• Choline: Are You Getting Enough?

    By Margaret Eich, MS, RDN

    Are you getting enough choline in your diet? Most women are not, and most women may not have even heard of choline. Choline plays an important role in fetal development, including brain development. Most people have heard they need to get enough folic acid (or folate) before and during pregnancy to prevent neural tube defects, but did you know that choline may also play a role in preventing neural tube defects, like spina bifida? Research has produced conflicting results in this area, but ensuring adequate choline intake makes sense while the research sorts itself out, especially given choline’s other benefits.

    In addition to a potential role in preventing neural tube defects, choline deficiency may also play a role in the development of fatty liver. Choline is also a precursor to the neurotransmitter acetylcholine, which is involved in muscle control and memory. 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.

    Choline is not technically considered a vitamin, since our bodies make small amounts, but our bodies don’t make enough to meet our daily choline needs. Therefore, we need to get choline in our diet. Non-pregnant women need 425 mg choline daily, and this goes up to 450 mg during pregnancy, and 550 mg while breastfeeding. In the US, average choline intake is well below this recommended level with women on average only taking in 260 mg choline per day!

    The best food sources of choline include liver, eggs, meat, seafood, legumes, and cruciferous vegetables like Brussels sprouts, and broccoli. One egg provides almost 150 mg choline, which underscores how helpful eggs are in meeting your choline needs. Not only are eggs rich in choline, but they are also just a very nutrient dense food to support your overall health, fertility, and pregnancy. Because choline is most concentrated in animal foods, vegans or vegetarians who eat limited eggs and dairy products are at highest risk for choline deficiency. Since so many US women struggle with getting enough choline, it’s a good idea to take a prenatal vitamin that contains choline, especially if you are vegan or vegetarian with limited intake of eggs.

    Looking for more information about nutrition for fertility and pregnancy? Book a nutrition consult today!

    References:

    1. Linus Pauling Institute at Oregon State University: Choline
    2. Caudill, et al. Pre- and Postnatal Health: Evidence of Increased Choline Needs. J Acad Nutr Diet. 2010; 110:1198-1206

     

  • Spring Cleaning – Pantry Edition

    By Elizabeth DeAvilla RD

    Now that that warmer weather is starting to roll in, (thankfully!) many of us will get the itch to start that good ‘ole spring cleaning! Here at Pulling Down the Moon’s nutrition department, we always suggest a great pantry clean out to help everyone with their nutrition goals for the year.

    Up to date?

    One of the first things I find myself looking for at the start of any clean out is that of expiration dates. May people still think that spices and other dry ingredients can last forever… not true! As a safety precaution, ensure that all your ingredients are not expired. Spices can tend to lose potency after as little as 6 months!

    Ditch the processed stuff

    You’ll hear this time and time again, the less processed the better, especially during the journey of fertility. The more processed the food is, the more likely it is to contain ingredients that may not be to enticing, especially to our bodies. Additives and preservatives can commonly cause negative effects like inflammation, as well as some intolerances within our systems, and best strategy to avoid? Ditch the processed stuff! This can commonly include things like canned meals, meats, and dried foods as well.

    Get it organized

    I’m not sure about you but I don’t always have hours upon hours to prepare meals. If I have to spend a large amount of time in the pantry looking for something, I’m almost more likely to run out and replace the item, thus why I always end up with multiple staples! Taking the time to organize, take things out of the boxes if possible, and creating a system can be so beneficial from not only a time perspective, but a food safety aspect as well. Storing whole grain cereals in Tupperware (BPA free of course!)  or rice in glass jars not only looks appealing, but is helpful for inventory!

    Restock your shelves with the essentials.

    If you were to go into your pantry today, could you put together a healthy meal that people would enjoy? This was always a struggle for me in my own pantry, until I started stocking the essentials. Things like dried beans, sauces, spices/seasoning, healthy rice, and usually have the potential to save the day when I just don’t have it in me to venture out to the store…. one more time! Keeping things such as heart healthy (and fertility friendly!) oils such as olive and avocado oil, whole grains such as wild rice and whole grain bread, as well as beans such as Lentils are not only meal staples, but are all supportive to our fertility journey.

