The word “diet” can mean “food or drink regularly consumed,” or “a regimen of eating and drinking sparsely so as to reduce one’s weight.” The latter definition is one that inspires fear in the hearts of many who have tried unsuccessfully to lose weight by “going on a diet.”One of the most common questions we get at Pulling Down the Moon is “how do general diet programs like Weight Watchers stack up for fertility?”   How diet impacts fertility was also the subject of a daylong symposium at the most recent meeting of the American Society for Reproductive Medicine.  Clearly, overweight is a challenge to fertility and can also block women from access to advanced medical fertility treatments like IVF.  But are diets the answer?

How Do Diets Measure Up?

In our view, for a diet to be fertility-friendly it must a) help women to attain and maintain a healthy weight for fertility b) target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat  c) eliminate overly-processed foods and encourage the consumption of minimally processed foods.  So how do “diets” stack up?

A) Help women to attain and maintain a healthy weight for fertility

While it may sound ridiculous, dieting does not seem to be the best way to lose weight.  An extensive 2007 review of weight-loss programs published in American Psychologist concluded that:

Dieters were not able to maintain their weight losses in the long term, and there was not consistent evidence that the diets resulted in significant improvements in their health. In the few cases in which health benefits were shown, it could not be demonstrated that they resulted from dieting, rather than exercise, medication use, or other lifestyle changes. It appears that dieters who manage to sustain a weight loss are the rare exception, rather than the rule. Dieters who gain back more weight than they lost may very well be the norm, rather than an unlucky minority.

Even well established programs like Weight Watchers struggle when we take a closer look at success and maintenance.  There is recent clinical data suggesting that Weight Watchers may be more effective than other diet programs at helping people lose weight and keep it off.   A 2008 study published in The British Journal of Nutrition reported looked at a sample of 976 “lifetime members”(defined as people who met and maintained their goal weight for at least 6 weeks) to see how many remained below their goal weight at 1 (26%), 2 (20.5%) and 5 (16%) years after they successfully completed the program.  On the surface this sounds encouraging but a closer look reveals this study has significant biases that make it next to impossible to generalize the findings.  Only about 6% of people who try Weight Watchers successfully attain and maintain their goal weight and meet the criteria to become lifetime members.  This study looked only at their most successful dieters and only 16% of that already small minority kept the weight off for 5 years.

The other problem with assessing the efficacy of WW is that we do not know what’s happening to the other 94% people who try the program and fail.  Are they experiencing the clinically relevant negative effects of dieting, including gaining back more than the weight they lost after a failed diet?

With these numbers in mind, there is a very good chance that many women who are told they need to lose weight in order to increase their odds of pregnancy have already failed at Weight Watchers.  Diets, it seems, are not the answer.

B) Provide ample amounts of nutrients that are important for good nutrition function and target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat

Major components of commercial diet programs – eating “low fat,” using artificial sweeteners, mass-prepared processed foods to support portion control and optimize convenience and emphasis on low fat dairy and “diet” foods – fly in the face of what we believe lie at the heart of healthy eating in general.  For women to find true success and optimal health they need to “un-learn” many of the dieting habits they have picked up over the years.  This means that frozen processed diet meals are out, as are the sugar-free and low-fat processed snacks.  Diet soda and artificial sweeteners are another crutch that needs to be discarded.  These overly processed food products may conveniently cut calories and “soothe the sweet tooth” (unfortunately artificial sweeteners may actually sharpen a sweet tooth in the long term) but they do not address the underlying causes of infertility – inflammation and poor blood sugar control – associated with overweight.

You can review a head-to-head comparison of a “healthy” low-fat diet versus a fertility-friendly menu in our blog A Tale of Two Diets to learn more about our contention that many of the “healthy” eating habits that have become conventional diet wisdom are simply wrong.   In our estimation an ideal fertility-friendly diet contains about 10% more fat and 10% less carbohydrates than a “typical” healthy diet.  The fats come from foods that naturally have fat in nature – full fat dairy in small amounts, fats from nuts, seeds and oils, as well as fats from grass raised meats and fish in small quantities.  Many of the fat-soluble nutrients and essential oils needed for optimal health are found in these natural fats.

C) Discourage overly processed foods and encourage the consumption of minimally processed foods.

