The Fertility Sisterhood_Episode 3 - Eating for Fertility: Audio automatically transcribed by Sonix

The Fertility Sisterhood_Episode 3 - Eating for Fertility: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Lara Messerlian:
1 in 6 couples struggle with infertility, and we know that the environment plays a big role in how our bodies reproduce.

Carmen Messerlian:
In the Fertility Sisterhood, join me, Dr. Carmen Messerlian, Harvard epidemiologist and fertility expert, and my sister Lara, as we discuss what everyone needs to know about how the food we eat, the water we drink, the air we breathe, and our everyday environmental exposures impact our health and therefore our fertility.

Lara Messerlian:
Now let's dive in and learn how we can clean up our lifestyles not only for ourselves, but for our future generations.

Lara Messerlian:
Welcome to the Fertility Sisterhood: Cleaning up your lifestyle for future generations. This is episode three, we're eating for fertility. I'm Lara Messerlian, and I'm joined by my wonderful sister, Carmen. So before we get into it, I'm going to tell you a little story about, so far, you've learned a little bit about me from, in every episode. I did extensive fertility treatments, including having my eggs frozen when I was around 35, and a couple years later, I met my husband. At the time that I froze my eggs I wasn't sure whether or not I was going to meet someone, I was getting to a certain age, and I wasn't really sure what was going to happen in my life. So I froze my eggs and hoped for the best. A couple of years later, actually, my family, we went on a trip to Greece, and I saw my sister there with my mom and dad, and we had a really nice time. And I explained to everyone, Look, it may be the case that I might be someone who will have to have, do IVF by myself and have a baby by myself, because I haven't met anyone significant yet. And I was getting to a certain age, and I was really worried about the fact that I might not have the life that I wanted and expected for myself, but I was going to do everything I can to make it happen. So I got back to New York, and I went to an IVF doctor. When I started the process, sure enough, two weeks later, I actually met my future husband and which was really great timing and really wonderful. All of a sudden, I knew that I'd met someone that I could share my life with, and it happened very fast, but I was also really unsure about the fact as to whether or not I could have a baby and whether or not we could have a baby together. So I ended up going to IVF, and there were a couple of key things that I think is really important for women to keep in mind. I had a few health concerns that I had no idea what's happening that made a significant impact on whether or not I could conceive a child. And one of those, and this is what we're talking about today when we're talking eating for fertility, I had a folic acid deficiency in a way. It was something where I couldn't absorb folic acid, I had to take folate in order to have enough folate in my body to support and conceive, and I think it's something that a lot of women may have without even realizing that it's something that they can do something about. So you might be taking your vitamins thinking, okay, I'm taking folic acid, I'm doing this and doing that, but if you don't actually go to the physician and get to do a battery of tests to see what's really going on, you know, there might be simple solutions. So that was one thing that I struggled with, and I can make some small changes in my diet and in my lifestyle. And, at the end, as I said, I had a positive result. But so, Carmen, tell me a little bit about folic acid and how it's different from folate, and why it's important to take folate for some cases like mine.

