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food feature

Food and Drink

Food and Drink

Traditional probiotic foods

Natto: a traditional Japanese food made from fermented soybeans Kimchi: a Korean pickled dish Miso: made by fermenting soybean, barley or brown rice with koji - a type of fungus Tempeh: an Indonesian food derived from fermented soybeans Kefir: a popular Northern European drink made by adding kefir grains to cow, goat or sheeps milk and letting the mixture ferment for a day Sauerkraut: Northern European dish produced by allowing salted cabbage to ferment on its own without the addition of any vinegar

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foods for fertility

Too often we think of supplements first when developing a fertility protocol, but as Nutritional Therapists foods should always be our main focus. Kaye Heyes examines which foods help improve fertility.

s many as one in seven UK couples 3.5 million people have difficulty conceiving(1) and far too many couples are confused about what they should be eating to improve their chances of conception. there is no denying that a healthy weight is a fundamental starting point for both men and women. A Harvard study of over 26,000 Us pregnancies found that there was an increased risk of infertility for women with a BMi below 20 or above 24. statistics like these imply that food and healthy dieting are serious contenders for fixing fertility. But which foods should be the focus of a fertility protocol?

intestinal and vaginal microflora may not be the first thing you think about

when working with a couple struggling to conceive, but scientific research shows that bacterial populations play an important role in reproduction. Abnormalities in vaginal flora (known as AVf) during pregnancy are now associated with reproductive failure and adverse pregnancy outcomes, including early and late miscarriage and preterm birth(4). Current research focuses on the lactobacilli-dominated vaginal microflora as being essential to protect women from genital infections. A 2009 study of over 1,000 pregnant women found that women without AVf in the first trimester had a 75 per cent lower risk of delivery before 35 weeks compared with women with AVf(5). researchers at Ghent University in Belgium found that a large percentage of iVf patients tested positive for bacterial vaginosis (BV)(4), whilst a 2007 review found an association between low concentrations of vaginal lactobacilli and the development of BV(6). the benefits of probiotics for healthy digestion and vitamin production are well-known amongst the general population and the probiotics industry is worth billions. According to The Ecologist more than one million bottles of danones Actimel are purchased every day in the UK - almost half of all probiotic drinks (10) . But most consumers are unaware that their sugary profile encourages the pathogenic bacteria they are trying to eradicate. for example, Actimels fat-free flavours contain dextrose, aspartame and acesulfame K, whilst their other versions contain approximately 12 per cent sugars from liquid sugar and dextrose(11). A healthier way to boost probiotic levels is to recommend that clients

include traditional probiotic foods in their diet such as natural yoghurt, kefir or sauerkraut. Prebiotic foods can also be of great benefit, especially those containing inulin and oligofructose such as bananas, raw garlic, raw and cooked onions and raw dandelion leaves(12).

in women, elevated oestrogen levels are linked to endometriosis(13) and polycystic ovary syndrome(14) both of which can lead to problems conceiving. increased oestrogen can be a problem for men too. for example, a 2012 Czech study showed that obese men had an increased risk of infertility because of an increase in oestrogen levels without a compensatory increase in follicle-stimulating hormone (fsH) (15). A University of Helskinki study demonstrated that diet plays a key role in oestrogen metabolism. they found that women with diets high in lignans and phytoestrogens had increased levels of sex hormone binding globulin (sHBG) and decreased levels of circulating oestrogen and testosterone.(16) if elevated oestrogen is a problem then including foods high in lignans such as flax seed, sesame seed, brassica vegetables and other phytoestrogens such as legumes, barley, oats and rice helps to restore oestrogen balance.

with oligospermia (semen with a low concentration of sperm). they found that men suffering from infertility had significantly lower levels of omega-3 fatty acids in their sperm than men of normal fertility(19). similarly a double-blind, placebo-controlled, randomised study in 2011 showed that plasma concentrations of ePA and dHA were associated with an increased sperm count, sperm motility, and sperm morphology(20). A review in the Journal of Midwifery and Womens Health found that adequate intake of omega-3 fatty acids, particularly dHA and ePA were crucial for potential mothers too. it concluded that between 200mg and 300mg of omega-3 fatty acids daily could help reduce the incidence of preterm birth and improve infant cognitive and visual performance (21). to put this into context a 100g portion of salmon contains approximately 1.5g of omega-3 fatty acids(22). the most widely available dietary source of ePA and dHA is cold water oily fish, such as salmon, herring, mackerel, anchovies and sardines.

fruits and vegetables

A 2011 Cochrane review estimated that between 30 and 80 per cent of male subfertility cases are due to the damaging effects of oxidative stress on sperm(25). A trial published in Fertility and Sterility recruited 17 men whose partners had a history of two or more embryo losses before 12 weeks of gestation. All couples whose male partners accepted antioxidant supplementation achieved a successful pregnancy. they concluded that for men with high levels of sperm dNA fragmentation or lipid peroxidation consuming a diet rich in antioxidant foods for three months could result in a successful pregnancy.(26) since fruits and vegetables are rich in antioxidants, the message of getting at least 5-a-day couldnt be emphasised enough to clients. However, a 2010 report by the european food safety Authority concluded that a cause and effect relationship has not been established between the consumption of food(s) claimed to be high in antioxidants and the protection of body cells and molecules
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good fats
there is a growing body of evidence that low omega-3 fatty acid levels are implicated in male infertility. A 2010 trial in iran concluded that more research should be conducted to assess omega-3 fatty acid supplementation as a therapeutic approach in men

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Food and Drink

How safe is oily fish?

