Lifestyle

Polycystic Ovary Syndrome (PCOS) affects millions of women worldwide, often making the journey to conception a challenging one. If you’re navigating the complexities of PCOS, understanding the role of insulin resistance is crucial not just for managing symptoms but also for enhancing your fertility naturally. This comprehensive guide aims to illuminate the connection between PCOS and insulin resistance, offering practical dietary and lifestyle tips to help you take control of your health. 

A journey of a thousand miles begins with a single step. Let’s start with understanding how insulin resistance impacts PCOS.

• Types of PCOS 
• What is Insulin Resistance?
• Causes of Insulin Resistance in PCOS
• Symptoms of Insulin Resistance
• Dietary Tips for Managing Insulin Resistance
• Which Labs to Request when you have PCOS
• Conclusion

Types of PCOS 

There are four different types of PCOS. Each type comes with its own set of challenges and requires tailored management strategies. 

• Insulin-Resistant PCOS: This is the most common type and is characterized by significant insulin resistance, leading to high insulin levels. Managing this type involves focusing on improving insulin sensitivity through diet and lifestyle changes.
• Inflammatory PCOS: Women with this type often experience symptoms like unexplained fatigue, skin issues like eczema or psoriasis, and elevated levels of inflammation markers. Anti-inflammatory diets and stress management techniques can be particularly beneficial.
• Adrenal PCOS: This type is linked to an abnormal stress response, leading to elevated levels of DHEA-S, a hormone produced by the adrenal glands. Stress reduction techniques and targeted dietary changes are crucial for managing this type.
• Post-Pill PCOS: Some women experience PCOS-like symptoms after discontinuing birth control pills. This type often resolves on its own, but meanwhile, focusing on hormonal balance and liver health can help.

Understanding which type or combination of types of PCOS you have can significantly impact your fertility treatment plan. It’s essential to work with a healthcare provider to determine your specific type and develop a personalized strategy.

Okay, so let’s dive into the first one: insulin-resistant PCOS. Up to 70% of women with PCOS have insulin resistance, so this tends to be the one we focus on the most in our practice. But really, all women should be concerned with blood sugar management when trying to conceive. 

What is insulin resistance? 

Insulin resistance is a condition where your body’s cells become less responsive to the hormone insulin. This means that the glucose in your blood isn’t efficiently absorbed into your cells, leading to higher blood sugar levels. For women with PCOS, this can be particularly problematic, as insulin resistance can exacerbate many of the symptoms associated with the syndrome.

In simple terms, when you eat, your body breaks down carbohydrates into glucose, which is the main source of energy for your cells. Insulin, produced by the pancreas, helps transport this glucose into your cells. When you have insulin resistance, your cells don’t respond effectively to insulin, so your pancreas produces more insulin to compensate. This can lead to a myriad of issues, including weight gain and difficulty losing weight, two common problems associated with PCOS. 

The relationship between PCOS and insulin resistance is complex. Though insulin resistance is commonly linked to obesity, it can also occur in women with PCOS who are lean. Research has shown that the mechanism of insulin resistance in PCOS differs from that seen in individuals with type 2 diabetes, suggesting unique cellular and receptor abnormalities. 

It’s crucial to address insulin resistance not only to improve your fertility but also to reduce the risk of developing other long-term health issues like type 2 diabetes and cardiovascular diseases. Therefore, understanding and managing insulin resistance through diet, exercise, and possibly medications such as metformin is vital for anyone dealing with PCOS.

Causes of Insulin Resistance in PCOS: 

This debilitating condition isn’t only limited to those struggling with weight issues; it affects lean women as well. Insulin resistance in PCOS involves a complex interplay between hormones and metabolic processes. 

In many cases, the body’s cells become less responsive to insulin, forcing the pancreas to produce more of this hormone to compensate. This condition, known as compensatory hyperinsulinemia, exacerbates the hormonal imbalances already present in PCOS, contributing to an increase in androgen levels. Elevated androgens can lead to several of the symptoms associated with PCOS, such as irregular menstrual cycles, acne, and excessive hair growth. 

Understanding the underlying causes and identifying symptoms can help you take targeted steps to manage them effectively. Research has shown that regardless of body mass index, the unique cellular mechanisms and insulin receptor functions in women with PCOS are inherently different. 

It’s essential to recognize these differences to tailor appropriate lifestyle and dietary modifications that can help regain control over your insulin levels and improve your overall reproductive health. Taking proactive steps can make a significant difference in managing both PCOS and insulin resistance.

