review study. They also looked at antioxidants vitamin D, dairy products, soy, caffeine and alcohol, which appeared to have little or no effect on fertility in this review, which is pretty interesting because we hear a lot about how caffeine can impact fertility and vitamin D. So I think there’s definitely more room for research around this, but an interesting find nonetheless. They also found that trans fats and unhealthy diets, which they classified as rich in red and processed meats, potatoes, sweets, and sweetened beverages, they found that these unhealthy diets were found to have negative effects on fertility. A few other studies from Harvard School of Public Health found that consumption of sugar sweetened beverages, especially sodas or energy drinks, was linked to lower fertility in both men and women, while drinking diet soda and fruit juice had no effect.

Another study looked at women who consumed high amounts of fast food and little fruit and found that it took them longer to become pregnant than those with healthier diets. And lastly, another study looked at couples that ate more seafood were pregnant sooner than those rarely eating seafood. So most pregnant women consume far less than the recommended two to three servings of low mercury fish like salmon, scallops and shrimp per week. And we know that one of the nutrients needed for fertility is zinc, which is found in high amounts in seafood, specifically oysters. So, as you can see, diet does in fact, play a huge role in fertility. There are countless studies examining different nutrients and overall dietary patterns, and we know that diet is the best way to influence changes on both egg and sperm quality. So what this means for you is you actually have a lot more control over your fertility than you may have thought or maybe were told or convinced. I want you to think about this because the way that you eat directly impacts your fertility.

And again, anything from ovarian health, hormone health, the health of your baby, all of this is impacted by nutrition. And when we’re thinking about a fertility diet, I want you to think less about specific nutrients or specific foods, and instead, try to focus on an overall balanced diet, one that includes healthy fats, complex carbs, protein, antioxidant rich foods. Iron rich foods. Foods with B vitamins like we talked about earlier. Omega three fatty acids that are found in fatty fish, flaxseeds or other nuts and seeds, dairy or calcium alternatives and limiting overall processed foods. Added sugars, caffeine and alcohol. So let’s dive into our next topic, which is why eliminating certain foods like gluten or dairy isn’t going to be the magic bullet for your fertility. So let’s get this disclaimer out of the way.

The Truth About Dairy, Gluten, and Fertility

If you have celiac disease, if you have gluten sensitivities, if you’re lactose intolerant, obviously it makes sense to avoid these foods. I’ve also seen women struggling with acne eliminating dairy, and that being very effective. But putting all of that aside, I tend to see many women going gluten free and dairy free and starting to cut more and more foods from their diet because they’re told that it will benefit their fertility. So the most recent research around dairy seems to be that there’s actually no impact on fertility, meaning you could include it or not, but it wouldn’t severely impact your fertility by cutting it out. And when we cut out dairy, we’re actually cutting out many beneficial vitamins and nutrients, such as vitamin A, calcium, vitamin D, et cetera. Now, for some people, cutting out gluten can be really helpful in a sense that their overall dietary pattern wasn’t that great to begin with. And cutting out gluten was the thing that helped them kind of focus more on eating more vegetables, fruits, healthy fats, grains, things of that nature. But it’s really not necessary to cut it out completely in order for you to conceive.

I want you, again, to focus on overall dietary pattern rather than fixating and restricting, because these foods aren’t going to be the magic bullet for you to get pregnant. If that were the case, every single person that went gluten free and dairy free would not have any fertility struggles. And as we know, that’s simply not the case. So in this last section, I want to briefly talk about weight and fertility. We tend to focus on being overweight, but I want to also mention the impacts of being underweight for fertility. So being underweight can impact your cycle health. It can impact overall hormones. I tend to see low progesterone, especially with women who are undereating.

And this can be a major factor because not only are you not giving your body the proper nutrients to nourish a healthy pregnancy, but you’re also causing more stress on your body. So as mentioned in previous episodes, stress has a huge part in fertility and over training, and undereating can cause a lot of stress on your body. In addition to that excess exercise, any other stress that you’re carrying, it all kind of adds up. I also want to touch on the other side of this conversation where women who are overweight or obese are automatically told that they need to lose weight. And often in a fertility clinic setting, they have to lose weight in order to qualify for fertility treatments. So whether it’s from a fertility clinic or just their regular doctor that they’re being told that they have to lose weight, this really doesn’t address any other factors when it comes to fertility. So in a 2022 study, there was a randomized controlled study of 379 women with obesity and unexplained infertility. They were randomly assigned to one of two preconception lifestyle modification groups that lasted 16 weeks.

The Impact of Weight Loss on Fertility

The first group underwent increased physical activity and weight loss through meal replacements and medication, and the second group had increased physical activity alone without weight loss. They followed them for three years, and then they measured the number of healthy live births, which they classified as full term infants of normal weight without any major anomalies. And what they found in this study, that the preconception intensive lifestyle intervention. So that first group that got meal replacements and medication for weight loss did not improve fertility or birth outcomes compared to the exercise intervention without targeted weight loss. So basically what it’s saying is that the focus on weight loss did not have an impact on overall fertility and live birth rate. And I know this is one study, and I know that research continues to develop on this, but I thought this was really important to share because it was a significant study following over almost 400 women over three years and really taking a look at how weight impacts fertility. And we’re so focused on the weight loss that we forget that there’s a bigger picture. The bigger picture is overall dietary pattern, inflammation, blood sugar balance, physical activity, nutrient status, and more.

So the focus should not just be on weight loss when we’re talking about nutrition for fertility, but rather focusing instead on a nutrient dense diet that balances blood sugar and that nourishes the woman who will be the mother. So I hope you found this episode helpful. In my next episode, I’m going to be talking with a previous client of mine, a woman who overcame her fertility struggles with PCOS, who was told that she absolutely needed IVF, and she went on to have a healthy baby naturally. So I’ll see you in the next episode. If you have questions, you want to reach out, feel free to send me a message on Instagram. My handle is at TTC dietitian. Bye.

If you want to listen to the full episode, head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome to the Healing infertility Podcast. My name is Anabelle Clebenar, registered dietitian, Functional Nutritionist and your new fertility bestie. Today I’m going to talk about the top three functional lab tests that I utilize in my practice, as well as root causes to your fertility struggles. Okay, so first, why do I even use functional lab tests in my practice? When we’re talking about a root cause approach, we’re trying to dig into why you’re experiencing certain symptoms. So if you have irregular cycles, if you have heavy periods, if you’re not ovulating, if you have PCOS, those are all symptoms. And we want to understand why that’s happening in the first place. So, for example, we want to think about are there any nutrient deficiencies that’s causing your body to feel more stress? Are there any imbalances in your gut causing more inflammation that’s impacting your hormone health? Do you have poor metabolic health? These are some of the root causes that we look at when we’re thinking about a functional approach to fertility. So I’m going to talk about just three of the lab tests that I use in my practice, which are the GI Map, which is a comprehensive stool test, the HtMa, the hair tissue mineral analysis, and I’m also going to talk about how I utilize a continuous glucose monitor for monitoring blood sugar and metabolic health.

