My Journey with Cushing’s disease
At 30 years old, I was fit, healthy and naturally a size 8–10. I knew my body well, which is why, when it started to
A. Many studies point towards the Mediterranean dietary pattern as being the optimal diet for fertility in terms of supporting both female and male fertility. The key features that make this diet optimal for fertility are owing to it being rich in antioxidants (vitamins and minerals), and healthy fats particularly omega 3 with fish featuring more heavily versus meat. It’s also rich in other healthy fats, particularly olive oil which has anti-inflammatory properties. It’s predominantly a wholefood diet and there isn’t much room for ultra-processed foods. However, interestingly, nothing is excluded on this dietary pattern. The occasional sweet treat and red wine can even be enjoyed, they just don’t feature every day for obvious reasons!
A. Following this dietary pattern might not make sense without understanding a little bit more about how we can apply this to a healthy and balanced plate scenario. To build a balanced plate, aim for half your plate to be vegetables and some fruit, 1/4 of the plate to be lean protein such as fish, white meat, or a plant-based protein like tofu, and 1/4 of the plate to be whole grains or root vegetables.
If we think about weekly protein intake, you’d ideally want to aim for two or more servings of fish per week, two servings of white meat per week, and one to two servings of red meat per week. Keep processed meat minimal and aim for whole cuts.
Nuts, seeds, and other healthy fats such as olive oil feature every day and ideally with every meal.
A. Antioxidants are vitamins, minerals, and other phytonutrients that help mitigate DNA damage (pro-oxidation) in the body. For example, vitamins A, C, E, folate (B9), minerals including zinc, selenium, and phytonutrients such as anthocyanins, found in berries. These can be obtained by consuming a diet rich in color (i.e. fruit and vegetables). Each nutrient has a plethora of benefits in relation to health and fertility. For example, vitamin C is important for immune regulation but also for supporting progesterone levels in women and semen quality in men. Folate (not folic acid) is important in the preconception period, not just during the first trimester of pregnancy.
Research suggests that adequate folate intake is associated with increased fertility in women undergoing IVF as well as healthier sperm in men. This is likely because folate supports a process known as methylation (which is involved in DNA synthesis), as well as egg maturation, embryo quality, and implantation.
A. Folate can be found in dark green leafy vegetables like kale and spinach, beans, pulses, nuts, oranges, strawberries, eggs, and liver, which is the richest source.
A. Alcohol, caffeine, and smoking or vaping should be minimised. It’s common knowledge that smoking is not good for our health and fertility, but the initial data around vaping is alarming. Avoid these and do consider what other chemicals and toxins you are exposing your body to. For example, with alcohol, moderation is key for both sexes. In women undergoing IVF, alcohol consumption is associated with lover birth rates. Studies have also highlighted that just five units per week can be detrimental to male fertility, resulting in reduced sperm quality. Five units can be as little as two large glasses of wine. If you fancy a glass of wine, choose quality over quantity. Aim for organic where possible as wine is sprayed with pesticides.
When it comes to caffeine, we know 200mg per day is the cut off for women in pregnancy and this seems like a sensible amount to consume as the upper limit. Consuming 1-2 cups of coffee per day is probably going to be around 200mg, but be mindful of hidden sources of caffeine such as energy drinks or chocolate. If you switch to decaf, do go for one that uses a chemical free decaffeination process.
Other toxins to be aware of include PAHS or “forever chemicals” such as pesticides. Aim to make the switch to organic for at least the “dirty dozen” dairy and meat. Plastics are also known to have a profound impact on fertility, so limiting exposure to these in the home and filtering your water is a good place to start.
A. It does depend on your current health status, but 3-6 months ideally. There are many considerations here, such as the impact of taking the oral contraceptive pill for a long period of time, which can deplete nutrients such as B vitamins, vitamins C, E, magnesium, selenium, and zinc. In an ideal world, I would also want to run a few blood tests and take a comprehensive look at thyroid function.
References:
Ahmadi S, Bashiri R, Ghadiri-Anari A, Nadjarzadeh A. An+oxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed. 2016 Dec;14(12), pp. 729-736.
Gaskins AJ, Afeiche MC, Wright DL, Toth TL, Williams PL, Gillman MW, Hauser R, Chavarro JE. Dietary folate and reproduc+ve success among women undergoing assisted reproduc+on. Obstet Gynecol. 2014 Oct;124(4), pp. 801-809.
Hoek J, Steegers-Theunissen RPM, Willemsen SP, Schoenmakers S. Paternal Folate Status and Sperm Quality, Pregnancy Outcomes, and Epigenics: A Systemaic Review and Meta-Analysis. Mol Nutr Food Res. 2020 May;64(9):e1900696
Jensen TK, Go?schau M, Madsen JO, Andersson AM, Lassen TH, Skakkebæk NE, Swan SH, Priskorn L, Juul A, Jørgensen N. Habitual alcohol consump+on associated with reduced semen quality and changes in reproduc+ve hormones; a cross-sectional study among 1221 young Danish men. BMJ Open. 2014 Oct 2;4(9):e005462.
Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infer+lity: a systematic review with meta-analysis of cohort studies. Nutr Rev. 2023 Jun 9;81(7), pp. 775-789.
Rao, W et al. (2022). The associa+on between caffeine and alcohol consumption and IVF/ICSI outcomes: A systematic review and dose–response meta-analysis, AOGS, 101 (12), pp. 1351-1363
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