We all seek convenience in our meal preparation but often to the detriment of the food we put in our bodies.  While Jenny Craig, Nutrisystem and Weight Watchers all provide recipes, they  also do a brisk trade in maximally processed meals and snack foods, none of which we feel we could endorse as fertility-friendly.  Processed, packaged in potentially toxic plastics and “fortified” with added vitamins and minerals – they aren’t true foods.  Read the ingredients of any of them for a tongue-twisting array of chemicals, preservatives and colorings.

Furthermore, we encourage women who are trying to conceive to eat organic and hormone-free as much as possible. The cardboard, plastic and Styrofoam packaging that wrap up convenience foods and snack-size packs are not good for our environment, either, and may be contributing to the chemical stew that is negatively impacting fertility in the first place.

What’s the Solution?

As we mentioned above, most women who have been told they need to lose weight in order to conceive or undergo IVF have likely tried dieting in almost every form possible and do not want to try another one.  So what to do?

Our answer lies in the concept of “nourishing up.” Nourishing up is the process of learning how to feed our bodies with real food that includes healthy fats and does not rely on processed low fat, sugar free or diet foods.  With nourishment come satiety, great digestion and optimal nutrition.  In obese and overweight women weight loss is not the goal of nourishing up but it is almost always a by-product.

Our therapeutic intervention for overweight and obesity, First Line Therapy for Fertility, introduces women to highly nutritious and satisfying eating guidelines based on the Mediterranean dietary pattern, which several studies have associated with potential protection against infertility (3, 4).  This dietary pattern emphasizes low-glycemic load, minimally processed foods and healthy oils from vegetable and fish sources.  Refined sugars and treats play a minimal role in this dietary pattern as do “diet foods” like processed low-fat dairy, and sugar free or fat free foods.  First Line Therapy has been shown to promote weight loss as well as improve markers of metabolic syndrome, such as decreasing LDL (bad) cholesterol, in women (5).

Dietitians who have received additional training in fertility nutrition and are up to speed on ART treatments lead the FLTF Program.  We educate women about Fertility Go (eat lots every day), Whoa (okay in moderation) and No (let’s skip these) foods, making it easy for women to customize their program to optimize sources of essential fertility nutrients (iron, omega-3 fats, B-vitamins and antioxidants).   In addition there is education and emphasis on foods and supplements that limit inflammation, which is implicated in many different infertility conditions including endometriosis, Polycystic Ovarian Syndrome (PCOS) and poor egg quality. With FLTF, we will help women choose foods that will nourish their bodies with the vitamins and minerals needed to maximize their fertility and help them feel satisfied, while at the same time helping them achieve a healthy weight.

Currently we have two groups of 5 women, one group in Chicago and one in DC Metro, who are participating in the FLTF program.  Stay tuned to our site for more information about their progress, to share their stories, challenges and successes, and to learn more about First Line Therapy for Fertility.

Sources

1.  Mann et al.  Medicare’s search for effective obesity treatments:  diets are not the answer. American Psychologist (2007), 62: pp 220 –233.

2.  Lowe et al. Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme.  British Journal of Nutrition (2008), 99: pp 925-930.

3.  Toledo et al. Dietary patterns and difficulty conceiving: a nested case–control study.  Fertility & Sterility (2011), 96: 1149-53.

4.  Vujkovich et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy.  Fertility & Sterility (2010), 94: pp 2096-101.

5.  Jones et al. A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism.  Journal of Clinical Lipidology (2011) , 5: pp. 188-96.

Click here to view the video on YouTube.

Margaret Wertheim M.S., R.D., L.D.N.

Margaret Wertheim, MS RD LDN

Here at Pulling Down the Moon, we are launching our new weight loss program entitled First Line Therapy for Fertility (FLTF). I couldn’t be more excited about this program, and in preparation I’ve been doing the program myself. I’m not trying to lose weight, but simply following the eating plan with a goal of maintaining my weight. First let me tell you a little bit more about how the program works, and then I’ll fill you in on my experience.

Once you enroll in FLTF, you will come in for an initial consultation with me in Chicago or with Laura in Rockville. During that consultation we’ll review your goals, medical and fertility history and current diet in detail. We will also take your weight, measure your waist and hip circumference and your body composition using near infrared or NIR. The NIR measurement will tell us what percent of your body is fat versus lean body mass, which means muscle, bone and everything else that isn’t fat. It will also give us your BMR or basal metabolic rate, which tells us how many calories your burn at rest. That number will be adjusted based on your activity level to a calorie amount to promote weight loss. Don’t worry, that’s where our attention to calories begins and ends. There will be absolutely no calorie counting in this program. Instead after we calculate your calorie goal, we’ll translate that into a certain number of servings from each of the different food groups. We’ll come up with a meal pattern that works for you. It’s entirely customizable and tailored to you.

