The Dr. Hyman Show - Why It is Essential to Prepare Your Bodies Before You Conceive a Baby

Episode Date: March 22, 2024

View the Show Notes For This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Are you, or someone you know, thinking about starting a family now or in the near future? Typically, the focus on reproductive health falls on the woman, and it begins after conception has already occurred, with minimal emphasis on diet and nutrition beyond prenatal vitamins.  However, the pre-conception window is a foundational time for both partners to take charge of their hormonal, metabolic, and overall health to ensure the healthiest sperm and egg possible for a healthy pregnancy and, most importantly, a healthy baby.  In today's episode, we're discussing the essential steps both men and women can take to foster a nurturing environment for conception. We'll delve into lab tests and tools to support hormone and reproductive wellness, the challenges and insults of our modern-day lifestyles, and how we can use Functional Medicine to take a proactive approach by embracing diet, supplements, and exercise to prime couples for a successful pregnancy while safeguarding against developmental conditions like autism and ADHD that are doubling, or even tripling from one generation to the next.  Whether you're just starting to think about having kids or already on your pregnancy path, this conversation is for you.  In this episode I discuss:  The importance of the preconception window (3:15)(5:05) How epigenetics impact the preconception window (3:58)(6:01) How parent’s diet and lifestyle imprint their children’s epigenome (5:03)(6:59) Limitations of Conventional Medicine during the preconception window (9:30)(11:26) The Functional Medicine approach to preparing to conceive (12:12) Breakdown of essential nutrients and biomarkers to ensure a healthy pregnancy (15:27) Sex hormone and bonus lab tests (21:00) Optimizing blood sugar and cardiometabolic health before and during pregnancy (22:40) Foods to eat and foods to avoid while gearing up for pregnancy (23:44) Eat your foods in the correct order (protein and fat first, then carbs (36:28) Tips for reducing exposure to endocrine-disrupting chemicals (38:14) The power of exercise, stress, and sleep for a healthy pregnancy (47:24) Supplement recommendations for men and women for the preconception window (51:35) This episode is brought to you by Rupa Health and AG1. Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com. Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year's worth of D3 and 5 Travel Packs for FREE with your first order.

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And today, welcome to another episode of our special feature in Doctors Pharmacy called Health Bites. And today we're talking about something that doesn't always get the spotlight it deserves, the preconception period. Now, having a baby is one of the most important moments in many of our lives. We know it's important to take care of your health during pregnancy and breastfeeding and the importance of taking care of the baby once it's born. But many of us give little thought to the importance of preparing to conceive and how to create a healthy environment for conception. And this applies to both the mother and the father, believe it or not. Now, are you thinking about starting a family now or maybe in the near future, or maybe your kids are getting ready to have kids? I don't know. Typically, the focus on

reproductive health falls on the woman and it begins after conception has already occurred with minimal emphasis on diet and nutrition beyond prenatal vitamins. However, the preconception window is just as important for a healthy pregnancy and most importantly, a healthy baby. Now, the preconception window is a foundational time for both partners, yes, both the man and the woman, to take charge of their hormonal, metabolic, and overall health to ensure the healthiest sperm, egg, and the chance at creating a healthy new life. In today's episode, we're discussing the essential steps that both men and women can take

to foster a nurturing environment for conception. We'll delve deep into lab tests and tools that can support your hormone and reproductive wellness, the challenges and the insults of our modern day lifestyles, and how we can use functional medicine to take a proactive approach by embracing diet, supplements, lifestyle, exercise, and more to prime couples for a successful pregnancy while safeguarding against developmental conditions

like autism and ADHD that are doubling or even tripling from one generation to the next. I mean, it's kind of scary out there. One in six kids have a neurodevelopmental disorder and much of that is preventable. So whether you're just starting to think about having kids or already on your pregnancy path, this conversation is for you. All right, let's get into it. Why does this matter? Why is the preconception window so important? Well, it's a time to optimize your health to give your baby the best chance of being healthy. Why is that important? Well, many of the issues we see in kids today can be prevented by addressing your health before conception.

In fact, one in 36 children today have autism. And I don't mean to tell you all this to depress you. I just want you to understand how important it is to make sure you create a healthy environment to plant the seed of a new life. And today, one in 36 children have autism. One in six kids, or about 17% of kids age three to 17, have a neurodevelopmental disability. 9.8% or about six million kids between ages three and 17 have ADHD, and 1 in 5 adolescents are living with prediabetes, and the obesity prevalence is 13% among 2 to 5-year-olds. Wait a minute. Did I just say that?

