Fertility

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, the journey of sustaining a whole other life in your body probably feels like an extraordinary experience but at the same time, a great deal of responsibility ( in a positive way of course! ) 

Although there are many aspects relating to the healthy growth and development of the fetus that are beyond our control, one of the main factors that we do have control over is our lifestyle choices- namely our diet. 

There are a handful of nutrients that you do not want to be missing out on during your pregnancy to ensure the best possible health outcome for your baby. These include choline, iron, calcium, Vitamin D, iodine, and folate to name a few. 

If you recently found out that you are pregnant or are planning on conceiving, you are in luck! Today, Wellspring Nutrition is specifically going to highlight the importance of folate, and how this nutrient can be a powerful ally for preventing a common type of birth defect- the neural tube defect.     

What is a Neural Tube Defect?

Neural tube defect is a birth defect that affects the central nervous system of the baby. In a developing embryo, the neural tube is the precursor to their brain and the spinal cord. Neural tube defect occurs when the neural tube does not properly go through the closure process to complete its formation. The two common types of neural tube defect include: 

• Spina bifida (swelling or protrusion of spinal cord or fluid in the back) 
• Anencephaly (exclusion of a major segment of the brain) 

What is folate?

Folate, otherwise known as vitamin B-9, is found in various foods. As they play an important role in the nucleic acid (DNA and RNA) production and amino acid (the building blocks of protein) metabolism, they are crucial to the functioning of cells.    

Folic acid is its synthetic form- meaning folate that is found in dietary supplements and fortified foods. 

Why folate is important

The need for folate significantly increases during pregnancy especially because the event of a neural tube defect is closely linked to maternal folate deficiency. Inadequate folate intake can lead to a high homocysteine level in the blood, which is considered to be a risk factor for neural tube defect. Homocysteine is an amino acid and as it is broken down by the vitamin B-complexes, having a high level of this usually indicates deficiency in vitamins. 

According to a recent study, another risk factor for neural tube development is the lack of DNA repair function. Since folate is crucial to DNA synthesis, folate deficiency can lead to a loss in the integrity of DNA. Thus, the mechanism for DNA repair is going to be negatively impacted. Genome stability is an important aspect of neural development for the embryo, and adequate folate intake is necessary for a properly functioning DNA repair mechanism. 

The timing of sufficient folate intake is important to consider. Neural tube formation of an embryo is completed around three to four weeks after conception. This means that anyone trying to conceive should ideally start incorporating folate in their diet as soon as possible, even if pregnancy is yet to be confirmed. 

Even if you are reading this much further into your pregnancy, there are still reasons to consume an adequate amount of folate.  

Other than lowering the risks of neural tube defects, research shows that sufficient folate intake during pregnancy is beneficial for the neurodevelopment of the child. There is a study that links prenatal folic acid supplementation to a lowering of the risk of Autism Spectrum Disorder (ASD), and advancements to the cognitive, motor and intellectual functions of the child.     

What food should I eat for folate?

Although the general recommendation is about 400 micrograms a day, pregnant women are advised to consume about 600 micrograms of folate every day.   

Here are some food items that are good sources of folate to help meet this target:

• Beef Liver 
• Spinach
• Black-eyed peas
• Chickpeas 
• Asparagus
• Brussel sprouts
• Romaine Lettuce
• Broccoli
• Eggs

As you can see, leafy greens, legumes, and liver are the best sources.  

Moreover, it is important to note that folate tends to be sensitive to heat and oxygen.  Especially for the leafy greens, it is advised to eat them fresh or have them lightly cooked. In a study that compared the folate retention for different food products, for spinach, boiling led to only 49 percent retention of folate. On the other hand, steaming proved to be the best way to preserve folate in vegetables. Another good news is that the same study found that grilling beef for an extended period of time did not result in much loss of folate as well. 

Other than foods naturally present with folate, consuming grain products may be helpful as well. This is because starting in 1998, the U.S Food and Drug Administration (FDA) mandated a folate fortification of grain products such as bread, rice, cereal, flour, and pasta.