Symptoms of Insulin Resistance: 

Recognizing the symptoms of insulin resistance can be a crucial step in managing PCOS effectively. Often, these symptoms overlap with those of PCOS, making it essential to pay close attention to your body and how it responds to different situations and dietary choices. 

Common symptoms of insulin resistance include: 

• Increased hunger and cravings, particularly for sugary or carbohydrate-rich foods
• Weight gain, especially around the abdomen, despite no significant changes in diet or lifestyle
• Fatigue or feeling overly tired, even after adequate rest
• Difficulty losing weight, even with diet and exercise efforts
• Dark, velvety patches of skin, often found on the neck, armpits, or groin area, known as acanthosis nigricans
• Frequent or increased need to urinate
• Increased thirst

If you notice these symptoms, it’s important to speak with your healthcare provider. Early diagnosis and management can help mitigate the risk of associated conditions, such as type 2 diabetes. Testing for insulin resistance typically involves blood tests to measure fasting blood glucose and insulin levels. Other tests, like the oral glucose tolerance test (OGTT), may also be utilized to get a comprehensive understanding of your body’s insulin response. 

Understanding these symptoms and seeking timely medical advice can empower you to take control of your health and make informed decisions about your lifestyle and dietary choices.

Dietary Tips for Managing Insulin Resistance

In our private practice, we work with many women with PCOS. In fact PCOS is the leading cause of fertility struggles among women. 70-80% of women with PCOS experience infertility. Luckily, there are ways to manage PCOS and insulin resistance, and still go on to have a healthy pregnancy. 

One of the cornerstones of managing PCOS and improving fertility is understanding and addressing insulin resistance. Insulin resistance plays a significant role in how PCOS affects your body, contributing to issues like weight gain, irregular menstrual cycles, and difficulty with ovulation. By focusing on lifestyle and dietary changes, you can effectively reduce insulin resistance and enhance your chances of conception.

Firstly, adopting a balanced diet rich in whole foods is crucial. Emphasize low glycemic index (GI) foods, which help manage blood sugar levels more effectively. Think whole grains, legumes, lean proteins, and plenty of vegetables. Incorporating these into your daily meals can stabilize insulin levels and support overall health. Dietary changes can improve insulin sensitivity by 25-30%

To further optimize your diet for managing insulin resistance, follow these specific tips: 

• Balance Your Carbs: Avoid eating carbohydrates on their own. Pair them with proteins or healthy fats to slow down digestion and prevent sudden spikes in blood sugar levels. Low glycemic index diets can improve menstrual regularity in women with PCOS by 50%
• Protein Intake: Aim for 1 gram of protein per pound of body weight each day. Quality sources include lean meats, fish, eggs, dairy, and plant-based options like beans and lentils.
• Fiber-Rich Foods: Include plenty of fiber-rich foods in your diet, such as fruits, vegetables, whole grains, and legumes. Fiber helps regulate blood sugar levels and promotes a feeling of fullness, which can aid in weight management. Aim for 30-40g of fiber per day. Using an app to track your food can be helpful here! 

Implementing these tips can promote better blood sugar control and overall health, making it easier to manage symptoms of PCOS and insulin resistance.

Regular physical activity is another essential component. Exercise not only aids in weight management but also improves insulin sensitivity. Aim for a combination of aerobic exercises like walking, swimming, or cycling, along with strength training to build muscle mass, which helps your body use insulin more efficiently. Regular physical activity can reduce insulin resistance by up to 60% – so it’s a good idea to find an activity you really enjoy doing! 

Stress management techniques such as mindfulness, yoga, or meditation can also play a critical role. Chronic stress can exacerbate insulin resistance and disrupt your hormonal balance, so finding ways to relax and manage stress is vital. 

Lastly, working closely with a healthcare provider to monitor your condition and perhaps incorporating medications like Metformin can further assist in managing insulin resistance. A comprehensive approach that combines diet, exercise, stress management, and medical guidance offers the best chance for improving fertility and achieving a healthy pregnancy with PCOS.

If you’ve recently been diagnosed with PCOS, here are some labs you can ask your doctor to run for you:

• B12
• Vitamin D
• Fasting Insulin
• Fasting Glucose
• A1c
• CRP
• Lipid Profile
• Thyroid Panel
• Liver Function Tests

Understanding the importance of specific lab tests can illuminate how best to manage PCOS and its associated insulin resistance. 