    The staples to keep/include:

    Grains/breads: Whole grains! We can’t stress this enough, adequate fiber is so beneficial to both men and women in health, especially in fertility. Complex carbohydrates will always take more time to digest and won’t spike your blood sugar. Whole grains have also been shown to curb hunger and balance some hormones. Choosing whole grain pastas, breads, cereals, and flour whenever possible is really the goal!

    Oils: Healthy fats are your friend, and cooking oils are a great place to start when adding them into your diet. Heart healthy oils such as olive, avocado, as well as coconut oils are great sources of omega 3’s. These oils will have great anti-inflammatory effects, as well as work as absorb all those important nutrients. Decreasing the amount of hydrogenated oils such as canola or palm, will always be beneficial, as they can have the reverse effect, causing inflammation, as well as containing high amounts of saturated fat.

    Canned goods: Overall, fresh or frozen foods are always my go-to grabs when it comes to vegetables, however especially during the winter months, I like to have a few cans of vegetables just in case. Always look for reduced sodium, as well as, single ingredients. Many have added preservatives to increase shelf life, avoid those!

    Want to learn more?  Schedule your nutrition consultation today!  Book online via Mind Body Online or call us at: 312-321-0004!

  • Tips for Spring Restoration

    By Cathy McCauley, LMT

    Spring arrives this month, and with it, more cold days (perhaps even snow)!  But March also brings the promise of new life. I love this time of year. The ground starts to smell fresh and ripe. Small green buds begin to swell from the earth reaching up, up, up. Birds chatter in the trees. The sun stays in the sky a little longer each day. After a long, cold winter of hibernation, spring restores nature’s beauty.

    Spring inspires us to restore ourselves, too and these self-care techniques will lead you to restoration of mind, body and spirit.  

    Hydrate. Drink a glass or two of water first thing in the morning. Keeping yourself hydrated helps boost your mood, improves brain power and protects you against disease.

    Make a gratitude list. Spending just a few minutes a day writing down what you are grateful for can dramatically shift your day. The more gratitude you have, the more open to abundance you become.

    Breathe. Set aside a few minutes each day to practice breathing. There are so many benefits! Among them, diaphragmatic breathing alleviates stress, reduces pain, strengthens internal muscles and moves blood to organs and tissues. If you’re not sure how to get started, schedule an Open the Breath (™) massage to receive some hands-on breath work coaching.

    Stretch. Five to 10 minutes of stretching in the morning increases energy levels, enhances circulation, reduces injury and centers your mind. Even better is a regular yoga practice. Pulling Down the Moon’s yoga classes can give you a jump start!

    Eliminate something from your diet that isn’t serving you. Instead of overhauling your entire diet, start by taking out one food that doesn’t nourish your body. Replace it with a different item that supports your desire for restoration. Learn even more by working with a nutritionist!

    Do you have ideas on how to restore yourself or tips for others? Please share them! I look forward to seeing you in the center. Many wishes for a beautiful spring!

    – Cathy

    Cathy is available for Fertility Enhancing, Therapeutic, Prenatal, and Postpartum Massage services at our Highland Park and Buffalo Grove offices!  Schedule with her at: 312-321-0004 today!

  • Can Acupuncture Help Treat My Endometriosis?