So back to my experience.  I’ve been on a weight maintenance FLTF plan for about 4 weeks now and I feel great! I am a Nutritionist who walks the talk, and I’ve always been a great vegetable eater, but FLTF took even me to a whole new level.  Here’s what I’ve noticed while on the FLTF plan:

1. I have more energy and never feel tired after eating. You know that carb coma fatigue you feel after a large meal of pasta or pizza, where all you want to do is veg out on the couch. You won’t feel that at all during the FLTF program. The reason is your blood sugar is going to remain so well-regulated that your energy will be steady. The majority of your carbs will mostly be coming from fruits, vegetables and beans with very limited grains and dairy. You will also always pair carbs with protein, which slows the absorption of sugar (created by the breakdown of carbs) into your bloodstream and prevents blood sugar peaks and valleys. The peaks and valleys are what leave you feeling really good 15 minutes after eating candy and tired, cranky, and searching for the next sugar fix after that. Don’t be scared off by limiting your grains and dairy. You can do it, and I’m going to help you.

2. Not eating sweets isn’t as hard as you may think. This plan has no sweets in it. Many weight loss programs promote jelly beans, “skinny” frozen desserts or other low-fat or sugar-free sweets. Instead I’m going to ask you to pretty strictly limit your sweets, but you’ll have fruit as well as sweet-tasting low glycemic index protein shakes to satisfy that sweet tooth. It may be hard to limit sweets at first, but it will get better. Once you cut out those sweets, the cravings will gradually disappear and you’ll be so excited about how great you feel and look, you won’t want to go back.

4. I’m eating more fruits and vegetables than ever: We are all constantly being told to eat more fruits and vegetables to improve our overall health and prevent disease. When it comes to cancer prevention, the recommendation from the American Cancer Society is at least 2 ½ cups of fruits and vegetables daily. I bet that while doing FLTF you will not only meet with recommendation, but go well above and beyond.

Let’s take a look at what I ate yesterday  – oatmeal, full-fat yogurt, walnuts, grassfed beef, tomato sauce, spaghetti squash, cannellini beans, kale, garlic, apple, almond butter, grapes, lentil soup, Brussels sprouts, butternut squash, blueberries. This day was jam-packed with nutrients and antioxidants! Let’s see how I did with eating a variety of different colors – red (grapes, apple skin, tomato sauce), orange/yellow (spaghetti squash, butternut squash, carrots in my lentil soup), green (kale, Brussels sprouts), blue (blueberries), white (cannellini beans, onions, garlic), brown (lentils, mushrooms, almond butter).

Here’s something that’s very important. Much of this may sound hard. I’m going to ask you to limit some pretty common foods, but I will tell you to always remember the 80/20 rule. What you do 80% of the time is what really matters. The other 20% is less important. Here’s an example: I’ve been doing FLTF, and I went to my sister’s house for dinner, and she was serving homemade pizza. Pizza has 2 things that I’m limiting –grains and dairy. What did I do? I ate the pizza, and I enjoyed it. I loaded up on veggies on the side. I’d been sticking to the plan most of the rest of the time, so it’s fine. In the beginning, it’s best to stick to the plan as closely as possible for maximum benefit, but there will always be meals that you can’t control. One meal is not going to make or break anything.

Because I’ve done and continue to do this program, I know the challenges and I’ll be able to give you recipes and tips to guide you through. I know you can be successful and you’ll have my support as well as the support of the other program participants.  The program costs $210 and includes a one-on-one session with a Registered Dietitian and seven group follow-up sessions.

FLTF launches in Chicago and Rockville on May 1^st, so call 312-321-0004 (Chicago) or 301-610-7755 to get more information or to sign up. Can’t wait to meet you and guide you through this exciting journey.

As I’ve said before, it took me seven years and five pregnancies to get two kids.  So, while pregnancy was a joyful time for me on some levels, it was also a time of stress and sleepless anxiety.  In fact my business partner Tami will often joke that my pregnancies were some of the most stressful times of her life.  Honestly, though, without yoga, massage and acupuncture I think I would have bitten my fingernails to the quick waiting for Jackson and Calvin to arrive safely.  What I didn’t know then was that seeking relief for anxiety through holistic means was also good for my boys.  A growing body of clinical evidence now suggests that prenatal stress, depression and/or anxiety is linked to adverse health outcomes for both moms and babies including preterm birth, preeclampsia and even future risk of chronic disease and obesity (1).