Now, there’s other labs that I utilize in my practice, like the Dutch hormone test, iodine testing, mycotoxin mold, testing different blood labs for nutrient levels, and assessing iron status and thyroid health. I’m not going to get into all of the different labs that I utilize with my one on one clients, but I am going to zero in on those three labs that I utilize over and over again and I think are the best places to start when we’re thinking about a root cause approach to fertility. So let’s first talk about your gut health, and specifically the GI Map test. So your microbiome is a genetic catalog of microbiota, and it’s composed of 3.3 million genes, and the microbiota are the gut organisms themselves. So these are composed of ten to 100 trillion microbial cells, bacteria, fungi, yeast, and parasites. There is a lot going on in your gut. So our gut is used for a variety of things. It’s mainly for your digestion and absorption of nutrients, but it also plays a huge portion in your immune system and inflammatory responses.

So first, when we’re thinking about digestion and absorption, the food that you eat so I hear this a lot from clients that they’re already eating cleaner, they’re already eating healthy. If you have any dysbiosis or dysfunction in the gut, literally your body is unable to digest and absorb those nutrients from the foods that you’re consuming. So this is why gut health partially one of the reasons why it’s so important. It’s also said that 80% of your immune system is in the gut, and the reason for that is because most of our lymphatic tissue is in the gut lining. So if that becomes inflamed, if your gut is inflamed from Dysbiosis, whether it’s not enough good bacteria or overgrowth of bad bacteria, if you have any parasites, anything that could disrupt your gut microbiome is going to impact your immune system because that lymph becomes inflamed and congested. And when we have inflamed and congested lymph, that impacts our immune system, that impacts how our body is able to heal, and that also will impact inflammatory cascades. So when we have those higher levels of inflammation that then impacts your hormones, that then impacts your reproductive health. As a result, leaky gut is also a big topic and something to consider.

Understanding the Link Between Gut Health, Hormones, and Metabolic Function

So in a typical healthy gut lining, we have these tight junctions. We have these cells that create a very strong barrier so that the things coming through your gut does not go into your bloodstream. When those tight junctions start to separate, it becomes more permeable and that leads to leaky gut syndrome. So things like chronic stress, industrialized gluten or wheat, various other things can impact those tight junctions so that it becomes more permeable and leads to a leaky gut syndrome. The gut also produces certain hormones related to satiety and hunger, like ghrelin and leptin. There’s other hormones that are secreted in the gut like CCK, gastrin, insulin and hormones that regulate hunger, like GLP One and peptide YY. So all of these different hormones that are either produced or regulated through the gut will also impact your metabolic health. Another function of the gut is waste elimination, which is impacted by stress, metabolic health, hydration, gallbladder function.

All of this impacts waste elimination. The third step in estrogen detox or estrogen metabolism is that it’s excreted through the gut. So if you have any constipation or anything that you’re not able to eliminate regularly and normally, that’s going to impact your estrogen levels, which obviously will impact your hormone levels and your ability to conceive. So we’re starting to understand more and more about how the gut impacts our hormone levels, our mood, all these different things. And lots of research coming out about this. When we’re thinking about mood, there’s a certain class of bacterial strains that are called psychobiotics. These actually impact the neurochemicals and neurotransmitters in our brain, like dopamine and serotonin. These are directly related to specific strains in the gut.

So our gut can impact our mood and our brain health, and similarly, our brain impacts our gut health. So this gut brain axis is a huge area as well. When we’re thinking about just overall health, mood, anxiety, stress, all of that plays a role with the gut. And if you’re curious, like, how does the gut actually impact your fertility? When the gut microbiota is imbalanced, it can trigger chronic low grade inflammation, which we talked about throughout the body. And this includes reproductive organs. So inflammation can disrupt hormone production and signaling which can lead to irregular menstrual cycles, ovulation problems, and decreased sperm quality as well. So obviously, there is a lot to talk about. We could do an entire series just on gut health.

The Significance of Gut Health in Fertility

But I wanted to introduce you into why gut health is so important when we’re thinking about functional approaches to fertility. Because as you can listen and hear, it has wide reaching effects. So in my practice, I utilize a test called the GI Map, and this will test for a bunch of different bacterial strains, parasites, worms. It tests immune health in the gut. It’s so comprehensive. And especially if you’re someone that deals with autoimmune diseases. IBS or IBD. Any digestive complaints, brain fog, skin problems like Acne or psoriasis, mood disorders like depression, anxiety, diabetes, weight loss issues and fertility struggles, then you are someone that would benefit from using a GI map to get a deeper look into your gut health and how that’s going to impact all these other symptoms that you’re experiencing.

Okay, so the next test, so to speak, or thing that I utilize in my practice to help get at deeper root causes, is a continuous glucose monitor. So a continuous glucose monitor measures your blood glucose throughout the day. It’s a really cool little device. And if you have diabetes, you probably know what this is. But it’s often used in people with diabetes, either type one or type two diabetes, to monitor their blood sugar throughout the day. More and more people are using this CGM device because blood sugar imbalances are so pervasive in our society. So it’s estimated that 80% of people will experience blood sugar in the prediabetes range for at least one meal per day. So again, even if you’re someone that eats really well and eats healthy and eats clean, it’s more common than we think.

And with diabetes being one of the bigger chronic diseases in our lifetime, it’s just important to monitor this while you’re still young and while you are eating a healthy diet, because you get that feedback and know exactly that what you’re eating is actually doing its job. It is impacting your metabolic health in a good way. A CGM can help you basically refine your diet to a much more specific degree. So I can tell you eat this amount of protein or eat this amount of carbs, but without specific data to your body, you’re just getting generalized information, which is great. But if you’re looking for deeper root causes, if you’re struggling with infertility, it’s time to really get down to the nitty gritty, right? You want to see how your body responds to certain foods. Because if you’re on a blood sugar roller coaster all day long, where your blood sugar is going way up high and then dipping back down low, you are causing more inflammation in the body. It takes a lot of energy for your body to be on that blood sugar roller coaster day after day after day. So I recently hosted a 30 day blood sugar reset program where everyone in the group received a continuous glucose monitor.

