Are Low-Calorie Sweeteners Making You Fat?

There is a global obesity epidemic. More than one BILLION adults are projected to be obese by 2025. Obesity is a major risk factor for the development of medical conditions such as diabetes and cardiovascular disease, as well as numerous types of cancers. Obesity, in either male or female partners, is associated with a decrease in the ability to become pregnant. Obese women are not only at an increased risk of having trouble conceiving, they are also at risk of: needing medications to conceive, being less responsive to fertility treatments, losing pregnancies to miscarriage, having children with birth defects, as well as having complications during pregnancy such as high blood pressure and diabetes.

 

Many people use artificial sweeteners or “diet” drinks as a substitute for whole ingredients with the hope of cutting calories. A recent study suggests that this may be a bad idea. This group followed people for 10+ years and found that people that used low-calorie sweeteners had a higher body mass index (BMI), larger waist circumference, and were more likely to be obese. This paper suggests that using low-calorie sweeteners may not be effective means of weight control, and might even lead to harm.

 

When I review studies like this, I think it’s important to note that these studies are NOT designed to prove that artificial sweeteners CAUSE obesity; rather, they show an ASSOCIATION at a population level. For me, as a physician and mom, this association is reason enough to be cautious about the use of artificial sweeteners. For others, especially die-hard Diet Coke drinkers, they might want more proof before changing their diet habits.

 

There is no easy solution for weight loss; diet drinks probably aren’t going to help. If you are overweight or obese, don’t lose hope. Even a modest weight loss (10-15% body weight) can enhance your natural fertility. It will take hard work through diet and lifestyle changes. Avoid sugary snacks and drinks in general. Consider using natural sweeteners like stevia (Dr. Greene’s favorite!) or honey (my favorite!) instead of artificial ingredients. Your selection in which sweetener you use, is likely going to depend on what is most important to you including considerations like why you are using a sweetener, why you are looking for artificial sweeteners (cutting calories), and taste. Please be an informed consumer and make sure that you know why you are making the choices that you make. Taking care of yourselves will help prepare you for a healthy pregnancy and prepare you to be healthy parents.

Male Fertility and Diet | NutritionFacts.org

Too often the entire focus of fertility recommendations are directed towards women. It is true that egg quality is the single most important factor in determining conception. That said, a healthy egg cannot overcome sperm with damaged DNA. So, let’s provide some guidance for what men should be doing with their food choices to improve the chance of a successful conception.  http://nutritionfacts.org/video/male-fertility-and-diet/

Iodine Supplements Before, During, and After Pregnancy; critical problem with a simple solution

The problem of iodine insufficiency during pregnancy has troubled me for years. So much so that I spoke at length about this in pregnancy book that I wrote as well as the fertility book. Now there is a very brief video made by Dr. Michael Greger that explains this problem more articulately than I ever did with simple recommendations—check your prenatal vitamin! Only about half contain this nutrient that is so important for your baby to build a healthy brain.     http://nutritionfacts.org/video/iodine-supplements-before-during-and-after-pregnancy/?utm_source=NutritionFacts.org&utm_campaign=94b0f568b9-RSS_VIDEO_WEEKLY&utm_medium=email&utm_term=0_40f9e497d1-94b0f568b9-23307533

Soy Helps Improve Metabolic Status in PCOS | Medpage Today

There is a a growing body of evidence that the outdated idea that soy inhibits fertility needs to be abandoned. There are too many studies now that have found the exact opposite. Here is one just published regarding women with PCOS:  http://www.medpagetoday.com/endocrinology/metabolicsyndrome/59561

Omega-3 Fatty Acids: another tool for ovarian rejuvenation

One of the most frustrating questions for women trying to conceive is “what can I do to improve my chances?” Given that women are born with every egg that they will ever have, there are a limited number of ways to optimize the health of the remaining eggs. But for those that are motivated, I have described steps like the use of Acai berry extract and CoQ10 as well as improved sleep and Vitamin D. Now for the first time, there is evidence that some women may be able to improve the responsiveness of their ovaries in as little as one month!

The typical diet of people living in the USA has changed dramatically over the last century. One glaring example has been in the type of fats that we consume on a daily basis. Essential dietary fats—those that we must get from foods because our bodies can’t make them—are typically classified as Omega-6 and as Omega-3 and serve many important physiologic functions. The ideal ratio of Omega-6 to Omega-3 is 1-to-1. However, the typical Western diet—popular amongst most Americans—has a ratio as high as 25-to-1. The result of this unhealthy shift is that many people are eating foods that promote inflammation. This unhealthy shift is associated with a higher risk of heart disease, diabetes, cancer and infertility.

