by Breea Johnson, MS RD LDN

I’m sure you have heard the saying “You are what you eat” but have you ever heard the saying “you are what you drink?” Beverages are everywhere – especially when the temperature increases in the summer time! The average American adult consumes about 28 ounces of sugar-sweetened beverages per day, equal to about 350 extra calories per day. While our typical client is much more health conscious than the “average American” I’m always surprised to see what people are drinking. Top on the list (other than water) is almost always diet sodas, skim milk and coffee, followed by artificially-sweetened ice teas and lemonades (like Crystal Light), fruit juice, herbal teas, sometimes sports drinks and alcohol.

Fluids – like food – are necessary in the diet. We know our bodies are about 78% water – found inside and in between cells and our brain is almost all water- thus explaining why even minor dehydration leads to difficulty thinking. We know that we need fluid for hydration (especially in times of increased fluid loss like exercise). We need fluid for detoxification – both from internal toxic by-products of metabolism to external toxins like chemicals that are converted to water-soluble compounds and eliminated. We need it for digestion and metabolism of food. And we know that without water, we would die within days. There’s no doubt that fluids are just as essential as food to our lives — and to our fertility – as fluids are needed for lubrication, cervical fluid production, detoxification, and overall metabolic support.

We tend to think of fluids as just added calories and not having any specific nutrients in them. But there are lots of nutrient rich beverages to enjoy.  Fertility-friendly fluids are naturally nutrient and electrolyte-rich and have no added sugar or artificial sweeteners.  Here are some Fertility-Friendly beverages to get some extra vitamins, minerals and phytochemicals into your body:

• Coconut water
• Water infused with sliced citrus fruits, cucumbers and herbs
• Nettle Tea infusion
• Cucumber lemon water – Slice a cucumber and lemon and place in pitcher of water and let chill for 2 hours.
• Seltzer water (8oz) with unsweetened fruit juice (1oz)
• Kombucha Tea
• Cranberry-infused Water (8oz water plus 2 oz unsweetened cranberry juice)
• Watermelon water – Blend 4 cups fresh watermelon, add to 6 cups water and add juice of 2 fresh limes.  Serve over ice.
• Herbal Teas like PDtM’s Nourish ARTea.

For more information on fertility-friendly fluids and our Nutrition Program, please contact Pulling Down the Moon or go to www.pullingdownthemoon.com and schedule an online appointment.

By Breea Johnson, MS RD LDN

Going through a loss can have a huge impact on our nutrition. We know that the mind and body are intertwined, with an even closer connection between the brain and the gut (otherwise known as the digestive system). Do you ever notice when you are nervous you feel it in your stomach? Or when you drink alcohol you feel it in your brain? Dealing with a loss can affect appetite; foods you typically like may seem tasteless and just trying to eat three meals a day may seem challenging. But the connection between what we eat and how it makes us feel and think is also perpetually linked. The brain is the most complex organ, as everyone knows, and it requires proper nutrition to function well.  Beyond nutritious sources of protein, carbohydrates and fat, the brain needs the complete spectrum of vitamins and minerals to properly function and for brain cells to communicate effectively. Most vital are neurotransmitters (i.e. dopamine and serotonin) which are made of amino acids—found in protein foods (meat, fish, dairy, beans, nuts, seeds, whole grains) which makes protein essential in improving mental performance. While the comfort foods may be calling your name – be sure to add some protein to keep you thinking clearly and feeling healthy.

by Breea Johnson, MS RD LDN

An important aspect of PCOS (Polycystic Ovary Syndrome) is the fact that it is a syndrome, not a disease, meaning it’s a collection of symptoms.  Working in fertility nutrition, I’m constantly fascinated by the many faces of PCOS.  Gone are the days where the typical PCOS patient is overweight, has insulin resistance, adult acne, facial hair growth and elevated testosterone levels.  Normal body weight and thin women can present with PCOS.  Women also may or may not have insulin resistance, which has been so commonly associated with PCOS.