B12: Vitamin B12 is crucial for energy production and neurological function. Deficiencies, often found in those with PCOS, can exacerbate fatigue and other metabolic issues. Women who are prescribed Metformin should be especially concerned with their vitamin B12 levels as this medication will lower B12 over time. 

Vitamin D: This vitamin plays a significant role in insulin sensitivity and hormone regulation. Low levels, common in PCOS, can impair glucose metabolism and worsen insulin resistance. 

Fasting Insulin: Measuring fasting insulin helps assess insulin resistance, a key factor in PCOS. Elevated fasting insulin levels can indicate that your body is struggling to manage blood sugar effectively. 

Fasting Glucose: This test checks for impaired fasting glucose, which can signify prediabetes. It’s a straightforward way to gauge how well your body is handling blood sugar regulation. 

A1c: Hemoglobin A1c provides an average of your blood sugar levels over the past three months, offering a comprehensive picture of glucose control. High levels suggest chronic insulin resistance or diabetes. 

CRP: C-reactive protein is a marker for inflammation, which is often elevated in PCOS. High levels can indicate chronic low-grade inflammation contributing to insulin resistance. 

Lipid Profile: This panel measures cholesterol and triglycerides, vital for understanding cardiovascular risk. PCOS often correlates with unfavorable lipid profiles, increasing the risk of heart disease. 

Thyroid Panel: Hypothyroidism is common in women with PCOS and can exacerbate symptoms like weight gain and irregular periods. A thyroid panel ensures that thyroid function is not contributing to metabolic issues. 

Liver Function Tests: These tests evaluate liver health, critical in PCOS management. Elevated liver enzymes can signal fatty liver, a condition frequently associated with insulin resistance.

Navigating the complexities of PCOS and insulin resistance can be challenging, but with the right strategies, you can take control of your health. By understanding the relationship between diet, lifestyle, and hormone balance, you can naturally improve your fertility and overall well-being. However, every journey is unique. If you’re looking for personalized guidance, our 1-1 coaching services are here to help. 

Our expert coaches specialize in tailoring advice to meet your specific needs, helping you to implement effective changes seamlessly. From customized meal plans to stress management techniques, we offer comprehensive support to ensure you achieve your health goals. 

Ready to take the next step? Contact us today and start your journey towards a healthier, more balanced life with our dedicated 1-1 fertility nutrition coaching services.

During pregnancy you are likely experiencing a lot of unexpected (and many times uncomfortable) changes to your body. You may be going through heartburn, extreme food aversions, constipation or simply feeling puffy and bloated all over the place. (But not to worry, as these symptoms are very common and natural during pregnancy!)

However, on top of all of this, the anxiety over weight gain may be looming over your head, especially when society holds a certain unrealistic body ideal for women and there is constant pressure to quickly “snap” back in shape postpartum. Afterall, stress is the last thing we want during pregnancy, but there is an unbelievable amount of expectation that goes into carrying another human being, when all we want is to have a healthy baby.  

Thus, in today’s article, Wellspring Nutrition is going to help clear up some of the confusion surrounding gestational weight gain to hopefully make your pregnancy journey the healthiest and the most fulfilling. 

What is going on in our body? 

Gestational weight gain is a natural and healthy aspect of pregnancy as your body is supporting fetal growth and development. Some of you may be wondering why you are gaining weight rather quickly during the early phases of pregnancy when the baby is not even that big. This is due to the fact that during the first 30 weeks, maternal fat stores are increased as the body is actively storing nutrients to meet the demands of growing the placenta, a brand new organ that forms just during pregnancy to sustain the growth of the baby, and the energy needs for later in the pregnancy and lactation. During the later stages of gestation, your body will divert a lot of its nutrients to the developing fetus.  

Although total weight gain is variable for each individual, there are certain patterns that are commonly observed. In many cases, the first trimester accounts for 5 percent of the total weight gain and the remaining 95 percent is slowly gained during the last two trimesters. 

Overall, aside from the extra fat deposits, the added weight comes from the placenta, the amniotic fluid (the liquid that surrounds the fetus for protection), increase in body water, expanded blood volume, tissue development in the breasts, and uterus and mammary glands amplification. These changes to your body are driven by hormonal shifts to prepare nourishment and a home for your baby!

Why is it important to be conscious? 