    Endometriosis is a condition in which the endometrial tissue that normally makes up the uterine lining, is displaced and found outside the uterus. This can present with an array of symptoms which includes painful periods, ovarian cysts, heavy periods, spotting before the period, and/or even infertility. Acupuncture and Chinese medicine can be very effective in treating it.
    According to traditional Chinese medicine (TCM) endometriosis is a condition that is termed as “blood stagnation”, and your acupuncture practitioner will determine the cause of it after your initial consultation. It can arise from the body’s inability to properly absorb the old stuck blood that is lingering in body. There are a myriad of acupuncture points and herbs which help break up this stagnant blood as well as strengthen the body so that it can deal effectively with the problem. The general recommendation is to come in for weekly acupuncture for at least 3 menstrual cycles. Herbs help accent the acupuncture’s therapeutic effect and treat on another level. The most notable changes that are observed, is a reduction or elimination of painful periods, regulate cycles so that there is no spotting before the onset of the period, shrink ovarian cysts, reduce the excessive flow of blood during the period, and helps increase the odds of pregnancy in those trying to conceive.
    In addition to acupuncture and herbs, it is highly recommended that the patient seek a nutrition consultation with us. In TCM we advise patients with endometriosis to have an anti-inflammatory diet, which means avoiding foods that are spicy, deep-fried, dairy, ice-cold foods/drinks, beef, grapefruits, raw foods, and do not over-eat. Include foods like dark leafy greens, chicken, pork, mint or jasmine tea, beets, seaweed, zucchini, asparagus, berries, apples, eat until you feel 80% full, to name a few helpful tips. Please feel free to email me with any questions in regards to acupuncture and the treatment of endometriosis at anna@pullingdownthemoon.com. I am available Tuesdays and Fridays at the Chicago location, but our office is open everyday of the week in the city for acupuncture appointments.  We have Acupuncture, Massage, Nutrition, Yoga available in Chicago, Highland Park, and Buffalo Grove.  Call us to learn more at: 312-321-0004 today!
    Anna Pyne LAc, MSOM, FABORM

  • Vitamin A: Are you getting the right amount?

    By Margaret Eich, MS, RDN

    Vitamin A is a fat-soluble vitamin that is essential for reproduction, vision, immune system function, and embryo and fetal development. There are two main types of vitamin A: preformed vitamin A known as retinoids, which are found in animal products, and are converted to retinoic acid, which regulates transcription of a number of genes. The second type of vitamin A is called carotenoids, which includes beta-carotene and hundreds of others. Only about 10% of carotenoids are capable of being converted to retinol and further to retinoic acid. Beta-carotene, alpha-carotene, and beta-cryptoxanthin are all capable of being converted to retinoic acid, though only small amounts are converted.

    Most women hear about vitamin A in terms of toxicity – that you shouldn’t take too much vitamin A prior to and during pregnancy, as it may cause birth defects, which is true. We recommend limiting the amount of preformed vitamin A from supplements to no more than 5000 IU (which is equivalent to 1500 mcg RAE). RAE stands for Retinol Activity Equivalents and is the standard way of expressing vitamin A requirements and amounts in food, as it accounts for the differential bioavailability of preformed vitamin A and carotenoids. Supplement labels usually use International Units (IU) to list vitamin A doses, which can sometimes make sorting out your vitamin A intake confusing! There is no limit for carotenoids like beta-carotene, as they haven’t been shown to be capable of causing vitamin A toxicity or birth defects. Some prenatal vitamins do contain preformed vitamin A, such as retinal palmitate, which is fine and maybe helpful if you struggle to meet your vitamin A needs, as long as the preformed vitamin A is less than 5000 IU. Make sure to check all of your supplements for vitamin A, as other combination formulas aside from your prenatal vitamin may contain vitamin A.

    The daily recommendation for vitamin A is 700 mcg RAE and increases to 770 mcg RAE in pregnancy. In the US, women are getting on average only 580 mcg per day – in other words, US women are not getting enough vitamin A. So while it’s important to make sure you’re not taking in excess vitamin A from supplements, it’s also important to make sure you’re getting enough vitamin A due to its essential role in reproduction, embryo development, and organ formation during fetal development.

    Your best sources of preformed vitamin A include liver, fish, dairy, kidneys, eggs, poultry skin, butter, and dark meat chicken. Your best (plant) sources of carotenoids include: sweet potato, pumpkin, carrots, cantaloupe, spinach, kale, collards, and butternut squash. Absorption and conversion of carotenoids to active vitamin A is variable based on the food it’s contained in, and an individual’s ability to digest and absorb it. Because of the variable in absorption, it makes sense to include a mix of preformed vitamin A and carotenoids to meet your vitamin A needs.

    Need some help sorting out your vitamin A intake. Book a nutrition consult today!

