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.
The greatest healthcare challenge facing us as a society today is related to obesity. It is now estimated that by 2030, 42% of the population in the USA will be obese resulting in a rise in healthcare costs of nearly $149 billion per year. But beyond the financial cost is the impact that obesity has on an individual basis. It is clearly the leading risk factor in the development of heart disease, diabetes and many forms of cancer. Clearly any one of us would like to minimize the impact that this could have upon our own child. New research has confirmed that our efforts to insure a child’s healthy future should begin even before that child has been conceived. Theories were proposed nearly two decades ago that a child’s life-long health risks for problems like diabetes begin shortly after conception. But it is within the last 5 years or so that studies actually began to prove that characteristics like a person’s ability to regulate their body weight can be permanently altered by their mother being overweight or obese during pregnancy. That’s because our ability to regulate our calorie balance (i.e., hunger, satiation, metabolism, etc) has to do with the hormonal and chemical balance that our developing brain was exposed to during fetal development. Although the early studies were done on animals, it hasn’t taken long to establish similar ties in humans as well. For instance, one recent study found that for every 22 lbs that a woman was overweight prior to pregnancy, her baby’s birthweight would predictably be about a half of a pound over the average. Then for each additional 10kg that an overweight woman gains during pregnancy, her child’s birthweight increases by an additional half pound. Along with this higher birth weight is a higher risk of cesarean section and subsequent health problems in childhood. That’s because birthweight is the earliest predictor of how our physiology will respond to our high-calorie and increasingly sedentary lifestyle. Babies either above or below the averages are at highest risk of being overweight or obese before they reach puberty. It has been confirmed that when overweight or obese women become pregnant, their children are at high risk of developing problems with high blood pressure, elevated cholesterol and an increased risk of becoming diabetic before they complete their teenage years. Recently, the Center for Disease Control and Prevention revealed the shocking statistic that nearly one in four adolescents today has diabetes or pre-diabetes. That’s nearly triple the rate of just a decade earlier—an alarming increase. So while we work toward finding more treatment options for overweight children and teens, we should also put greater effort toward identifying and assisting women at risk. Intervention before they become pregnant and during pregnancy can not only improve their health (and fertility), but their child’s entire future. Here are just a few of the strategies that have been shown to work: • Whenever possible, assist patients in losing weight prior to conception • Encourage healthy nutrition during pregnancy • Promote exercise during pregnancy • Identify and treat insulin resistance as early as possible (preferably prior to conception) • Encourage breast feeding—helps mom get back to healthy weight after delivery while reducing rapid weight gain in newborn infants • Avoid hormone disrupting chemicals like bisphenonal A (BPA)—which have been linked with excessive weight gain
*The following is an excerpt from my book PERFECT HORMONE BALANCE FOR FERTILITY[u1] . If you’re working to lose weight or wondering if/how this may improve your chance for conception then read on…
Fat cells are not passive calorie warehouses, but rather mini endocrine factories that produce at least 20 different hormones, collectively called adipokines. These hormones direct your metabolism and help your brain keep track of your energy stores to control appetite and budget how your body uses this energy. Adipokines also help your brain determine if you have enough fat stores to sustain pregnancy. Your brain also takes into account how effectively you can share your energy with your baby—if you’re insulin-resistant, your body doesn’t channel energy to the fetus as effectively. As you modify your diet, fat cells adjust their adipokine secretions to bring them more into balance, improving your fertility profile. Here are some of the key adipokines and how they affect your weight.
- Leptin tracks how many calories you have stored as fat—the more fat you have, the more leptin in your blood. When leptin levels are high, your brain suppresses your appetite and revs your metabolism to help you burn calories. But when leptin is chronically elevated, at it is in obesity, your brain tunes out the appetite-suppressing effect. Low leptin, on the other hand, signals low fat stores—a red flag that your brain should halt ovulation.
- Adiponectin helps your body use fat as fuel. As you gain weight, though, you produce less adiponectin, and low levels are associated with fertility problems. As you lose weight, fat cells release more adiponectin, increasing your chance of conception.
- Resistin is released by fat cells, resisting insulin’s ability to help store glucose. If you’re overweight, resistin rises, leading to insulin resistance and reduced fertility.
Over the last 25 years, infertility rates have risen in proportion to the rise in obesity in men and women in their reproductive years. One analysis determined that at least 10 percent of today’s fertilty problems are related to overeating. The good news for obese people is that losing 10 percent of your body weight will improve your chance of conception (if you’re overweight, not obese, you’ll see the benefits after losing only 5 percent of your body weight). So create short-term goals on your path to hormone balance and don’t focus on attaining your ideal body weight.
Excerpt from Perfect Hormone Balance for Fertility