Women, especially women who have struggled to conceive, may feel guilty about experiencing anxious emotions during this “blissful” time.   Yet preparing for a new baby, no matter how hard one had to work to get it, can be stressful.  Changes in the body during pregnancy, including the strains of a growing belly  and nighttime muscle cramps, can also disrupt sleep, which increases stress.  Rather than worry about worrying, we suggest you take the bull by the horns and enjoy a 360 degree self-care program during pregnancy.  And honestly, it will never again be as easy to justify self-care like acupuncture, massage and yoga as it is when your efforts are a “double-dip” – good for mom and great for baby.

Here are several strategies for decreasing maternal stress and improving overall well-being during pregnancy:

1.  Get acupuncture.  A 2010 study in Obstetrics and Gynecology found that acupuncture treatment alleviated symptoms of stress and depression in pregnant women and women experiencing infertility (2, 3).  Acupuncture has also been shown to be effective at managing morning sickness, back and pelvic pain and labor pain.   Make sure, however, that you see a practitioner who is experienced in treating pregnancy.

2.  Do prenatal yoga.  Compared to controls, women who did prenatal yoga experienced significant reductions in physical pain from baseline to postintervention compared with women in the third trimester whose pain increased.  Women in the yoga group  showed greater reductions in perceived stress and trait anxiety in their third trimester than women from the control group (4)  The same women also experienced better sleep and less wakefulness (5).

3.  Get prenatal massage.  Research shows that women who received prenatal massage reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased, which decreased excessive fetal activity; the rate of baby prematurity was also lower (6).

4.  Seek expert prenatal nutrition counseling.  There are specific nutritional strategies for managing weight gain, avoiding conditions like Gestational Diabetes and Pre-eclampsia and improving digestion (less heartburn, avoid constipation).   At Pulling Down the Moon we target our prenatal nutrition consults based on trimester.

Our Prenatal Passport is an excellent way to surround yourself with support and expert prenatal wellness care.  The Prenatal Passport includes your Initial Acupuncture Consultation, one Pregnancy Massage and a two-session Prenatal Nutrition Package as well as a free 3-session package of our “Divine” Prenatal Yoga class visits for just $372.00 – (Divine yoga currently available in Chicago only) which represents a savings of almost $150!  The Prenatal Passport also make a great gift.  Gift certificates are available at our online store shop.pullingdownthemoon.com.  

1.  Entringer S et al.  Prenatal stress and developmental programming of human health and disease risk: concepts and integration of empirical findings.  Curr Opin Endocrinol Diabetes Obes. 2010 Dec;17(6):507-16.

2.  Smith CA. 1.  SMith The effect of acupuncture on psychosocial outcomes for women experiencing infertility.  J Altern Complement Med. 2011 Oct;17(10):923-30. Epub 2011 Oct 6.

3.  Manber et al. Acupuncture for depression during pregnancy:  a randomized controlled trial.  Obstet Gynecol. 2010 Mar;115(3):511-20.  

4.  Beddoe AE et al.  The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress.  J Obstet Gynecol Neonatal Nurs. 2009 May-Jun;38(3):310-9.

5.  Beddoe AE et al. Effects of mindful yoga on sleep in pregnant women:  a pilot study. Biol Res Nurs. 2010 Apr;11(4):363-70.

6.  Field, T. (2010). Pregnancy and labor massage therapy. Expert Review of Obstetrics and Gynecology, 5, 177-181.

Cathleen McCauley L.M.T.

By Cathy McCauley, LMT, NCTMB

Spring has officially sprung and a multitude of signs show the season is upon us. Take a walk through your neighborhood and you see crocuses blooming and green buds taking shape. The earth is fertile and bursting with life.

With spring here, it’s the time for rejuvenation and cleansing. The longer days bring a renewed boost of energy. With spring, you receive the opportunity to release any stagnation that has accumulated during the winter and start fresh in mind and body. You can look ahead and make plans for the coming year.