However, consumption of refined grain products should be limited during pregnancy to prevent significant spikes in your blood sugar levels.  

Looking for more support? 

Our fertility dietician Anabelle is available for one-on-one consultation and can help you address any of your concerns regarding fertility, pregnancy or hormonal imbalances like PCOS! 

References

1. “Chickpeas (garbanzo beans, bengal gram), mature seeds, cooked, boiled, without salt.” https://fdc.nal.usda.gov/fdc-app.html#/food-details/173757/nutrients

2. “Embryology, Neural Tube.”  https://www.ncbi.nlm.nih.gov/books/NBK542285/

3. “Folate.” https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

4. “Folate and Folic Acid on the Nutrition and Supplement Facts Labels.”https://www.fda.gov/food/new-nutrition-facts-label/folate-and-folic-acid-nutrition-and-supplement-facts-labels#:~:text=For%20folate%2C%20the%20DV%20is,consume%20500%20mcg%20DFE%20daily.

5. Gao Y, Sheng C, Xie RH, Sun W, Asztalos E, Moddemann D, Zwaigenbaum L, Walker M, Wen SW. “New Perspective on Impact of Folic Acid Supplementation during Pregnancy on Neurodevelopment/Autism in the Offspring Children – A Systematic Review”PLoS One. 2016 Nov 22;11(11):e0165626. doi: 10.1371/journal.pone.0165626. eCollection 2016.PMID: 27875541 PMCID: PMC5119728 https://pubmed.ncbi.nlm.nih.gov/27875541/

6. “Homocysteine” https://my.clevelandclinic.org/health/articles/21527-homocysteine

7. McKillop DJ, Pentieva K, Daly D, McPartlin JM, Hughes J, Strain JJ, Scott JM, McNulty H.“The effect of different cooking methods on folate retention in various foods that are amongst the major contributors to folate intake in the UK diet.” Br J Nutr. 2002 Dec;88(6):681-8. doi: 10.1079/BJN2002733. PMID: 12493090 https://pubmed.ncbi.nlm.nih.gov/12493090/

8. “Pregnancy diet: Focus on these essential nutrients.”https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082

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

10. Wang X, Yu J, Wang J.“Neural Tube Defects and Folate Deficiency: Is DNA Repair Defective?” Int J Mol Sci. 2023 Jan 22;24(3):2220. doi:10.3390/ijms24032220. PMID: 36768542 PMCID: PMC9916799 https://pubmed.ncbi.nlm.nih.gov/36768542/

Oatmeal contains high levels of minerals, such as magnesium and zinc, in addition to fiber and B vitamins. This makes it a great food option if you are struggling with PCOS. Oatmeal can be your quick fiber-rich breakfast, an afternoon snack or eaten really anytime of day! The ingredients are minimal, and you probably have them in your pantry already. It’s a win-win.

Which type of oats is best for PCOS?

The less processed it is the better! Instant oatmeal is the most processed form of oats. Then it’s old fashioned oats and lastly steel cut oats. Steel cut oats have a sharper texture than old fashioned oats that some people don’t enjoy. If it’s your preference, old fashioned oats would still be a healthy choice!

Which breakfast is best for PCOS? 

The best breakfast for PCOS is well balanced with lean protein, healthy fats, and whole grains/complex carbohydrates. As a bonus you could even add in some veggies, like if you were having a smoothie or eggs. 

Examples of lean protein choices for breakfast include:

• Eggs
• Nut butter (peanut, almond, etc.)
• Nuts and seeds (chia seed, ground flaxseed, etc.)
• Greek yogurt
• Leftover fish or chicken — Hey, who says breakfast has to be “breakfast food”? 😉
• Tofu
• Some plant-based milks with protein like Ripple

Healthy fats such as polyunsaturated and monounsaturated fats are also important in helping us to feel full. These fats give us energy to start the day off right! We can get these healthy fats from foods such as salmon, sardines, avocado, nuts (walnuts, pistachios) and seeds (for example chia and ground flaxseeds).  