Think about this. 2 to 5-year-olds are not just overweight. They're obese. 13% more than 1 in 10 kids between 2 and 5 are obese. And why is that happening? Is it because they're all eating Doritos as babies? No, there's something also happening in the womb that programs these kids to be overweight. And we're going to talk about what that is and how to prevent it.

Now, overweight parents before conception, who are overweight before conception, have a four to six times higher risk of having a child with increased birth weight and obesity. This is from the International Journal of Obesity. Now, everything I'm talking about today, I'm not making up. It's all from peer-reviewed literature. All the references are in the show notes if you want to dig into the studies yourself. But I want you to understand this is really an important field. And unfortunately, in medicine, we tend to ignore data we don't know what to do with. But the truth is we can use it to up-level our health, to optimize our health, and to prevent a lot of the things that we see. So we're going to include all the science that's relevant to use, not just what

doctors are doing, because they are often 20 to 50 years behind the science. So how do we prevent all these neurodevelopment issues, ADD, autism, obesity, diabetes in kids? What do we need to do? We need to address the risk factors that drive impaired imprinting. We call it epigenetic imprinting. I'm going to explain what that is. So basically, what is epigenetics? Epigenetics is the way our bodies determine which genes are expressed and which are not, and ultimately program the baby in the womb for its future health. Now, genes play a part, but epigenetics plays a much bigger part in determining

the health of the baby, not just when it's born, but throughout its whole life. I mean, think of genes as the keys on a piano. They don't change, right? They're fixed. You got 88 keys, but think of your epigenome as the piano player, able to play an infinite number of songs. Which songs in the book of life are expressed is controlled by the epigenome. It sits above your genes. It's like the regulator for your genes. And that's a good thing, right? Because most of the epigenome is controlled by our lifestyle and our environment. Now, what are the things that influence our epigenome? Well, it's the things you'd expect. Our older processed diet, the lack of protective foods, healthy food, our lifestyle, gluten stress, lack of exercise, lack of sleep, nutrient deficiencies, certain medications, your weight, body composition, chronic diseases like

obesity, type 2 diabetes, high blood pressure, PCOS in pregnancy. Women have a lot of these. I mean, I talk about this a lot, but I was once visiting Spelman College, and it's a women's college, a black women's college in Atlanta, and 50% of the entering class of women, of 18-year-old women, have a chronic disease, one of these problems. But also autoimmunity issues, environmental toxins also can program bad things into the baby. And we'll talk about how to reduce exposure and help elimination of those toxins. And also anything that drives inflammation can shape the development of a growing fetus. Now, inflammation can be caused by any of the things I just talked about, but many other

things too. So we're going to talk about inflammation because that's a really important trigger for dysregulated biology. Now, the host or mother or father in this case imprints the genetic material of the germ cells, meaning the mother imprints her eggs and the father imprints his sperm with everything he's doing in his life or she's doing in her life. This is really important to understand. So you actually have to take care of your sperm and egg before conception. Now, these traits that are programmed in through the epigenome can be passed to the offspring. Now, this can affect the likelihood of having obesity and various comorbidities like

heart disease, diabetes, and more. And what's even more striking, and this is kind of scary, is that these epigenetic changes can be passed down transgenerationally, for example, from grandmother to mother to child. So for example, children born to obese or overweight mothers have an increased risk of obesity, lower respiratory tract infections, and lower childhood IQ. This is from Frontiers in Endocrinology. I'm not making this stuff up.

Children of obese parents are at greater risk for developmental delays, including things like fine motor skills, problem solving. This is from the Journal of Pediatrics. A 2020 study conducted by the Pregnancy and Childhood Epigenetics Academy, or PACE, investigated the link between DNA methylation changes, essentially how our genes are controlled or regulated, how our epigenome is controlled, and maternal gestational diabetes in newborns' cord blood, and discovered reduced

levels of methylation in two specific areas of the cord blood DNA. So what this means is that looking at women who had diabetes or in pregnancy, that diabetes affected the epigenetic programming in the newborn baby's cord blood cells. Okay, so they looked at two specific areas, a gene promoter associated with autism called OR2L13, doesn't really matter, and a gene called CYP2E1, both known to be involved in type 1 and type 2 diabetes. So essentially there's genes that are screwed up in English, okay, that are screwed up if a woman has gestational diabetes, or I would say maybe even prediabetes, that it increases the risk of autism and increases the risk of type 1 and type 2 diabetes in the fetus,

