New Study Finds Weight Loss Does Not Improve Fertility

by Margaret Wertheim, MS RD

If anyone saw the headline in the past couple of days from Penn State that Weight Loss does not Improve Fertility , you may be wondering how this can be given we often tout our new fertility-friendly weight loss program at the Moon called FirstLine Therapy for Fertility (FLTF). Well, I’m afraid that I will have to beg to differ with the researchers’ conclusions, and I’ll tell you why. First here’s a little background on the study:

In this study, the researchers took 29 women who were morbidly obese, which means they had a BMI over 40. They measured frequency of ovulation before and at the following time-points after gastric bypass surgery (1, 3, 6, 12, and 24 months). The researchers report no change in ovulation frequency from before to after surgery. They report ovulation frequency at about 90% before and at all time-points post-surgery.

My first problem with this study is that ovulation and fertility are not the same thing. Just because a woman is ovulating doesn’t mean she can get pregnant. Of course, ovulation is necessary for pregnancy, but ovulation and fertility are in no way synonymous. The question really is can these women get pregnant and stay pregnant. We know that obesity is associated with increased insulin resistance, inflammation and may increase miscarriage and preeclampsia risk.

The researchers also report a baseline ovulation rate of 90% in these women, so if they are using ovulation as a measure of fertility these women don’t sound in any way infertile to me. It seems that it would very difficult to achieve a statistically significant change in ovulation rate with weight loss when you’re starting at 90%.

Finally, weight loss as a result of modifying your diet and lifestyle in a very healthy way such as we do with FLTF (including high quality protein, lots of vegetables, legumes, nuts, fruit and healthy fats) is very different from weight loss induced by gastric bypass surgery. The Roux-en-Y gastric bypass procedure inherently creates malabsorption of nutrients, and women who undergo these surgeries often need to take multiple vitamin and mineral supplements and need to be closely monitored to prevent and correct nutritional deficiencies. While weight loss is of course the goal in women who are overweight, at the Moon we work on nourishing up in order to correct any existing nutritional deficiency and ensure plenty of nutrients that are supportive of fertility and pregnancy.

I look forward to any comments or questions on this topic!

Fertility Rambo – Pregnancy After Loss

Beth Heller, MS

October 15 was Pregnancy and Infant Loss Remembrance Day.  By coincidence (or not?) this past week I met four women who had found their way to Pulling Down the Moon after experiencing some sort of pregnancy loss.  Having walked in their shoes myself, I am ultra-aware of the challenge facing these women.  To get to a baby, women who have experienced loss must walk the very same path that led them to pain and heart break in the past.  This takes a lot of courage – what I call”Fertility Rambo” courage.

Here’s an excerpt from our book The Infertility Cleanse .

For those of you who do not know my story, I was one of those gals who unfortunately needed seven years and five pregnancies to get two children.  One of my losses was particularly difficult – a stillbirth in the 38th week of a pregnancy.  For this book Tami asked me to write about how I managed to make it through the subsequent pregnancy which resulted in the arrival of my first son, Jackson, one month before Pulling Down the Moon opened our first center in Chicago.  She probably thought I might have some words of wisdom for dealing with the anxiety and, yes, I would call it post-traumatic stress that are part of a subsequent pregnancy after such a loss.

I don’t.  You see, I didn’t become a buddha during my pregnancy with Jackson – I became Rambo.  I strapped on my ammunition, my night-vision goggles and popped a few grenades in my pockets and set off into a jungle of terror.   It came down to a simple cost-benefit analysis.  I knew that I wanted a baby so badly that I would risk the devastating disappointment of another loss.

  Just last week I spoke to a woman who had suffered two very late miscarriages in a row.  She was still reeling from her most recent loss and was asking me that same heartbreaking question – how am I going to have the courage to do this again?  So I shared with her my Rambo story.

“Are you sure you’re my yoga teacher?” she asked.

“Yes.  I’m teaching you Rambo Fertility Yoga, ” I replied.

So here’s what I told her.  Literally imagine that you are a fearless person – whether that’s Rambo (my image) or Joan of Arc or a Resistance fighter during World War II  – and each morning put on all your trappings of fearlessness.  Whether it’s Rambo’s Uzi or fishnet stockings with a pistol tucked into your garter, or a suit of shining armor, put it on.  When the waves of panic start to roll in you can rest your hand on your sword hilt.  It’s amazing how brave you can become when call on these archetypes of courage.