And last but not least, don’t forget the healthy carbs! Most women with PCOS think they have to avoid carbs and this is simply not true. Fruit, whole grains/complex carbohydrates are considered healthy carbs.

Best fruit choices for PCOS:

• Whole, fresh fruit – all kinds!
• Frozen fruit
  • Most of the time frozen fruit does not have added sugar. So there is nothing wrong with eating frozen fruit. 
• Dried fruit without added sugars
  • Double check the nutrition facts label and try to avoid dried fruit with sugar. 
  • If it does have sugar remember this quick tip: Keep total added sugars under 25 grams per day for women. 

Examples of whole grains/complex carbs for breakfast include:

• Whole grain bread or English muffin
• Oatmeal
• High fiber, low sugar cereal
• Low sugar granola
• Plantains/potatoes

Best Oat Recipes For PCOS

Chocolate Peanut Butter Cup Oatmeal:

1/4 cup rolled oats
1/2 cup unsweetened nut milk
1 tbsp all-natural peanut butter
1 serving chocolate protein powder
2 tsp ground flax seeds
1 tsp chia seeds
sea salt to garnish

Instructions:

Mix oats, flax seeds, chia seeds and nut milk in a bowl.

Microwave for 1-2 minutes

Stir in peanut butter and protein powder.

Top with a sprinkle of sea salt.

Looking for more Support?

Be sure to check out our Free Live Masterclass all about the top 3 ways to naturally enhance your fertility (perfect for those struggling with PCOS and hormone imbalances!) 

Is gluten and dairy-free good for PCOS? What’s the best diet for me? Maybe you’ve had these same 2 questions swirling around in your head and you are struggling with the right choice. Wellspring Nutrition is here to help clear the confusion!

Is dairy free better for PCOS?

The answer is “Not, exactly”. If you struggle with PCOS and are also trying to get pregnant, full-fat dairy such as Greek yogurt or milk is a better option for you. 

These two foods provide healthy carbs and a good amount of protein. Here’s a study showing how the intake of full fat dairy may decrease risk of infertility. On the other hand foods like ice-cream or processed cheese (like American cheese) should be limited because they provide less nutrition. 

Women with PCOS can eat moderate amounts of dairy products while also including a balanced diet of other nutrient-rich foods and still see improvement in symptoms. If you choose to eliminate dairy, it is best to discuss this with a dietitian to make sure you are still getting calcium and vitamin D. Non-dairy sources of calcium include tofu, canned sardines or salmon, tahini, dark leafy greens and some non-dairy beverages that state calcium is included. 

Does gluten make PCOS worse?

There is a lack of scientific evidence that supports a gluten free diet for PCOS. It’s important to know that there can be a downside to following a gluten free diet if you don’t need to. As a Registered Dietitian and Fertility Expert I want to help make things easier for you. So if you don’t have a gluten allergy or intolerance then it likely isn’t necessary for you to follow a gluten free diet for PCOS.

Removing gluten means not eating nutritious whole grains and possibly missing out on getting enough fiber, iron and B vitamins. Eating whole grains has been shown to reduce the risk of heart disease and diabetes. So let’s make this easy! Keep on reading for how I can help you. 

What should I eat if I have PCOS?

Let’s review some very important foods that’ll help decrease your symptoms.

Fruit

Choose a variety of fresh, whole fruit to enjoy. Frozen fruit is a great option! Fruit (and dairy) contain natural sugars that also come with important nutrients like vitamins and minerals. Added sugars such as white sugar, brown sugar, syrup or agave nectar have no additional nutrients like vitamins and minerals. Added sugars are what we want to limit in our daily food choices. 

Some women with PCOS are told they can’t eat fruit because of the sugar content – but that’s simply not true! Fruit has important phytonutrients and antioxidants that help decrease inflammation. 

It’s just important to pair your fruit (and carbs) with a source of protein or fat. 

For example: 

Apple + Peanut Butter 

Banana + Almond Butter

Nectarine + Cottage Cheese 

These small changes will help you balance out your blood sugar, which will then help balance your hormones. 