in the baby, in the offspring when it's born. Now, these suggest that epigenetic mechanisms play a role in how maternal gestational diabetes affects the risk of autism disorders and diabetes conditions in kids. Now, in mice, the female offspring from obese fathers showed an altered expression of pancreatic islet cells. That's the cells in the pancreas that make insulin, and that leads to impaired insulin secretion and glucose tolerance. So think about this. If the father's overweight and has a daughter, that daughter is going to have poor insulin secretion, lower glucose tolerance, and more risk of diabetes. This was published in Nature, one of the preeminent journals in the world. Prenatal exposure to stress or major depressive disorder also causes changes in DNA methylation, and that leads to low birth weight

and long-term epigenetic alterations, including lower stress resilience and in the methylation, and that leads to low birth weight and long-term epigenetic alterations, including lower stress resilience and in the male offspring, a higher risk of ADHD. So just think about that for a minute. If the father or the mother has stress or depression, that changes epigenetic programming, that leads to low birth weight, an inability to deal with stress, and an increased risk of ADHD in the male offspring. This is concerning. Now, let's not get too much more into the depressive stuff. I just want you to know that we have an understanding of how our environment, our diet, our lifestyle, toxins, all influence the epigenetic programming and the risk of having a baby with bad health outcomes.

Now, this is mostly preventable. And this is where conventional medicine misses the mark. It just doesn't go deep enough. It doesn't look at a preventive approach, a holistic approach to couples who are wanting to conceive and have a baby. The advice kind of stops with prenatal vitamins, but there are a lot of things that are important that never get addressed, like diet, nutrient status, inflammation, hormones, environmental toxins. They don't talk about it. And men's reproductive health, forget about it. It isn't addressed or optimized at all. Think about it. I mean, the men are sort of out of the equation, but they're half the equation when it comes to putting the seed of a new baby in the womb, right? The sperm. And now our conventional approach to

pregnancy doesn't offer patients a deep dive into the health and the biomarkers that they need to know what's going on. Now, this is really important. Traditional medicine typically does not routinely test the things that are often the most important to know when you're trying to prepare to conceive and to optimize your health, including sex hormones, nutritional deficiencies, toxins, metabolic health. I mean, a whole list of stuff. And if they do test stuff, it's very superficial and doesn't give you the deep insights you need. So we need a lot of things. We need all your hormones, estradiol, progesterone, testosterone, LH, FSH, prolactin, DHEA, sex hormone binding globulin, AMH, a lot

of things really important. So all, by the way, all this is in the show notes. You don't have to memorize this stuff. Go check it out. All the tests are in there, what you should be getting, what you should be asking for, and what's important to know about your health before you conceive. Also, it doesn't fully test a thyroid panel. I'll do a TSH, but not the full thyroid panel, and you'll miss a lot. We're seeing, for example, in this company I co-founded, Function Health, I'll talk about in a minute, that about 13% have autoimmune thyroid disease and don't even know it. And they can have normal TSH. You should check not only the TSH, but something called free T3 and free T4 thyroid

antibodies. These should just be standard. Why is that important? Well, undiagnosed thyroid issues can cause menstrual issues, fertility issues. When you're pregnant and have a low thyroid or suboptimal thyroid, it can have really bad effects on fetal outcomes. For example, low thyroid, hypothyroidism increases the risk of miscarriage, hypertension in pregnancy, anemia, low birth weight, preterm labor, and even developmental issues. In fact, we used to have a term for it, it's kind of not that nice term, but we used to call it cretinism. If you're a cretin, it's a very pejorative word actually, but it reflects a name that we gave to people who were born to mothers who are hyperthyroid. They would come out very mentally handicapped and their health was severely compromised.

A lot of other things critical to know. Vitamin D, and we'll get into why of all these, but just stay with me because we're going to get into why of all these. But we don't check vitamin D. We often don't check folate, B12, magnesium, zinc, omega-3s. These are widespread deficiencies in our society. 80% have vitamin D deficiency or insufficiency. Methylation issues, probably half the population with folate, B12. Magnesium, probably 45%. Zinc, probably 40%. Omega-3s, probably 90 plus percent have omega-3 deficiencies. And these are critical for the developing fetus and also critical to have

healthy sperm and egg. These are really important to optimize, not after you find out you're pregnant, but before and obviously during the pregnancy. And this is really why I co-founded this company, Function Health. It's basically a health platform that provides you access to all the biomarkers we just talked about and lots more, including metabolic health and many other things. And it'll help you learn about your numbers and how to optimize them with deep insights in science. And it's just $4.99 a year for twice-year testing. Now, if you're interested in learning more, just go to functionhealth.com forward slash mark, and you'll learn more about it and can sign up. It's great. You don't jump the wait list because there are about 150,000 people on the wait list.