A Chinese proverb says, “Make your whole year’s plans in the spring, and your day’s plans early in the morning.”  The proverb comes from the fact that farmers sow their seeds in early spring to ensure a good harvest and highlights the importance of being proactive.  Applying this concept to fertility, you can see the importance of starting early in taking care of your reproductive health. When you begin to pay attention to your bodies’ rhythms, cycles, signs and symptoms, your chances can increase in creating a fertile environment.

If you haven’t been as proactive about fertility as you’d like, spring is the perfect time to make plans for the future. It might be time to talk to your doctor about a fertility blood work up to determine what’s really going on with your hormones. You could make an appointment with a nutritionist to overhaul your eating habits to be more fertility friendly or take a yoga class to learn some breathing and relaxation techniques for stress reduction.

Click here to learn about the Fertility Awareness Check-Up available from Fertility Centers of Illinois for just $90

Also, the concept of spring cleaning our bodies can become an important ritual. You need to clear out the toxins and rejuvenate any stagnate energy in the body to boost immunity and increase fertility health. Since spring is the time for new beginnings, it’s a good opportunity to experience something new. Acupuncture helps balance the energy in the body and stabilize the organs and bodily functions. Reiki, a gentle form of vibrational energy healing, helps restore harmony in the body, mind and soul and clears emotional blockages. Fertility massage focuses on opening up the abdominal and reproductive organs to promote the immune system and assist in blood flow. Massage also greatly reduces tension and helps you feel great.

In the spring, people begin to feel better as the temperatures increase, the sunlight shines and the world turns green. Pour some of that warmth and light into your reproductive health to invigorate and rejuvenate your personal fertility journey.

We’re here to guide you along your path and hope to see you soon!

Seasonality is a concept that went out of vogue with the advent of super-stores and refrigerated shipping.  I remember seasonality from my childhood growing up in Michigan when I could guess the month from the fruit my mom placed on the breakfast table.  If she served cantaloupe or watermelon I could put money on the fact that school was out for the summer.  Oranges and grapefruit were winter fruits, which we would occasionally pack home with us from our winter break trips to Florida for a sunny treat on short winter days.  Berries were an early summer thing, although Michigan raspberries were available through October if the weather was warm…and if there was homemade apple sauce on the table it was late September.  Ditto vegetables.  We simply didn’t eat tomatoes when they weren’t growing in our garden.  And when summer ended and the garden turned brown there was squash – lots of it – to be stored for stews and soups during the cold winter months.

But as I got older, stores got bigger.  Suddenly cantaloupe was available in January…pale, crunchy cantaloupe but cantaloupe.  Tomatoes, too, and disturbingly large red apples began to appear.  My mom got a job and had less time for gardening.  So the food on our table changed.

I often wonder how much of our obesity, infertility and chronic health problems arise from the simple fact that we’ve allen out of rhythm with our food source.  For optimal health and fertility, traditional medical teachings recommend eating seasonally and locally.  In keeping with the ancient belief that we are healthier and happier when our bodies are in tune with the cycles of nature, it follows we should eat foods that grow in our geographical area while they are in season.  Traditional systems teach that foods and people in the same geographical area have “similar energy.”  This may be true in the sense that plants and the people living as neighbors share the same weather, air, soil and “roots.”  Whether indigenous or adoptive species, plants that thrive in particular areas are there because they are well-suited and have established harmony with their surroundings.  When we eat foods that exist in harmony with our surroundings, it’s believed we take some of that harmony into our own bodies.

So, what’s “in” for April?  The light flavors of spring are in right now and are full of fertility-supporting nutrients.  Many stores now state the origin of their produce so for an added bonus choose fruits and vegetables grown nearby.  Seasonal spring choices contain antioxidants and anti-inflammatory compounds.  Since many conditions that cause infertility – PCOS, endometriosis, fibroids and poor egg quality – are associated with oxidative stress and inflammation, increasing your intake of these fruits and veg are a great idea!

• Arugula – looks and acts like a green but is classified as a cruciferous vegetable and may help healthy hormone metabolism. Arugula is also lower in oxalates, chemicals in leafy greens like spinach, which interfere with calcium absorption.  You can stir a handful of arugula into a delicious Spring Minestrone soup for a delicious satisfying meal.
• Artichokes – an excellent source of Vitamin C and believed by some cultures to be an aphrodisiac.
• Asparagus -great source of potassium,  vitamin A and folate and is naturally low in sodium.  Also believed to be an aphrodisiac…
• Beets – contain betelains, antioxidant and anti-inflammatory compounds.  Eat beets lightly steamed or grate them raw into salads to because the benefits of betelains are thought to diminish with heat.
• Leeks – while not as extensively studied as its cousin garlic, leeks are an allium vegetable and have many of the same beneficial sulfur-containing compounds as garlic.
• Morel mushrooms – a great source of the antioxidant compound selenium.  Morels have also been studied for their natural blood sugar balancing action.
• Strawberries (if you live in the South) – strawberries are a fertility superfood filled with antioxidant vitamins and lignins, fiber that has been shown to lower cholesterol.  Lignins are also a favorite food of beneficial gut bacteria and has been called a “pre-biotic” because it promotes a healthy intestinal flora.