  While it may sound silly, using this sort of visualization to conquer a fear can be enormously cleansing.  By choosing an archetype of courage we become courageous ourselves.  The fear and panic thoughts that arise have no place to stick to this image and, with effort and conviction, they become just that – thoughts.

I am always glad when women find us at Pulling Down the Moon.  We’ve been there, we get it and we can help women walk the path to pregnancy with courage and grace.  Techniques like yoga can help with grieving and manage the anxiety of the subsequent pregnancy.  Traditional Chinese Medicine uses acupuncture and even herbal strategies to prevent miscarriage.  Prenatal massage provides loving, nurturing “hands-on” support for anxious moms-to-be.  Most of all we are a healing community with one goal – to help women thrive and find their inner strength during this challenging journey.

If you are struggling with loss please don’t hesitate to reach out.  You can contact me at beth@pullingdownthemoon.com or comment here.

Faith, Hope and Detox

by Beth Heller, MS

Eliminating environmental toxins may play a role in supporting our reproductive health. Here’s our short-list for minimizing exposure and maximizing defense against environmental toxins.

1. Whenever possible choose organic and hormone-free foods.

2. Use a probiotic to help support good digestion and elimination.

3. Add an Organic Phytonutrient Powder to your diet to bolster anti-oxidant support and regularity.

4. Ask about our ART Recovery/Prep Program and products like Female Balance that can support our body’s detoxification processes.

5. Make sure your body care products contain NO synthetic dyes or fragrances, NO lab-derived preservatives or emulsifiers and NO detergents.

Graph

From: Ruder et al. Human Reproduction Update, Vol.14, No.4 pp. 345-357, 2008

We are very excited to introduce a new line of body care products called Anointed Body Care to our Pulling Down the Moon stores.

Valencia Orange – Tea Tree – Rosemary & Myrrh Deodorant by Anointed Body Care

Pulling Down the Moon invites you to try this 100% handmade deodorant infused with the seductive scent of oranges, a refreshing hint of tea tree and a splash of musky, down-to-earth rosemary and myrrh.While many antiperspirants contain aluminum, which may release toxins into the body while preventing the natural detox process, Anointed Body Care deodorants are aluminum-free and lovingly handcrafted with the finest all natural ingredients: only pure vegetable oils, pure water, pure essential oils, natural preservatives and natural emulsifiers are used. All of their products are crafted for superior performance from earth-friendly and animal-free ingredients to refresh and invigorate your soul.

CLICK HERE TO GO TO OUR STORE

Hope Scented Body Lotion

Pulling Down the Moon encourages you to let yourself get carried away with Hope Scented Body Lotion created by Anointed Body Care. The scents of rose geranium, oranges and lemons will take you to a place where your worries are gently soothed away by this ultra-creamy lotion that contains Natural Oils and Vitamin E to nourish and moisturize your skin. Smooth on after bath or shower for daily radiance and silky skin.

Faith Scented Body Lotion

Pulling Down the Moon would like you to experience the benefit of Anointed Body Care’s all-natural, handcrafted Faith Scented Body Lotion. The scented infusions in this ultra-creamy lotion will remind you to stay grounded as you surround yourself with the earthiness of bergamot and cedarwood and encourage you to rise above your worries with the heavenly scent of lavender. Faith contains Natural Oils and Vitamin E to nourish and moisturize your skin. Smooth on after bath or shower for daily radiance and silky skin.

Anointed Body Care products are lovingly handcrafted with the finest all natural ingredients: only pure vegetable oils, pure water, pure essential oils, natural preservatives and natural emulsifiers are used. All of their products are crafted for superior performance from earth-friendly and animal-free ingredients to refresh and invigorate your soul.

Anointed Body Care products contain NO synthetic dyes or fragrances, NO laboratory-derived preservatives or emulsifiers and NO detergents. Each label clearly identifies the product’s contents and scents.