PRO TIP: If you’re looking for more help with balancing your hormones for fertility – check out my FREE masterclass all about the top 3 things you can be doing to naturally enhance your fertility. 

Here are the daily recommendations for added sugars. Keep total added sugars under 25 grams per day for women and under 36 grams per day for men. 

Vegetables

Choose a variety of vegetables and eat them daily. There is no one vegetable that’s better than another. Just like fruit, vegetables have important nutrients like vitamins and minerals. Both fruit and vegetables also have fiber, which is important for managing PCOS. A symptom of PCOS can be insulin resistance. In the simplest of terms this means we want to increase the amount of fiber we eat to improve blood sugar control. This in turn helps with insulin resistance and managing PCOS.

It’s recommended that women up to 50 years of age eat 25g of fiber per day. But, more than 90% of women fall short of meeting the recommendations for fiber. 

Try tracking your fiber intake for a few days to see how you stack up compared to the daily recommendations! 

Protein & Healthy Fats

Including protein with every meal and snack can be very beneficial for PCOS. Protein helps us to feel full and satisfied between meals. This is important so that we avoid overeating and mindless snacking throughout the day. Both of these two things can help maintain a healthy weight. 

Examples of good protein choices include lean meats (fish, poultry, lean beef or pork), tofu, beans, lentils, nut butters, eggs, nuts and seeds. 

Healthy fats such as polyunsaturated and monounsaturated fats are also important in helping us to feel full and give us energy. We can get some of these healthy fats from fish such as salmon, sardines, avocado, nuts (walnuts, pistachios) and seeds (for example chia and ground flaxseeds).   

Whole grains & starchy vegetables

Whole grains and starchy vegetables are considered healthy carbs. They can also be a significant source of fiber. Fiber helps us to feel fuller longer and so it is a great weight management tool. It’s recommended to eat the skin of white potatoes whenever you have them because that’s where a lot of the fiber comes from. White potatoes also have potassium which is important for our blood pressure. 

Examples of whole grains: brown rice, wild rice, quinoa, whole grain bread products

Examples of starchy vegetables: potatoes (sweet and white potatoes), green peas, plantains, yucca, and corn. 

Are there foods I should limit?

While there are many foods you can eat, you also want to be aware of foods to limit. This simply means we should enjoy them occasionally. We don’t necessarily want to make them daily food choices. 

Added sugars

The number one culprit of added sugars in the American diet is still sugar sweetened beverages like soda, energy drinks and even sports drinks. As previously mentioned, keep total added sugars under 25 grams per day for women. Instead try adding fruit, sliced cucumber and/or mint leaves to water. 

Saturated fat

Major sources of saturated fat are fried foods, ice cream and desserts. These foods are more like a treat and should be limited. 

Processed foods

Processed foods contain very little nutritional value. You’ll also want to watch for eating too many low-fiber foods like white bread, white rice. It’s not that you can never eat them, but if it’s all you eat then we want to think about expanding our food choices. To best manage PCOS we want a healthy diet full of fruit, vegetables, healthy fats, protein and fiber from healthy carbs (whole grains/starchy vegetables). 

Other considerations for managing PCOS

Some of our best non-food tools for managing PCOS include exercise, adequate sleep and stress management. We know how hard it can be to exercise throughout the week! You might be thinking, “it’s impossible”, but even small spurts throughout the day add up. For example, if you are able to walk 15 minutes twice per day that’s already 30 minutes!

The recommendations for exercising are 30 minutes 4-5 days out of the week and can help manage symptoms. You can also incorporate strength training two days out of the week. 

There is a possible link between stress and higher BMI in women with PCOS. If you are having a hard time managing stress, consider stress reduction strategies like deep breathing, yoga, journaling and yes even exercise. For more, check out this article on “10 Ways You Can Relieve Stress Right Now”. 

Research shows that sleep helps to regulate our cardiovascular, immune system and metabolism. Sleep is an important part of being and staying healthy. According to the Sleep Foundation, 7-9 hours of sleep is recommended for ages 18 and up. 