Carmen Messerlian:
That's such a great story. And I remember those days as being initially very difficult for you when you were in the uncertainty phase of finding a partner and advancing maternal age, which, in these days, is considered older than 35, which is quite a few women still are looking for their partners after 35 and looking for their life partners and not sure about their fertility status because they've never actually tested their fertility before. So you are one of many women that have the same concerns after 35, where they have not found their partners and want to have a family and just not sure what to do, and freezing eggs seems like a like a solution, but it's not the answer to everyone's problems in the sense that it forces a woman to go through IVF. And, you know, our strategy in the work that I do is really to optimize your health across the life course, and diet is one of the most important things that you have some ability to control and modify every single day to improve your general health, but it also improves your fertility health. And you brought up a really good point, which is for a percentage of women and men across the population, this mutation that's called the MTFGR mutation, we won't go into it, but it doesn't allow you to absorb, actually, it's not the absorption that's the problem with folic acid. So when you take folic acid, which is really a critical nutrient in food that we need to enhance and allow us to reproduce. Folic acid levels and folate in our blood is associated with better fertility, better outcomes with men, and better outcomes with women, and people who have deficiencies in folate in their blood have reduced fertility. So this is something that's really important. It's an easy nutrient in the sense that we can get in lots of food sources like dark green, leafy vegetables, for example, but we also rely on our prenatal vitamin for this. And for some people, that prenatal vitamin that has folic acid in it is not able to be metabolized in the usable form. And so, for a certain group of people in the population, instead of taking folic acid, you need to take something called the methylated folate, so it's already been broken down in a way that your body can use in the metabolism that's required for fertility and all of other bunch of cellular functions. So the point is that just taking your prenatal vitamin for some people is not going to do the trick to get you the folate levels that you need for optimal fertility. And so I really suggest that anybody who's trying to get pregnant or planning a pregnancy or in a pregnancy, that taking the methylated folate, which is 5MTHF, is actually the ideal nutrient to take in your supplementation so that you can enhance your fertility. So you had a very good example where your body was depleted of folate because you had the MTFGR mutation, you had no idea until you actually started trying to conceive, and you had a history of miscarriage loss so they started checking on you, through blood tests to figure out whether or not you did have some underlying cause for this. And that's how they identified the MTFGR mutation, which is not uncommon in the population. I also have that same MTFGR mutation. So yes, a folic acid supplementation through a prenatal vitamin does not always do the trick for some people, and taking the methylated version of that, the 5MTHF, is really important, and you could do that through inexpensive supplements you could even buy on Amazon. Obviously, take higher quality ones if you can. There's brands that are really good and affordable for people. Yeah, I think that's a great point that you raised about folic acid and not realizing that your prenatal vitamin may not allow you to have the optimal levels that you need for successful reproduction.

Lara Messerlian:
So are there any foods that you recommend that are like high in folate, that are rich in folate, that are a good substitute as well to supplement on top of a vitamin?

Carmen Messerlian:
Okay, no, you raise a good point also about dietary sources. So obviously, the best option is to enrich your diet. Supplementation is important, but enriching your diet is super, super important to try to enhance what you take in every day. Your body can use best through the foods that you eat, the foods that you choose. Dark green, leafy vegetables, beans, peanuts, sunflower seeds, fresh fruits and fruit juices, whole grains, liver, seafood, these are all natural sources of folate, and they're good sources and high sources of folate. But in addition to that, even with a diet rich in folate, it's really recommended for women who are planning a pregnancy or trying to conceive to take folic acid through a vitamin or supplement. And as I said before, taking the optimal form, which is the methylated folate, is important for people who have potential mutation or can't metabolize the folic acid in the usable form.

Lara Messerlian:
For example, instead of eating potato chips and other processed foods that have saturated fats, we're moving on to the next topic, eat stuff that is healthy like organic peanuts or organic nuts. So let's talk about processed foods and saturated fats. I know that having a busy a lifestyle you just would grab sometimes whatever's easiest to eat, maybe eating out of the house multiple times a day, which I did every day for about ten years, and not really thinking about what is in the eating, even eat healthy organic foods when shopped at home. I spent a lot of time eating out. Let's talk about processed foods and saturated fat. So what is your advice on how to eat healthy? Eating is natural and healthy as possible to support your overall health and fertility.

Carmen Messerlian:
Another good point. Definitely, good points that you're raising around processed foods. So there's two reasons why we don't want processed foods. One is that they're not always the most nutrient-rich foods. They're usually fried foods and tend to lean more on high fat and high saturated fat. So that's one reason. But another really important reason is what we talked about, in the previous episodes, regarding endocrine-disrupting chemicals like phthalates and PFAS chemicals, which are really found quite, in quite high levels in processed foods. So in order to make that processed food and package that processed food, the making of the food and the packaging of that food is usually in plastic containers or plastic packaging or wrapping food, what we call food contact material that's usually plastic-based and also has an additional concern. So the plastic is where we get concerned about what the phthalates and the plasticizers that we talked about in previous episodes, but in addition to that, the food contact material to make those packagings oil proof, waterproof, stain proof, leak proof, all those really great functions that the packaging makes it so that in order to make those features, they coat those packagings in PFAS chemicals, and PFAS are known for their functionality that includes oil proof, waterproof stain proof, leak proof, and so you get contamination in the processed foods. So you could put something that looks like it's healthy in a processed packaging, and it'll end up with chemicals that leach out from the packaging into your food. So takeout is a big no for that reason.