Success Stories from the 30-Day Shift Program

We provided them with custom macronutrients, we provided them with meal plans that were blood sugar friendly, and the results were absolutely incredible. So some of the results from the 30 day shift program included improved meal scores, improved daily scores, improved morning fasting glucose, improved average glucose, improved glucose variability, cycles became more regular, decreased feelings of hangriness and moodiness, increased energy levels and weight loss in that 30 day period. One woman in the group got her period naturally for the first time. So she previously had needed to take a medication prescribed by her doctor to induce a period. She was seven months postpartum. Two clients got pregnant, one person lost over 16 pounds, and that person also had their insulin decreased. So they were diabetic and their doctor was able to decrease the amount of insulin that they needed after this 30 day program of using a continuous glucose monitor paired with coaching from me and the meal plans that we had created for the program. So these were some of the findings that we were able to gather from the 30 day shift program.

And as you can see, we had absolutely incredible results. I knew that using a CGM was beneficial, but to be honest, I was really pleasantly surprised to see how quickly those changes impacted people. We also had people reporting that they had more energy, improved mood, weight loss, and this was all, by the way, by increasing their food intake. So I know for a lot of us, we think that we have to be on a 1200 calorie diet, that we need to be keto, all these really extreme things. But when I gave them their macro prescriptions, many of the women were shocked because they were undereating for so long. They didn’t know that they needed to increase the amount of calories that they were eating and increase the amount of protein and carbs and fat that they were eating to actually support their hormone health. So again, I see this time and time again where people cut out gluten, they cut out dairy, they cut out sweets. And yes, sometimes cutting those foods can be helpful for you in the short term.

But long term, if you’re undereating and not supporting your body in a way that promotes good metabolic health and good hormone health, that’s going to create more stress on your body and long term impact hormone health. Okay, so the last test that I want to talk about is the HtMa or hair tissue mineral analysis. And to be honest, this is a newer lab that I’m utilizing in my practice. But because I’ve seen such incredible results by using this test, I think that really everyone needs this in their life. So the hair tissue mineral analysis is a test that analyzes the mineral content and heavy metals in your hair so a hair can represent your tissues. And when we typically test in the blood, your blood can borrow nutrients and minerals from other places so that it remains in homeostasis. But when we use a hair tissue mineral analysis, first of all, you’re cutting your hair. So it’s non invasive.

The Importance of Minerals in Hormone Health and Fertility

You don’t have to go for a blood draw, but it also gives a snapshot of the past three months of your mineral levels. So there are certain macro minerals like sodium, potassium, calcium, and magnesium that often need a lot of support when we’re thinking about our hormone health, because these minerals think of it as like the spark plugs to hormones, to other systems in the body. So there are a number of things, obviously, that can contribute to someone having fertility struggles. And I want to talk about how that relates back to minerals. So, for example, if someone is experiencing recurrent miscarriages, which is due to often sluggish thyroid or low progesterone, research is finding now that proper nutrition has a tremendous impact on pregnant women. So lack of specific vitamins and minerals can not only cause premature births, but can also interfere with a woman’s ability to ovulate and conceive. So we need adequate amounts of and balanced minerals in both men and women. And thyroid specifically is one of the most important factors when we’re thinking about infertility.

It can impact ovulation energy production, immune function, and egg quality in women. So even when we’re thinking about testing the thyroid, how do we go even one level deeper? Why is your thyroid sluggish or not optimal? In a not optimal state, it’s often due to iodine. We need adequate amounts of iodine for thyroid hormone to work. So there are different minerals connected to different parts of the body, so to speak, that we have to look at to understand the deepest root cause of why someone might be struggling with their fertility. Another mineral that I often see depleted in women is magnesium. So we need magnesium again for proper thyroid health. But magnesium also gets depleted because of our stress response. And because so many of us are dealing with chronic stress, I often see magnesium being tanked.

And when magnesium is tanked, that actually causes more stress. It’s kind of like this vicious cycle that’s going on. And due to our food system, to our depleted soils, a lot of our food that typically would have magnesium in it doesn’t have as high magnesium content as a result of mass producing items and factory farming and all of those things, which I’m not going to get into. But just know that magnesium, we don’t get enough of it through our food due to those reasons, and because we don’t have enough, it causes more stress. That stress has an impact on metabolic health, on gut health, on immune health, and so much more. Another mineral that I like to look at specifically for fertility and also metabolic health is potassium. So we talked before about macronutrients and blood sugar balance, but the importance of potassium when it comes to blood sugar is also really important to discuss. So potassium can sensitize our cells to thyroid hormone, which means we need potassium for our cells to receive that thyroid hormone.

And if we don’t have enough, then they become less sensitive to insulin. Potassium also has insulin like effects, so it helps the blood sugar get into the cells. So if glucose can’t get into the cells, whether because you have insulin resistance or a lack of insulin, it ends up hanging out in the blood, creating higher blood sugar levels. And potassium is also involved in the conversion of glucose into glycogen, which is your stored blood sugar. So not having enough glycogen in your liver can mean that our bodies are forced to use alternative fuel sources in between meals, which will raise the risk of blood sugar dips. So we’re just zooming in on a few minerals here to start to give you a picture, an idea of why this is so important. As you can see, our gut impacts our stress, and minerals impact stress, and stress impacts blood sugar, and blood sugar impacts mineral status. All of these things are connected.

That’s because our bodies are not silos. What happens in your reproductive organs is not happening on its own by itself. We have to take a bigger picture and look at the different body systems and how they’re working together to create an environment that is safe and healthy for a baby to grow in. So I hope this podcast episode helped you get a better understanding of some of those functional lab tests that we utilize, and also some of the root causes when we’re thinking about functional fertility and how to approach your fertility from a whole body standpoint. A holistic way that looks at not just what’s going on with your hormone health and ovulation, but also your nutrient status, your gut health, your mineral status, your metabolic health, your nervous system. All of these things play a huge role on your fertility. And that is why you have to be thinking about these deeper root causes when we’re thinking about fertility struggles. So I hope you enjoyed this episode, enjoyed recording it.

I would love to hear your feedback. If you enjoyed this, please share it with a friend, tag me on social media, and I will see you in the next episode. Bye.

If you want to listen to the full episode, head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Hey, everyone. I’m Anabelle Clebenar, registered dietitian, functional nutritionist and your new fertility bestie. In this episode, I’m going to cover why some of the things you’ve tried in the past haven’t been working for you, what a conventional approach to fertility looks like, and why you need to start thinking about a different approach to your reproductive health. All right, let’s dive in. So if you’re like many of my clients, you’ve probably tried a whole bunch of different things on your fertility journey. I’m guessing you probably started tracking your cycles. Maybe you’ve used ovulation predictor kits. Maybe you cut out some of your favorite foods.