Looking for more Support?

Be sure to check out our free live masterclass all about the top 3 ways to naturally enhance your fertility (perfect for those struggling with PCOS and hormone imbalances!) 

References:

1. Chavarro JE, Rich-Edwards JW, Rosner B, Willett WC. “A prospective study of dairy foods intake and anovulatory infertility.” Hum Reprod. 2007 May;22(5):1340-7. doi: 10.1093/humrep/dem019. Epub 2007 Feb 28. PMID: 17329264.
2. Dietary Guidelines for Americans 2020-2025, https://www.dietaryguidelines.gov/food-sources-calcium
3. “Gluten-Free Diet: Is It Right for Me?”
4. “Added Sugars” https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars 
5. Dietary Guidelines for Americans 2020-2025, https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf 
6. The Sugary 6 Infographic, https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/sugary-six 
7. “Polycystic Ovarian Syndrome”, https://www.eatright.org/health/pregnancy/fertility-and-reproduction/polycystic-ovarian-syndrome 
8. “Basu BR, Chowdhury O, Saha SK. Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome.” J Hum Reprod Sci. 2018 Jan-Mar;11(1):10-18. doi: 10.4103/jhrs.JHRS_78_17. PMID: 29681710; PMCID: PMC5892097.
9. “10 Ways You Can Relieve Stress Right Now”, https://health.clevelandclinic.org/how-to-relieve-stress/ 
10. “How Much Sleep Do We Really Need?”, https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

Ever wondered what steps you should take to optimize your nutrition before starting IVF?

Well wonder no more!

Here are 3 steps to preparing for your IVF journey

1.Take the time to optimize your lifestyle with your partner, whoever they may be!

It is important to keep in mind that dietary and lifestyle changes don’t happen overnight. Did you know that it takes approximately 3 whole months for both your eggs and sperm to fully mature? This really highlights why it is so important to spend at least 3 months prior to your first cycle of IVF making any required changes to your diet and lifestyle.

This may include:

• Optimizing your diet (I’ll go into more detail later in this blog post).
• Understanding your cycle. Speak to your fertility specialist or dietitian about your current menstrual cycle and ovulation. There are likely several strategies you can undertake to optimize and balance your cycle.
• Start or maintain a healthy, exercise routine. The current physical activity guidelines for adults state that you should aim to get at least 150-300 minutes of moderately intense exercise each week or 75-150 minutes of vigorous exercise each week for optimal health.
• Take steps to reduce your stress. Studies have repeatedly shown that chronic stress increases the level of inflammation in our body which increases oxidative stress and subsequent damage to the quality of our eggs and sperm. See my previous blog post for tips on how to reduce your stress!

2. Increase your consumption of dietary antioxidants!

One way you can do this is to adopt a Mediterranean-style diet. This pattern of eating has numerous benefits (particularly when it comes to fertility and IVF!).

⁠It has been shown to:⁠

• ⁠Improve both egg and sperm quality⁠
• Increase embryo yields when you are undergoing IVF⁠ treatments
• Optimize fertility outcomes
• Enhance pregnancy outcomes (encourages carrying a healthy baby to full term with no complications)
• Decreases inflammation in the body thus improving both egg and sperm quality and increases the likelihood of conception

So what does a Mediterranean diet look like?

• Consuming plenty of colourful fruits and vegetables⁠ every day. A simple way to achieve this is to aim for at least 3 different colors on your plate at every meal!
• Consuming wholegrains (breads, cereals, rice, quinoa etc.)
• Cooking and using healthy fats like extra-virgin olive oil
• Eating a variety of different nuts and seeds⁠
• Including legumes/beans⁠ in your diet (think of them like a vegetable with protein!)
• Plenty of seafood (with a particular emphasis on oily fish) at least twice each week
• Moderate consumption of dairy foods, eggs, and poultry (chicken, duck, turkey)⁠
• Limiting your consumption of red meat⁠

A Mediterranean style diet will ensure that you get all of the below nutrients that studies have shown are essential for quality eggs and sperm.