Pranayama & Meditation for Fertility – New Class at Pulling Down the Moon

Tapped out, exhausted, running on fumes. These are common phrases we hear from women who are struggling to become pregnant. Some have described the emotional and physical roller coaster of the fertility journey as “sucking the life” out of them. Thankfully, the teachings of yoga have an answer for this state of mental and physical exhaustion.  The Sanskrit word prana means “life force” and the word  pranayama can be understood as exercises that help us to control and strengthen the life force in our body – or put in more mainstream terms pranayama is the yogic science of breathing. Numerous studies have shown that the practice of pramayama elicits an immediate down-regulating effect on the stress response (Sengupta et al.).  In addition, pranayama is traditionally viewed as a gateway to deeper practices such as meditation.

While breathing seems to be an elementary, even unconscious, activity most of us would benefit from breath work.  Our patterns of work keep us curled around computers or slumped in our cars.  Common breathing problems include short shallow breathing, holding our breath due to stress, reduced physical activity and time in nature as well as poor posture that limits our ability to take full, deep breaths.   Yoga sages also believed that our breath reflects the state of our mind.  Traditional teachings state that the more we can control our breathing the better we will be able to work with our negative thought patterns.

Our new drop-in class in River North is called “Pranayama & Meditation:  Tools for Rejuvenation” and will be a weekly exploration of yoga breathing and meditation techniques designed to promote rejuvenation and well-being in a supportive environment.  In this weekly drop-in class you will experience the supportive community of Pulling Down the Moon, learn gentle stretches to encourage better breathing patterns and delve deeper into the benefits of specific yoga breathing techniques (pranayamas).  Each session will end with a short meditation.  All are welcome at any stage of the fertility or pregnancy journey.

This weekly drop in class will be held at our River North Center on Thursdays from 6-7 p.m. starting November 1.  Don’t miss it!

Sengupta, P Health impacts of yoga and pranayama:  a state of the art review.  Int J Prev Med 2012 July; 3(7):444-458

 

 

 

Fertility Yoga Poses You Can Use Now!

By Beth Heller, MS RYT

As you may imagine, we get a lot of questions regarding fertility yoga.  It would be helpful to know what’s on your mind regarding the topic.  Do you have any specific questions for us?  If so, please send them in and we’ll do our best to respond.  At the Moon we generally recommend women who are trying to conceive try yoga.  Our reasons are as follows:

  1.  Yoga has been shown to reduce stress.  Chronic stress can impact our ability to conceive as well as cause other health problems.  The process of “trying” can be enormously stressful so yoga helps us be healthier now and prevent potential future repercussions of stress.
  2. Better brain chemistry through yoga!  Yoga has been shown to increase levels of GABA, a brain chemical that is in short supply in cases of depression and anxiety.
  3. Yoga’s gentle stretching helps to release tension in the muscles of the hips and groin.  Stretching tight muscles and connective tissue can reduce constriction of blood vessels and nerves, potentially improving blood flow to reproductive organs.
  4. Yoga moves stagnant, tight body tissue which can help remove waste and toxins from the body through the lymph system.
  5. New clinical research conducted with Fertility Centers of Illinois showed that participation in Pulling Down the Moon’s six week Yoga for Fertility program significantly  reduced anxiety levels.

Here are two poses you can use to gain some of the benefits above (more are found in the yoga chapter of our book Fully Fertile). 

Hip Opener .  Lie on your back and cross the right ankle on to the left knee.  Keeping your low back grounded on the floor, draw the left leg in toward the body.  Thread your right hand through the triangle created by the right knee and interlace your fingers behind the left thigh.  You should feel a gentle stretch in the right hip/low back.  If you experience any discomfort in the knees, release the leg and practice the pose with the left foot on the floor.  Repeat other side.

Reclining Bound Angle   Lie back on a blanket or pillow with the soles of the feet together.  Let the knees drop out to the sides and stretch the arms out from the body.  Breathe here, allowing gravity to help release the hips and groin.

First Line Therapy for Fertility

Exercise and Fertility – How Much Is Too Much?

Some women have a less-than-healthy relationship with physical exercise. Some may hate it and struggle to fit it in to their day. Chronic under-exercise can make it hard to maintain a healthy body weight or may contribute to sluggishness and depression. On the flip side, there are those of us who train hard every day, use exercise to maintain an “ideal” body weight or feel anxious when exercise is limited. Chronic over-exercise can raise levels of the stress hormone cortisol as well as negatively affect the function of the hypothalamic-pituitary-ovarian axis (the hormonal system that governs reproductive function). Your relationship with exercise will dictate whether you need to slow down or speed up.

