Being a woman is not easy, whatever your age. Advice on how best to navigate our path to health, beauty and happiness can be tricky and that is one of the reasons why London’s top fertility specialist Emma Cannon and I decided to choose regular topics to talk about, related to female well-being and fertility and this is the first of such Q & As, dedicated to nutrition and fertility. I compiled a list of questions, alongside my website readers, while Emma answered the questions together with her clinic’s nutritionist Victoria Wells. I hope you will learn something new and find the advice useful and relevant to your body’s current needs.
How important is the diet for female fertility?
We have known for years that the food we eat affects our ability to conceive, so eating healthily can improve our chances of getting pregnant and support healthy pregnancies. You need to be aware that certain foods and drinks are known to lower fertility and that both under-eating and over-eating can contribute to infertility. More specifically, certain nutrients can support each phase of the cycle, for example B vitamins are required to support the release of the egg and support implantation. Relatively simple changes can increase your chances of getting pregnant.
Is our emotional state affected by how we nourish our bodies with food?
Our relationship with food is often a reflection of how we care for ( managing stress & getting enough sleep ) and nourish ourselves. We must not overlook the need to feed our fertility on an emotional level, as good emotional health is important prior to conception and throughout pregnancy. Remember that food influences our mood and energy levels, so by eating natural, rather than processed foods, you will help to improve your emotional stability.
Can you talk in some detail about the connection between cycle of nature, fertility cycle and the food that we consume?
By understanding our menstrual cycles we can optimise our fertility. Start by learning which foods are helpful and which ones are best to be avoided in order to become more emotionally balanced and preserve your fertility.
Eating seasonally means that we are eating foods that are optimal at that time of year. Engaging in the world around us and all the ebb and flow of nature helps us to engage in our own bodies and be more aware of the changes that occur within us. Throughout our cycles and throughout our life, nature is not static and neither are we. I really encourage women to nurture themselves with food that nourish the blood in the time after the period. Foods high in iron, meat, liver, beans etc. – we don’t eat enough of this sort of food or when we do it is poor quality. Meat sometimes gets a bad press but a lot of us need it and really benefit from it. Just don’t eat it all the time and eat small amounts!
What do you think about ‘January detoxing’ and its effect on female body and fertility?
The idea of detox and ‘cleansing’ is not an idea that is central to Chinese Medicine, it is an idea that has come out of Western naturopathy. It is derived from the belief that toxicity is a major cause of disease and that the body is ‘dirty’ or ‘unclean’. Personally I think it has its roots in guilt; it peddles the belief that it is OK to live out of balance and to overindulge, because you can always go on a detox and that will put everything to rights again. I call it the ‘detox to re-tox’ mentality.
A good seasonal cleanse in the spring is a good thing in a patient that is damp and hot and could do with simplifying the diet and increasing exercise
Mothers naturally purge and detox in the days following childbirth, hence the nights drenched in sweat to help eliminate the toxins accumulated during pregnancy. This should be followed by a period of deep nourishment and warmth to bring the energy back to the centre of the body and to sustain her strength through breast-feeding and the nights of broken sleep. I had a great detox over Christmas – it was called the flu! I couldn’t eat or drink and sweated toxins out of my body; as my energy returned I ate simple foods and avoided alcohol. I now feel great; my body decided and there was nothing enforced about it, all I was required to do was to give into it. There are other times too when a detox would be advocated.
An enforced detox in the middle of winter in a cold and deficient type will only cause more health problems. Energetically January is the worst time of year to detox as the body is tired and cold and needs to be warm and rested. Energetically spring is the best time ( so this post is quite timely .)
Many women have a sensitive relationship with food and the subject of dieting. What should guide women when it comes to nutrition when they want to conceive or be fertile for longer, before they go into menopause?
Women who have struggled with weight and followed different diets tend to focus on avoiding, rather than choosing foods for optimal health. Food choice is complex and the wealth of information available can be conflicting, leaving many women simply confused. Women are best advised that eating healthily most of the time is good enough and one shouldn’t feel guilty about the odd treat.
Eat a healthy natural diet, avoid processed foods and eat minimal amount of sugar
Eat to feel good – because feeling great feels amazing! Having a good relationship with food is key. I always say that the less one obsesses about food, the healthier one is – that does not mean you can’t be passionate about it. Just don’t obsess about every mouthful. It isn’t sexy!