Pregnant women are advised to be cautious of consuming too much oily fish because of the potential mercury ingestion. In the UK a 2004 joint report by the Scientific Advisory Committee on Nutrition and the Committee on Toxicity agreed a maximum level of two portions of oily fish per week for women of childbearing age due to concerns about mercury (23). However a 2008 study concluded that ocean fish consumption should be actively encouraged during pregnancy. High levels of selenium in ocean fish can prevent oxidative brain damage and other adverse consequences of mercury toxicity. The study questioned the safety of freshwater fish, however their selenium content can be far lower than their mercury levels, potentially making them more dangerous (24).

such as dNA, proteins and lipids from oxidative damage. following the report it was made illegal to imply potential health benefits on package labels of products with a high orAC value (29). However, there have been many studies demonstrating a clear link between eating a diet high in phytochemicals and a reduction in the physiological measurements of oxidative stress. the authors of a trial published in the Journal of the American College of Nutrition concluded that, it may be almost impossible to isolate the pieces of the nutrition package when whole foods come with everything already properly bundled. (30) And that is probably the real issue here. instead of focusing on whether a certain packaged food can claim to be high in antioxidants on the orAC scale, we should be promoting a diet with an abundant variety of vegetables and fruits of different colours so that high quantities of naturally occurring antioxidants are consumed. With this is in mind, foods to recommend to clients that have been found to have the highest antioxidants levels include deeply pigmented fruits such as cranberries, blueberries, plums, blackberries, raspberries, strawberries,

blackcurrants, figs, cherries, guava, oranges, mango, grape juice and pomegranate juice. Vegetables particularly rich in antioxidants include: artichokes, cabbage, broccoli, asparagus, avocados, beetroot and spinach. its also worth letting clients know that steaming these foods reduces the antioxidant content much less than boiling does. An italian study examining the benefits of the Mediterranean diet found that olive oils, wine or apple vinegars added to salads increased the antioxidant capacity significantly. interestingly, certain aromatic herbs such as lemon balm and marjoram could increase the antioxidant capacity of a salad portion by up to 200 per cent(31).

Reproduction Update HERE FOR explained REFEREnCEs that zinc is implicated in testicular development, sperm maturation and testosterone synthesis and as an antioxidant plays an important role in scavenging reactive oxygen species (ros) which can easily damage sperm quality.(35) in women zinc plays a role in egg maturation, ovulation and luteolysis, all of which can be affected by ros (35). Uterine fibroid tumours, a cause of infertility, have been linked with low zinc status. A 2011 study found that plasma concentrations of zinc were lower in women with uterine fibroids(36). Pumpkin seeds are the richest vegan food source of zinc, according to the U.s. department of Agriculture National Nutrition database for standard reference with sesame seeds, sunflower seeds and cashew nuts also high(37).


Primarily nutrition is about the food we eat and how we eat it not the supplements we take. regular food intake from a diverse organic diet that contains adequate good fats, protein and complex carbohydrates and is rich in antioxidants should provide the body with the raw materials for reproduction. l

nuts and seeds

Nut and seed oils are high in tocopherols which act as antioxidants helping to prevent oxidative damage (32). they are also important vegetarian sources of omega-3 fatty acids, especially flaxseeds, hemp seeds and walnuts. A Californian study in 2012 showed that 75g of walnuts every day over a 12 week period had a similar effect on sperm count, sperm motility, and sperm morphology to omega-3 fatty acid supplementation (33). of all the nutrients linked to fertility, however, the mineral zinc is probably one of the most important, especially for men. A 2009 study concluded that where a mans zinc intake is known to be low, his sperm count and sperm motility is likely to be correspondingly low leading to subfertility(34). A review in Human

Advice from the Zita West Clinic, London

Zita West says: Focus on whole foods with high nutritional value. Lean protein such as chicken and fish, eggs, pulses and legumes. Essential fats are vital for egg and sperm quality so include raw nuts and seeds, oily fish and avocados. Increase brightly coloured vegetables and fruit to ensure a good antioxidant intake. Forget five-a-day, eat at least seven to ten in a day!

Kaye Heyes graduated in Nutritional Therapy from CNM in October 2011. She runs Health on a Plate using nutrition and NLP to support parents with young families and womens health. She recently set up a project to support mothers in their post-natal transition period.

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