Maybe you cut out sugar, alcohol, gluten, dairy, grains. Maybe you’ve tried a whole bunch of different supplements because you saw an influencer talk about them. Or maybe you got an Instagram ad and you thought, hey, why not try it out? And maybe you even went to your doctor and you were met with some really terrible advice like lose some weight, or just wait another six to twelve months and then come back. So let’s break down why some of these things are not working for you, and also why this approach to fertility doesn’t make that much sense. Okay, first let’s talk about period tracking apps and ovulation predictor kits. The issue with period tracking apps is that they use an algorithm to determine when you’re ovulating. So if you’re simply entering data into an app and it’s going to tell you when you ovulate again, that’s based off of a typical 28 day cycle with ovulation happening on day 14. And if you veer away from that, which many women do, then you’re missing your timing, right? So if you’re relying solely on a period tracker algorithm, you may be missing out on the cues that your body is giving you.

So every cycle, our body has certain hormonal cues and signs that it gives you to let you know when ovulation is coming. And you can also confirm ovulation by tracking your temperatures. If you’ve gone up one step and you’re using ovulation predictor kits, this can be helpful for many women, but for others, it’s not. So, for example, if you have PCOS, ovulation predictor kits are not a good use of your money because ovulation predictor kits measure luteinizing hormone or LH. And in women with PCOS, they have higher levels of LH throughout their entire cycle. So if you have PCOS and you’re using an OPK or ovulation predictor kit, you’re likely getting a positive test. But that doesn’t necessarily mean that it’s a positive LH surge that’s associated with ovulation. And if you don’t have PCOS and you’re using ovulation predictor kits and you’re timing things accordingly and you’re still not getting pregnant, there’s likely something else going on that needs further investigation.

The Balancing Act of Elimination Diets: Navigating Health, Social Life, and Fertility

Now, if you’re like many of my clients, you’ve probably tried a bunch of different elimination diets. Maybe you tried going gluten free or dairy free, sugar free, grain free, or maybe you tried all of those all at once. You may have felt a little bit better, you may have even lost some weight. But the issue with cutting out all of these different foods is that you’re depriving yourself of enjoyment, of experiences with your friends and your family. You’re depriving yourself of entire food groups, and you may actually be putting more stress on your body than actually necessary. So, for example, dairy products have a lot of nutrients that are needed and beneficial for fertility. So things like vitamin D, vitamin A, magnesium, and calcium, these are all necessary for fertility to occur. And often these nutrients are depleted in women who are struggling with infertility.

I had one client who had to eliminate fruit because she was told that fruit has too much sugar in it and she had PCOS. And when I told her that she could actually eat fruit, the smile and the joy that came to her was so amazing, because I have seen so many women depriving themselves of healthy foods, things like fruit or oatmeal or dairy products, that it’s just not necessary. So if you’ve been doing that to yourself, I want to give you the permission right now to scale back and start to incorporate some of those foods that you love and enjoy and are actually healthy and beneficial for you. All right, now let’s shift gears and talk a little bit about what a conventional approach to fertility looks like, especially if you’ve already gone to your doctor or to your OB. And you were told to just keep trying for another six to twelve months before any lab work could be done, and you felt like it was either dismissive or just not good enough. I totally get it. Let’s talk about what this approach is and the reasoning behind it. So first, if you go to your OB and you’re over the age of 35, they’re going to tell you to keep trying for another six months.

And if you’re under the age of 35, they’re going to tell you to keep trying for another twelve months. Now, if you are trying to get pregnant ASAP, which I feel like for many people, once they decide they want a baby, they’re like, it’s go time, and you don’t want to wait that full twelve months. Wait till the end of the episode, because I’m going to share a little bit more about what you can do to be proactive during this time. So in a typical conventional fertility setting, they’ll first do an initial evaluation with a thorough medical exam, physical exam, and look at the health of both partners. They’ll ask you about ovulation, about your cycle history, any previous pregnancies or miscarriages, and hopefully they’ll also talk about lifestyle factors like smoking, alcohol, and exercise. Then a semen analysis will typically be done to assess sperm count, motility, and morphology. So this is to help determine male fertility potential, which about one third of all infertility cases are male factor, and then they’ll do an ovulation assessment. So for the female partner, ovulation is assessed through blood tests to measure hormone levels like progesterone and ultrasound monitoring.

Fertility Tracking and Treatment Options

To track follicle development, you may do an HSG, which is an X ray procedure to check for blockages or abnormalities in the fallopian tubes and uterus. There may be testing to check ovarian reserve. So this is a blood test to evaluate the quantity and quality of a woman’s remaining egg supply or ovarian reserve. They may look into some underlying causes. So any additional tests that are needed for hormonal imbalances like PCOS, endometriosis or structural issues, and then typically what is recommended is to start on ovulation induction medicine. So typically clomid or letrozole are prescribed and those are used to induce ovulation. If that doesn’t work on its own, the next step is to do an IUI or intrauterine insemination, which involves placing a specially prepared sperm directly into the uterus around the time of ovulation to increase the chances of fertilization. And then IUI is typically done anywhere between three to six times or three to six rounds.

And then if that’s unsuccessful, typically the next step is IVF or in vitro fertilization. So this involves retrieving in eggs from the woman’s ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryos into the uterus. It’s important to note that infertility treatments can be complex and not always successful. So the approach taken between different fertility clinics, between different couples is going to be different depending on unique circumstances and decisions made by the doctors and by you as a couple. So to recap, you would go from doing initial tests to being prescribed ovulation induction meds to trying IUI, and then if that didn’t work, to try IVF. So let’s look at some stats on IVF for a moment. One round of IVF typically costs anywhere between $10,000 to $25,000, depending on the state you live in. This is for the United States, and IVF success rates really vary from clinic to clinic.

But the most recent stats that I pulled up was that the overall success rate was between 25% to 30%. So this changes depending on the age of the woman. So if we’re looking at women under the age of 35, for the first embryo transfer, the success rate is 41.4%. And for women between the ages of 35 to 37, the first embryo transfer success rate is 31.6%. I don’t know about you, but if I was spending upward of $25,000, I would want something that had a higher success rate than 41%. In the best case scenario, that’s less than a 50 50 shot if you think about it. And I know for many couples, IVF is truly their only option. Whether you have a blocked fallopian tube, if your partner has a history of testicular cancer, or any of the other hundreds of situations that would lead a couple to doing IVF.

The Power of Functional Medicine and Addressing Root Causes

But it’s certainly not the answer for all couples, which what the current conventional medical model directs couples to. So for many people, addressing underlying factors like hormone imbalances, blood sugar imbalances, nutrient deficiencies, gut health all of that has a profound effect on their fertility. And I know this because this is the work that I do and I see it firsthand every single day. So if you’re thinking, okay, if it’s not IVF, what other way is there? Well, Functional Nutrition or Functional Medicine is the approach that I’m going to talk about because it’s what I use with my one on one clients as well as inside my group program, the Holistic Fertility Method. So, Functional Medicine is a holistic approach to healthcare that aims to identify and address the root causes of health issues rather than just treating symptoms. So it focuses on understanding the underlying imbalances and dysfunctions within a body that could be contributing to disease or a health condition. And while specific root causes can vary depending on each person, there are some common root causes that are typically addressed in functional medicine. So, the first is poor diet.