So what do we do in functional medicine? How do we think about this differently? Well, we want to get the right lab test to start with. We want to know where you're at. Test, don't guess, right? Get your levels tested, preconception, and then optimize those things that are out of balance. Optimize your hormones, optimize your nutrients, optimize your toxin levels, meaning get rid of them. So what are the things we need to know and why? We talked a little bit about these, but nutrient testing is so important. And we do that extensively with function health and you need to do it. And your doctor is probably not going to do this. Vitamin D. Now, why is this important? So vitamin D is crucial for hormonal health, for immune function, for many, many other things. And if you have adequate levels, it increases the chance of conceiving and also having a healthy pregnancy.

This is from reproductive biology and endocrinology. What about folate? Folate you might have heard about in pregnancy. Why is it important? This is really critical. You need this on board before you conceive. Really important. Because if you don't, it leads to neural tube defects, neurologic defects, spina bifida, all kinds of problems.

In the days following conception, the genes that govern your brain wiring are turned on and off in a process that requires folate. So it's critical for building a healthy brain in a developing fetus. If you start the prenatal vitamin after you learn you're pregnant, it's too late. So you want to start prenatals for both men and women. And we'll talk about, yes, men, why, right? Need preatals do. Before conception, a Norwegian study that followed 85,000 women from 18 weeks into their pregnancies until six years after delivery, right? Maybe six years after, revealed that women who took folic acid four weeks before conceiving and at least eight weeks after were 40% less likely, now get this, were 40% less likely to have children diagnosed with autism versus those who

did not take supplements before conception. This is in JAMA, the medical journal JAMA. Now, we want a prenatal with the right type of folate, ideally methylfolate and not folic acid. What about B12 and B6? These are important. B12 is super important, but what we check is something called homocysteine. And this is on our function health panel, not typically what you get checked. But high levels of homocysteine indicate inadequate function of folate, B12, or B6. And if you have high levels, it has a lot of bad associations with a high blood pressure in pregnancy, diabetes in pregnancy, and it's a much more sensitive indicator of these nutritional deficiencies. We also need to know about iron. So why is iron important? Well, often women need more blood during iron because they have to give it to the baby.

They'll draw on their iron stores. Women often are menstruating, obviously, before they get pregnant. So they're often at risk for iron deficiency. But if you have low iron, you can potentially not ovulate every month. You'll have anemia. You'll have trouble with red cell production. It affects fetal development. And get this, 35% of women under 50 are iron deficient.

35%. It's like one in three women. So this is a big issue. Now globally, over half a billion women of reproductive age are anemic. Now we're talking about pennies a day of a nutrient that can have profound impact on the outcomes of infants and babies and the future health of our children. So next nutrient is really important. Again, this is not checked with your regular panel, checked on function health, is omega-3 fats. Now, why is it important?

Well, it reduces the total body and reproductive system inflammation and also supports balance of your hormones. Now, omega-3s are critical for neurologic development, for brain development, the fetus, and of course, adults too. It affects your risk of depression, ADD, and lots of things. Now get this, men who had higher levels of omega-3s in their sperm have better sperm quality, higher total semen volume, and higher levels of testosterone. So think about that. You can improve the quality of your sperm just by taking the right vitamins as a man. For women, omega-3s support egg quality and the health of the lining of the uterus, which is critical for implantation and maintenance of early pregnancy and preventing miscarriages, improves pregnancy rates and prevents miscarriage. So it's really an important

thing to have. There was a result from a study, a cohort study that showed that women taking omega-3 supplements were one and a half times more likely to conceive than women not taking omega-3 supplements. This is from human reproduction. So think about it. Just taking omega-3s can increase your risk by 50% of getting pregnant in the field of medicine where we're seeing exploding rates of infertility. What else do you need to know? Magnesium. Magnesium is a critical mineral. It's involved in over 600 enzymatic reactions in the body, and it's critical in fetal development. The bad news, over 50% of Americans are low or deficient in magnesium. It's also a risk factor for preterm labor and preeclampsia or high blood pressure in pregnancy. In fact, that's what we give women when they come in with preterm labor to the emergency room

