Health & Nutrition: Infertility

I have also received some questions on infertility and diet lately. Although there are true medical conditions that prevent conception, there are also environmental factors that influence it significantly. A recent study was published by Harvard researchers and then reviewed in an article in Newsweek. On a personal note, I have observed three couples who have walked though infertility and found that by changing the mother's diet, they have successfully conceived.

Something very important to note is that in all these nutrition posts I am encouraging people to have a healthy diet, not encouraging them towards dieting. There are hundreds of fad diets. Anything I advocate is based on my motto:

"Moderation, not elimination, but not excess"

The only reason to eliminate a food from your diet is that it is harmful. There are allergies and there are intolerances. Those are genetic reasons why some people cannot eat certain foods. The rest of us need to apply what we know is wise and moderate.

Here are some thoughts on nutrition and fertility:
1) If you have been diagnosed with IBS, avoid whole wheat products. Avoiding wheat in your diet can reduce inflammation in your body and promote healthier levels of insulin and stress hormones.

2)Incorporate 2-3 whole milk dairy products into your diet. If you don't tolerate them very well plain, use chocolate syrup to sweeten milk, eat naturally sweetened yogurt and cheese which will help you to absorb it better. This is from a recent Harvard study based on the Nurses Health Study found in the newsweek article.

3)Check your BMI. If your body mass index is low or high, you have either too little or too much fat on your body which can affect hormone production. An ideal BMI for fertility is between 20 and 24. Body fat can influence your production of hormones and help to produce mature eggs during ovulation. If you do not have enough body fat it can lower your production of these hormones. If you are overweight, your body will have high levels of leptin which can suppress production of the neccessary hormones.

4)Enjoy moderate exercise.

5) Avoid all trans fats and use more unsaturated fats. As little as 4 grams of trans fat or the amount found in one donut has been shown to decrease fertility tremendously. Throw away all your salad dressings and use ones that are made only with olive oil. Eat more nuts and seeds.

Some of these recommendations are found in a very nutritionally sound book I've heard about called "The Fertility Diet". I am not surprised however by the fact that it is advocating a healthy diet. Another outstanding book on vegetarian nutrition, particularly helpful on suggestions for eating more plant proteins, is Laurel's Kitchen. The latter is quite old but it does have some of the best information I've read on vegetarian nutrition. Oddly enough, this was the book that taught my mother about nutrition and the majority of the information that was printed in the late 1970s STILL applies. Just goes to show you that a healthy diet doesn't change. It isn't a fad.

A good idea of what one day would look like that would be healthy (depending on your BMI goal)
Breakfast: a large bowl of Oatmeal with brown sugar, ground flaxseed and some whole milk
Snack: an apple
Lunch: egg salad on rye wasa crackers with carrots/veggies
Dinner: Lentil casserole with cheddar cheese (for the recipe you can check out my mom's blog)
Green salad with Olive oil based dressing
A glass of whole milk with chocolate syrup or full fat all natural ice cream (Breyers)

Health & Nutrition Highlights

As a registered dietitian, many people ask me questions about nutrition. Most of it revolves around weight loss tips or questions about foods considered "healthy" but I also love to serve as a source of health information, especially when it involves dietary treatments.

IBS
I received a question from a friend about Irritable Bowel Syndrome, or IBS, that can be addressed with dietary treatments. Many people simply ignore their symptoms of gas, bloating, alternating constipation and diarrhea. Doctors often use IBS as a catch all for what we like to call in medicine, "non-specific symptoms". Most people think pf their low-grade gastrointestinal symptoms as "that food just doesn't agree with me"; or they ignore them because these symptoms usually appear at times of greater emotional stress.

The intestinal tract is made of two parts: the upper portion, called the small intestine formed of three distinct segments, and the lower intestines, called the colon. Both are highly responsive to emotional stress because they interact with hormone production. For instance, the GI tract is the largest producer of seratonin in the body. Seratonin is a stress reducing hormone that makes us feel relaxed and happy. So, when you eat chocolate, you do feel happier because your brain is happier from all the seratonin it just produced in your gut.

Based on an understanding of our intestines, here are some basic recommendations for treating IBS:
1) Stress reduction with exercise
2) Supplements: take fish oil/omega 3 supplements daily to reduce inflammation. Also consider a Vitamin D/Calcium supplement if you are not outside at least 3o min/day. Take Metamucil every day for additional soluble fiber.
3) Water: drink at least half your body weight in water- try adding lemon or cranberry juice

Dietary strategies for managing IBS are based on a higher-soluble fiber diet and avoiding food intolerances. If this does not work, then try a month-long elimination diet. This is to "rest" your GI system from common intolerances to clear out any overgrowth of bacteria in your GI system which cause excess gas and bloating. Then, after a month, add back in things like yogurt, but only one per week. This helps to add back in healthy bacteria into your colon while identifying true triggers.

The most common cause of IBS is what is called a "fructo-oligosaccharide" intolerance. This is a short-chain carbohydrate molecule that is not broken down as it should be in first part of the small intestine. Instead of that carbohydrate being digested properly, it reaches the colon in its full state, interacting with the bacteria and fermenting, causing gas.