When I see clients with PCOS, 90% of the time it is because a woman wants to conceive in the coming months and does not get a regular period.  The other 10% want to conceive at some point in their life, have tried medication and were not happy with the side effects and want a more natural way to manage PCOS and induce ovulation.  Many women do not even realize they do not have a normal cycle until they discontinue the birth control pill which has medically induced their cycle for many years.

While the causes of PCOS is unclear, we do know that it is related to an underlying hormonal imbalance and that working to balance hormones and increase the sensitivity of the hormone, insulin, can definitely benefit a woman with PCOS.  While we have a comprehensive nutritional treatment strategy for PCOS at Pulling Down the Moon, a few of our important recommendations are:

• Eat low glycemic carbs: Lowering the intake of refined carbohydrates such bread and pastries and increasing nutrient-dense foods can be beneficial to decrease insulin levels.  Insulin is the “store and save” hormone, as elevated insulin levels make it difficult to lose weight.
• Try FlowPro: Myo-inositol, part of the B-vitamin complex , has been found in multiple research studies to help increase insulin sensitivity and induce ovulation in a high percentage of women with PCOS.  Some research has found it to be equally effective as Metformin in restoring ovulation.  Myo-inositol has also been found to increase progesterone levels and decrease testosterone levels. 
• Have your Vitamin D levels checked:  Studies have shown that women with PCOS have very low levels of Vitamin D (25-OH) which may contribute to insulin resistance.  The lab test is a blood test that your primary care physician can administer.

• Get screened for autoimmune thyroid disease: PCOS has been linked to autoimmune thyroiditis) with studies showing a three-fold increase of autoimmune thyroid disease among women with PCOs.  In addition to having the standard thyroid tests performed by your primary care physician, have you thyroid antibodies checked.

While PCOS is not a well-understood syndrome, there are many treatments both conventional and alternative that really work to help reduce symptoms and induce ovulation.  A client recently emailed to tell me that after 3 weeks of taking FlowPro she got her period for the first time naturally and within a few cycles was pregnant.  If you have any questions about PCOS and nutrition or would like to set up an appointment with a Pulling Down the Moon nutritionist, please click here or call (312) 321-0004.

By Breea Johnson, MS RD LDN

Recently, I had the opportunity to visit Growing Power’s Urban Agriculture Farm in Milwaukee, Wisconsin.  Founder Will Allen is a national guru of local and sustainable food and grows food year round to supply many restaurants, farmers markets and schools in the Midwest.  So, what does this have to do with fertility, you ask? Well, Allen believes that farming isn’t as much about the growing of fruits, vegetables and grains; rather it’s about building soil which he often refers to as “fertile soil.” His message is this:  Without nutrient-rich soil, plants won’t grow, his land will be barren and he will have no fruits or vegetables to sell.  As I listened to him speak, I couldn’t help think about the relationship between “soil fertility” and “human fertility” and my work at Pulling Down the Moon specializing in fertility nutrition.  While growing vegetables may seem like a huge departure from helping women conceive, there are actually many more similarities than you might think.  

If you have ever tried to grow organic vegetables this thought may have crossed your mind. I’m personally finding in my spring venture the amount of work required to grow vegetables organically, with no pesticides, fertilizers or Miracle Gro. Vegetables may sprout in ordinary potting soil but in order to get them to grow and thrive and produce offspring they need soil that is completely nutrient-rich and thriving with microorganisms – along with sun and water, of course.  When you ask Will Allen what his biggest asset is on his urban farm, he won’t say equipment or even the people, he will always say the worms.  With hundreds of thousands of worms living on his farm, he utilizes them to compost food waste scraps into beautiful and nutrient-rich soil in order for his plants to thrive.  It’s easy to see with a visible eye how nutrient rich the soil is and taste of the vegetables is so unbelievable that I literally crave their spicy salad mix!