• Omega-3 fatty acids
• CoQ10
• Zinc
• Vitamin D
• Selenium
• Folate
• Vitamin E
• Vitamin C
• Lycopene

Studies have also shown that the wholegrains in a Mediterranean-style diet will aid the implantation of your fertilized egg!

3. Get a tailored supplement plan!

There are many ways that nutritional supplements can improve your chances of conceiving during IVF. However, it’s not as simple as taking your average prenatal.

A tailored supplement plan will take into account several factors including your:

• Age
• Medical history
• Reproductive history
• Current oral intake
• Weight and height

This will mean that you are taking supplements that have been individually tailored for your specific needs!

If you would like to learn how to optimize your nutrition before starting IVF, schedule your free 30 minute 1:1 strategy call with me!

References:

1.Mediterranean Diet 101: Meal Plan, Foods List, and Tips (healthline.com)

2. Maternal whole grain intake and outcomes of in vitro fertilization (nih.gov)

 

 One of my favorite parts about working in functional nutrition is that I get to take a deeper dive into the root causes of health issues. Fertility is something that is so interconnected to every system in the body, that we sometimes forget that something that may seem totally unrelated, could actually be the root of everything else. That’s why I’m excited to talk about how gut health specifically impacts fertility. 

he gut impacts your entire body – from modulating risk for chronic diseases like heart disease, diabetes, and cancer, to impacting your mood, anxiety and depression. There is A LOT of research happening these days around gut health, and there’s more coming out every day about how the gut microbiome impacts fertility. 

What is the Microbiome?

So first, let’s talk about what the gut microbiome actually is. The gut microbiome is essentially all the bacteria that live inside your digestive system, specifically the large intestine. In the gut there are 100 trillion bacteria cells – more cells than our body’s own cells! 

While there can certainly be bad bacteria that cause infections and disease, there’s also a whole host of beneficial bacteria that work hard to digest and absorb our food, signal neurotransmitters to our brains, fight inflammation and boost immunity.

The microbiome impacts:

• Energy levels 
• Mood, stress and brain health
• Digestive health 
• Immune function
• Skin health 
• Inflammation 
• Weight 
• Hormones 

Keeping our microbiome happy is essential for almost everything else happening in the body! The problem is, for many of us our gut balance between good bacteria and bad bacteria is way off. Whether you’re having obvious digestive symptoms (gas, bloating, constipation, diarrhea, etc.), or something else is going on in your body – you likely need to take a closer look into the health of your microbiome. 

5 Ways Gut Health Impacts Fertility 

One of the most clear connections between the health of your microbiome and fertility, is through the regulation of sex hormones, namely estrogen. 

Gut Health and Hormone Balance 

Estrogen is a hormone that the body makes, uses and then needs to get rid of. It goes through three phases of detoxification to be able to remove it from the body. The last step in the process is controlled by the gut microbiome.

There’s an enzyme in your large intestine called Beta glucuronidase, and it’s responsible for unpacking estrogen and allowing to it be re-circulated and re-absorbed in the body. 

When you have high levels of B-glucuronidase, it’s usually a sign that you likely have excess estrogen in your body (estrogen dominance) and may have even experienced some of these symptoms, like menstrual cycle problems, painful periods, heavy bleeding, etc. 

Signs of Estrogen Dominance:

1. Mood swings/mood instability
2. Water retention
3. Difficulty losing body fat
4. Acne and skin issues
5. Irregular periods or anovulatory cycles
6. Painful cycles
7. Low sex drive
8. Difficulty building lean muscle mass
9. Poor recovery from exercise
10. Sleep issues

When our bodies can’t eliminate excess estrogen through the GI tract it actually impairs fertility because it throws off the ratio between estrogen and progesterone, and ultimately causes a higher risk for miscarriage.

 
Remember, any dysbiosis prior to pregnancy is also going to worsen during pregnancy, so it’s a good idea to work on your gut health prior to conceiving. 