Nutrient poor diets that are high in processed foods, sugar, unhealthy fats, and artificial additives can lead to nutritional deficiencies and imbalances. And this contributes to various different health problems, including infertility. The second is chronic inflammation. So, prolonged inflammation caused by things like poor diet, stress, lack of exercise, environmental toxins, gut health this can all disrupt the body’s natural balance and lead to chronic disease and impair reproductive function. Third is gut health imbalances. So an unhealthy gut with an imbalance of beneficial and harmful bacteria can lead to digestive issues, immune system dysfunction, and systemic inflammation, which also leads to fertility struggles. Fourth is stress and adrenal dysfunction. So chronic stress can impact the adrenal glands, which leads to imbalances in stress hormones like cortisol, adrenaline, epinephrine, norepinephrine.

And these directly affect sex hormones like lowering progesterone, which is needed in adequate amounts to sustain a pregnancy. Fifth is hormonal imbalances. So think about disruptions in hormone levels like your thyroid hormone or sex hormones. Estrogen, progesterone, testosterone, insulin and others can lead to a range of health issues. So it’s estimated that one in eight women will develop thyroid problems during her lifetime. And having poor thyroid function can interfere with the release of an egg from your ovary, which is ovulation, and it impairs fertility. In many fertility cases, subclinical hypothyroid has been found to be a root cause. The 6th root cause is toxin exposure.

Unraveling Fertility Challenges: Toxins, Infections, and Immune System Factors

So exposure to environmental toxins, heavy metals and pollutants can accumulate in the body and cause harm to organs and tissues, including reproductive organs and tissues. The 7th root cause is chronic infections. So, hidden or recurring infections can trigger chronic inflammation and disrupt the immune system function, which makes the body feel unsafe for pregnancy. We have a few more to cover. So the next one is immune system dysregulation, an overactive or underactive immune system can contribute to autoimmune conditions and increase susceptibility to infections, which then leads to fertility problems. Mitochondrial Dysfunction so, mitochondria are the energy producing organelles inside of your cells. Think of it as like the battery or the powerhouse of the cell. This is what creates energy.

Dysfunction here can lead to decreased cellular energy and impact overall health, including fertility. Sleep disturbances, so, poor sleep quality inefficient sleep, not being able to fall asleep, having a wired but tired brain at night, these can all negatively impact your overall health and contribute to a range of health issues that will impact fertility as well. And then there’s also psychological and emotional factors. So mental and emotional well being can influence your physical health. So any unresolved trauma or chronic stress can actually contribute to fertility struggles. So, functional medicine practitioners use all of this comprehensive data, patient history, in depth functional lab testing, and a personalized treatment plan to help you address these root causes and promote optimal health and well being. And the focus is often on lifestyle changes like nutrition supplements, stress reduction, and other therapeutic interventions to support your body’s natural healing mechanisms, restore balance, and make your body feel safe for pregnancy. So, as you can see, a functional approach to fertility is very different from the conventional approach.

In a conventional approach, it’s basically taking some pills to try to induce ovulation, and then if that doesn’t work, IUI or IVF. And in a functional approach, we’re looking at underlying factors to help get your body into a healthy pregnancy state. And while making these changes to your diet and tracking your cycle are all important first steps to take, if you’re currently struggling to get pregnant, it’s probably time you look into some of these deeper root causes and work with a practitioner who can help guide you through this. So, that’s all for this episode. In the next episode, we’re going to dive deeper into some of these root causes, and specifically which tests you can take so that you know what is contributing to your fertility problems. If you enjoyed this episode, tag me on Instagram at TTC dietitian or send me an email. Let me know what you thought of this episode. If you found this helpful, please share it with a friend.

And thank you so much for listening. I’ll see you soon.

If you want to listen to the full episode head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome to the Healing infertility Podcast. I’m your host, Anabelle Clebenar, registered dietitian, functional nutritionist, and your new fertility bestie. Today in our first episode, we’re going to explore the reasons why you may be struggling to conceive and take a look at some of the causes that I typically see when it comes to clients struggling to conceive naturally. Now, for some, getting ready to start a family is this really easy dragon process. But for many, many couples, the challenges of trying to conceive take a huge mental and physical and emotional toll. And today, I really want to cover some of those contributing factors that I tend to see with clients and hope that this can give you some insight and to take some proactive steps to addressing these things and hopefully improve your chances of conceiving naturally. Now, obviously, there’s many reasons why a couple may be struggling to conceive. There could be things like chronic diseases.

There could be issues with sperm quality, structural issues like a tilted uterus or blocked fallopian tube. And today, I’m going to cover some of the most common things that I see with clients when it comes to not being able to successfully conceive naturally. So the first contributing factor that I want to talk about is excess stress. This is the type A girlies, the women who thrive off intense exercises like Barry’s Boot camp or Orange Theory. Five to six times a week, these women need their morning coffee, an afternoon coffee. They tend to worry a lot about the future and possibly have anxious tendencies. These women are expert multitaskers. They have their work piled high, they strive for perfection, and they tend to put a ton of pressure on themselves.

So if you’re nodding your head yes to this, definitely continue to listen on. So being in a constant state of stress actually triggers the release of cortisol, which is a hormone that can suppress other essential reproductive hormones, specifically progesterone. So with these women, I see a lot of imbalance in cortisol, whether that means that their cortisol is sky high or it’s actually tanked low because it’s been so high for such a long time that now the body is not responding to that signal. And they have chronically low cortisol. So these stressors can come from a variety of things like over exercising, undereating mental stress, the stress of high expectations. All of these can be contributing factors to infertility. So why does this happen when we push ourselves too hard in the gym? Or if we’re not giving our bodies enough fuel that can actually throw off our balance of hormones? So this can impact your menstrual cycle? It can affect when we push ourselves too hard in the gym or not giving our bodies enough fuel. This can mess with our menstrual cycles and throw off the delicate hormone balance.

How Do Intense Workouts Impact Fertility?

