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.

by Beth Heller, MS RYT

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

by Margaret Wertheim MS RD

When it comes to fertility and pregnancy, folic acid, iron and calcium are the vitamins and minerals that tend to get much of the attention. We would argue that there are quite a few other nutrients that don’t get nearly enough attention, and one of these is choline. Choline is an essential nutrient that your body can synthesize in small amounts, but the majority must be obtained in your diet. While you may constantly hear about the importance of folic acid for the prevention of neural tube defects like spina bifida, research indicates that higher choline intake during pregnancy is associated with lower risk of neural tube defects as well. In addition, choline is converted to betaine in your body, which assists in the conversion of homocysteine to methionine, thus preventing homocysteine levels from becoming elevated. Elevated homocysteine is associated with increased risk for cardiovascular disease and miscarriage, and in one study was associated with poorer egg and embryo quality in women with PCOS undergoing IVF. Furthermore, choline is a precursor to the neurotransmitter, acetylcholine, which is involved in memory and muscle control. In a study in rodents, when mothers consumed higher levels of choline, their offspring had significantly better memory throughout their lives. Thus choline intake during pregnancy may have a very long-term impact on memory and brain function from infancy into adulthood.

According to the National Health and Nutrition Examination Survey, the average choline intake in pregnant women is only about 338 mg/day, while the daily requirement during pregnancy is 450 mg. Daily choline needs increase to 550 mg while breastfeeding, as breast milk is a rich source of choline. Good food sources of choline include eggs, meat and fish, dairy, legumes, and certain whole grains, nuts and seeds. Vegans and vegetarians with limited intake of eggs and dairy products are at increased risk of having a choline-deficient diet. Very few prenatal vitamins contain any choline at all, and those that do usually contain only very small amounts. Luckily, Prenate Pro and Prenatal Plus both contain 200 mg choline, which can give you the extra boost you need to ensure you’re meeting your daily choline requirement. That being said, it’s also absolutely essential to include choline-rich foods in your diet on a daily basis.

References:
Linus Pauling Institute at Oregon State University: Choline

Caudill, et al. Pre- and Postnatal Health: Evidence of Increased Choline Needs. J Am Diet Assoc. 2010; 110:1198-1206

Berker, et al. Homocysteine concentrations in follicular fluid are associated with poor oocyte and embryo qualities in polycystic ovary syndrome patients undergoing assisted reproduction. Reproductive Endocrinology. 2009; 24(9):2293-2302.

Zeisel, et al. Importance of methyl donors during reproduction. Am J Clin Nutr. 2009; 89( suppl):673S-677S.

By Beth Heller, M.S.

So, you think you eat healthy?  Read on and you might be surprised.  The low-fat dietary pattern that is generally touted as healthy is actually low in nutrients that have been shown to be important for fertility.  To illustrate this point, we charged Pulling Down the Moon nutritionist Margaret Wertheim, R.D. to run a nutritional comparison of two diets 1) a typical low-fat diet taken directly from the practice manual of the American Dietetic Association and 2) a fertility-friendly meal plan based on Pulling Down the Moon’s nutrition program.  The results were  striking.

Here’s the low-fat diet based on recommendations from the American Dietetic Association:

Typical Low Fat Diet - Click to enlarge

And here’s the fertility-friendly eating plan per Margaret’s recommendations:

Fertility-friendly Diet - Click to enlarge

At first glance, both diets look pretty healthy.  The calorie content is the same – just around 1830 calories.  Yet, a nutrient comparison reveals a different story.   Head-to-head the Pulling Down the Moon plan blows the typical low fat diet pattern away in key fertility nutrients.  The low fat diet proved deficient in  iron, vitamin E, vitamin D and very low in the omega-3 fatty acids EPA and DHA – all nutrients that are linked to optimal fertility and healthy ovulation.  The difference?  The fertility-friendly diet derives about 10% more of its calories from healthy fats at the expense of carbohydrates.   Foods in the fertility-friendly diet are also less processed – note the absence of  ”diet” dressings,  as well as”low fat” and “sugar free” foods.