Lara Messerlian:
Let's talk about that for a sec, because I have to admit, one time I was talking to my mother-in-law, who I love, and we were talking about processed foods, and she did not know what processed food is. She said, what is exactly a processed food? I don't know what you're talking about. And I think in America, we're just, we go to the grocery store, we get whatever we have on the shelves, and we don't even realize that what we're consuming is processed. Though it was easy to avoid meals or foods in a can, or can you define that a little bit? Because a lot of people don't even know what it means to have food that's processed, quote-unquote processed.

Carmen Messerlian:
Yeah, agreed. So, yeah, so processed foods, almost everything we eat is unfortunately processed in the United States. If it's not a fruit or vegetable or something in its original form, it's considered processed. So any food that's not in its original form is processed. Fruits, vegetables, meat that you get from the grocery store, anything at Whole Foods that's in the perishable site, like I just said, the meat counter, the fish counter, the fruit and vegetable counter, those are all fresh fruits and fresh vegetables and fresh, unprocessed food. Processed foods is everything in the middle aisle. So pretty much anything in the middle is considered processed. Anything that's been changed in its form and packaged is considered processed. So you can consider ketchup processed, for example. So you.

Lara Messerlian:
You know, chicken nuggets, for example.

Carmen Messerlian:
Chicken nuggets are processed too. So anything that's changed from its original form. So trying to stick to a more holistic diet, a more wholesome diet, something that's more in its original form, is obviously healthiest because it's got less steps. So every one of those steps to make those foods, let's just use ketchup, for example. In order to get ketchup into that plastic bottle, it's gone through a whole host of steps, including taking the tomatoes, boiling them down, probably in a pot that's lined with some sort of nonstick processed chemical, then processed into a plastic tubing to get it into its bottle, right? So every one of those steps, if you look at the manufacturing of food, any food plant, plastic conveyor belts, plastic tubing, plastic packaging, every one of those steps, there's contamination of these endocrine disrupting chemicals or environmental chemicals that we're concerned about into the food. So this is the main reason why we want to avoid processed foods is because there's contamination with chemicals, and those chemicals we know harm reproductive health. They're associated with lower semen quality, they're associated with poor ovulation, they're associated with higher risk of miscarriage, they're associated with longer time to pregnancy. And there's plenty of studies that tell us that these chemicals are bad for us and that the advice here is to limit your contact with processed foods. I eat ketchup, people eat ketchup, we can't control every food, but we have choices to make. Not getting your apples pureed in a container, for example, buy fresh apples. Not getting your meat processed like a chicken nugget, make your own chicken nuggets if you can. We can't always stick to that, but when you do have a choice, make the choice to stick to the original form food: fresh fruits, and vegetables, fresh meats, lean meats. Saturated fats is an important one. Saturated fats have been associated with reduced fertility for both men and women, including reduced testosterone and men and trans fats as well, so keeping an eye on your fat content and the kinds of fats that you eat. So there's good fats, and then there's bad fats. So saturated fats, we consider the not-good fats, and those can be found in fattening meats like red meat has saturated fat in it. And the good fats are what we want to focus on, which is the omega fatty acids and the omega fats, which are from natural sources like fish and seafood, and nuts, and these fats are, actually enhance fertility. You want to increase your omega fatty acids, those kinds of fish-based fats and seed-based fats, but you want to decrease your saturated fats, which tend to be more for meats and processed foods.