by Margaret Wertheim, MS, RD, LDN

There is clear evidence that a healthy body weight maximizes fertility and IVF success rates, but when it comes to specific foods or vitamins and minerals, the evidence gets a little murkier. There are a number of reasons for that, but perhaps the most important reason is that diet changes don’t happen in a vacuum; you can’t change one thing in a person’s diet without something else changing. For example, you decrease the carbs while keeping the calories the same and the fat and/or protein in the diet must increase.  In the era of evidence-based medicine, nutrition recommendations to support fertility aren’t always clear-cut. I can’t say “eat almonds, and you’ll definitely get pregnant,” but I do know if you eat healthier you’ll probably feel better, have more energy, and it may help you get pregnant.

In my work as a nutritionist at Pulling Down the Moon, I’ve worked with women that are at a completely normal weight and outwardly look healthy, but they’re overwhelmed and exhausted, and using sugar and caffeine to make it through the day. They are filling their bodies with low-calorie pre-packaged “stuff” masquerading as food in order to avoid weight gain. I would argue that just because they have a normal BMI doesn’t mean they are “healthier” or more likely to conceive than a woman who is somewhat overweight, but eats really well. There are overweight women who eat very healthfully and normal weight women who don’t and vice versa. Does weight matter – absolutely, but I would argue there is much more to it than that. Dietary quality needs to be considered in all women and men, regardless of weight. Here are three ways to improve the quality of your diet to improve your overall health and vitality, and they just may also help you conceive:

1. Follow a Mediterranean diet pattern. Following a Mediterranean diet pattern may increase chance of pregnancy when undergoing IVF, according a 2010 study in the journal Fertility and Sterility. The Mediterranean diet pattern is characterized by high intake of vegetables and plant oils like olive oil, fish and legumes. In this study, women who were most adherent to a Mediterranean diet pattern were 40% more likely to become pregnant via IVF than women who were less adherent to this pattern. The authors suggest that the higher intakes of folate and vitamin B6 in the more adherent group may explain the benefit of the Mediterranean diet on pregnancy.

2. Focus on Nutrient Density. Nutrient density means that you want to try to get as many vitamins and minerals as you can from the food you’re eating. This means the grains you eat should be whole grains. For example, experiment with different types of bread. “Whole wheat” bread that is really soft and spongy is probably not made from 100% whole grains, and thus isn’t as nutrient dense. The refining process in taking whole wheat to white flour strips the wheat of valuable fiber, protein, vitamin E, and B-vitamins like folate. Try sprouted or 100% whole grain bread as well as other whole grains like brown rice, quinoa, millet and oats. Other nutrient dense foods are legumes, nuts and seeds, fruits, and vegetables along with appropriate portions of high quality meat, fish and dairy. The idea is to minimize empty calories found in sodas, sweetened beverages and desserts. They offer only calories and sugar, which may cause unwanted weight gain, low energy levels, and also may negatively affect your mood.
3. Eat a wide variety of different colors. Research indicates that oxidative stress may play a role in endometriosis, PCOS, male factor and unexplained infertility. Increasing dietary antioxidants may help to offset this increased oxidative stress. Many vitamins and minerals have antioxidant functions including vitamins A, C and E and minerals like zinc and selenium. Does this mean you should start popping supplements of these vitamins and minerals? Not without the recommendation of a qualified nutritionist or healthcare professional, who understands when it’s appropriate to supplement and when it’s not. More is not always better when it comes to supplements. Instead focus on food.