or when they have high blood pressure in pregnancy. We give them intravenous magnesium. Why not take it before you're pregnant and during pregnancy to make sure your levels are adequate so you don't have these problems, right? Big surprise if medicine did that, but that's another topic. Okay, so what about zinc? Now, this is another mineral that's critical in fetal development and also prevents preterm birth. So preterm labor, 17% of the world's population is deficient in zinc and many more have suboptimal levels. So really important to

make sure these nutrients are optimized. It's not that hard. You take a multivitamin, vitamin D, fish oil, and you're basically covered. So it's not that hard. It's not that expensive. You just need to take the right nutrients. And we're going to link to products and things that we recommend that I have looked at that I've used in my patients that have the right kind of nutrients, the right forms of nutrients, don't have any junk in it. You know, why take blue dye when you're pregnant on a prenatal vitamin, right? You want even healthy things to take that are not full of fillers, additive chemicals, and weird junk that you don't need. But basically we've done the homework for you and provide guidance on what

to take. All right. So getting the right nutrients is super important and optimizing levels is really important before conception, both for the mother and the father. So what should we be testing? Let's just kind of do a little review. Women should test their sex hormones between day 19 and 22 of a 28 day cycle to help see where your progesterone is because that's important in conception. You should check testosterone, prolactin, estrogen or estradiol, your adrenals through DHE sulfate, FSH, LH, and AMH. All to tell you how things are going with your hormones and give the doctor a sense

of what's going on. And through Function Health, you can get guidance on what to do about these and what they mean. Thyroid, really important to test properly. I just mentioned that it's imperative to have optimized thyroid levels before conception to have a healthy baby and a healthy pregnancy. Now, these are tests, additional tests that I recommend that go above and beyond what you might get to understand the whole picture. Cortisol, which measures your stress response. CRP, a measure of inflammation. And we talked about inflammation. Critical in creating a healthy environment is to reduce inflammation in the body. Environmental toxins, something we all are exposed to and have

to deal with and we can remove by changing our lifestyle or filtering water, air filters or chelation or other treatments as needed. And I do this for a lot of women. I test them before pregnancy. I get the mercury out of their bodies so they can have a healthy baby. All these things, mercury, lead, arsenic, all of which affect fetal development. Also, it's important to look at your metabolic health. We're seeing exploding rates of obesity in pregnant mothers, overweight, and this is a sign of poor metabolic health. And this can create epigenetic programming that leads to an obese or diabetic baby and child and adult. It's bad news. So you want to get your metabolic health straight. And what do you need to know? Obviously, you're fasting glucose, but also fasting insulin,

something never checked by typical doctors, your A1C, measure your average blood sugar. So managing blood sugar and insulin during pregnancy is so important for a healthy baby and to protect their long-term health and prevent them from getting obesity, diabetes, heart disease, and lots more. We also want to do a deep look at your cardiometabolic health, which is linked to your blood sugar control, but it's looking at your cholesterol in a new and important way called lipoprotein fractionation. I've talked about this on many podcasts. We'll link to that in the show notes. But essentially, this is a much better way of looking at your cholesterol. It's only 1% of cholesterol tests, so I doubt you probably got it from your doctor. But it looks at the quality of

your cholesterol, not just the amount. And it gives you a good idea of whether you have good or poor metabolic health. Now, sadly, when you go in for pre-pregnancy counseling or for testing during pregnancy, you don't get most of these tests and have very little visibility on what's truly happening in your body. And again, that's why I've co-founded Function Health, a health co-pilot that allows you to test for all this and more for less than 500 bucks. You can go to functionhealth.com forward slash mark to sign up and jump the wait list. All right, so let's talk about what you can do. After all this bad news, what can you do to optimize your health before pregnancy, both men and women, and using diet,

lifestyle, things that are mostly under our control? First thing is get rid of all the junk in your diet, right? Get all the processed food two to three months before conception. All the chemically extruded food-like substances. They don't even meet the definition of food, but all this junk we want to get rid of. We want to get also heavy metals from your diet, from mercury-containing fish, makes a huge, huge importance in health of the fetus. In fact, there's been a link between ultra-processed foods consumption and heavy metals in the food supply and autism, which is exploding. We used to have 1 in 10,000 kids had autism when I was

in early training. Now it's like 1 in 36. So it's not just better detection, something is going on that's affecting our kids. Clinical trials suggest that heavy metal exposure and also poor diet from ultra-processed foods are primary epigenetic factors responsible for autism and ADHD. This is from the World Journal of Clinical Pediatrics. This is not my opinion, right? So get this, ultra-processed food and heavy metals have both been linked to autism. Why should we be eating these foods? They should be illegal or at least highly labeled. So eat this and your kid may have autism.