What foods are fructo-oligosaccharides? The most prominent sources in our diet are whole wheat and high fructose corn syrup. These are some dietary recommendations based on the study that explored this intolerance, which was published in an October 2005 article of the Journal of American Dietetic Association:

1) Eat a high soluble fiber diet. Soluble fiber foods including oats, pears, apples and beans regulate the digestive system by forming softer stools.
2) Avoid high fructose foods and trigger foods (which is different for each person)
- avoid whole wheat and use sprouted grain breads
- avoid full fat dairy
- avoid dried fruits and fruit drinks
- avoid high fructose fruit like melons or grapes and eat more berries.
- avoid all processed foods containing high fructose corn syrup.
- avoiding gas producing vegetables (esp in their raw state) like broccoli, raw carrots, raw onions, raw cucumbers, cabbage
- avoid excess caffeine which can trigger diarrhea and accelerate digestion

Baby Update: Week 18

This week the baby is developing it's layer of brown fat. This is the good kind of fat that is essential for temperature regulation. The teeth milk buds are also forming and the bones continue to harden.
The baby is also growing rapidly in weight. Over the next two week, it will grow from 6 to 8 ounces. It is no longer a small filet mignon... but is turning into some serious meat :) At least my appetite is continuing to grow; this week it is cheddar cheese and apples.
Apparently, the baby hasn't grown enough to push my uterus forward because I don't have a serious belly bump-- it hasn't grown enough to really show itself. But I am assuming by 20 weeks we'll have some progress on that. Still no maternity clothes.
The baby has another new friend: Bo Daukas was born this morning. Congratulations to our friends the Daukas family.
Only one more week until the photo op!

According to...

... Jordan, my brother-in-law:

"Bacon is meat's candy bar".

I heartily agree. He says he didn't make this up himself, but I think it's hysterical... Did you know that there is a blog out there for other bacon lovers like myself? I haven't found it yet, but I will.

Baby News

No new news, just plugging away at staying full and healthy...and happy at 17 weeks. The newest development is that lack of sleep increases my emotional state. Now I understand why pregnant women cry at commercials. I haven't cried at one yet, but the tears are right there every time.
The next big update in the baby world will be in two weeks, when we will get another picture of the baby. Until then, we'll be debating on whether or not to find out the sex of the baby. We are leaning towards no, but then again, you never know... sometimes, you can't deny certain objects on the screen :)

Pregnancy Pluses and Minuses

The pluses:
-being treated like a princess :)
-attention
The minuses:
-being hungry every three hours
-your pants getting tight

Office space...

Stories from the field.
Travis arrived at work yesterday to tackle another day of training. He plugged through and around lunch time, his friend from school and boss, stopped by to talk to him. They got into a discussion about the career path at Allstate and then she suggested that they continue it over lunch. She said the only thing was that her car was in the shop and she needed Travis to drive.
Travis said sure, obviously.
But you have to understand what our Camry looks like. Its a 1994 sedan with two missing hubcaps and it hasn't been washed in a while. Not only that, but when she got into the front seat, Travis has to scramble to clean up the front seat. He has to move his day-old cereal bowl and spoon, some papers. Then in the backseat there were woodchips all over the upholstery because he had picked up wood for our New Year's party and hadn't cleaned it up.
Then they drove to the Biltmore area (which is very ritzy) to the California Pizza Kitchen. As they pulled in to the parking spot, his boss went to open the door. Only to realize that the door handle is broken off (courtesy of Steve). She had to use her two fingers to pry the handle open.
Great first impression.

Baby Update: Week 16

Our appointment went great yesterday! We hadn't gained any weight but maybe 1/2 a pound, but the PA said not to worry. She said just to keep eating when I'm hungry. It will come. She said not to worry either about barely showing... she said not to expect it for another 5-6 weeks! But, contrary to her opinion, some of my pants are a little tighter even though maternity aren't quite in the rotation yet. I'm sure there will be plenty of time for that.

As for you baby, we get to go back in two weeks and get a new picture taken! I was expecting to have to wait four more weeks, but they said to come back sooner. We just need to figure out when Daddy can come home from work and meet us so we can see you together. You are about 6 inches long and about 3 ounces now. You have formed all your fingernails... right along with your mamma!

In September when Steve was in the hospital, I accidentally shut the tip of my thumb in the car panel. I got my Christmas wish, and it fell off, having grown very fast since I am pregnant. So we are both growing our nails fast! I painted the rest of my fingernails what I call "Barbie Doll Pink". Not quite the color I was expecting, but it was the only Opi color my family had around. If you are a girl, little Baby, you might appreciate it. But then again, your Dad liked it too...

And he's off...

In the early hours of the morning, Travis left to rejoin the rat race, affectionately known as, a JOB. The whole city was sad to see him leave early retirement. It even rained on his behalf. Yet, we are so grateful that the kind people of AllState Insurance are in need of a faithful Financial Analyst. At this point, we are probably more excited about the income than the job capacity to be interesting, but beggars can't be choosers...

Week 15

This is an exciting week for you, Baby. You celebrated Christmas with your father and I in Maryland with the Jansens and Dahls. You also had your first airplane ride... I think you liked this one more than you will like future ones outside the womb.
And yesterday evening, your father and I celebrated our 2nd anniversary. We have shared two happy, happy years together and are looking forward to this 3rd one together where you will join us.
Last night you partied with us at a beautiful New Year's Eve party hosted by the Nams-- our dinner club all joined us along with the Jazeks and Steve and Janis. Everyone except Travis' parents stayed the night... and we all woke up this morning to egg casseroles, homemade cinnamon rolls...and, of course, lots of coffee.
You are very hungry lately, and have been keeping me eating. You are really growing... but my belly isn't quite big enough yet to need maternity pants. We'll see how big you are next week at our 4 month appointment! Apparently you are about 5 inches long now and getting bigger every day. This second trimester is where I probably will gain the most weight to at the rate I'm eating~ but it is nice to have energy back and an appetite. I even ran 3 miles yesterday which felt like a huge accomplishment! I need my strength and we both need the exercise after all the holiday lounging.
We love you Baby and can't wait to see you.... our current favorite names are Kate and Carter. Our middle names are set and mirror our own: Elizabeth for a girl, and John for a boy. Both are our grandparents names that we'd like to carry on the tradition with for the firstborn. The name hunt is difficult though... and it has only just begun.