According to a recent review, without a healthy microbiome, estrogen metabolism and function becomes impaired and can lead to a number of health consequences including endometriosis, PCOS, endometrial hyperplasia, and infertility. 

Authors of this review concluded that treating the gut microbiome to modulate estrogen levels should be considered as a new future treatment for estrogen-mediated diseases including infertility. 

Gut Health and Weight 

The gut microbiome has been associated with higher pre-pregnancy weight as well as more weight gain during pregnancy. We know that excess weight impacts fertility, and researchers have found that those who are overweight have a different microbiome, with different types of bacterial strains than their normal weight counterparts. 

There’s evidence that higher calorie diets rich in sugar and processed foods actually skew the balance of microbes. In fact, a recent study showed that the diversity of these microbes can be influenced by diet within just 24 hours! 

Diets based in fruits, vegetables and plenty of fiber support the microbiome, whereas the Standard American Diet (SAD) has been shown to be detrimental to the microbiome. 

Gut Health and Thyroid 

As mentioned earlier, when there is an imbalance in the microbiome, it impacts immunologic and metabolic functions. A study in 2015 found that hypo- and hyper-thyroidism was associated to small intestinal bacterial overgrowth (SIBO), and another study in 2019 found an association between dysbiosis and thyroid cancer and thyroid nodules. 

Since your thyroid health is so important for not only all metabolic function, but also fertility, it’s important to take this into consideration. 

An under-active thyroid can impact fertility in a few different ways: 

1. Decreased cellular energy – meaning less mitochondria (your cell’s powerhouse) on ovarian cells, causing irregular or absent cycles. 
2. Increased prolactin – which suppresses ovulation by blocking the release of FSH 
3. Decreased insulin sensitivity – more insulin in the blood increases androgens, which can disrupt ovulation and is especially detrimental for women with PCOS 

Gut Health and Inflammation 

You don’t need to have inflammatory bowel disease to have inflammation in the gut, or your gut causing inflammation in other parts of the body. For example, if you have intestinal permeability (aka “leaky gut”), there could be bacterial products entering the blood stream, causing your immune system to attack them and cause chronic inflammation. 

Since inflammation is linked to so many chronic diseases and infertility, this is an important link to consider. 

Gut Health and Pregnancy Complications 

Research has shown the poor gut health was associated with higher risk of preeclampsia, gestational diabetes, and preterm birth. The microbiome has also been looked at for infant health and studies have shown a connection between imbalances in the microbiome with increased risk of eczema, asthma, and allergies. A healthy microbiome will also contribute to your baby’s immune function, inflammation, and healthy weight throughout their life. 

How Do I know if I need Help with my Gut Health and Fertility? 

So by now I’m sure you’re convinced that gut health plays a major role in fertility. But how do you know if taking a daily probiotic is enough? Ask yourself:

• Have I been suffering with digestive issues for years (this is just my new “normal”)
• Do I often fluctuate between feeling constipated or having loose stools?
• Are there foods that I avoid because I can’t tolerate them?
• Do I have frequent acid reflux? 
• Do I have signs of estrogen dominance? (heavy period, PMS, excess weight and weight loss resistance, etc.) 

If you answered yes to any of these questions or you just feel that it’s time to take a closer look into your gut health, then set up a free discovery call with me to see how functional nutrition can help you on your fertility journey. 

And let me know in the comments below what was surprising for you about this blog post! 

References

1. https://www.ncbi.nlm.nih.gov/pubmed/28778332
2. https://www.ncbi.nlm.nih.gov/pubmed/25564410
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216449/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137456/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4845518/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701523/
7. https://www.ncbi.nlm.nih.gov/pubmed/28388917
8. https://www.ncbi.nlm.nih.gov/pubmed/30584647
9. https://link.springer.com/article/10.1007%2Fs12020-014-0509-2
10. https://www.ncbi.nlm.nih.gov/pubmed/32070720
11. https://www.ncbi.nlm.nih.gov/pubmed/32064643
12. https://www.ncbi.nlm.nih.gov/pubmed/32063084