Eating a varied diet is essential. In addition to antioxidant vitamins and minerals, phytonutrients, which are naturally-occurring compounds found in plants, also function as antioxidants. Certain phytonutrients give color to plants, and many have additional benefits beyond their antioxidant value, such as anti-inflammatory actions. Eating a varied diet that includes a wide variety of different colored fruits and vegetables is essential. Leafy green vegetables are incredibly healthy, but if you eat leafy greens at the exclusion of other vegetables, you miss out on the nutrients provided by yellow, orange, red, blue, and purple fruits and vegetables. We all get stuck in ruts where we feel like we’re eating the same things day after day. Let the changing season inspire you to start visiting your local farmer’s market or branch out at the grocery store by trying some new vegetables. Buy a new cookbook and try out some new recipes.

While I can’t tell you that eating specific foods is absolutely going to improve your fertility, a nutrient poor diet is definitely not going to help. I’ve worked with many people who expressed their initial reluctance to schedule a nutrition appointment, and then had a change of heart. One woman told me, “What’s the worst thing that’s going to happen from my changing my diet? I’m going to feel a lot better? That works for me!” This attitude always makes me smile. I find it inspiring to work with women who are really trying and succeeding in improving their fertility by hitting it from all angles – exercise, nutrition, acupuncture, stress management and relaxation in order to really maximize their chances of natural conception or success with ART.

 Click here to schedule a phone or in-person consultation with Margaret.  

Margaret Wertheim, MS, RD, LDN is a Nutritionist at Pulling Down the Moon, Integrative Care for Fertility, Inc.

References:

1. Vujkovic, et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertility and Sterility. 2010;94(6):2096-2101.
2. Ruder, et al. Oxidative stress and antioxidants. Human Reproduction Update. 2008;14(4):345-357.
3. Mendiola, et al. A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics. Fertility and Sterility. 2010;93(4):1128-1133.

Chicago has had an amazing winter and a very early spring.  This past week has found us meditating on flip-flops…in March!

 While it’s super fun to slip on a pair of summery wedges and paint our toenails pink, open toed shoes and flip-flops aren’t the only reason to pay attention to our piggies.  When it comes to the holistic view of fertility  feet occupy a place of honor.  If you’ve ever had fertility acupuncture you know that many of the points that support the reproductive system are located in the feet and ankles.  Reflexologists assert that the feet literally provide a map of the body and that we can use foot manipulation to impact different physical organs.  Yoga, too, teaches that healthy feet are important for better menstrual function, dispelling toxins and improving immunity.

So what’s so special about our feet?  In yoga, the feet are seen as the foundation of our being that is connected with the earth.  The most basic of yoga poses, mountain pose, challenges us to simply stand and find balance from our feet to the top of our head.  If we close our eyes in mountain pose, we can visualize the outlines of our feet on our yoga mat…literally our footprint in the world.  One of the strangest things for the new yoga practitioner is exercising in bare feet rather than sneakers.   Postures are practiced barefoot to maximize our awareness of our feet.  Yoga postures also stretch and stimulate different points on the feet that are associated with different organ systems in the body.

Symbolically, the challenges of fertility lead us away from our feet into our head as we spin our mental wheels searching for the silver bullet that will blast us past “trying” time into mommy time.  Our feet, particularly when we practice yoga asana, bring us home from our imaginings and projections to the here and now.

On an energetic level, the feet are associated with our first chakra.  Chakras are energy wheels located along our spine and each chakra is associated with both physiological functions and spiritual life-lessons.  On a psycho-spiritual level the first chakra is associated with security, trust and our sense of belonging.  Physically, the first chakra governs our immune system, gut health and lower back.  The feet are also very important for the flow of apana energy, the energy current in our body that moves downward from the pelvis to the soles of the feet, governs the menstrual cycle and the ability for our body to dispel toxins.

So, be kind to your feet.   Try not to cram them into uncomfortable shoes and make sure they  are frequently touched or nurtured.   Here are some tips for fertility-friendly feet:

1.  Shake hands with your feet once a day.  To do this, take your fingers and thread them between your toes (pinky finger between pinky and second toe, ring finger between second and middle toe, etc.).  Once your fingers are threaded, gently squeeze and massage the ball of the foot.   Repeat on the other side.
2. Keep your feet warm.  Cold feet mean decreased circulation.  With summer coming we face “air conditioner freeze syndrome.”  Keep a pair of fuzzy socks in your bag or desk for the days when you feel like you work in a refrigerator!
3. Experiment with reflexology, the science of foot massage.  Either see a professional reflexologist or try out “reflexology socks,” that actually outline the different areas of the foot and their associated organ system.
4. Try yoga.  If you’re a runner or walker, your feet may need a good stretch.  Time spent in yoga class in bare feet can help feet become more flexible and improve circulation to these important fertility “organs.”  Click here to view our upcoming Yoga for Fertility schedule for DC Metro and Chicagoland.