So intense exercise like Orange Theory without proper rest can disrupt hormone production and our menstrual cycle. And the same thing with not consuming enough calories or essential nutrients. This can also lead to irregular ovulation, your period going Mia, having a short luteal phase, or just periods that absolutely suck because they’re so freaking painful. And all of this comes back to stress. So it’s been shown in research that chronic stress can impact everything from your digestion, your immune system, detox systems, hormones, memory. It can cause brain inflammation, and it can also impact your gut health. So stress really touches all parts of our health, which is why this is one of those main contributing factors that I tend to see come up over and over again for so many women. So addressing that chronic stress is going to be so important for not only conceiving, but also maintaining a healthy pregnancy and preventing early loss.

The second contributing factor to infertility that I see quite often is poor blood sugar management. So if you’ve ever experienced a sugar high after having too much soda or candy or cookies or anything like that, you know exactly what I’m talking about. So unstable blood sugar can cause things like insulin resistance, delayed ovulation, irregular periods, and it can even affect egg quality. So for women with unmanaged diabetes or insulin resistance, they’re particularly at risk for fertility challenges because of this reason. This is also true for women with polycystic ovarian syndrome or PCOS, because their body has a harder time digesting and breaking down carbohydrates, and that leads to more insulin resistance. This is often a root cause to a lot of fertility struggles, even in women who don’t have PCOS or insulin resistance. Because the way that we tend to eat in general, making a generalization here, but the way that we’re taught to eat isn’t necessarily the best way to improve our metabolic health. So for many women, they’re undereating protein and overeating carbohydrates or overeating fats.

And not having a proper grasp on how to eat for blood sugar management can cause a cascade of events that will make it harder for your body to conceive. This also causes inflammation, and blood sugar imbalances are so pervasive. That’s why it’s so important to make sure that you’re eating a real good balance of macronutrients and not relying on your carbs. Scratch that last part. Okay, so not only does blood sugar imbalances lead to inflammation, but it also impacts egg quality, increases your testosterone, and delays ovulation. The third contributing factor to infertility that I run into a lot with clients is excess inflammation. Inflammation is the body’s natural response to injury, infection, or any harmful stimuli. So, for example, when we get a cut or an infection, inflammation is your body’s way of sending healing agents to the affected area to fight off those invaders and initiate the repair process.

Unraveling the Impact of Chronic Inflammation

It’s like an alarm going off and then someone coming in to address the person trying to invade. What happens when we have chronic inflammation that persists for a long time? Is it can cause health issues, including those related to fertility. So we have good biomarkers to be able to tell when someone has high inflammation. So, for example, Creactive protein, or CRP, this is a marker of inflammation. However, if someone comes back with high CRP, we need to figure out where that inflammation is coming from. For some clients, this can be inflammation from a parasite in the gut. It could be from bacterial overgrowth, or it could also be from not having enough beneficial bacteria. So, especially for women who have had multiple rounds of antibiotics, I often see their gut results being really low.

And having low beneficial bacteria can also cause inflammation. So, how does this impact fertility? So, when we have inflammation that’s chronic, it disrupts our hormone balance, which, again, is crucial for ovulation and conception. Chronic inflammation can also affect the health of egg quality and sperm quality, making it harder for fertilization to occur. Inflammation in reproductive organs can lead to scarring and damage, which can also further complicate things. And when we’re thinking about a functional approach to fertility, we’re always looking for the root cause. So, why is there inflammation and where is it coming from? That way, we can address it, calm down the inflammation, and make our bodies a safe place for reproduction to occur. The last bucket of a possible the last category that I want to talk about is micronutrient deficiencies. I tend to see this a lot with my mamas, with secondary infertility, after going through pregnancy, birth, breastfeeding, there tends to be a lot of nutrient and mineral deficiencies.

But even if you aren’t dealing with secondary infertility, the way that our food system is set up, the way that our medical system is set up, there’s so many ways that this can cause nutrient and mineral deficiencies in our bodies. Whether you’re taking certain medications or coming off of birth control, all these things impact our nutrient levels. So I’m sure you know that our bodies require a wide range of vitamins and minerals to function optimally, and fertility is no exception. So, micronutrient deficiencies like folic acid, zinc, iron, vitamin D, vitamin A, magnesium these can all impact reproductive health. And these nutrients play a critical role in supporting the development of a healthy fetus and a successful pregnancy. Mineral imbalances also impact fertility. So, for example, when we’re thinking about zinc, an excess of copper in the body can interfere with zinc absorption, which leads to hormone imbalances. So we’re always trying to see what the possible root cause can be.

And for some women, it can be all four of these things together. For some, it’s just one thing. But we’re always trying to figure out what is the cause of someone struggling to conceive and how can we address it? So, as a functional dietitian, I often recommend these comprehensive tests, whether it’s a stool test or a mineral test, a micronutrient test to really tailor personalized nutrition plans to support women on their preconception journey. And the upside to all these causes of infertility is that there’s a way to address them naturally using a combination of functional lab testing, supplements and nutrition protocols. So I’m really excited to share more with you in the coming episodes. And if you found this episode to be helpful, please share it with a friend who’s also on the road to Motherhood. I’ll see you in the next episode. Bye.

As an expecting mother, despite all the excitement and the anticipation, there are indeed many things to worry about and proper nutrition during pregnancy might be one of them. Aspiring to give your baby a strong healthy start to life and to ensure their flourishing growth, you might be wondering what types of food or nutrients to actively incorporate in your diet throughout the duration of your pregnancy.  

If this is your situation, you have come to the right blog post! Wellspring Nutrition is here to clear up any confusion and steer you to the right path of healthy eating for you and your baby.     

While doing your research, you have likely come across recommendations regarding the different B vitamins, vitamin D &C , calcium, omega 3 fatty acids, iodine, iron, folate, choline and so on…  

Some of these may sound familiar while for the others not so much. This might become a bit overwhelming. 

Thus, in today’s blog post, we will specifically breakdown the importance and the purpose of choline, a potentially overlooked but critical nutrient that pregnant women are highly encouraged to consume adequate amounts of and how you can add them to your prenatal nutrition repertoire.   

What is choline?

Choline is a nutrient that plays an essential role in the physiological process of living organisms, as it supports metabolic functions, maintains the structural integrity of cells, and aids the activities of the brain and nervous system. They are present in many of the foods that we are already familiar with (more on this later in this article!), although they are also naturally produced in the human liver. Despite this, many people, including pregnant women, do not reach the recommended intake of choline set by the Institute of Medicine (IOM). As a matter of fact, the National Institute of Health (NIH) reports that 90-95 percent of pregnant women do not consume the adequate intake (AI) of choline. For pregnant women, this AI is set to be 450 milligrams per day, while for lactating women, it is 550 milligrams per day. This is because lactation further increases the bodily demand of choline due to the rich source of choline in human breast milk, making choline a crucial nutrient postpartum as well.   

Why is choline intake during pregnancy so important?