We acknowledge that any topic surrounding weight, and especially discussing numbers can be extremely triggering for some. There is definitely no merit to obsessing solely over a number on a scale, when you already have a lot going on. Nevertheless, having a general idea of what a healthy pregnancy weight gain should look like is important in preventing certain pregnancy complications as well as for the long term health of you and your baby.

Insufficient gestational weight gain is linked to low birth weight and small-for-gestational-age (SGA) newborns. Babies who were born at a low birth weight are predisposed to cardiovascular and metabolic complications later in life. On the contrary, excessive gestational weight gain leads to a higher likelihood of macrosomia (infants being much larger than average) and large-for-gestational-age (LGA) newborns. These birth outcomes are associated with future obesity, diabetes and cardiovascular disease for the child. Unfortunately, for the mother, excessive weight gain is also considered to be a significant determinant for gestational diabetes and hypertension, labor complications, difficulty with breastfeeding, and even pregnancy loss. 

It has been shown that mothers with an accurate knowledge of gestational weight gain recommendation were more likely to meet those targets, indicating that having some level of awareness will lower the likelihood of the mother and the baby to have adverse long-term health outcomes.  

How much weight should I be gaining?

As mentioned earlier, there is variability in the total amount of weight gained in pregnancies among different women, and thus there is no uniform approach that is deemed appropriate for everyone. However, there are certain national standards that have been created.  

The Institute of Medicine (IOM)’s clinical recommendation range for total weight gain is categorized based on the person’s prepregnancy BMI:

Underweight (BMI of under 18.5): 28 to 40 pounds/ 12.7 to 18.1 kg

Normal Weight (BMI between 18.5 to 24.9): 25 to 35 pounds/ 11.3 to 15.8 kg

Overweight (BMI between 25 to 29.9): 15 to 25 pounds/ 6.8 to 11.3 kg 

Obese (BMI over 30): 11-20 pounds/ 4.9 to 9 kg

The BMI scale is undoubtedly not the most reliable way of determining someone’s weight category and its associated health implications, as it fails to discriminate between muscles and fatty tissues. However, it serves as a convenient ballpark estimate to figure out what you should be aiming for.    

Moreover, the recommended weight gain is higher if you are carrying twins. The recommendation is 37 to 54 pounds (16.8 kg to 24.5 kg) if you are normal weight, 31 to 50 pounds (14.1 to 22.7 kg) if you are overweight, and 25 to 42 pounds (11.3 to 19.1 kg) if you are  considered to be obese in the BMI classification. 

It is important to keep in mind that these are standards in the U.S as the IOM (now called the National Academy of Medicine) is an American non-governmental organization. Interestingly, there has not been an international consensus among what is considered to be the “appropriate” range of gestational weight gain. For instance in Japan, where low gestational weight gain is rather common, the recommendation has an upper limit of 12 kg (26.4 pounds) for underweight and normal weight women, and an individualized plan for anyone above those weight classifications. Countries like Ghana, Italy, Canada, Bulgaria, Nicaragua, and Denmark have recommendations that are similar to the U.S IOM specification. Switzerland and Brazil also have identical recommendations to those of the IOM for the underweight, normal weight and overweight category, but have an upper limit of 7 kg (15.4 pounds) for anyone in the obese classification.  Furthermore not all countries go by the pre pregnancy BMI category. Some countries in Latin America have recommendations to attain a goal BMI on the basis of gestational age.  Other countries have general guidelines that are not based on the mother’s body size or gestational age. Examples include India which has a recommendation of 10 to 12 kg (22 to 26.4 pounds) total weight gain, France which recommends an average total gain of about 12 kg (26.4 pounds) , and Myanmar which recommends an increase of 1 kg (2.2 pounds) a month from the fifth month of gestation to the end of pregnancy.   

Thus, you should keep in mind that the IOM recommendation is just one point of reference, and using your best judgment based on your health status or consulting your healthcare provider for your specific circumstance may be beneficial.     

It is important to note that for mothers in the overweight or obese category, research indicates that it may actually be beneficial to gain minimal weight or even no weight at all. For overweight and obese mothers, gaining less than the IOM’s recommendation of 15 pounds significantly reduced the risk for preeclampsia, cesarean delivery, and large for gestational age (LGA) infants.   