Dietary Comparison LF vs. FF - Click to enlarge

This exercise illustrates a central concept of Pulling Down the Moon fertility-friendly eating that we call “nourishing up.”  In short, nourishing up means that even at your perfect body weight you may still be getting insufficient nutrients for optimal health and fertility (read more about nourishing up in a previous post here).  Remember that current dietary guidelines are based on the idea of preventing deficiency (helping us survive), rather than promoting wellness (helping us thrive).  Even  ”healthy” diets such as the low fat diet above are missing the mark.   Note that this low fat diet doesn’t even include guilty pleasures and convenience foods like McDonalds, Starbucks and Lean Cuisine. Also note that the fertility-friendly diet is rich and satisfying, and doesn’t feel like “diet food.”  Our belief is that many women end up starving themselves of important nutrients in order to lose or even maintain their weight.

For this reason we recommend that women who are trying to conceive seek out a nutritionist who specializes in fertility to learn important steps they can take to optimize their diets for fertility.  In addition we also offer the Pulling Down the Moon Pregnancy Prep Program, a three part program of nutritional supplementation that includes Prenatal Plus, a prenatal vitamin that has been optimized to include nutrients like CoQ10, extra B-vitamins, omega-3′s and choline, Probiotic Powder to support digestion, elimination and the immune system, and our Organic Superfood a 100% certified organic fruit and vegetable drink to provide antioxidants their most effective form – that of whole food.*

Have we convinced you that diet is important?  Click here to book an appointment with a Pulling Down the Moon nutritionist or call 312-321-0004 (Chicago)/301-610-7755 (Rockville) for more information.

*These statements have not been evaluated by the Food and Drug Administration.  These products are not intended to diagnose, treat, cure or prevent any disease.

For optimal health and vitality, 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 allow take some of that harmony into our own bodies.

Yet as we enter deep fall, some of the most touted fertility foods, like berries and melons, are heading out of season.  But that’s no reason to panic.  Instead of spending a fortune this winter on raspberries that have been shipped from half-way across the world, take a deeper look at your flora.  Farmer’s markets are an obvious way to explore what’s locally and seasonally available in your area.  In addition, many larger grocery chains have begun to label produce as locally-grown when applicable.

Here are some tips for reaping the best of Fall’s fertility bounty:

1. Think slow, think stew.  Fall and winter vegetables tend to be tougher and heartier than the delicate sprigs and tender fruits of spring and summer.  Kale, collards and sweet potatoes hold up well to slow-cooking methods like stewing or braising.  The benefit of stews and one-pot-meals is that the veggie cooking liquid is consumed as part of the dish, thus preserving nutrient content.
2. Turn on the oven.  Cruciferous vegetables, including cauliflower, cabbage and Brussels sprouts release a caramel sweetness when slow roasted in a hot oven.  These vegetables are fertility “must eats” and contain compounds that help regulate our body’s hormone levels.
3. Experiment with beans.  Bean soups and chili are nourishing dishes that contain fiber that promotes healthy digestion and elimination.
4. Squashes and sweet potatoes are anti-oxidant powerhouses.  Slow roasted or mashed, they can also quench a sweet tooth.

For more info about a nutrition consultation with a Pulling Down the Moon nutritionist call 312-321-0004 (Chicago) and 301-610-7755 (Rockville).

by Beth Heller M.S. and Laura Dubrule, R.D., L.D.N.

At Pulling Down the Moon we will often recommend a “cleanse” diet following a miscarriage or failed ART cycle.  While a cleanse can, at times, entail the elimination of one or more common food allergens like dairy, wheat and soy, elimination is not the basis of our program.  More often than not our cleanse consists of limiting processed sugar and other processed foods, artificial additives and colors while focusing on foods that support our body’s anti-inflammatory and detoxification processes.  The cleanse program at Pulling Down the Moon is individualized and takes into consideration a woman (or man’s) past and present digestive function, hormonal and other symptoms, medical history and current lifestyle.

One key element of our program is supporting hormone balance.  After a failed ART cycle or a miscarriage, a woman’s body must re-establish hormonal balance and function.  It may have been months since her last natural menstrual cycle. Weight gain during treatment may also impact hormone balance.  Yet another common symptom reported by our patients post-ART is anxiety and a lasting case of “the blues.”   It’s very easy to attribute these emotional side-effects to disappointment but there may also be a physical component.   The hormone medications used during the stimulation phase of an ART cycle, and the progesterone supplementation post-IUI and ET, can cause emotional side effects and these hormones can be slow to leave the body.  The liver is charged with processing these steroids before they can be excreted.  To do this it requires ample amounts of amino acids (in particular sulphur-containing amino acids), as well as the vitamins and minerals that work as co-factors in detoxification pathways.