It might change people's eating behavior. Now, food quality also is really important because it impacts epigenetic programming related to autism and neurodevelopmental diseases, meaning not just the bad stuff, but not having enough of the good stuff. And what's really bad is the American food supply is not so good, right? It has levels of lead, arsenic, and mercury that exceed what is known to be scientifically safe, right? Food coloring contains trace amounts of heavy metals that are allowed by the FDA, high fructose corn syrup, refined seed oils, fertilizers, pesticides, all these things contain trace amounts of heavy metals, mercury, lead, and cadmium can be found in the core blood of a baby. And they're associated with bad things.

These changes in the DNA methylation patterns, which program the epigenome, and those lead to impaired cognitive function. So we want to get rid of all the junk, all the processed food, all the coloring, all the atoms. It should be in it anyway, but anyway, just more important when you're getting ready to conceive. Conventional dairy, not so great. Lots of antibiotics, hormones, pesticides, all negatively affected growing fetus. Lots of sugar, ain't so good either, especially high fructose corn syrup, which is in everything, particularly sugar, sweetened beverages. We know that sugar, sweetened beverages promote insulin resistance in the mother, and that affects the baby's risk of being obese and diabetic. So what the mother

eats affects the baby's risk of being obese and diabetic. That's really important. And also, it's not just sugar. It's refined grains like flour. All these things like sugar and flour lead to insulin resistance and even something called PCOS or polycystic ovarian syndrome. It's not an ovarian problem. It's a dietary problem. And it's usually caused by this high concentration of sugar and flour in our diet. And that can be totally prevented.

Some things are harder to change, right? For example, environmental toxins are everywhere. Glyphosate is an important herbicide that's used on 70% of all crops. And it's concerning because it has transgenerational epigenetic effects that affect the offspring. Now, this is crazy, right? And this is on 70% of crops. This is an herbicide. So we can talk about how to reduce that.

But essentially, it's by buying organic or regenerative food and so forth. Now, large fish are also something you should be aware of. And this is like tuna, swordfish, halibut, sea chilean, sea bass, and so forth. And there's great guides we're going to link to it. The Environmental Working Group has a guide. The National Research Defense Council has a guide on mercury fish. So you know which are the lowest, which are the highest, and you can avoid all the highest ones. But we know that, for example, mercury is a potent neurotoxin. Also, inflammation, as I mentioned, by any means will drive impaired conception and poor pregnancy outcomes. And those are things like leaky gut, which is really common in our society because of our diet and the lack

of fiber and processed food and damage to our microbiome. And this causes something called metabolic endotoxemia. So think about it. When you eat junk food, processed food, sugar, starch, all that changes your microbiome and it feeds the bad bugs. And those bugs produce toxins that get absorbed. And those toxins trigger inflammation. Those inflammation changes lead to prediabetes and some resistance and more trouble all the way down the road and epigenetic changes. And that leads to a bad environment to conceive and digest it. Now, what should we be getting rid of in addition to the things I mentioned that can cause this?

Well, trans fats, which shouldn't be eaten anyway. This is shortening, margarine, and so forth. Low quality fats are not good to eat eat like refined oils, seed oils, things in ultra processed food. Gluten can be an issue for some, but not everybody. Uh, GMO corn, processed soy, but not whole soy, not whole non GMO soy, but processed soy can be very significantly damaging and can interfere with hormone function in men and women. Uh, caffeine, not a good thing to be doing while you're, uh, trying to get pregnant or during pregnancy. So coffee, green tea, black tea, not that trying to get pregnant or during pregnancy. So coffee,

green tea, black tea, not that they're bad, but during pregnancy, they're bad. Too much of these things also can wear out your adrenals. They can also, as I mentioned, have adverse effects on the fetus. Alcohol, well, I mean, it's now known to be harmful at any dose. Enough said. Don't drink it before you get pregnant and during pregnancy. What shouldn't you be eating? Well, these are goals, but I think it's really important, you know, if you want to have a healthy baby to prepare the oven properly. And that means eating real whole foods, nutrient-dense foods with micronutrients and lots of phytochemicals before and during pregnancy. And when they did this in studies, they found that women who did that had a lower risk of prediabetes, of gestational diabetes, of gestational high blood pressure, hypertension, and of preterm labor. Think about it. If you eat healthy food, you're less likely to have