Given that it’s not easy to encourage people to make lasting dietary changes, a recent study looked at the effects of starting a high potency omega-3 fatty acid supplement upon ovarian function and hormone balance. For this study, they put 27 women on a 4 gram supplement and measured their FSH levels before and 30 days after starting this program. Even within this short time frame—effectively one menstrual cycle—they found a dramatic improvement in the omega-6 to omega-3 ratio. Their inflammatory markers improved and their FSH levels dropped. Given that FSH level is considered a marker of ovarian sensitivity; this result is interpreted to mean that their ovaries were more sensitive and thus more fertile.

A cautionary note; they did not find an improved ovarian sensitivity in the women in the study that were obese. It is possible that with longer time and with weight loss, obese women might also experience improved fertility. Obesity has been linked to worsening infertility as well as resistance to some of the treatments offered to normal weight women. It is theorized that obesity itself produces inflammatory chemicals in the body which in turn trigger a state of hormone imbalance. In act, it was discovered that all of the women in the study—including the women that were obese—had improved markers of glucose metabolism. That suggests that the omega-3 fatty acids could help reduce the risk of diabetes and maybe make it easier to lose weight as well.

Another important benefit of omega-3 fatty acids is that they can reduce oxidative stress. That means that consuming these healthy dietary fats can reduce the risk of DNA damage to a woman’s eggs—another important fertility promoting benefit. So although this was a small study and needs to be confirmed in a longer time period, you don’t need to wait. Make this health promoting change in your fertility promoting plan now. Here are a few practical suggestions:

  • Switch to a low-fat diet plan taking care to avoid animal fats when possible
  • Use products at home that include healthy omega-3 fatty acids instead of butter
  • Incorporate more olive oil, Flax seeds and tree nuts into your daily diet
  • Start taking a daily supplement—preferably a plant based one (rather than fish oil) like those made by Life’s DHA
  • IMPORTANT NOTE TO MEN: Emerging evidence suggests that increasing your omega-3 fatty acid consumption can improve sperm shape (teratospermia) as well!!

Women Getting Pregnant Later AND Aging at a Slower Rate; a review of the data

Most women are aware that their fertility declines more rapidly than other—often more visible—signs of aging. In fact, the ovaries have very unique properties. They begin a prolonged hibernation-like state from infancy until the start of puberty. During this ten to fourteen year period, the ovaries remain inactive; producing neither hormones nor mature eggs. However, there are still biological signs of aging taking place within the resting ovary but at a much slower pace than after the menstrual cycles begin. Then throughout the reproductive years a group of eggs is lost each month. In some women—depending on their diet and lifestyle—eggs may be lost at a faster pace. This happens for instance in women that use tobacco products. As I’ve written about previously, the blood test for the hormone AntiMullerian Hormone (AMH) is considered by most fertility specialists today to be the most reliable assessment of a woman’s ovarian reserve (the approximate number of immature eggs that she has available at any given time). Now there are also new ways to actually measure how we age physiologically as well.

One study recently demonstrated that people do age at variable rates. They quantified the aging process by measuring various physiologic and genetic markers over a 12 year period in 954 individuals beginning at age 26. They correlated their findings with each test subject’s appearance and their quality of life. They found that those that appeared to be aging faster also had measureable changes in their physiology, cognition and physical complaints consistent with their appearance. The researchers also analyzed their DNA. Their analysis supported that some individuals were aging faster than others and that diet and lifestyle seemed to be a major influence on the rate of aging. In fact, some people seemed to age 3 years for each 1 year that passed on the calendar while others didn’t seem to be aging at all during the 12 years of the project. So taking steps to improve your health and wellness may in fact slow your rate of aging. However, there are still some changes taking place that can’t be delayed indefinitely.

In most species, females are able to conceive throughout their natural lifespan. Humans are unique from most other mammals in that women typically live about half of their life after their fertility has ceased. It has also been reported that women that conceive later in life tend to live longer. Efforts to look at the genetic relationship have found that there are 17 genetic markers that explain about 30% of the occurrence of premature ovarian failure. That means that most ovarian aging is related to other factors including damage to the egg’s DNA (telomere length) that naturally occurs over time. There are also changes that occur in the egg’s power house, the mitochondria. Each egg has 20,000 to 800,000 of these important power units. Each mitochondrion has its own small strand of DNA. We inherit all of our mitochondria from our mother. As women age, the DNA of mitochondria within the eggs becomes damaged. This damage cannot be repaired. As a result, the mitochondria are intimately linked to egg quality. They not only impact the chance that an egg will fertilize and grow successfully but also the health of the child that results. There are also other ways that delaying pregnancy may influence the child’s health but in a more positive way. There is considerable evidence that children born to older mothers may have more positive cognitive and behavioral outcomes.

There is a growing trend for women to delay childbearing. Doing so is associated with higher socioeconomic status, increased educational achievement, higher income level and smaller family size. It may be due to any or all of these reasons or it may be due to greater readiness for pregnancy or more that children of older mothers tend to fair better when it comes to cognitive and behavioral measures. Others feel that it may due to a more mature mother-child interaction. Whatever the reason the benefits are present without any elevated risks in psychiatric problems.  So even though cause and effect cannot be established in the available studies, advanced maternal age seems to have a protective effect upon the psychological and cognitive development of children. Now there is also evidence that carrying a pregnancy may in turn have healthy implications on the aging of the mother as well.