Our ART Recovery/Prep Program focuses on limiting sources of external hormones by discouraging foods that contain hormones and hormone-like substances.  Chief offenders in this area include factory-farmed dairy and meat products which contain the hormones and growth factors used in production.  There are also hormone-like chemicals in pesticides and plastics.  By limiting these external sources of hormone-like substances and increasing the intake of foods that support good hormone function (fiber, lignans and lignins, a range of whole grains – not just wheat! – , healthy fats, cruciferous vegetables, antioxidant rich fruits and veg and added-hormone-free protein) we have the potential to bolster our body’s ability to metabolize and excrete excess hormones and restore balance in the reproductive cycle.

Our Rockville nutritionists Laura Dubrule, R.D. recently  shared a case with me that drove this message home.

My patient is 43 and had experienced two failed IVF cycles in quick succession (6 months time).  Her physician had noted several potential factors contributing to failure including egg quality and endometrial lining quality.  In addition, the patient had recently been diagnosed with PCOS.  Since her last IVF the patient was unable to lose the 8 pounds gained during IVF treatment despite eating a healthy diet and working out four times per week.

We discussed the impact of IVF medications on hormone levels as well as the impact of various dietary choices on her body’s ability to break down and clear excess hormones. We focused especially on tweaking her already health-supporting diet to include significant amounts of cruciferous vegetables and berries every day as well as a daily serving  of legumes.  I suggested she add two supplements, RePro Cleanse and FlowPro, to her regimen as well as vitamin D.

I was very surprised when the patient returned for follow-up having lost 8 lbs over the preceding two weeks.  At Pulling Down the Moon we are extremely careful not to encourage rapid weight loss but upon review of my patient’s diet it was clear that a reduction in calories was not a major factor in her weight loss. The patient reported feeling that the weight came off her abdominal area, that she had lost a bloated feeling, and that her clothes fit the way they used to.

The patient also told me about the resolution of another symptom she hadn’t mentioned in our initial consult. She had been experiencing high levels of anxiety while driving, especially on the highway.  This was not her experience historically, but had been a recent development.  Over the course of the two-week cleanse, this driving anxiety completely disappeared.

While we can’t be certain, we suspect that this rapid loss of water weight and alleviation of anxiety may have been due to an increased clearance of excess steroid hormones that had been circulating in her system.   Whatever the reason, the result was excellent.  While there is still work ahead, my patient is very pleased with the results of her cleanse and feels more like herself than she has in months.  We both agreed that anything we could do to reduce the lingering effects of ART would only help her feel more prepared for her next round of treatment.

We believe that a nutritional consultation can make a big difference in the fertility journey.   Our consultations are available in person in Chicago and the DC Metro area and by phone from almost anywhere else.  Call 312-321-0004 (Chicago) or 301-610-7755 (Rockville) for information.

RePro Cleanse includes kudzu, flax, rice protein and other micronutrients that support the liver’s detoxification processes. Because it contains plant estrogens and is designed to help balance and promote clearance of excess reproductive hormones, we do not use RePro Cleanse when a woman is on fertility medications or birth control.  We often recommend supplementation with Re Pro Cleanse when women are recovering from a failed cycle or miscarriage, or in cases of hormone-related conditions like fibroids or endometriosis.  We will also use RePro Cleanse when a woman’s IVF cycle is cancelled/postponed due to high baseline estrogen levels.   Used as directed over a period of 2-4 weeks we feel that this supplement can help jump start a woman’s recovery process in preparation for a subsequent cycle, be it ART or natural.  Of course we recommend that our patients clear any/all supplements with their physicians.

