Elanso

Among the top reasons patients in their 20s and 30s seek my help in losing weight is the desire to have a baby. Some women have had irregular periods for years (a tip off for conception problems), with their doctors telling them it’s weight-related. For others, they’ve had regular periods for years, but just don’t seem to conceive, whether the old fashioned way, or with fertility-drug treatment. What’s the connection between obesity and fertility, and how can your diet and lifestyle influence fertility? That’s the topic of my TODAY segment (check back later for the video).

First, let’s look to Mother Nature: Women on both the very thin and very heavy ends of the weight spectrum have trouble getting pregnant. While the absolute science is not yet here to tell us why, there are a number of scientific observations that point us in a direction of how to manage this problem, and marry both lifestyle and medical treatments to treat fertility problems not related to anatomical issues (liked blocked fallopian tubes).

I’d like to give you some strategies for optimizing what you can control in your lifestyle – of healthier eating, weight, and activity – to help resolve fertility issues.

Abundant studies show that overweight and obesity clearly promote infertility – and the heavier a woman is, the lower the rates of fertility. A study from this past December in the journal Human Reproduction showed that a woman roughly 50lbs overweight was about 25% less likely to achieve a regular pregnancy (without medical help.) Those with about 100lbs to lose were about 45% less likely to conceive easily.

While we don’t know the reasons for this, it appears that excess weight hampers a woman’s fertility, even when her ovulation is fine, and she has no weight-related health problems (like diabetes or high blood pressure). In addition, those women undergoing fertility treatment, typically need more hormones and adjusted dosing, compared with healthy weight woman. Translation: if you’ve been trying to conceive and have not – check with your doctor, and revisit your lifestyle for the first step in this fertility pathway: healthier eating, weight loss, and a physical activity plan to optimize the factors you can control.

While there is not guarantee that these strategies will work, women following this 10-step plan, based on a number of scientific observations, might have an easier time conceiving:

1. Know your Body Mass Index If it’s over 25, aim to lose 10% of your starting weight (if you’re at 150, that’s 15 pounds). The good news is that just a 10% reduction of starting weight loss can often make the difference in ability to conceive. Click here to find out your Body Mass Index.


2. Discuss your reproductive health with your primary care doctor or obstetrician. You need to rule out a biological basis for your fertility, particularly anatomical blockages, which will not be resolved by dietary and lifestyle changes.


3. Cut way back on processed foods, particularly carbohydrates. Aim for whole grains. When we think of “carbs” many of us don’t think of whole grains. If you consume a lot of processed products – white flour and pasta products, carb/fat/salt combinations (think chips) or carb/fat/sugar combinations (think cookies and cake) – downsize those servings, and up your intake of whole grains. You’re not limited to whole wheat – look for products like couscous, quinoa, flax, and spelt – all of which provide abundant B vitamins, fiber, and plant protein.


4. Increase your intake of fruits and vegetables to at least 5 a day. We often don’t think of fruits and veggies as carbohydrates. These are nature’s perfect food – fiber and water rich, with abundant vitamins and minerals that vary with the color of the food. Fruit is often referred to as “nature’s candy”. Plan a colorful plate.


5. Substitute some plant proteins for animal proteins. Plant proteins, (in contrast to animal proteins – like chicken or beef) are a good way to pack in protein with the added balance of fiber, and multiple vitamins and minerals. Don’t eliminate concentrated lean proteins, but aim to substitute these as a dish in a soup or stew. You’ll feel content on fewer calories, which can help your weight loss effort.


6. Keep a balance of carbohydrates, fats, and proteins. Don’t eat for nutrients alone, and think of the whole food content. Choose real foods – simply prepared and unprocessed as possible. Aim for a balance of ALL the major nutrients – carbohydrates, protein, and heart healthy fat. Balance is key to fueling your body for conception. When certain foods and groups are eliminated, that imbalance might have consequences in nutritional adequacy, which might contribute to fertility. Skip the high protein, low-carb diets, or ultra-low protein diet (say goodbye to juice fasts) – even to lose weight (more on that later).


7. Take a daily vitamin/mineral supplement at least 6 months prior to trying to conceive. A vitamin is good insurance to meet nutritional needs. They’re called supplement for a reason – they ADD to, but do not replace a balanced diet. Choose a supplement of 100% RDI, or a prenatal version. Check with your doctor or pharmacist to optimize your choice.


8. Get 30 minutes of physical activity most days. The metabolic stimulus of exercise goes back to cavewoman days. We were foragers for food, and were forced to be physically active. Activity positively influences brain chemistry, joint and bone function, balance, heart function, hormonal activity, and many other body functions. You don’t have to run a marathon, but aim for 30 minutes of walking each day. Get a pedometer to monitor your steps, with 10,000 daily steps an optimal goal. If you can, mix in some strength training to support muscle tone.


9. Practice stress management. We live in such a stressful world. Learn to address and manage your stressors, to help prevent overeating and weight gain, as well as interference with body hormone secretion, which can be strongly affected by stress.


10. Avoid the quick fix for weight loss. Using the changes above, you should anticipate a weight loss of about ½ to 2lbs a week, depending on your starting weight. You can do this in two ways:
    
    -Count calories from the start: Most women will fall into this rate of loss when consuming anywhere from 1400-1600 calories each day or-
    
    -Multiply your PRESENT weight by 15, to determine calories to maintain your present weight. If you reduce that by 500 calories daily, you’ll lose 1 pound a week; reduce it by 250 calories a day, you’ll lose 2 pounds a month. It’s up to you. (So, if you weigh 150lbs, you’ll need about 2250 calories to maintain. To lose a pound a week, you’ll need roughly 1750 calories). Quick weight loss always fails.

Make the mental adjustment to change your lifestyle for the long term. It’s the perfect time to make this commitment to yourself and your family to lifelong health. A healthy lifestyle is its own reward.

What do you think?