Lara Messerlian:
So what's the difference between a saturated fat and a trans fat, then?

Carmen Messerlian:
So a trans fat, that's a great question. So a trans fat is basically, it's a change in how the fat is originally shows up in the food when you fry it, for example, when you fry your process a fat, the, this processing of the fat actually results in what we call a trans fat, and that trans fat is basically what happens when the fat is processed through either high temperatures and or frying. And they're also considered another word for them, which is a little bit more fancier, low-density lipoproteins. You want to decrease your low-density hypo, low-density cholesterol levels and increase your high-density cholesterol levels. So the high-density cholesterol levels come from, like I said, fish and seafood and nuts and those types of sources, whereas the LDL, or the low-density lipoproteins or cholesterols, are the ones that we talked about that are associated with reduced fertility.

Lara Messerlian:
Okay, so would we find more trans and saturated fats in processed foods like for example, so if I'm buying canned soup, for example, I have to, is there any way for me to see what the percentage is on there so that I can say, well, yeah, this is high in trans fat?

Carmen Messerlian:
Yes.

Lara Messerlian:
No, I always read the label, that little thing, but is there a way for me to see how much something I'm getting?

Carmen Messerlian:
Yeah, so the labels of all foods in the United States have the percentage of saturated fat, and the percentage of trans fat should be labeled on any product that you purchase, and that's a good way of checking. So you want to keep those trends fat levels as low as possible, but almost all processed foods have trans fats in them. So anything from the cakes, pie crusts that you buy, the biscuits, the frozen pizzas, the cookies, and packaging, crackers, margarine, butter, these foods all have trans fats in them. So you can't avoid them completely, but you want to reduce your intake of it. What really matters is really increasing your good fat. So increasing the kinds that we talked about relative to the bad ones. So the bad ones that we just talked about, you want to reduce those, and you want to increase your good cholesterol, your good fats, so that the ratio between those two is more in favor of the high-quality fats that you actually need that are really important for reproduction that actually enhance and support your reproduction.

Lara Messerlian:
So on to organic foods, because a lot of people don't actually believe that organic foods are any different than conventional foods. They just think it's more expensive version of the same thing, and I understand that, but I've read a lot of, I'm not a scientist, but I read a lot about buying organic, and I'm someone who supports that movement. I like eating organic fruits and vegetables and foods, and I try not to eat processed foods, but I read a lot about what foods have the most amount of pesticides and the most chemicals. And one thing that I had read was about strawberries, conventional strawberries, having a very high amount of pesticides and chemicals. So tell me more about organic foods and products that we should be taking in and what kind of vitamins we should be getting from those foods in order to help us with our overall health and our fertility.

Carmen Messerlian:
Yeah, so also a great point. So fruits and vegetables and our produce are a great source of nutrients. Vitamin C and a whole host of other vitamins are found in fruits and vegetables, so we want to encourage as much fruit and vegetable consumption as possible every single solitary day. I know that's hard to do. It's more creating a habit of it and finding sources that you love and just sticking to them if you can. So if there's things that you absolutely love, just keep eating them. Variety is obviously important, but if you don't like fruits and vegetables, stick to the ones that you do and just try to eat them often. So any kind of fruit and vegetable is important, conventional or organic. The point is that chemicals are, the pesticides that we're talking about that are found in conventional foods, and organic foods are not free of pesticides, they just have a lot lower concentrations on the residue of the fruit and vegetable that is organic. No fruit or vegetable anywhere on the world has zero chemicals in it, zero pesticides in it just because of the nature of how we grow our food and soil. There's contamination across crops and stuff that have used pesticides. Pesticides or chemicals that are used to destroy or control weeds, insects, and pests in a crop, and they have been used to support crop growth and enhance and increase the volume of fruit or vegetable that's being grown, but these chemicals are known through our science to impact your reproductive health. Pesticides have been associated with miscarriage risk, with birth defects, with semen quality, with egg quality, with a whole host of reproductive outcomes with longer-term to pregnancy. We want to avoid or reduce as much as possible pesticides in our diet, that's a goal for every person who's trying to conceive a pregnancy. Now, if you can't afford a full diet of organic foods, fruits, and vegetables, that's not possible for everyone because, for organic foods tend to be obviously more expensive, like you mentioned, the cost is higher. There are things you can do. For example, if you have to buy conventional fruits and vegetables, wash your fruits and vegetables really well, that's a number one step. So if you have to buy conventional, wash your fruits and vegetables really well, rinse them, dry them, and then serve them to your family or serve them to yourself. So that's something you could do if you have to stick to conventional. If you can afford some organic foods, pick the ones that are known to be in the Dirty Dozen. There's a list called the Dirty Dozen, and the Dirty Dozen list are ones that we know have a high concentration of pesticide residue on the fruits and vegetables. And so, swapping those Dirty Dozen fruits and vegetables for organic ones would be your first bet. If you have to choose only a small group of produce that you want to switch to, you should stick to the Dirty Dozen as the ones you want to switch out to. And I could tell you what the Dirty Dozen is, if that helps. If you guys want me to share that, I can.