About Laura Dubrule

Laura brings an eclectic mix of passions to her nutrition counseling. Her years studying acting in New York taught her the importance of connecting with our bodies; this deep sense is fundamental to her understanding of diet and nutrition. Laura completed the program in Nutrition and Food Science at Hunter College in New York, and then went on to complete her dietetic internship at Stony Brook University, a program with an integrative and functional approach. She returned to the city and practiced in a worksite wellness program, delivering individualized nutrition counseling to bank employees in Manhattan and Brooklyn. Her vision for her clients could be called “whole foods meet real world.” She believes that food is meant to be enjoyed and works with her clients to find healthful approaches to eating that are satisfying and enjoyable.

Laura is thrilled to be working in concert with acupuncture, yoga and massage professionals because she believes that the nourishment and care of our hearts and souls is integral to the nourishment of our bodies. She considers it a privilege to be a resource to men and women on their fertility journeys and to celebrate every step long that path as an act of love and creation.

by Beth Heller, M.S.

To fully comprehend the latest research on omega-3 fatty acids and embryo quality it’s important to understand that the goal of medicated fertility cycles is not simply to make a lot of eggs.   In fact mild ovarian stimulation that results in fewer follicles seems to provide the best results.  This approach allows only the healthiest follicles and oocytes to develop.  Since developing follicles produce estrogen, fewer developing follicles also mean lower estrogen levels during the cycle.  This is also potentially beneficial as higher estrogen levels may negatively impact uterine receptivity and deter embryo implantation.

New research suggests that a higher intake of omega-3 fatty acids ALA, DHA and EPA may support this objective (1).  In 225 women undergoing IVF diet data was collected using a food frequency questionnaire.   Intake of  the omega-3 fatty acids ALA,EPA and DHA were calculated, as well as omega-6 (LA) intake and the ratio of omega-6 to omega-3 fats in the diet.

In this study, the women with the highest dietary intake of omega-3′s had lower estrogen response, developed fewer follicles and had better quality embryos, even after controlling for confounders like age and BMI.  A higher omega-6 to omega-3 ratio was associated with higher numbers of follicles.  If the goal of fertility treatment is to help women produce fewer, higher-quality eggs, this research suggests that women undergoing ART  should strive to increase consumption of omega-3 fatty acids and decrease the amount of omega-6 they consume.

As a result of these findings, the research team recommends that twice-weekly fish intake should be encouraged in women during fertility treatment.  While generally useful, this recommendation does not take into consideration the risk of toxicity from fish consumption – especially in the perinatal period.  In fact,  the fish richest in omega-3 fatty acids are the ones most likely to contain mercury and other contaminants.  For this reason, our recommendation at Pulling Down the Moon is that women work to lower their intake of omega-6 fats (found in snack and fast foods, factory/grain-fed red meat and processed oils), increase  their intake of leafy greens, nuts and seeds and supplement their diet with a high quality, purity tested fish oil supplement.

Supplements are only a small part of fertility nutrition, however.  For more information about fish oil, diet and egg/embryo quality, schedule a consultation with one of our nutrition specialists. Learn more about omega-3 fatty acids here.

1.  Hammiche et al. Fertility and Sterility. Vol. 95, No. 5, April 2011 1820-23

By Beth Heller, M.S.

Cauliflower is a fantastic fertility food.  Walnuts, lean protein and berries are terrific too.  But if you do not consume, digest and assimilate these foods effectively they cannot help your fertility.   This process of consumption, digestion and assimilation  (and we’ll also add elimination) is what nutritionists call gut function.  Good gut health is important for many health conditions, including fertility. Let’s take a closer look at these variables:

Consumption: Both Traditional Chinese Medicine and Ayurveda place a great deal of emphasis on how we consume our food.  On the surface this means mindful eating, not eating in the car or standing in front of the microwave.  In addition, choosing food that is locally grown and in season is recommended by these traditional systems.  The taste buds, too, are an important part of the gut.  To be fully satisfying, traditional medicine systems teach a meal should contain six vital tastes:  sweet, sour, salty, pungent, bitter and astringent.  In fact, “western” scientists are now learning that certain tastes convey specific health benefits.  For instance flavonoids, the powerful antioxidants found in red wine, green tea and citrus that are believed to convey important health benefits, are bitter in flavor.   Interestingly, our taste for bitter foods increases with age – as our body’s innate antioxidant systems are losing their efficacy.  Nutrition researchers even hypothesize that a preference for bitter taste in aging animals may be evidence of an evolutionary advantage.  Sadly, our Western diet emphasizes primarily the salty and sweet tastes – leaving the pungent chilis and bitter melons and fruit to other cultures.   Bottom line:  we should consume food mindfully – from eating in a calm environment to paying attention to the range of flavors in the food we eat.

