If Deena Harris had known years ago how some foods can affect fertility, her life might have been dramatically different.
For one thing, the 30-year-old pharmacist could well be mothering a noisy, happy house teeming with kids. She also may not have lost three babies when they were just 18 weeks in her womb. And she and her husband, Jeff, likely wouldn't have spent their life savings on the hollow promise of fertility treatments that ended in failure.
But Deena didn't know. And so the past four years have been all about the things she couldn't have.
But then she met Dr. Jeremy Groll, a reproductive endocrinologist and fertility specialist at Wright-Patterson Air Force Base in Dayton, Ohio, where Deena works. After examining Deena, Groll told her two things: one, she was likely insulin resistant (a condition that can impair fertility); and two, a diet of fertility-boosting foods might help her become pregnant.
Within eight weeks of following Groll's diet, Deena had lost 15 excess pounds; a few months later, she conceived. She gave birth to her daughter, Hailey, in October 2006.
"I felt great," she recalls. "By the time I got pregnant, I was in the best shape of my life."
Even if Deena's fairy-tale ending isn't as universal as we'd like it to be, her underlying problem is common enough. Affecting 25 per cent of the population, insulin resistance is a condition in which the body has trouble responding normally to the hormone insulin, making it a risk factor for diabetes. Insulin resistance occurs when the pancreas overproduces insulin in an attempt to metabolize carbohydrates properly. That triggers
a rush of testosterone, which causes anovulation (irregular cycles that make becoming pregnant difficult). When conception does take place, insulin resistance impairs how well the fetus attaches to the uterus. The result: a three times higher than average miscarriage rate and a three per cent annual growth in Canada's reliance on reproductive medicine.
Polycystic ovary syndrome
To make matters worse, many women with insulin resistance also have polycystic ovary syndrome (PCOS), a hormonal disorder that affects five to 10 per cent of women.
In addition to irregular periods, PCOS causes facial hair, acne and benign ovarian cysts. As with insulin resistance, PCOS affects a woman's ability to become pregnant and to carry the pregnancy to term; up to 70 per cent of sufferers miscarry because of poor placenta attachment. Ninety per cent of women with PCOS are also insulin resistant.
Deena was one of them. Her doctor had diagnosed her with PCOS when she was 21 and successfully treated her unwanted facial hair and irregular cycles – but not her infertility. And so, believing that determination and persistence would eventually turn the tide, Deena and Jeff spent years trying to become pregnant, undergoing round after round of fertility drug injections, artificial insemination and tests. Not surprisingly, all but one of their attempts failed. In 2005, Deena conceived triplets, only to miscarry at 18 weeks. "It was," she says carefully, "a huge emotional roller-coaster."
Page 1 of 4Yet reversing Deena's infertility was no more high-tech than knowing which foods to eat and when. "The simplest treatment is to control your carbs, increase your protein, lose weight and get exercise," says Dr. Yaakov Bentov, a research fellow at the Toronto Centre for Advanced Reproductive Technology. "It's the least expensive option, and it's proven to be effective."
And then some. During a 1998 clinical trial, Australian researchers put 67 anovulatory women on a diet to lose around 22 pounds each. Within five months, 90 per cent were ovulating regularly. Of those, 32 per cent became pregnant and another 40 per cent conceived with additional treatments by a fertility specialist. In short, as the women lost weight, their bodies stopped overproducing insulin and testosterone; their cycles returned to normal, and so did their chances of getting pregnant.
Watch what you eat
Not that Deena floated effortlessly from frustrated to fruitful overnight. She first needed to learn to eat differently, following a strict 1:1 ratio of complex carbohydrates to lean protein with every bite. "Balancing the daily protein intake with an equal amount
of carbs, gram for gram, while keeping starchy carbs to a minimum has been shown to be the lowest stimulus for insulin secretion," says Groll in his book, Fertility Foods: Optimize Ovulation and Conception Through Food Choices (Fireside, 2006). It's
this even balance at each meal that keeps insulin from getting in the way of ovulation and implantation, he adds.
But for carb-loving Deena, it was a bit tougher than just crossing the street to avoid the patisserie. Groll had put her on a daily diet of 70 grams of protein (he typically recommends between 60 and 80 grams daily), an equal number of carbohydrates and 35 grams of fat, or half the protein intake. "While it was hard to get that much protein into my diet," she recalls, "my carb intake was four times too high." But within two weeks, she had "turned into a label reader" and learned to add up grams by using nutritional information on food packages. She loaded her diet with fruit, vegetables and fibre-rich complex carbohydrates such as whole wheat bread, along with fertility foods such as olive oil and cinnamon. She also kept her daily food and exercise totals in a journal. "I read my journal to Jeff at night," she says, giggling. "He wasn't that interested, but the accountability was really helpful."
But it's not just what you eat that counts; it's when you eat it. Three main meals plus a morning or afternoon and evening snack should be spaced three to four hours apart (similar to the schedule of a person with diabetes) to manage blood sugar and appetite, explains Susie Langley, a registered dietitian at Create IVF Clinic and the Sunnybrook and Women's College Hospital Fertility Centre in Toronto.