Lara Messerlian:
Yeah, tell us what the Dirty Dozen is in fruits and vegetables. And also, when it comes to washing your fruits and vegetables, I heard using salt, for example, on apples.

Carmen Messerlian:
And I don't know about that. I don't know if that's something, I don't know the science behind using salt. I just think like using water and washing it well and rinsing it well and running it through multiple cycles or even letting them sit in water for a bit and then draining it and then letting them sit in water for a bit and draining them. But the ones that I would swap out with, if you could only afford a small number of organic fruits and vegetables, I would stick to swapping out your strawberries for organic, your spinach or kale, your nectarines, your apples, your grapes, your peppers, your cherries, your peaches, your pears. Celery, tomatoes, potatoes. blueberries, cherry tomatoes, these are all the ones, those are the list of priorities, the ones that you'd be better off switching. And if you can't, like I said, not everybody can afford organic, there is a cost difference, washing your fruits and vegetables really well is important. But a diet rich in fruits and vegetables is supportive of fertility, it's probably the number one thing you could do to enhance your fertility along with increasing your omega fatty acids, and you're making sure you get the right kind of folic acid or folate methylated folate in your diet, avoiding saturated fat, or avoiding trans fats, reducing those as much as you can. Vitamin D is something else that we haven't talked about. Vitamin D helps reduce inflammation, also helps support fertility, and something that I always encourage people to take at levels that are supportive of your health. Your prenatal vitamin may not afford you the right levels. I tend to take over a thousand IUs of vitamin D every day, and it's safe to take that level. Even up to 5000 IUs per day is safe to take. So these are things that I recommend individuals trying to get pregnant do, increasing your vitamin D, increasing your fruit and vegetables, increasing your omega fatty acids, taking the right type of folic acid. There's another nutrient that we didn't talk about, which is called Myo-inositol, which has been shown in science to, in research to, enhance fertility, improve fertility, and individuals that have low levels of this in their bodies, tend to have lower fertility. So you can take a Myo-inositol supplementation, it's pretty affordable to take, and actually has been shown to enhance and improve your fertility, and something that you can do very easily and very cheaply through either supplementation or a natural source.

Lara Messerlian:
Yeah, so as I said, when I went to the IVF doctor, it's when I really realized that there were a couple of underlying health issues that I was struggling with that I had no idea was actually going on. One of them, as I said, was the gene mutation for the folic acid. Another issue that I had was something that I wasn't even aware, I was having inflammation in my body, which was causing me to have miscarriages. And then I also had a gene mutation for, prothrombin mutation, which is like a coagulate, blood clotting disorder. Having a couple of, it seemed like simple, serious but simple items that I had with my health that I could make changes again to my lifestyle and to the medicine that I could take so that I could have a successful outcome in terms of fertility. I think there's a lot of women out there who may be having miscarriages and may be struggling with fertility without realizing that there are a few simple health issues that you might have that you can actually deal with directly and take supplements and take eat healthy and cut out certain things out of your lifestyle but will make a huge difference in your outcome. So tell me a little bit about the myo.