A key takeaway from this article should be to have a general idea of what a healthy weight gain looks like for you individually, but without dwelling too much on the number on the scale and focusing on creating a lifestyle that is healthful to you both physically and mentally. For instance, in terms of food, focusing on the nutrient density in order to nourish your baby instead of overly obsessing on calories intake would go a long way. Please feel free to check out our articles on prenatal nutrition, as they discuss crucial nutrients that are needed during pregnancy! 

Additionally, exercise during pregnancy will not only help prevent excessive weight gain but also assist with the alleviation of other pregnancy complications such as gestational diabetes and hypertension, high blood pressure, and edema. It will have a positive impact on your mental wellbeing as exercise can contribute to better sleep as well. There are certain types of exercise that pregnant women are discouraged from taking part in, so make sure to consult with your healthcare provider first.      

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. Aoyama T, Li D, Bay JL. “Weight Gain and Nutrition during Pregnancy: An Analysis of Clinical Practice Guidelines in the Asia-Pacific Region.” Nutrients. 2022 Mar 18;14(6):1288. doi: 10.3390/nu14061288. PMID: 35334946 PMCID: PMC8949332 https://pubmed.ncbi.nlm.nih.gov/35334946/  

2. Donangelo CM, Bezerra FF. “Pregnancy: Metabolic Adaptations and Nutritional Requirements.” Encyclopedia of Food and Health, (2016): 484-490. https://doi.org/10.1016/B978-0-12-384947-2.00565-1

3. Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL. “Gestational weight gain and pregnancy outcomes in obese women: how much is enough?” Obstet Gynecol. 2007 Oct;110(4):752-8. doi: 10.1097/01.AOG.0000278819.17190.87. PMID: 17906005 https://pubmed.ncbi.nlm.nih.gov/17906005/

4. Lain KY, Catalano PM. “Metabolic changes in pregnancy.”Clin Obstet Gynecol. 2007 Dec;50(4):938-48. doi: 10.1097/GRF.0b013e31815a5494. PMID: 17982337 https://pubmed.ncbi.nlm.nih.gov/17982337/

5. Langley-Evans SC, Pearce J, Ellis S. “Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review.” J Hum Nutr Diet. 2022 Apr;35(2):250-264. doi: 10.1111/jhn.12999. Epub 2022 Mar 20. PMID: 35239212 PMCID: PMC9311414 https://pubmed.ncbi.nlm.nih.gov/35239212/

6. Scott C, Andersen CT, Valdez N, Mardones F, Nohr EA, Poston L, Loetscher KC, Abrams B. “No global consensus: a cross-sectional survey of maternal weight policies.” BMC Pregnancy Childbirth. 2014; 14: 167.Published online 2014 May 15. doi:10.1186/1471-2393-14-167 PMCID: PMC4031379 PMID: 24884985 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031379/ 

7. Shulman R, Kottke M. “Impact of maternal knowledge of recommended weight gain in pregnancy on gestational weight gain.”Am J Obstet Gynecol. 2016 Jun;214(6):754.e1-7. doi: 10.1016/j.ajog.2016.03.021. Epub 2016 Mar 21. PMID: 27012961 https://pubmed.ncbi.nlm.nih.gov/27012961/ 

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

9. “Weight gain during pregnancy.” https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy#:~:text=For%20twin%20pregnancy%2C%20the%20IOM,42%20lb)%20for%20obese%20women. 

10. Zhou, M., Peng, X., Yi, H, Tang S, You H. “Determinants of excessive gestational weight gain: a systematic review and meta-analysis.” Arch Public Health. 2022 May 3;80(1):129. doi: 10.1186/s13690-022-00864-9.PMID: 35505415 PMCID: PMC9066815 https://pubmed.ncbi.nlm.nih.gov/35505415/

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

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)

If you’re currently trying to conceive, you may have seen information around the internet about prioritizing non-toxic skincare and products – why?

What Are EDC’s?

The reason for prioritizing non-toxic products for fertility is to reduce the number of chemicals and endocrine disrupters you’re using on your body, which can impact your hormone health and reproductive health.

Some known endocrine disrupting hormones are:

• Pesticides – like glyphosate
• Phthalates – found in so many skincare products
• PCBs and Dioxins
• BPA Plastic
• Chemical retardants
• Perfluorochemicals found in clothes

Honestly, it can get very overwhelming pretty quickly when you start to think about the sheer volume of chemicals found in our skincare, makeup, cleaning products (even baby products!!)

Below I wanted to share some of my favorite non-toxic skincare brands to help you see that there are so many amazing companies producing clean products that won’t mess with your hormones or impact your chances of conceiving.