In your book ‘Total Fertility’ you say that ‘popular diets usually try to be a one-size-fits-all, rather than bespoke and aimed at the individual’ – why is individual approach to our daily diet important for female fertility?
We are all different and Traditional Chinese medicine seeks to achieve balance for the individual, rather than a dietary approach for a population. This is what it means by ‘differential diagnosis’ – in other words two people will manifest imbalance in entirely different ways. It’s about identifying individual needs and imbalances and addressing them. Tailored personal advice also takes into consideration culture, lifestyle and personal preferences, which means a person is more likely to be able to make changes.
If someone has been anorexic in her teens or 20s, will it have an effect on the fertility once the woman decides she is ready to have a ‘baby? Can the negative effect of the eating disorder be overcome when it comes to fertility?
Eating disorders that affect fertility include anorexia and also over or under eating patterns in women that have a normal weight. Women diagnosed with anorexia in their younger years tend to have a BMI just within the normal range or just under and this can affect fertility. Underweight women are less aware that their weight may influence their fertility, whereas overweight women are usually more aware of this fact. From a Chinese medicine point of view these women often present with chronic Blood deficiency and Yin deficiency.
Very few, if any, weight loss diets are written with conception in mind’. Does it mean that our society places more importance on looks rather than on keeping people healthy, well and fertile?
Many women are conflicted in that they want to be thin and pregnant. However attitudes towards health are changing – if you look at the best-selling lifestyle books, the emphasis now is on replacing unhealthy, processed ingredients with healthier alternatives.
Many women think that in order to keep hydrated one needs to drink lots of fluids, like water or herbal teas. Can you please elaborate on the subject of hydration and nourishment that comes from food?
Staying hydrated is important for general health, as well as promoting energy levels. Food and other fluids, besides water, including tea, herbal teas, soups and broths count towards your total fluid intake.
If a woman needs to lose weight, what are the general guidelines for her in order not to compromise her well-being & fertility ?
Gradual weight loss is recommended to preserve reproductive function. Ovulation may be triggered by losing 5-10% of weight but even small losses can be beneficial. Fertility is a peripheral need for the individual, so if the brain signals that there is a massive reduction in calories the body may get the message it is not the optimal time to conceive – so slowly does it !
In general, do female nutritional needs vary in teens, 20s, 30s and 40s ?
Adolescence is a period of rapid growth and teenagers need extra calories, sufficient protein and have increased requirements for calcium, iron & zinc.
In general female nutritional needs don’t vary from adulthood until menopause, but in the UK a proportion of women of all ages have low intakes of some vitamins and minerals. Individual needs must also be met, for example women have higher requirements if they participate in sports on a regular basis.
Why is digestive health an integral part of female fertility?
Our ability to receive nourishment from our food requires that we have a good digestion and that we are emotionally balanced to receive nourishment. We can eat the best diet in the world, but if we have poor digestion then we are unlikely to improve our health by diet alone.
The word ‘diet’ has a negative emotion attached to it. How can we change it into a positive that feeds our body in the correct way ?
Yes, I agree the word ‘diet’ has many negative connotations and for many it is linked to failure. Instead of using diet we need to frame it in the context of making healthy eating choices.
Do you recommend taking supplements to your patients or can we fulfil our nutritional needs via food alone?
All women trying to conceive are advised to take 400 micrograms of folic acid daily until week 12 of pregnancy. Folic acid aside, it is possible to fulfil nutritional needs through diet alone. But as we have discussed above, many women are not eating an optimum diet. I recommend a personalised approach, looking at a person’s diet and lifestyle and where appropriate, nutritional testing for deficiencies. However, synthetic supplements may have a low bio-availability, meaning they are difficult for the body to digest and absorb. In my clinic we use food state supplements that are highly bio-available to correct any individual deficiencies.
What’s your view on sugar, meat, dairy – are they as bad for us as the press makes them to be?
The addition of hidden sugars in our foods is one of the great food travesties of our time and has no doubt led to the obesity crisis. Sweet flavoured foods are actually the most nourishing of all foods. These include pumpkin, squash and carrots. They help the digestive system function and can provide great energy to the body. However, the creation of refined sugars is one of the biggest nutritional disasters of our time and its impact is only just being realised by medics, health media and the food industry.