diabetes during pregnancy, high blood pressure in pregnancy, and have a preterm delivery, right? And this is from the American Journal of Obstetrics and Gynecology. Also, good quality protein is very important. You need adequate, more protein before and after. You need high quality protein and more than you think before, during, and after pregnancy because you're beating a new baby and growing something. So about half to one gram per pound a day. Also for fertility, you need a lot of nutrients that are in protein, iron, carnitine, choline, creatine, zinc, selenium, B12, vitamin A, all in healthy animal protein. And what I mean by that, well, grass-fed or regeneratively raised beef, lamb, venison, and these contain zinc, selenium, iron,

carnitine, beef liver. I know you may not like that, but it's good. Chicken livers are good too. Lots of vitamin A, really important bioavailable vitamin a you can use fish but i would only eat the smash fish salmon very small wild salmon mackerel anchovies sardines and herring maybe you don't like those i do but uh you don't have to eat them you can take the omega-3s if you don't like them but you need to make sure you have all those and what do they have they have selenium they have vitamin d they have choline they have particularly omega-3s. And also clams and oysters are great because they're a source of B12 and zinc you need in pregnancy. Pasture-raised eggs, also important, including the egg yolks, which are high in all the nutrients

to create a new life. Think about what an egg is, right? It has all the nutrients to create a healthy new life. The B12, folate, B6, chicken, make sure it's pasture raised. Pork can be okay that has thiamine, zinc, but make sure it's raised in a way that's sustainable, regenerative, and so forth. Bone broth can be great too.

It's full of collagen, glutamine, glycine, amino acids you need for a healthy baby. Sometimes dairy can be okay. If it's goat or sheep, yogurt, recommend that. Also, you want to eat a lot of low glycemic fruits and veggies, whole grains, beans, all fine during pregnancy, lots of antioxidant, rich foods, full of polyphenols, all the colors and bright colors and vegetables and fruit.

These contain a lot of nutrients you need like beta carotene and other carotenoids, vitamin E, vitamin C, selenium, zinc, CoQ10, all important. And so you want to have these on board before conception, right? And not only, again, for women, but for men. For example, CoQ10 improves sperm concentration, motility, and morphology, meaning it improves how much sperm you have, how good they swim, and how they look, right? You don't want sperm with two heads. Antioxidant properties also of foods help neutralize the effects of what we call reactive oxygen species on the sperm. In other words, oxidative stress or rusting,

which can damage sperm. So these antioxidants can protect the sperm and again, lead to a higher likelihood of a healthy baby or even conception. One study showed that antioxidants in your diet can increase male fertility by fourfold. That's 400%. And in medicine, when we see a 20% change, we think that's a lot like, well, govir reduces heart disease by 20%. I think it's kind of irrelevant, honestly. This is 400%. And it can also increase the chance of a successful pregnancy having antioxidants by up to five times. And there's a lot of ways to help combat oxidative stress using diet and antioxidants. This also has positive effects on sperm count, as I mentioned. Fruit's great, but you want to stay away from the pesticide-containing ones. You can use the Environmental Working Group, Dirty Dozen List. We'll put the link in that in the show notes, but you want organic apples, blackberries,

blueberries, strawberries, cherries, raspberries, cranberries, dragon fruit, kiwi, all these yummy foods. You want fat fruits, right? Fat fruits. What is fruit fats? Fruit fats or fat fruits, avocado, coconut, great. Veggies, non-starchy veggies, although you can have sweet potatoes and things are fine. Leafy greens, spinach, kale, have a lot of folate, vitamin K, red bell peppers, asparagus, mushrooms, dark chocolate's great for iron and polyphenols. Yep, dark chocolate's okay. Just make sure you eat not too much of it. Also, the other thing you want to do is support your microbiome. The mother's microbiome plays a huge role in the health of the baby.

So you do that through prebiotic fibers, fiber-rich foods, fermented foods. We talk a lot about probiotic and prebiotic fibers. I've done many podcasts about this and also many links and articles we'll put in the show notes. But you can have sauerkraut, yogurt from goat and sheep, kefir, kimchi, natto, tempeh, all great fermented foods. Antioxidants, all the carotenoids, which are important for babies as well. These are in all the kind of yellow, orange vegetables and fruits. Vitamin C is important.