So, think about it. If soil nutrition is essential for soil fertility then human nutrition is essential for human fertility, right? Yes, there absolutely needs to be a nutrient-rich environment (body) for a baby to develop.  In order for this to happen, nutrient-rich foods need to be consumed.  Fruits, vegetables, whole grains, beans, nuts, seeds, quality meat and dairy, eggs and fish have what is termed “nutrient density” – lots of vitamins, minerals and phytochemicals per calorie. A diet full of these foods and void of processed nutrient-empty foods is sure to turn your body into a “nutrient-rich” one – perfect for seed planting! 

Another big connection between soil fertility and human fertility are the benefits of microorganisms. Our microbiota (the bacteria that live on and within us) actually outnumber cells that are on our body.  We call them “probiotics” as they are “good” bacteria that can be found on vegetables (specifically fermented vegetables such as sauerkraut and kimchi), fermented beans and cultured dairy such as yogurt and kefir.  Almost all cultures include a fermented food or beverage as part of their daily diet, likely leftover from a time when fermentation was used to preserve foods prior to refrigeration. In our modern times of trying to kill off all bacteria we are starting to realize that the bacteria can actually be very beneficial to health, especially in fertility. Not only do the bacteria help break down food in our digestive system so we can absorb and utilize more nutrients, but they also help keep pathogenic bacteria at bay (such as E. Coli) and help keep our immune system supported.  Similar to soil fertility, the worms keep the pathogenic bacteria low and the beneficial bacteria high while producing nutrients in the composted material. Plus, recent research shows that beneficial bacteria may help prevent early pregnancy loss and improve IVF outcomes.

I often get asked if nutrition is actually important in the role of fertility. While my first instinct is to say “Of course,” as nutrition is important in every aspect of health, I think that comparing human fertility to soil fertility makes it a more obvious connection.  Can you plant a thriving garden in a clay-filled, nutrient-void soil, shady, bug-less patch of your yard?  You can try, but the chances of it growing are slim.  Can you dig up some dirt, add some compost, some worms and seeds in a sunny spot and water and expect to grow tiny seedlings? Your chances are definitely better!  

For more information on Pulling Down the Moon’s nutrition program please visit www.pullingdownthemoon.com or call (312)321-0004 to discuss the best nutrition options for you.

Kimberly Wong, RD, LDN

Spring, in unbroken tradition, has long been a celebration of the fertility of the earth. Similarly, this glowing season marks a time of renewal and revitalization in one’s fertility journey. Thus, in new hope and anticipation, what better way to welcome the coming months than by improving your fertile body with the natural nutrients of Mother Nature.

While it seems like the path to parenthood may at time be paved with difficult words upon deeply scientific concepts, the movement for local foods, dubbed with the endearing, folksy name “locavorism,” is much less esoteric and was spawned in the mid-2000s in an effort to promote sustainability and eco-consciousness.

Fertility vocab 101: locavore, (\ˈlō-kə-ˌvȯr\, noun), one who eats foods grown locally whenever possible.

Repeat. Memorize. Embrace.

Here’s the 411 on why becoming a locavore can aid in optimizing your preconception nutrition status. In short, locally farmed foods a) provide more vitamins and minerals per serving than do their grocery store counterparts b) encourage increased consumption of fresh fruits and vegetables and c) frequently boast a pesticide-free label.

Local foods travel far fewer miles than your average megastore produce. While it seems convenient to run to the corner store and buy a pint of strawberries to meet our daily quota for our 9-A-Day, what we end up with in hand is quite the reverse of nutritious and fresh. In fact, a food is only considered local if it is grown within 100 miles of where it is sold. Conversely, the average carrot will travel 1,838 miles from farm to table.

While this particular carrot travels the rough equivalent of DC to Mexico City, greater than 50% and up to 90% of its vitamin C content will be lost within the first day of travel. Other essential nutrients fall prey to time-, temperature-, and light-sensitivity: the vital B vitamins, particularly folate, and vitamin E. These particular nutrients are all antioxidants that not only protect from an array of disease, but also help prevent harmful oxidative stress that has been linked to both male and female infertility.