Digestion: In yoga’s sister medical science Ayurveda, we are taught to stoke “agni”  (digestive fire) prior to meals.  This can be done with yoga, exercise and in cases where the digestive fire is weak, an herbal aperitif. The digestive fire is so important that Ayurvedic lore says “if agni is strong we can convert poison into nectar; if agni is weak, we convert nectar into poison.”  Eating too much can also dampen agni, just like throwing a big log on a fire.  Eating too many cold foods can also dampen agni.  Use the Appetite Scale at the end of this blog to help you use agni to your advantage.  For optimal digestive power, eat when you are at a level of 2-3 and stop eating when you are at 7.

Assimilation:  The old adage is true.   The best way to get optimal amounts of vital nutrients is to eat a balanced diet filled with minimally processed fresh foods.  This is because the macronutrients (fat, protein and carbohydrates) as well as the micronutrients (vitamins, minerals and other beneficial chemicals) in food work best in combination with each other. Food sensitivities, health conditions and even chronic stress can impact how we assimilate nutrients.   For instance, when we are very nervous we may find that food just “sits” in our stomach like a rock.  This is because the flight or flight stress response has down-regulated the digest/nest body functions and is shunting blood to the skeletal muscles rather than the stomach.

Elimination:  When food rushes through the digestive tract (diarrhea) or stagnates there (constipation) we experience discomfort.  Poor digestion may also put us at risk for disease.  Diarrhea may speed food through the gut too quickly for vital nutrients to be absorbed.  It can also wreak havoc on the beneficial bacteria in our gut.  Constipation, on the other hand, allows for potentially toxic substances (including hormones and carcinogens) to be “re-digested” from fecal matter and returned to the body.  Imbalances in the intestinal and vaginal flora can also make women vulnerable to conditions like bacterial vaginosis that are associated with infertility and early pregnancy loss.  We can support gut bacteria by eating sources of soluble fiber (oats, lentils and beans) that support “good” bacteria and limiting the consumption of refined sugar and saturated fat, that nourish “bad” bacteria.

So, this week as you fill your refrigerator and your plate with fertility-friendly foods, notice  how you are consuming your food and  pay attention to your gut function.  Eat when you are hungry, stop when you are full.  Enjoy a full range of flavors at every meal – searching beyond your habits for pungent, sour and bitter flavors.  Finally, pay attention to how your body is eliminating waste and strive for the Goldilocks’ approach of “not too fast, not too slow.”   These actions can be truly transformative.

Working with an integrative nutrition specialist trained in fertility can be very helpful for resolving issues related to menstrual and reproductive function.  Call 312-321-0004 to learn more about Pulling Down the Moon’s nutrition specialists.

Agni Gauge:

0 Starving

1 Hunger Pains

2 Very Hungry

3 Hungry

4 Could Eat

5 Neutral

6 Could Stop

7 Full

8 Uncomfortable

9 Over-Filled

10 Stuffed

by Beth Heller, M.S., R.Y.T.

You may have noticed signs at your local Whole Foods Market promoting the ANDI score of different foods.  ANDI, in case you missed it, stands the for Average Nutrient Density Index, a rating scale that compares the amount of nutrients per calorie in particular foods.  The ANDI is the creation of Eat Right for America founder Dr. Joel Fuhrman M.D.

The ANDI score rates foods on the inclusion of many different nutrients including:

Calcium, Carotenoids: Beta Carotene, Alpha Carotene, Lutein & Zeaxanthin, Lycopene, Fiber, Folate, Glucosinolates, Iron, Magnesium, Niacin, Selenium, Vitamin B1 (Thiamin) Vitamin B2 (Riboflavin), Vitamin B6, Vitamin B12, Vitamin C, Vitamin E and Zinc.  It also factors in the ORAC score X2 (Oxygen Radical Absorbance Capacity) which is a method of measuring the antioxidant or radical scavenging capacity of food.