     

  • Nutrition Strategies for Endometriosis

    By Margaret Eich, MS, RDN

    March is Endometriosis Awareness Month, and today we’re sharing some nutrition tips to support endometriosis. If you have endometriosis, work with your doctor on an appropriate treatment plan, but try these lifestyle tips to help manage your endometriosis as well:

    The omega-3 fatty acids, EPA and DHA, have anti-inflammatory properties and thus may help reduce inflammation in endometriosis. Cold water fatty fish and fish oil supplements are the best sources. In addition, taking omega-3 fatty acids during pregnancy may help to prevent preterm labor and are important for baby’s developing brain and vision. Fish oil is great, but we shouldn’t forget about also eating seafood, which is very nutrient rich and supportive of fertility and a healthy pregnancy. It’s just important to focus on low mercury fish and limit to 12 oz per week. Some good choices include wild salmon, sardines, whitefish, herring, and oysters.

    Consider a trial of a gluten free diet. One study showed that a gluten free diet helped to reduce endometriosis pain. Gluten is in wheat, rye, and barley and relatives of wheat like spelt and kamut. Instead substitute naturally gluten free grains and starches like quinoa, sweet potatoes, potatoes, butternut/acorn squash, brown rice, and legumes.

    Maximize your fruit and vegetable intake. This one is a no-brainer, as high fruit and vegetable is associated with better overall health and reduction in risk for many chronic diseases. Aim to include vegetables with both lunch and dinner and breakfast when possible. Include fruit to satisfy sweet cravings after meals or paired with protein at snacks.

    Want to learn more?  Schedule with a nutritionist today!

    Sources:

    1. Halpern G, et al. Nutritional aspects related to endometriosis. Rev Assoc Med Bras. 2015; 61(6): 519-23.
    2. Marziali M, et al. Gluten-free diet: a new strategy for management of painful endometriosis related symptoms? Minerva Chir. 2012;67(6): 499-504.

     

  • Couples Guide to Holistic Health

    by Elizabeth DeAvilla RD

    While becoming parents as a couple takes two, preparing your bodies is definitely an experience that takes both teamwork as well as some independent actions.

    Know that everyone has different needs

    We all know that men and women have different needs, that’s a given, and we also know that reasons of infertility can be very different as well, I mean, our bodies are built differently, thankfully! Let’s say that we need to increase or decrease a certain hormone, well, in our partner’s case it may be the same story, but with a whole different food group! Being able to understand where certain problems lie, could lead to very different solutions. While there are definitely foods and supplements that work wonders for both, no matter the gender, just know that what one partner is following for treatment may not be applicable, or even supportive of the others.

    Exercise together

    I used to hate running with my husband, he was so competitive, and I found myself trying to race him all the time. I bit the bullet and finally let him in on how I was feeling and he had a great response, “Oh, I thought that was your pace!” It was something that we had never talked about, and never set that game plan. Now we’re able to go out, set a good, (tolerable!) pace and have an enjoyable time. We are able to act as a cheerleader, as well as give accountability when that couch looks oh so tempting as well!

    Be that Cheerleader

    We all could use that high five every once in a while, and who better to give it than the one working towards the same goal? In fertility journeys there are many hurdles, as well as small successes when you look for them. Following treatment plans, taking our supplements/medications, completing medical/therapy appointments, procedures, positive results for one/both partners are all great ways to celebrate when you can!

    Want to learn more about how nutrition can help you and/or your partner?  Schedule a nutrition consultation today! Save in February with our $99 Wild Card special for an initial nutrition consultation!

    Questions?  Call us at: 312-321-0004.  Elizabeth is available on T/R evenings in Chicago and alternating weekend days including Highland Park.  She is available for phone consults as well for your convenience.

    .  

  • Setting New Goals for 2019

    by Elizabeth DeAvilla RD

    When it comes to setting goals for the new year, especially nutrition goals, there’s some tricks of the trade to keep in mind to help ensure success.

    Making Positive Goals

    When I set out to make goals for myself, I always get excited. it’s a new opportunity to take steps in health, education, fitness, emotional health, all for the better. One thing that I do try to keep in the back of my mind is what can I add to my life. I find that positive goals work best, not deprivation goals. Think of the feelings that you have when you make the goal of exercising for 20 minutes/3 days a week. I get excited about new workout clothes, about positive body image. Now think of the goal of giving up pizza. Not the same warm fuzzy feelings! Even as a registered dietitian, that “goal” sounds awful. Know that while we’re all trying to move in a positive direction, when we talk about giving up things that are commonly staples, even if just weekly staples, this can have a negative impact on our views, especially when it comes to food. If it’s something that weighing on you, maybe change that goal to incorporating more vegetables as pizza toppings, and everyone wins.  