Page 2 of 4Although diet is a proven fertility booster, many women trying to become pregnant don't consider their eating habits until they're desperate. "My biggest bugaboo is that they come to you at the last minute," says Langley. "If you want a dietitian to make it right because you're having a procedure done next week, it's not fair. I'm talking about doing this at least three months in advance. Diet should be the first consideration, not the last."
Had Deena known, it would have been hers. As it is, changing her diet and starting her first-ever exercise program proved to be just what the doctor ordered. Her daughter may still demand nightly room service, but Deena is brimming with energy and joy. "I get less sleep than I used to," she says happily, "but I finally have what I've always wanted."
What is polyscystic ovarian syndrome?
Women with polycystic ovarian syndrome (PCOS), who have irregular or nonexistent menstrual cycles, are at an increased risk of developing endometrial cancer, says Dr. Yaakov Bentov, a research fellow at the Toronto Centre for Advanced Reproductive Technology. During a cycle, a mix of progesterone and estrogen protects the endometrium, or lining of the cervix. Like women in menopause, those with irregular cycles only produce estrogen, which increases the risk of endometrial cancer. "You usually think of it as an old person's disease," says Bentov, "but PCOS patients have developed it at 30. If a woman is not having her period at all or every few months, she must go to her doctor."
Diet and pregnancy
Trying to get pregnant? Try these foods:
• Olive oil: While fat does beget fat, some is necessary for your well-being. Olive oil is a great choice – it reduces your risk of insulin resistance.
• Decaffeinated drinks: The coffee debate is back on. For years, researchers believed caffeine was the reason coffee stops blood sugar from spiking. Not so. It seems chlorogenic acid, a compound in coffee, may be behind this benefit and that caffeine actually impairs insulin sensitivity. Solution? Kick the habit or make it a decaf.
• Green tea: Yes, it does have small amounts of caffeine, but green tea also contains epigallocatechin gallate, an antioxidant that greatly improves glucose tolerance.
• Royal jelly: A 2002 study found that when researchers fed this honeylike substance to ewes (whose placental physiology is close to that of humans), ovulation and pregnancy rates substantially increased. Most manufacturers recommend 500 milligrams twice daily.
• Buckwheat: Researchers at Commonwealth University in Virginia discovered that when patients with polycystis ovarian syndrome took a 600-milligram daily dose of D-chiro-inositol (dCI), a compound found in buckwheat seeds, their insulin levels dropped by 33 per cent and ovulation increased threefold.
• Cinnamon: What's apple pie without cinnamon? Just another sugar hit. Cinnamon contains a compound that actually makes fat cells more responsive to insulin. In 2003, a Pakistani study established that half a teaspoon (two millilitres) a day greatly reduces blood sugar, triglycerides and total cholesterol.
Page 3 of 4Fertility-friendly exercises
"Getting fit makes you more fertile – simple as that," says Dr. Jeremy Groll, a reproductive endocrinologist and fertility specialist at Wright-Patterson Air Force Base, in Dayton, Ohio. "Exercise improves your insulin sensitivity."
But not just any exercise; the idea is combo fitness. An aerobic workout (such as running or biking) will increase your heart rate and lower body fat, but adding resistance training will build lean muscle and improve insulin response by 40 per cent. "It appears there is a synergistic benefit, and the two types of exercise combined are better than each one alone," says Groll. "Your skeletal muscle is the most insulin sensitive, so by improving lean muscle mass, you have more tissues to have that metabolic effect."
Aerobics: Walking, swimming, water aerobics, cycling or gardening
• Goal: Five 30-minute sessions a week
• Getting started: Aerobics work best if you raise your heart rate by 50 or 60 per cent, then maintain it throughout the exercise. To calculate your target rate, count your resting heartbeats per minute and add half of that number to your resting heart rate (resting heart rate of 80 plus 40 equals 120). Begin and end every session with a five-minute warm-up and warm down, to avoid injury and muscle strain.
Resistance: Weight training (pushups, bench presses, bicep curls), Pilates or yoga
• Goal: Two or three 20-minute sessions weekly
• Getting started: If you like weight training but aren't sure which weight is right for you, do one repetition of an exercise with the maximum weight you can manage. Forty per cent of that weight is how much you should begin working out with. (If you can do one
20-pound bicep curl, use eight-pound weights.)
Pilates and yoga: These are good options if you're not the sweaty-socks-and-barbells type. Originally developed in the 1920s and lauded for building muscles without bulk, Pilates focuses on core body strength and works several muscle groups simultaneously. Yoga, too, is a total body workout – the postures reduce tension, resting heart rate and blood pressure while increasing flexibility, tone and core strength. "Whether you believe it can help you tap into the universal consciousness and live in harmony with nature or not," remarks Groll, "the physical act of practising yoga postures will help you meet your exercise goals to increase your fertility."
Page 4 of 4
Register for our Healthy Living News e-newsletter from Health editor Pauline Anderson, and get health news delivered straight to your inbox.