The upshot of this is that a food like kale has a score of 1000 on the ANDI and a food like cola has a score of 0.6.  In other words, kale provides far more nutrients per calorie than soda.  At first blush, the ANDI seems like it could be the Rosetta Stone of nutrition.  It makes quantitatively clear what most of us already intuitively know – and might tip the balance in our decision between, say, and orange (ANDI = 109) and a banana (ANDI = 30).

But there are places where this scale gets murky.

• Take foods that contain healthy fats, for instance.  Olive oil scores a 9 on the ANDI, walnuts score a 14 and avocado, one of the most perfect fertility foods, scores a measly 30.  In fact, if we stuck to high ANDI foods we would most definitely consume a diet that is too low in healthy fats like the monounsaturated fats in olive oil and avocado and the omega-3 polyunsaturated fats in walnuts and fatty fish like salmon.
• Low fat dairy products, which have been shown to be associated with ovulatory infertility and may contain high amounts of hormone-like substances like IGF-1 that are suspected to be related to reproductive cancers, have a higher ANDI than the full-fat dairy that at least one study has shown to be protective for fertility.
• Beans and lentils also score relatively low on the ANDI (~100) despite the fact that they provide protein and special forms of fiber that promote friendly GI bacteria and support our body’s ability to eliminate waste.

So what’s the bottom line on the ANDI and fertility?   In our opinion, the best way to use the ANDI is to fine-tune your choices within individual food groups.  For instance, oats and barley top the ANDI for whole grains while white rice and white flour don’t even make the top 10.  The ANDI might make our trips through the produce department easier too, helping us to choose romaine (389) over iceberg (110) for salad.  In terms of overall diet, however, this scale is only one piece of knowledge in a bigger picture of fertility friendly eating that includes lean sources of protein (like organically raised meats, beans and lentils) and healthy fats.

By Breea Johnson, MS RD

A recent published Cochrane review reported that the partners of men taking oral antioxidant supplements had significantly higher pregnancy and live birth rates than men taking no antioxidant supplements.  While this may be a somewhat controversial topic in the world of fertility because a) the appropriate dosage for each man may differ and b) the advantages of “mega-doses” of antioxidant supplements are not well established the benefits of antioxidants are clear, especially from food sources. Antioxidants are vitamins (like vitamin C, vitamin E, carotenoids, and Coenzyme Q10), minerals (such as zinc and selenium) and phytonutrients (flavonoids and polyphenols, for example) that most people consume on a daily basis. If you are eating more greens and beans than the average American chances are you also are consuming more antioxidants. The best sources of antioxidants are fruits, vegetables, beans, nuts and seeds.

Antioxidants are highly beneficial for health because they prevent DNA damage from oxidative stress. Think of oxidative stress as what happens after a nail is left outside – it begins to rust and age because of lack of protection from the elements. The same thing can happen to the body – both inside and out – and antioxidants can provide the added protection. Oxidative stress also affects optimal sperm function by altering membrane fluidity, sperm motility, count and morphology.

An antioxidant-rich diet is key to quench the excess reactive oxygen species (ROS) caused by inflammation (i.e. a poor diet, smoking, alcohol, stress, chemical toxicity). Here are some easy tips to help increase antioxidants:

• Eat your green veggies. Push aside the lettuce for more nutrient-rich greens such as kale and chard.
• Try a daily green drink. We recommend Phytoganix which is loaded with antioxidants such as raspberries, blueberries, goji berries, lingonberries, spirulina, green tea, astragalus, ginger, green cabbage, beets, carrots and spinach!
• Add a serving of nuts to your diet daily – try organic, raw, and unsalted almonds, cashews, walnuts and pecans!
• Red beans are one of the highest sources of antioxidants – and they are great especially added to soups and salads!
• If you are taking a multivitamin, make sure it is high quality and a great source of antioxidants.
• Omega-3 fatty acids are also protective of ROS and help keep sperm membrane fluidity – great sources are dark leafy greens, wild salmon and walnuts! Or try a high-quality omega-3 supplement.

To learn more about how nutrition may affect male sperm quality, book an appointment with a Pulling Down the Moon nutritionist by calling (312) 321-0004 or visit www.pullingdownthemoon.com and click on “Schedule an Appointment.”