Increasing evidence suggests that the way in which fat is distributed on a woman’s body may impact fertility.  While body fat is essential for reproduction  (a range of about 17-22% body fat is necessary for menstruation) too much body fat impairs a woman’s ability to conceive.

Body shape also predicts fertility.  Pregnancy rates, in both natural and assisted reproduction, go down with fat accumulation around the waist and trunk independent of overall body weight (1).  As opposed to the tush and thigh fat associated with the pear pattern, apple fat is more metabolically active.  It produces cytokines, chemicals that promote insulin resistance and low-level chronic inflammation.  These factors may lead to other disturbances in reproductive function.  The apple shape is also characteristic of women with Polycystic Ovarian Syndrome (PCOS), a condition associated with infertility.

Click here to access your waist/hip ratio and determine your relative health risk.

If your waist-to-hip ratio is in the less healthy range, don’t despair.  There are effective steps you can take to change your body fat profile.

• Exercise:  All forms of exercise, but particularly resistance training, has been shown to help decrease abdominal fat.  Strength training increases lean muscle mass throughout the body and this increased lean tissue boosts metabolism in a lasting way.  Spot training (hundreds of ab crunches) has not been shown to be effective.
• Weight loss is helpful for decreasing abdominal adiposity but this loss is greater when exercise is added.
• Relaxation training:  Stress has been shown to promote the accumulation of abdominal fat.  Yoga, meditation and breathing practices can help to lower the circulating stress hormones that promote the formation of abdominal fat deposits.  Massage can also help you learn to relax.

Making lasting changes is more effective with support and expert advice.  Our nutrition and other holistic programs including massage, fertility yoga and acupuncture can help you meet your goals and are available in person and by phone.  Call 312-321-0004 (Chicago) or 301-610-7755 (DC Metro) for more information!

1.  Kuchenbecker et al.  The Subcutaneous Abdominal Fat and Not the Intraabdominal Fat Compartment Is Associated with Anovulation in Women with Obesity and Infertility.  J Clin Endocrinol Metab, May 2010, 95(5):2107–2112

Cathleen McCauley L.M.T.

By Cathy McCauley, LMT, NCTMB

A woman experiences gradual yet profound changes during pregnancy and the postpartum months following the birth experience. Pulling Down the Moon now offers massage packages to accompany you on your journey during this special time.

Beginning in the second trimester, or week 14, the Moon’s certified prenatal massage therapists provide safe, nurturing and supportive massage focused on your specific needs.  Treatments can melt away pregnancy pain and discomfort, increase relaxation and promote health and wellness for mother and baby.

Numerous studies show the benefit to both mothers and babies who receive prenatal massage. According to a 2010 study, research shows that women who received prenatal massage reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased, which decreased excessive fetal activity; the rate of baby prematurity was also lower.  In a study of labor pain, women who received massage therapy experienced significantly less pain, and their labors were on average three hours shorter with less need for medication (Field 2010).

After you’ve given birth, your body slowly returns to its non-pregnant state, typically taking six weeks. Massage during this postpartum period supports your recovery from giving birth, reduces pain caused by structural and muscular changes and encourages relaxation and stress relief.  The postpartum time can be an emotional experience, filled with joys and challenges.  Postpartum massage may contribute to healthy family development and reduce the likelihood that excessive musculoskeletal pain will distract from the pleasure of motherhood (Field 1996).

Experience the benefits of maternity massage. Purchase a 60-minute prenatal or postpartum massage three-pack for $340 and save $10 per massage. Schedule an appointment with one of the Moon’s certified prenatal and postpartum massage therapist in the Chicago Area (312-321-0004) or the DC Metro area (301-610-7755).

We look forward to accompanying you on your journey!

References:

Field, T, Grizzle N, Scafidi F, Shanberg S. Massage and relaxation therapies’ effect on depressed adolescent mothers. Adolescence. (1996, 31:903-911).

Field, T. (2010). Pregnancy and labor massage therapy. Expert Review of Obstetrics and Gynecology, 5, 177-181.

Osborn, C. (2012). Pre- and Perinatal Massage Therapy, A Comprehensive Guide to Prenatal, Labor and Postpartum Practice. Baltimore, MD. Lippincott Williams & Wilkins.