    Making Smart Goals

    We’ve all asked ourselves what can I do to give myself the best chance of achieving what I’m setting out to do? Start with changing the goal you’re setting. When our goals are ones that are commonly called Smart Goals, this can provide us with the structure to make even the most difficult tasks, a bit easier.

    Specific: What is the exact goal that you’re looking to accomplish? When people come to me with the end goal of “being healthy” I have to take a step back. As a practitioner, my ultimate goal for patients is always health, but that is such a broad term. Is it achieving a healthy BMI? Is it lowering a certain laboratory value? Is it to finish a 5k? by setting a specific goal, this will help you and your team of experts devise the best game plan for success.  

    Measurable: Lets go back to the goal of “being healthy.” What does that even mean? Is it fitting into the pants we wore in high school? Bringing our blood pressure down to a healthy number? Take what you would like to achieve and put a number to it, a time line, give yourself some accountability. By this February 28th, I will have incorporated breakfast into my daily meals at least 5 days a week. Small supportive actions such as purchasing a calendar to track all the successes would make your successes even more visible.

    Attainable: I once had asked a small child what she wanted to be when she grew up, she said a unicorn. Now in her head, as a 6 year old, this was totally attainable–in my current lifetime, not so much. When setting goals, we need to make sure that what is desired is actually something that we can accomplish, and do so in a healthy manner. Is it obtainable for me to grow 5 inches and become the next big super model, probably not, but achieving a healthy weight loss goal of 10lbs over the next 3 months? Totally do-able in my case.

    Time Bound: Sometime in the next year, I’m going to run a 5K. We all remember how long a year is, right? 365 days to make a change, and lets be honest, “Tomorrow” is a pretty common date when we’re trying to make some changes. By changing that date to April 30th, this then allows for us to make that plan, and take the steps necessary with respect to time to allow for success.

     

    Making Permanent Goals

    They say it takes 2 weeks to make a habit, right? Well… sort of, first we have to get to where we want to be. In terms of that breakfast goal, yes, after a few weeks of incorporating that first meal of the day, your body will adjust, and you’ll being to feel those hunger cues bright and early. That “being healthy” goal? We’re going to have to establish a new baseline first. By taking the small steps that we outlined earlier, this will have the best chance of becoming a success. Lets start with incorporating more vegetables on our pizza, then maybe adding in those workouts a few times a week, then voila, we ran that 5k in April, and by May, we’re proud of our success! But it doesn’t end there! We need to keep up with our new health(ier) lifestyle, and this means maintenance. Maybe this would be continuing with the workouts (try a FREE Yoga for Fertility community class!) as we would with any other appointment that we make, by adding more vegetables to our grocery list every time we shop. Pretty soon these are all going to be more habitual and for that we all deserve a pat on the back.   

    Set yourself up for success and support with the ART Recovery Prep ProgramStart in January and save!

  • Supplements for Immune Support: Separating the Research from the Hype

    By Margaret Eich, MS, RDN

    It’s January, which means it’s officially cold and flu season. When you’re trying to conceive or pregnant, you have to be extra conscious of what you’re putting in your body. Certain over-the-counter medicines may not be appropriate during this time; so it’s important do what you can to stay healthy. Hand washing, getting plenty of sleep, eating healthy, and managing stress are all helpful ways to do that. What about supplements? There’s plenty of info online about miracle immune support supplements, but what does the research really show? Here’s a quick summary of some popular immune support supplements and the ins and outs of what you should know while trying to conceive or pregnant:

    Vitamin D: Vitamin D supplementation may help prevent upper respiratory infections, though the evidence is mixed. Vitamin D plays an important role in the immune system, so you definitely want to avoid vitamin D deficiency as this may impair immune system function. Vitamin D also may affect fertility, so it’s a good idea to have your vitamin D level tested, so you can supplement at an appropriate level. Vitamin D is a fat-soluble vitamin that can be toxic at very high doses, so make sure to discuss an appropriate dose with your healthcare practitioner.