Choline assists the anatomical development of the fetus, and consuming the sufficient intake level is associated with decreasing the likelihood of certain birth defects. Several studies also link adequate choline consumption to an improved cognitive function and development for the fetus. Let’s look at these one by one.

Development

Choline plays a crucial role in the overall physical growth of the fetus, particularly for the establishment of the spinal cord as well as the proper brain and neural pathways development especially in the hippocampal region, where its core features involve attention, learning and memory. Choline also supports cellular growth, transportation of macronutrients from the mother to the baby and provides anti-inflammatory benefits during pregnancy. Because certain  neurodevelopmental processes of the baby are completed within the duration of the pregnancy, it is important to be conscious of not being deficient in such key nutrients.

Healthy Birth

Research suggests that choline deficiency during pregnancy is linked to the increased risk of Neural Tube Defects (NTD) while the risk decreases with higher choline consumption. NTD is a serious condition where the neural tube, which is responsible for the initial development of the brain and the spine, does not go through proper closure. The Center for Disease Control and Prevention (CDC) reports that a spinal cord defect and a brain defect are the two most common forms of NTD.  

Additionally, choline supplementation may help prevent premature birth. This is because docosapentaenoic acid (DHA), a type of omega 3 fatty acid, has recently been found to be associated with decreasing the likelihood of a preterm birth, and studies have shown that choline supplementation could be a effective approach to increase the availability of DHA in our body. 

Cognitive Function 

Maternal choline intake during pregnancy is also potentially associated with the improved long-term cognitive function of the child although further research is needed to support this claim for humans (Many of the previous studies are done on rats and mice…). 

There are however several human studies that indicate a strong connection between improved cognitive outcomes such as for information processing speed, memory and learning ability of the child and higher prenatal intake of choline. This may be unsurprising considering how as discussed earlier, adequate choline intake provides the foundation for the healthy neurodevelopment of the fetus.  

What food should I eat for choline? 

So, how can we achieve this 450~550 milligram-a-day goal? 

Here are some foods that are excellent sources of choline:

• chicken
• salmon
• eggs
• beef
• milk
• legumes
• quinoa
• pork
• wheat germ
• tree nuts such as almonds and pecans
• cruciferous vegetables

For more information, we suggest checking out the USDA Database for the Choline Content of Common Foods to make more informed food consumption decisions!

Should I take supplements? 

Animal food products such as whole eggs, meat and seafood contain the most concentrated amount of choline.  If you are on a vegan or a vegetarian diet and are concerned about not hitting the daily choline intake goal, the Dietary Guidelines for Americans 2020-2025 (chapter 5 covers all of the basics of nutrition during pregnancy) recommend consulting a healthcare specialist for guidance of whether or not taking choline supplements would be suitable for you. It is important to note that many prenatal supplements contain an insufficient amount of choline if any at all. Thus, it is recommended to seek out dietary supplements that consist only of choline, or a combination of choline and B-complex vitamins. These usually contain somewhere between 10 milligrams to 250 milligrams of choline per dose.   

The Dietary Guidelines for Americans 2020-2025 reports that many Americans including pregnant women are failing to meet the recommendations for the consumption of different food groups and subgroups such as vegetables, fruits, grains, and proteins. These are food groups/sub groups that contain choline and other essential nutrients that aids a healthy pregnancy.    

We will be releasing more articles to spread increased awareness of the importance of prenatal nutrition so please stay tuned and we look forward to seeing you again! 

References 

1. Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. “Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study.” FASEB J. 2018;Apr;32(4):2172-2180. doi: 10.1096/fj.201700692RR. Epub 2018 Jan 5. PMID: 29217669 PMCID: PMC6988845
2. “Choline.” https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
3. “Dietary Guidelines for Americans.” 2020-2025, https://www.dietaryguidelines.gov/food-sources-calcium
4. “Facts About Neural Tube Defects.” https://www.cdc.gov/ncbddd/birthdefects/facts-about-neural-tube-defects.html#:~:text=NTDs%20occur%20when%20the%20neural,anencephaly%20(a%20brain%20defect).
5. Irvine N, England-Mason G, Field CJ, Dewey D, Aghajafari F. “Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children: A Critical Narrative Review.”  Nutrients. 2022 Jan; 14(2): 364. doi: 10.3390/nu14020364 PMCID: PMC8778665 PMID: 35057545
6. Korsmo HW, Jiang X, Caudill MA. “Choline: Exploring the Growing Science on Its Benefits for Moms and Babies.” Nutrients. 2019 Aug; 11(8): 1823. doi: 10.3390/nu11081823 PMCID: PMC6722688 PMID: 31394787
7. “Science Update: High-dose DHA influences immune responses during pregnancy, may reduce risk of preterm birth.”

https://www.nichd.nih.gov/newsroom/news/012122-DHA#:~:text=longer%20being%20updated.-,Science%20Update%3A%20High%2Ddose%20DHA%20influences%20immune%20responses%20during%20pregnancy,reduce%20risk%20of%20preterm%20birth&text=Taking%20supplemental%20docosahexaenoic%20acid%20(DHA,the%20risk%20of%20preterm%20birth.

8. Zeisel SH, da Costa KA. “Choline: An Essential Nutrient for Public Health.” Nutr Rev.  2009 Nov;67(11):615-23. doi: 10.1111/j.1753-4887.2009.00246.x. PMID: 19906248 PMCID: PMC2782876

If you are currently pregnant you are most likely encountering quite a lot of surprising changes to your body. It is normal for your body to experience certain levels of discomfort, as the mother’s organs, especially the lungs, kidneys and heart get strained due to the fetus’ need for oxygen and nutrients, and the elimination of waste products.   

Thinking about the health of you and your baby during pregnancy can be overwhelming. There are numerous health complications that may occur and thus maintaining your well being can be a challenging endeavor. 

Today, we will specifically discuss gestational diabetes, a health condition during pregnancy that has been on the rise, and tips on how to manage it.  

What is Gestational Diabetes? 

Gestational diabetes is diabetes (excessively high blood glucose/sugar levels) that may occur during pregnancy. 

An organ called placenta that supports the growth and development of the baby forms in the mother’s uterus during pregnancy. The placenta synthesizes hormones that reduce the effectiveness of insulin, a type of hormone that is secreted by the pancreas. 

When food is consumed, insulin controls the storage and the usage of the blood sugar. Therefore, because insulin is less effective during pregnancy, a modest increase in blood sugar levels is common and a normal part of pregnancy. However gestational diabetes is detected when this increase in blood sugar becomes excessive. 

This type of diabetes usually goes away once the pregnancy is over but it has potential long term consequences for both the mother and the baby. Having gestational diabetes increases the likelihood of the mother developing type 2 diabetes later in life. It is also linked to the development of obesity and type 2 diabetes for the child.  