Once you know your “exercise personality,” we can begin to make recommendations. In general, a fertility-friendly exercise program should include cardiovascular exercise that is low-impact and low to medium intensity, which means keeping our heart rate under 60% of max. Exercise modalities like strength-training are also fabulous when you’re trying to conceive. Strength training increases lean muscle mass and helps us keep our bodies strong and shapely (although we need to be careful here – a body fat percentage of at least 22% is generally accepted as necessary for a regular menstrual cycle). In addition to looking good, lean mass means increases metabolism and builds stronger bones. Yoga is another must-try for those who are trying to conceive. The yoga poses increase strength, improve flexibility and help to balance our hormones. Yoga has been proven to reduce levels of the stress hormone cortisol and specific yoga postures can be used to increase the flow of blood and life energy (prana) to reproductive organs.

So get out and exercise, but exercise wisely. For some of us, this will mean increasing our exercise levels, and for others it will mean slowing down – and some of us will find that what we’re doing is just right. Remember, this is not the time to try and get ripped, drop your body fat percentage to “Hollywood” standards or train for a marathon. A fertility-friendly exercise program will leave you feeling nourished and relaxed.

Fertile Fall Eating

For optimal health and vitality, traditional medical teachings like Ayurveda and Traditional Chinese Medicine recommend eating seasonally and locally. In keeping with the ancient belief that we are healthier and happier when our bodies are in synch with the cycles of nature, we should strive to eat foods that grow in our geographical area while they are in season. Traditionally it’s believed 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.

For summer that meant enjoying the melons, berries and tender greens that grow in abundance. Yet there is no need to despair for fall and winter. 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 local flora. Farmer’s markets are one way to explore what’s locally and seasonally available in your area. Many big grocery chains have begun to label produce as locally-grown when applicable. With their rich, deep flavor squash, sweet potatoes, onions and dried mushrooms have the muscle to stand up to chilly days.

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.Bake, bake, bake. 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. The heat from the oven warms your home, too.

3.Experiment with beans. Bean soups and chili are nourishing dishes that contain fiber that promotes healthy digestion and elimination as well as stabilize blood sugar levels.

4.Squashes and sweet potatoes are anti-oxidant powerhouses. Slow roasted or mashed, they can also quench a sweet tooth. Here’s an easy fertility-friendly recipe: rub sweet potatoes with olive oil, sea salt and chipotle pepper powder and wrap in foil. Cook all day on low in your slow cooker and the serve with a squeeze of fresh lime.

For specific nutrition advice regarding fertility-friendly eating or weight loss for optimal fertility, click here and book an appointment with one of our Pulling Down the Moon Fertility Nutrition specialists in the Chicago and/or DC Metro area. Phone consults are also available.

Acupuncture for PCOS – Points to Ponder

By Beth Heller, MS

At Pulling Down the Moon, when we come across a tough problem we often turn to our acupuncturists and ask “isn’t there a needle for that?” It seems like every day we read another study where researchers find that acupuncture is beneficial for something…especially fertility. Recently the focus was on Polycystic Ovarian Syndrome. Researchers in Sweden announced that electro-acupuncture improves hormonal profiles and menstrual cycle regularity in patients with PCOS when compared to physical exercise and control groups.

Evidence is piling up that acupuncture is an effective treatment for PCOS. This latest study spotlighted one potential mode of action for acupuncture. The women from the both the acupuncture group and the exercise group actually showed a decrease in the activity of their sympathetic nervous system. In addition, women in the acupuncture group showed a decrease in unhealthy belly fat (abdominal adiposity) when compared to the exercise and the control groups. This finding is exciting because abdominal fat is associated with many of the negative health consequences associated with PCOS, including diabetes and heart disease and potentially infertility as studies show that “apple shaped” women may be more prone to infertility than “pear shaped” gals.