A new series of investigations is finding that a healthy pregnancy may slow aging process. In animal studies, it has been a consistent finding that pregnancy has a rejuvenating effect upon mother through a process called parabiosis (connecting the circulation between the young and the old). In humans, studies have found measureable benefits including improved liver functioning, improved reparative abilities within the central nervous system and protective effects upon the heart following a healthy pregnancy. There is also data suggesting that unhealthy pregnancies can identify women at risk of age-related conditions like diabetes, stroke and heart disease—possibly identifying those at risk so that preventive measures can be initiated. So it seems that healthy women have a longer opportunity to conceive and that when women in their later years get pregnant that they remain healthier longer.

In summary, the links between fertility and healthy aging are far more complicated than previously believed. We can reassure women that taking steps during their younger years to live a healthy lifestyle should optimize their opportunities for pregnancy. We can not only track a woman’s fertility status through ovarian reserve testing but now we can also freeze/store eggs to extend their reproductive years. Then, by taking steps to optimize a women’s health during pregnancy, women may both have a healthier child as well as slow their own aging.

Functional Fertility Foods: eating soy foods associated with higher IVF success rates

There are few topics as emotionally driven as food choices. For most of us, our dietary choices are guided mostly by our taste preferences, familiarity (think comfort foods) and convenience. In fact, much of what passes as nutritional science in the popular media is incorrect or overstated. As a result there are often widely held misconceptions and untruths about what is a “healthy food.” A classic example is soy based food products. About 4 years ago, I wrote a column  to debunk the popular (and inaccurate) belief that some of the hormone-like chemicals—called phytoestrogens—in these healthy beans could interfere with fertility. The latest research goes one step further suggesting that these foods actually boost the pregnancy rates in women undergoing advanced reproductive techniques (ART).

It’s been well established that adding soy based foods can lead to small changes in the hormone balance  of people that eat them. But for too long, people that wanted to promote unhealthy dietary choices successfully created concerns among fertility patients. Then two clinical studies came along that demonstrated women taking soy supplements during either ovulation induction  treatment or IVF cycles  had higher pregnancy rates. The problem with these studies however was that the supplements that were used boosted the level of phytoestrogens to levels that are over 10 times higher than people eating a traditional Asian diet. New research has provided more practical insights into the health benefits achieved by simply switching to easily obtained soy based foods.

This latest study  was very practical because they looked at the dietary choices in a group of 315 women that ultimately completed 520 ART cycles in 2013. Better still, they followed them prospectively to minimize the risk of obtaining biased results. They then looked at various results from their IVF cycles. They found that the eggs from women that were eating foods that contained soy had a higher fertilization rate. More specifically, they found that the clinical pregnancy rate was 11% and live birth rate was 13% when they compared women that were eating soy to age-matched women that were not. In fact, women that were consuming the most amount of soy had a nearly 80% higher chance of success. Bottom line was that soy containing foods seem to be very beneficial to women undergoing fertility treatment without making huge dietary changes.

An important step towards validating any finding is to then try to establish a theory of how the intervention may have resulted in the finding. The previous studies on soy supplements and IVF outcome suggested that the isoflavones—these are the estrogen-like chemicals in soybeans—resulted in a healthier uterine lining and thereby improved the ability of embryos to implant. They based this assumption on the fact that the ultrasound imaging of the lining appeared different. This recent study did not find any such changes. Instead, they hypothesized that the benefit are demonstrated by the fertilization rate of the eggs from the women eating soy vs. those that weren’t The fact that it was higher in the soy group suggests that eating soy may improve egg quality. Regardless of the mechanism, all of the research agrees that dietary soy is associated with higher pregnancy rate and greater chance at a live birth.

Maybe the most important aspect of clinical research is guiding and motivating patients on how and when to implement changes. Given the large number of products that now contain soy as well as the various “meat substitutes” (ie, veggie patties, soy milk, soy yogurt, soy butter) it makes sense to encourage women going through IVF to try to make some conscious changes to select these products or to eat soybeans. Another potential advantage of reducing meat, chicken and fish consumption is that plant based proteins contain far less of the unhealthy aspects of our modern diet like; hormone disrupting chemicals, pesticides and antibiotics. The end result is not only a higher chance of conceiving but also having a healthier pregnancy and giving your child the very best start possible.

[r1]Link to https://thegreeneguide.wordpress.com/?s=soy

[r2]Link to http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=906924&fulltextType=RA&fileId=S0007114500001872

[r3]Link to http://www.rbmojournal.com/article/S1472-6483(10)60465-8/abstract

[r4]Link to http://www.fertstert.org/article/S0015-0282(04)02356-8/abstract

[r5]Link to http://www.fertstert.org/article/S0015-0282(14)02529-1/abstract