Carmen Messerlian:
Myo-inositol. No, I know it's hard to say. Myo-inositol is, and the folate, and vitamin D, these are all things that reduce inflammation. Inflammation is counter-reproduction. You want to keep your inflammation levels as low as you possibly can throughout your body in order to enhance your fertility success. Higher levels of inflammation are associated with lower fertility, a higher risk of miscarriage, like you said. Some people have, like you did, some biological reasons for higher inflammation. Other people, it could be through a poor diet or poor lifestyle, alcohol, caffeine, smoking, drugs, those kinds of things increase your inflammation. But, like I said, the Myo-inositol is a supplement that you could take, or you could pick foods out that are more high in these in these nutrients that allow you to reduce your inflammation naturally, and these are through fiber-rich foods, fruits, and vegetables like beans and nuts and seeds, and cantaloupe, all examples of sources of Myo-inositol. But again, the supplementation is a way of making sure you get at least a minimum level, and these things help reduce your inflammation in your body that can then help you achieve your fertility outcomes, hopefully with less time and less risk and less miscarriage risk. So I just want to just point out some signs that individuals who took Myo-inositol supplementation, the males had improved semen quality, they also had improved sperm parameters and had improved fertilization rates during IVF, and higher rates of pregnancy success among couples going through IVF. For women, individuals that took Myo-inositol supplementation, they had increased ovulation, they had better progesterone levels, and they had a higher chance of natural pregnancy among IVF patients. So if they were undergoing IVF, they had a higher success rate of natural conception. It also improves your FSH levels and reduces risk of gestational diabetes if you do get pregnant. So there's a really good reason to take this supplementation, and it's, like I said, associated with really good positive outcomes. And many people could be deficient in this without even realizing it. Just like you said, your diet sometimes is not its best when you're, especially if you're a working mom or a professional person, you tend to cut corners on yourself, and your diet is probably the first thing you start to take a corner on and start eating a bag of chips for lunch with a Diet Coke, right? Because you're rushing around and you're in the middle of meetings or trying to juggle your lifestyle or diet can be impacted in a negative way. But we also can learn about ways that we can improve our diet.

Lara Messerlian:
Okay, thank you again for joining us today. As you hopefully heard throughout this episode, we talked about the things that you need to eat for fertility. Make sure, you know, you're taking the right kind of folic acid folate, make sure you're getting enough omega fats, and you're eating lots of healthy fish, antioxidants like that are coming from these healthy fish and supplementation. Get your vitamin C or E or D and your miso. Can you say the word Carmen? Myo.

Carmen Messerlian:
Myo-inositol. It's a tough one. I know.

Lara Messerlian:
I struggle with it, it's a tough one. Make sure you try to get organic foods. Avoid the Dirty Dozen if that's all you're able to do for yourself. Try not to eat saturated fats and trans fats and eat processed foods, stick to the healthy omegas. And hopefully making, again, some small changes over the grand scheme of things will end up helping you slowly step your way into a healthier you and a healthier path, and for a healthier fertility journey. Thank you again for joining us. We're so grateful to be here, and we hope that you get lots of information and inspiration from my sister and I. Thanks for listening. Ciao, sister, love you.

Carmen Messerlian:
Bye, sister. Love you.

Lara Messerlian:
Bye.

Carmen Messerlian:
Bye.

Carmen Messerlian:
Thank you for listening to the fertility sisterhood, brought to you by Rescripted. We hope it has left you feeling more educated and empowered about the role environmental factors play in our reproductive health.

Lara Messerlian:
If you've enjoyed this week's episode, be sure to visit SEED-Program.org to learn more about Dr. Messerlian's research. To stay up to date on the podcast, follow Rescripted on Instagram and TikTok at @Fertility.Rescripted or head to Rescripted.com.

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