My Favorite Non-Toxic Brands for Fertility

• Tata Harper – I love their face masks and toners
• Ilia – beautiful bronzers and highlighters
• Kosas – pretty much all my makeup is from this brand. Super high quality
• Follain – I used to work for this company and learned soo much about clean beauty. Awesome resources and beautiful products.
• Credo – they have stores across the US and they carry so many different brands. One of my favorite stores to visit when I’m in NYC, Boston, or San Francisco.
• Primally Pure – their deodorant is amazing!

There you have it! I know there are so many more amazing brands out there, so if there’s one you know and love, let me know in the comments or DM on Instagram!

Looking for More Support?

We cover environmental toxins in DEPTH inside of my program – Nourishing Fertility. To learn more and snag $100 off the course, check out our FREE masterclass here.

5 easy ways to reduce stress while trying to conceive

Embarking on a fertility journey can feel long and overwhelming at times. It is important to have strategies in place to help you cope with stress and anxiety, particularly if you are a Type-A personality that likes everything to be perfect at all times! These 5 tips will help you to reduce your stress while you are trying to conceive.

Try as best as you can to take things back-to-basics, by taking perfectionism off the table. Focusing on the basic pillars of health and wellness, can reduce stress without adding additional overwhelming tasks to your already very long to-do list.

If our stress levels remain high for too long, we can end up with elevated levels of cortisol, a hormone that is made up of the same building blocks as progesterone.

If our body is busy focusing on making cortisol, it places less importance on progesterone production, leading to a reduced supply. This can lead to several negative side-effects, particularly in respect to fertility including:

• Estrogen dominance
• Decreased ability to conceive
• Difficulty with mood stabilization

Progesterone helps us to grow a thick uterine lining which is then shed during menstruation. If we don’t have enough progesterone, then we end up with a lighter period, and a thinner uterine lining to support healthy implantation.

So we can see just how big of an impact stress can have on our ability to conceive!

Try these 5 easy ways to reduce your stress while you are trying to conceive:

1. Ensure you get regular movement

Be sure to move your body daily, even if it is in a very gentle way. Research has shown time and time again, that exercise is incredibly beneficial for stress and our mental health as a whole.⁠ Try activities like yoga, walking, and tai-chi to get your blood flowing.

2. Get enough sleep

Take this time to create a relaxing night time routine to help you unwind and get adequate sleep. Try taking time off devices to read, listening to a podcast, trying a mindfulness exercise or talking to a loved one. Aiming for 7 to 8 hours of sleep each night will help your body to get the rest it needs, without adding additional stress hormones into the mix.

3. Connect with others
⁠

Remind yourself of the supportive community that you have around you on this journey. Reach out to friends, family, support services at your fertility clinic or a counselling service if you need to.⁠ Research has shown that good social supports have a number of protective effects on our health (all of which are beneficial for improving our chances of conceiving) including:

• Decreased blood pressure
• Normal heart rate
• Reduced cortisol levels

4. Keep busy!

⁠Type-A people are prone to overthinking and dwelling on the negative. Staying busy during your fertility journey can help you to stay positive and not focus on the things that we can’t control.

Take up a new hobby, clean out that cupboard, cook a new recipe or plan a day trip to somewhere you haven’t been before! Keep your mind and hands busy as often as you can to help reduce your stress.⁠

⁠
5. Reframe your thoughts⁠
⁠

Reminding yourself of the strength it has taken you to get to this point can be helpful for Type-A personalities. Try to avoid dwelling on negatives and focus on the facts. Spending time in a negative space will only make the process feel harder. Writing down your thoughts and linking them with facts can be a helpful visual and can help you to break negative thought processes.

For example, if you regularly think “I’m not meant to be a mother, this will never happen for me”, counteract this thought with several facts for example:

• I have several caring and motherly instincts and that is clearly seen in how I care for my partner and friends
• This may not happen right now, but that does not mean it will never happen

⁠If you try these tips and are still struggling to find enough support while you are trying to conceive, book your free 30 minute 1:1 strategy call with me to learn how I can support you using functional nutrition, specialty lab testing, and targeted supplements. Can’t wait to speak to you!

⁠
References:

1. Social Support and Resilience to Stress (nih.gov)
2. Why Stress-Baking and Cleaning Make You Less Anxious | WIRED
3. Exercise as Stress Relief (healthline.com)