Next, shopping for local foods is a calming, rewarding, and positive experience. Sifting through the wagons of crisp kale, chatting with its grower, and breathing fresh air may be considered so pleasurable that it increases the frequency of fresh fruits and vegetables, and grass-fed/cage-free proteins in one’s diet. Even without a drastic increase in servings per day, the mere substitution of local foods decrease the amount of commercialized foods in the diet. This, in turn, essentially cuts back the amount of processed foods, refined carbohydrates, saturated fats and preservatives in the diet. Just think—a mere trip to a local market can bring you one step closer to an anti-inflammatory, lower-glycemic, fertility-friendly diet!

Finally, local foods tend to offer pesticide-free and organic varieties. The upside to directly dealing with the foods’ producer ensures the elimination of any confusion. Pesticide-residues on fruits and vegetables and hormone/antibiotic-residues in meats and their by-products are of concern to fertility because of the accumulation of such toxins has been linked to reproductive damage.  

The Environmental Working Group has developed the infamous “Dirty Dozen,” which notes the foods that are likely to be highest in pesticide residuals. Do try to buy these foods organic and locally when possible. Conversely, they have released the “Cleanest Twelve” which indicates the produce lowest in pesticides.

Words of caution: the label “organic” does not mean that the produce was grown locally. While it may lack harmful toxic chemicals, it may have travelled several days to arrive to your location and thus also lacking in vital nutrients.

Although the warm summer-like weather donned upon us this year with as much surprise as our back-to-back blizzards, take this opportunity to explore new grounds in your fertility journey and tune into your inner locavore and enjoy the one predictable mainstay this spring: the flood of fertility-friendly, nutrient-rich produce into our fresh markets.

Check out http://www.rawdc.org/dc/fruitDC.html, an excellent online resource with more details and links to local farmers’ markets, CSAs, and organic retailers scattered across Northern Virginia, Washington, DC, and Maryland. For nationwide information, check out http://www.localharvest.org/.

Click here to schedule a fertility nutrition consultation with Kimberly Wong at Pulling Down the Moon in Rockville.  For more information about nutrition counseling visit our website at www.pullingdownthemoon.com.

Pulling Down the Moon nutritionist Breea Johnson guest-posts on Beth and Tami’s Fertility Authority blog this week.  For more information about fertility nutrition and supplements, you can visit our e-tail fertility boutique.   Our supplement line is “PDtM Approved” and adheres to the standards Breea discusses here.  Of course, nutrition is a highly individualized subject, so we recommend a consult with a fertility nutrition specialist to make sure your program suits your needs and diagnosis.  Check out Breea’s must-read post here.

Perhaps the most common question we get at the Moon is “where should I start?”  Women and couples are interested in doing everything they can to increase their odds of conceiving.  But among all the services available – nutrition counseling, acupuncture, yoga for fertility and massage – where to begin?  For the answer to this question, stay tuned to our blog this week as we discuss the different treatments we offer at Pulling Down the Moon and who will best benefit from these treatments.

The most important thing to recognize, though, is that using holistic treatment for fertility requires your participation.  Unlike a medical regimen, where you simply follow the directions your doctor provides, holistic treatment asks you to become involved in identifying and correcting physical, mental and emotional imbalances in your life.  In a sense, these treatments require you to be part of the treatment team.  This is true even if you are also using medical fertility treatments in addition to holistics.

The other point to make about holistic therapy is that it can take some time to work.  Treatments like acupuncture have shown short-term benefit (as few as two acupuncture treatments have been shown to increase IVF success rates), but studies using a longer treatment time frame actually have much more impressive results.  Nutrition changes can also be effective immediately, especially in terms of improving gut function, but other more long-term effects (potential improvement in egg or sperm quality, reduced inflammation, ovulation induction in PCOS) can take several months to achieve.   We feel great for a few hours after yoga or a massage – but longer term practice of these modalities actually leads to a lasting calm in which our body and mind can begin to heal themselves. 