Wellspring Nutrition has compiled a list of five tips that can help you get through your pregnancy in the most healthful way possible, especially if you are struggling with gestational diabetes or have risk factors.   

Tip #1: Exercise

Research suggests that consistent physical activity during pregnancy reduces the risk of gestational diabetes by 50 percent.  

The recommended amount and level of physical activity depends on how active you were prior to pregnancy, but the general recommendation is 150 minutes of low to moderate intensity physical activity per week. Here are some examples of activities that are generally safe to do: 

• Walking
• Swimming 
• Light aerobics 
• Cycling
• Yoga
• Pilates
• Light jogging 

If you were very active before pregnancy, you should be able to maintain the same level of activeness but it is best to consult with a health care specialist first.  

Other than lowering the risk for gestational diabetes, there are many benefits to staying active during pregnancy for both you and the baby. For the mother, physical activity can also lower the risk for gestational hypertension, high blood pressure during pregnancy. Staying active also boosts cardiovascular function, decreases back pain, contributes to better sleep, minimizes the loss of bone density due to pregnancy, and reduces edema (swelling caused by pregnancy) of legs and feet. For the baby, an appropriate amount of exercise leads to longer gestation (prevention of preterm birth), potential improvement for their brain development, and an increased likelihood of them having a healthy BMI during childhood.  

Please keep in mind, however, that there are certain types of physical activities that pregnant women should avoid. Activities that could lead to abdominal trauma must be avoided. These are few examples of physical activities that you should avoid: 

• Contact sports (soccer, wrestling, basketball, football etc.)
• Downhill skiing 
• Scuba diving 
• Horseback riding
• Heavy weightlifting 
• Hot yoga

Regardless of your background or your specific condition, if you are looking to stay active during your pregnancy, you should speak with your health care provider to ensure the safety of you and the baby.  

Tip #2: Being aware of optimal weight gain during pregnancy

Gaining weight during pregnancy is a natural and normal process. This is absolutely not the time to be attempting any kind of weight loss. It is also important to be mindful of what a healthy weight gain should look like during this critical period. 

During the first trimester, mothers should be consuming around the same amount of calories as prior to pregnancy and should be expecting around 2 to 4 pounds of weight gain. After the first trimester, gaining around 0.8 to 1 pound per week is considered to be ideal. During the second and third trimester, mothers should be consuming about 350 to 450 additional calories compared to their pre-pregnancy days. 

The optimal total weight gain is around 25 to 35 pounds for someone with a BMI in the normal range. If you are carrying twins, however, the optimal range is between 37 to 54 pounds.  

Tip #3: Eating quality carbohydrates

Controlling your blood sugar levels is essential for managing gestational diabetes. Choosing the right type and amount of carbohydrates to consume is a great place to start. 

Although skipping carbohydrates might sound tempting if you are worried about your blood sugar levels, this is never recommended. Carbohydrates supply energy for the placenta and it supports the healthy growth of your baby. There is no evidence for the effectiveness of a low carbohydrate diet for managing gestational diabetes and the general recommendation is a minimum of 175 grams a day, although it may depend on the individual.   

When consuming carbohydrates, choosing the type with a low glycemic index is highly recommended. The glycemic index of a food indicates how rapidly it causes the blood sugar level to rise.  Low glycemic index foods raise the blood sugar level much more slowly compared to high glycemic index foods, due to its slower rate of absorption.    

Mothers with gestational diabetes should avoid refined grains such as white rice, white bread, white pasta, and white flour as well as foods containing a lot of added sugars since they usually have higher glycemic index. 

The recommended carbohydrates on the other hand are starchy foods with high dietary fiber content such as whole/unprocessed grains, beans/legumes, vegetables, and fruits. 

Additionally, carbohydrate consumption should be spread out throughout the day- instead of eating a few big meals a day, having smaller meals distributed within a day helps control major blood sugar fluctuations.  

Tip #4: Watching your diet

Although pregnant women should consume more calories during their second and third trimester, the quality of your food should be prioritized over quantity. 

Other than carbohydrates, there are several macro and micro nutrients that you should be actively incorporating in your diet during your pregnancy especially if you are dealing with gestational diabetes.

Research suggests that consuming protein from lean meat (unprocessed), fish, and plants are favorable for the treatment of gestational diabetes. In fact, women with gestational diabetes are recommended to consume 350 grams of fish per week. Check out our blog about high protein foods here as well, as we talk about safe types of fish to consume during pregnancy. 

The overall fat intake for women with gestational diabetes should be around 20 to 35 percent of total energy intake and the consumption of saturated fat should be restricted.  

There are several vitamins and minerals that play an important role during pregnancy. Iron, calcium, folic acid (Vitamin B9), and 25-Hydroxyvitamin D are a few examples. 

Here are the Institute of Medicine (IOM) recommendations for these micronutrients:

• Iron: 27 milligram/day
• Calcium: 1000 milligram/day
• Folic acid: 600 microgram/day
• 25-Hydroxyvitamin D: 5 microgram/day

These dietary advice are not just specific to women with gestational diabetes but apply to all pregnant women to ensure a healthy pregnancy with the best possible outcomes.

Tip #5: Screening 

This is especially important if diabetes runs in your family or you are considered to be overweight prior to pregnancy. 

Although lifestyle modification is key for gestational diabetes management, visiting your healthcare provider and receiving nutritional guidance or possible clinical treatment tailored to your individual needs should be a priority as well.

It is recommended that all women regardless of a history of type 2 diabetes be screened between 24 and 28 weeks of pregnancy. If you have risk factors for type 2 diabetes, getting screened at your first prenatal visit is advised. Regardless of your health history, receiving prenatal care, especially during the first trimester is crucial as that is the most critical time for the baby’s development.

Looking for more support? 

Whether it is guidance regarding hormonal imbalances like PCOS, or any fertility or pregnancy concerns, Wellspring Nutrition has your back! Our fertility dietician is available for consultation. 

References: 

1. “Exercise During Pregnancy: Safe And Beneficial.” https://newsnetwork.mayoclinic.org/discussion/exercise-during-pregnancy-safe-and-beneficial-too/
2. “Insulin Basics”, https://diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics
3. Rasmussen L, Poulsen CW, Kampmann U, Smedegaard SB, Ovesen PG, Fuglsang J. “Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus.” Nutrients 2020 Oct 6;12(10):3050. doi: 10.3390/nu12103050. PMID: 33036170

 PMCID: PMC7599681

4. Smith A, Colleen A, Spees C. “Wardlaw’s Contemporary Nutrition, 12th Edition.” McGraw Hill, 2022. 

1. “What Is Glycemic Index.” https://www.eatright.org/health/wellness/diet-trends/what-is-glycemic-index