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  • Looking Beyond Weight: How the Food You Eat Affects Your Fertility

    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.


    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.

  • Beyond Flip Flops: Feet and Fertility

     by Beth Heller, MS RYT

    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.



  • Apples, Pears and Fertility – How Shape Impacts Our Ability to Conceive

    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


  • Mindfulness and Fertility: Finding the Present Moment

    When we begin a yoga or meditation program we want to jump straight to the “meat:”  how and when will this practice create peace of mind?  If after two sessions we have not achieved at least a semblance of calm we label ourselves a failure.  We can’t help it.

    Traditional meditation training involved little instruction and relied on the arising of tranquility and insight.  In his book “Diamond Mind:  a Psychology of Meditation,” master teacher Rob Nairn notes that Western meditators often don’t come as easily to the natural arising of insight and will often use the practice of meditation to suppress psychological process instead of promoting it.  So Nair’s approach is to emphasize making “friends” with the mind and developing an attitude of playfulness towards practice.

    Meditation is a process that balances concentration with letting go.  We practice over and over again allowing ourselves to be fully present in each arising moment.  Why?  Because it’s only in the present moment that a new understanding can arise.  Everything but the present is ruled by either memory of the past or imagination of the future.   This is a very important point for those of us who are trying to conceive.  That journey can be so encumbered by past disappointments and future fears and hopes that the present is almost completely obscured.  Together, though, with the help of breath and awareness we can begin to carve out a moment of “now” in which peace can arise and deep healing can occur.

    For today, let’s try to sit in the now.  Don’t freak out if you feel like your mind is a Niagara Falls of emotions and thoughts.  This is NOT failure, it’s success!  You have become aware of your mind. As you continue to practice this awareness will grow and mature until you learn that you are actually a peaceful, content being experiencing a roller-coaster ride of experiences.  Here’s a very simple technique for staying present:

    Sit quietly, either in a comfortable cross-legged position or in a chair with your feet flat on the floor and your spine straight.  Close your eyes and place one hand on your lower abdomen.  Inhale deeply through the nose and feel the breath move down into the belly, expanding and moving the hand outward as if you’re filling up a balloon in your tummy.  Exhale through the nose, feel the belly begin to  deflate as you softly count the number “10.”  Inhale again, and with the exhale softly say to yourself “9.”  Inhale, exhale 8…and so on down to “1.”  As you count down from 10 to 1, feel as if you are consciously unwinding the forward momentum of your mind.  Feel as if you are a car exiting the highway and slowing down to a country road where you have time to look at the beautiful scenery and be present.   Once you begin to practice this technique daily you may find that after you’ve counted down your ten breaths you’re happy to sit a bit in peace.  Enjoy!  That’s the present moment.

    If the exercise above was challenging, don’t despair!   Pulling Down the Moon will be offering a Mindfulness for Fertility class in conjunction with the psychologists of Fertility Centers of Illinois starting April 28.  Stay tuned for registration info and details…