So what’s right for you?  Stay tuned to our blog this week for a deeper exploration of what holistic fertility techniqes are right for you.   Also, feel free to post your questions.  We’ve got experts standing by. 

Be present, be positive!  Paige

By Breea Johnson, MS RD LDN

Fish oil with Omega-3s (that supply DHA and EPA) are a class of supplements commonly recommended for women with infertility. While nutritionists stress the importance of quality when choosing supplements, many people buy fish oil from their local store for convenience or to save money. This past week a lawsuit was filed in California against fish oil manufacturers [CVS Pharmacy Inc.; General Nutrition Corp. (GNC); Now Health Group Inc.; Omega Protein Inc.; Pharmavite LLC (Nature Made brand); Rite Aid Corp.; Solgar Inc., and TwinLab Corp]. The lawsuit charges that these companies sold fish oil that contained “undisclosed and unnecessarily high levels of contamination with polycholorinated biphenyl (PCB) compounds.”

What are PCBs? PCBs are a class of chemicals that are now illegal. However, they were utilized for many different purposes in industrial manufacturing – such as in coolants, PVC piping, pesticides and paints among other things. They are now considered one of the POPs (Persistent Organic Pollutants), a group of the most toxic compounds that still exist in our food and bodies despite being outlawed years ago. According to the EPA, PCBs have been shown to cause cancer in animals, and negatively affect the immune system, reproductive system, nervous system, and endocrine system, amongst other ill health effects. Here is an excerpt from the EPA’s website about the effect of PCBs on reproduction in animals and humans:

“PCB exposures were found to reduce the birth weight, conception rates and live birth rates of monkeys and other species and PCB exposure reduced sperm counts in rats. Effects in monkeys were long-lasting and were observed long after the dosing with PCBs occurred.

Studies of reproductive effects have also been carried out in human populations exposed to PCBs. Children born to women who worked with PCBs in factories showed decreased birth weight and a significant decrease in gestational age with increasing exposures to PCBs. Studies in fishing populations believed to have high exposures to PCBs also suggest similar decreases. This same effect was seen in multiple species of animals exposed to PCBs, and suggests that reproductive effects may be important in humans following exposures to PCBs.”

According to the Environmental Working Group, one of the highest food sources of PCBs include farm-raised (or Atlantic Salmon), with 16 times the amount of PCBs as wild salmon. Thus, supplementing your diet with a fish oil that contains PCBs or eating farm-raised salmon to obtain omega-3s may do more harm than good. It’s important to know where your supplements (and food) are sourced from, and how the companies treat and process it to form a supplement. There are many companies that sell high-quality fish oil. Read more about the quality of our fish oil here. Please consult with a Pulling Down the Moon nutritionist if you have more questions concerning this matter.

For more information:

www.fishoilsafety.com

www.ewg.org

If you build it, they will come. Co-Founders Beth Heller and Tami Quinn share their story on why they decided to create Pulling Down the Moon.

Here’s a good new/bad news situation.  The bad news is that more women are likely to receive a diagnosis of  Gestational Diabetes Mellitus (GDM) in the coming months.   The good news is that if you’re in the trying to conceive process and eating a fertility-friendly diet like the one we use at Pulling Down the Moon you are well on your way to preventing this condition which can be dangerous to mother and baby. 

Previously, a diagnosis of GDM was based on blood sugar measurements that identified women at higher risk for developing diabetes later in life.  The new standards take into consideration risks to the mother and baby, including overweight babies, early delivery, c-section delivery and pre-eclampsia (a life threatening rise in blood pressure that endagers health of mom and baby).  When these outcomes were added to the equation, experts found they needed to make the diagnostic criteria more stringent.  With the new guidelines, it’s estimated 16% of pregnant women will be found to have GDM instead of the 4-6% who currently get diagnosed.

Just in case you needed a bit more motivation to either get started or keep going with your fertility-friendly diet, do it for diabetes prevention and the health of your future child!