In 1986 John Yudkin, author of ”Pure, White & Deadly” put forward the idea that glucose alters our metabolic processes and increases plasma concentration of cholesterol and triglycerides. This leads to an increase in the size of the liver, kidneys, adrenals & causes calcified deposits on the kidneys. Further more, it disrupts oestrogen levels, adrenals, cortisol and insulin. Instead of listening to Yudkin’s message about sugar, physicians and governments went with the cholesterol and saturated fat hypothesis and soon the food industry was taking fat out of everything. In order to make the food palatable without the fat, they laced the food with hidden sugars and the rest is history. Well, actually, the rest is obesity, infertility, heart disease, diabetes, increased risks of cancer and autoimmune diseases.
However, given the amount of sugar hidden in foods and the levels at which it is consumed, we nearly all greatly exceed our requirement for the sweet stuff. That said, it is possible to include some sweetness in our lives without doing too much harm. In his book, Yudkin suggests we don’t need sugar at all but there is some research to suggest that darker sugars, like muscovado, which contains the highest levels of molasses, are not as bad as the white refined sugar. Naturally sweet foods such as pumpkin, lentils and rice are said to nourish Qi and help the digestive function. Their sweetness is different from refined sugar in that it is released slowly into the system and does not result in the empty hit or a sugar high.
According to Chinese medicine dairy is a good Yin tonic. A recommendation from the Nurses’ Health Study is to include one to two servings of full-fat dairy products a day and to cut out low-fat dairy foods. Greek yogurt is one option, as it has more protein than natural yogurt and more calcium than milk. Another source to try is Kefir. It is a fermented milk product (usually well-tolerated) and a probiotic food. Probiotics support a healthy intestinal environment that aids digestion and boost immunity. Kefir is a source of vitamins, minerals and essential amino acids.
Meat is the most blood-nourishing of foods, acting as a tonic. In a balanced diet, it is good to have a little meat, but not too much, as it can be difficult to digest. However, it is excellent for helping when there are issues of blood deficiency. Meat is highly nutritious as it provides the body with protein, healthy fats and can be a source of vitamin B12, B3, B6, zinc, selenium and iron. Women entering pregnancy need adequate iron reserves and iron bio-availability from meat is higher than from plant sources. Always buy your meat from a good source and use the bones for broth (that should form the base of your soups and risottos). For people with poor digestion avoiding mixing meat and milk can be helpful. You don’t have to eat large cuts of meat, you can cut meat up into small pieces and add to rice and noodles; I always think it is easier to chew and digest if it is already in bite-sized pieces, especially if you are eating it at night.
What kinds of food should women try to avoid (if at all), as well as eat more of? Are there any pro’s to eating a predominantly organic diet in terms of fertility?
From a Chinese medicine point of view no food can be considered inherently ‘bad’, it is a matter of who is eating it and in what quantities. Processed foods contain hidden sugars, salt, fat and artificial sweeteners.
In the clinic we advise caution on soy intake: it is worth remembering that the way we consume soy in the West is very different from its consumption in the East, where soybeans are typically consumed as whole foods & preference is given to fermented forms of soy, for example tofu & soy miso. It has been proposed that some women with sub-fertility may be more sensitive to soy and as the evidence is limited on whether soy affects fertility, I recommend caution when eating it.
Eat five to eight servings of fruit and vegetables a day and a range of nuts and seeds to ensure adequate antioxidants. Antioxidants reduce levels of free radicals and modulate the inflammatory response. Eat fruits and vegetables of a variety of different colours, especially berries, tomatoes, citrus fruits and dark green leafy vegetables. Also ensure you eat cruciferous vegetables like pak choi, broccoli, cauliflower, brussel sprouts, kale and cabbage. A study published earlier year by the British Journal of Nutrition found that organic fruits and vegetables can contain as much as 70% more antioxidants than non-organic produce. The authors of the study estimated a switch to organic would allow an increase of 20-40% in antioxidant consumption. So for people who find it difficult meet recommendations for fruit and vegetables a switch to organic increases their antioxidant intake.
What can we do in order to improve our digestive health ?
Fermentation produces food that is nutrient-dense and rich in probiotics and enzymes. Vitamin C and certain B vitamins can be synthesised during the fermentation process. The probiotics in fermented food may play a crucial role in nourishing our gut flora, often referred to as the forgotten organ. Gut flora influences the development and function of the immune system and promotes healthy gastrointestinal function. Fermented foods are often more easily digestible having been pre-digested by the active enzymes.
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