We know that the stress hormone cortisol promotes fat storage in the belly as opposed to peripheral storage depots (a.k.a. tush and hips). Stress also aggravates blood sugar regulation and can negatively impact reproductive function. It is possible that these findings suggest a new direction for healing for PCOS that emphasizes stress reduction. If so, in addition to diet and exercise, the new prescription for PCOS should emphasize meditation and relaxation as well as exercise and diet for optimal efficacy.

Click here to schedule an appointment with a Pulling Down the Moon fertility acupuncture specialist in Chicago or Rockville today!

Am J Physiol Regul Integr Comp Physiol. 2009 Aug;297(2):R387-95. Epub 2009 Jun 3

Inflammation, Fertility and Essential Fatty Acids (EFAs)

by Beth Heller, MS

Inflammation is our body’s immune response to damaged cells, infection or allergy.  Acute inflammation is our body’s immediate response to injury or infection and is characterized by redness, heat, swelling and pain that are caused by increased blood flow into the inflamed area.  In addition to increased blood flow, the acute phase of inflammation is characterized by the presence of white blood cells and phagocytes (immune cells that clean up cell damage by “eating” it).  In a healthy body, acute inflammation is matched by an anti-inflammatory response that takes over once injury is past and promotes healing in the damaged tissues.  Chronic inflammation results when the acute immune response remains active as a result of stress digestive problems, environmental toxins, allergies, etc.   In the case of chronic inflammation, pro-inflammatory immune cells continue to circulate in the body and damage healthy tissues including blood including vessel linings (atherosclerosis), joint tissue (arthritis) and gut mucosa (food intolerance).  Interestingly, the mediators of inflammation are also implicated in insulin resistance.  Chemical messengers released by the immune cells of the inflammation response actually cause target cells in the fat and liver tissue to lose their ability to respond to insulin.

Acute inflammation is actually a normal part of many reproductive processes – cyclical changes in the ovaries, egg maturation and ovulation, and changes in the endometrial lining all have an inflammatory component.  However, conditions like endometriosis, Polycystic Ovarian Syndrome (PCOS), pelvic inflammatory disease (PID) and premature ovarian failure have been linked to chronic inflammation and adverse pregnancy outcomes.  Researchers hypothesize that chronic inflammation may impair the uterine environment and/or disrupt the specific chain of immune system events that allow an embryo to implant (Levin et al. 2007).

The main chemical mediators of inflammation are prostaglandins, chemical messengers that turn the immune component of acute inflammation on and off. Prostaglandins are made on an “as-needed basis” from long-chain fatty acids present in the cells of an infected/damaged area. There are two main groups of prostaglandins: pro-inflammatory prostaglandins (called Phase 2 prostaglandins) which stimulate acute inflammation at the injury site and the anti-inflammatory prostaglandins (called Phase 1 and Phase 3 prostaglandins) that turn it off.

Arachidonic acid is the main pro-inflammatory Series 2 prostaglandin active in the body. Its role is to signal the acute inflammatory response in injured cells and is released in the presence of injury or irritation. Arachadonic acid is present in our diet in animal products (meat and dairy) and can also be manufactured from linolenic acid (also known as Omega-6 fatty acid found in corn oil, soy bean oil and in the meat of animals that are fed corn).  On the side of the “good guys” is eicosapentaenoic acid (EPA) which is chiefly found in marine plants and animals. EPA is part of a family of compounds called Omega-3 Essential Fatty Acids that also includes alpha linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). EPA is the lipid structure our body uses to make beneficial prostaglandins that reduce inflammation.

The “primitive” human diet contained an estimated 1:1 ratio of omega-6 to omega-3 fats. Today our diet is far more skewed toward the pro-inflammatory omega-6 fatty acids, about 10:1. Unfortunately, since the fatty acids we eat are ultimately incorporated into our tissues, this dietary shift has skewed our physiology toward inflammation.

Strive to decrease intake of omega-6 fats (refined oils like corn and soy, and processed foods made with these oils) and increase the intake of omega-3’s (dark leafy greens, walnuts, seeds, fatty fish). The most bio-available sources of omega-3’s are marine/fish oils. Unfortunately, due to environmental toxicity concerns, intake of fatty fish must be limited in women who are pregnant or trying to conceive. As such, we do recommend a high-quality fish oil supplement that provides ample omega-3s.

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