    Vitamin C: While there is currently no evidence that taking vitamin C once a cold starts helps reduce severity, people who take vitamin C regularly tend to have colds that don’t last as long as people who don’t take vitamin C. Also people who take vitamin C regularly and are under lots of physical stress (marathon runners, skiers, etc.) had lower incidence of colds in one study. Vitamin C is generally well tolerated and safe to take while try to conceive or pregnant, though high doses of vitamin C may cause diarrhea. Vitamin C supplementation is not recommended in people with a history of oxalate-containing kidney stones.

    Zinc: Zinc deficiency makes it more likely that you’ll catch a cold or other infection, so ensuring adequate zinc intake is important. Make sure to avoid oversupplementing zinc. The daily upper limit is 40 mg. You should not take more than 40 mg daily except for short time periods as directed by a healthcare practitioner. Make sure to check all supplements for zinc content when determining your daily intake, as some prenatal vitamins have as much as 25 mg zinc.

    Sources

    1. Linus Pauling Institute at Oregon State University: Vitamin D: https://lpi.oregonstate.edu/mic/vitamins/vitamin-D#immunity

     

    1. Linus Pauling Institute at Oregon State University: Vitamin C: https://lpi.oregonstate.edu/mic/vitamins/vitamin-C#common-cold-treatment

     

    1. Linus Pauling Institute at Oregon State University: Zinc: https://lpi.oregonstate.edu/mic/minerals/zinc

     

  • Rethinking the Cleanse

    By Margaret Eich, MS, RDN

    The New Year is here and it’s one of the most popular times of the year to do a “cleanse.” This often comes from wanting to “detox” after eating too much or too many sweets during the holidays. For many, it’s a way to try to jump start some quick weight loss. For women trying to conceive, any type of restrictive cleanse or eating plan truly isn’t appropriate. Fertility and pregnancy are “metabolically expensive” processes for your body, meaning that you really need adequate calories, protein, and nutrients for optimal function. Here at Pulling Down the Moon, we focus on a nutrient dense, anti-inflammatory diet that eliminates certain foods for a period of time in order to determine if certain foods are negatively impacting your health, but also to give yourself a period of time away from foods that aren’t serving you, which may help to reduce cravings in the long-term.

    Here are few things we focus on:

    1. Modify the food coming in. Start by looking at the quality of food you’re taking in. Reducing/eliminating added sugar is a great way to help balance blood sugar levels and reduce cravings for many people. Eating more organic food is also important, as one study showed that eating more high pesticide fruits and vegetables was associated with lower likelihood of pregnancy and live birth when doing fertility treatments. In addition, higher intake of fast food has been associated with longer time to pregnancy. Choosing organic minimally processed meats, fruits, and vegetables, when possible, is a helpful component for a cleanse.
    2. Don’t focus solely on food. There are a number of chemicals in food packaging and personal care products, such as BPA, parabens, and phthalates that are hormone disruptors and thus may adversely affect fertility. It’s important to educate yourself about these sources, and start choosing more natural alternatives. The Environmental Working Group’s Skin Deep database is a great place to start.
    3. Support digestion. A healthy digestive system is a foundational part of good health and fertility, as our digestive system helps us digest and absorb our food optimally. In addition, our gut can have a profound impact on the rest of our body. Supporting healthy digestion ensures regular elimination of hormones like estrogen that can play a role conditions like fibroids and endometriosis, when in excess. Drink plenty of fluids, include probiotic foods regularly, and include at least 5 servings of non-starchy vegetables per day. These vegetables provide food to nourish your gut bacteria, which may have a profound impact on our digestion, immune system, and health.  

    These are just a few aspects that we discuss during the ART Recovery/Prep cleanse at Pulling Down the Moon. Schedule an appointment today, if you’d like to discuss how a cleanse program might be helpful for you.  Try it this month and save with our January special!

    Remember that changes to diet and lifestyle are a lifelong process that last beyond a few week cleansing period. A cleanse or reset period can be a helpful jump start for more lasting change!