All support reproductive health. All the kind of yellow, orange vegetables and fruits, vitamin C is important, all support reproductive health. In animal studies, the carotenoids actually, from these kind of yellow, orangey vegetables, they enhance ovarian function, they improve ovulation, they help make progesterone, which is called the progestational hormone. That's why it's called progesterone. Helps progesterone synthesis. It helps the embryo develop in females.

Really important. So these are all things you can do. And what are those foods? Cantaloupe, orange, bell peppers, sweet potatoes, yams, carrots, pumpkin, all yummy to eat. Also nuts and seeds are important. And they're really great for fertility because they have high amounts of omega-3 to omega-6. They're low in saturated fat. They have a low glycemic index or low, they have high

monounsaturated fats and high amounts of fiber, vitamins, minerals, bioactive compounds, protein. In fact, a 2020 study found that men who ate 60 grams, about two servings, maybe two handfuls of mixed nuts a day without changing any other aspect of their diet, their bad process, sad diet, for 14 weeks had beneficial DNA methylation changes, better sperm count, sperm size, sperm motility, and viability of their sperm. This was from the journal Andrology. Now think about that. Just eating two handfuls of nuts, even in the context of a crappy diet, creates beneficial changes in your epigenetic programming and all of your sperm characteristics. That's pretty amazing. Also, they're a good source of vitamin E, which is important. That protects

sperm membranes against free radicals and oxidative stress. Whole grains and legumes, if you can tolerate them, are a great source of fiber, prebiotic fiber. They help the gut microbiome and they feed the good bugs. Gluten-free grains can be fine. I like black rice, red rice, wild rice, teff, amaranth, buckwheat. My favorite is Himalayan tartary buckwheat sprouted powder. It's so yummy and it's full of lots of anti-inflammatory antioxidants. Also quinoa. Millet's a little high glycemic, but you can have that. Legumes are good. Lupini beans, white beans, lentils, peas, black-eyed peas, mung beans, non-GMO soy. You can have edamame, tofu, tempeh.

Also, herbs and spices are great. They help balance your blood sugar. They help with all the antioxidants in them. They can help regulate inflammation. So you want to prioritize good quality protein, healthy fats, lots of fiber, lots of antioxidants at every meal. You want to avoid ultra processed foods, starch, sugar. You want to make sure you eat in the right way too. It's not only what you eat, it's when you eat, how you eat and so forth. So we call it food stacking. Start the day with

protein and fat for breakfast, right? It can be eggs. It can be a protein shake, lots of options. I sometimes, you know, have a fish for breakfast, like kippers, right? You can have that and you get the omega-3s and all the goodies. You want to avoid sugar and carbs for breakfast. It's pretty much what the American diet is, right? Cereal, pancakes, muffins, bagels, you know, sugar, sweetened coffees, teas. I mean, it's just basically what we all eat. It's dangerous.

If you're going to eat any carbs, you can put, for example, blueberries or strawberries in your smoothie. That's fine, but you want to make sure there's protein and fat that prevents the glucose spike. You also want to eat veggies, fat, and protein before carbs. So having bread at the beginning of a meal when you go to a restaurant, worst idea. Start with fat and protein and veggies, and then if you want a little dessert, you can have that. Why? Because it slows the absorption of sugar in the gut. It prevents the spike in insulin and prevents the whole cascade that happens as a result. Also exercise underrated. Just walk after eating. When

you walk after eating, it creates a sink for all the glucose and it drains out of your blood and goes into your muscles and store to use properly. Resistance training also really important because building muscle helps glucose absorption over time. It helps improve insulin sensitivity. You can track your sugar if you want. You can use a glucose monitor and see how it impacts your sugar levels. You can try levels. I'm an investor and advisor. Levels.link forward slash Hyman, I think it is.

We'll put a link in the show notes where you can learn more about it. Also, I want to talk about environmental toxins. Why? Because they're everywhere and there's things we can do to reduce our exposure. But essentially, you know, they're ubiquitous. Let's talk about some of the bad ones. BPA is used in the production of plastics. That's bisphenol A, epoxy resins, and it's a hugely endocrine disrupting chemical.

A study showed high levels of microplastics in every single sample of placental tissue. So our kids are going to be exposed to this. We just want to reduce the amount and we want to help our bodies detoxify. Studies show that prenatal exposure to BPA is linked to poor methylation, which is part of the epigenome programming that leads to obesity and increases the risk of obesity in children. Also in adults, right? It also harms fertility, not only in women, but in men, right? So if you get exposure to BPA from plastics, credit card receipts, ATM receipts, you know, parking tickets, I mean, this is hard to avoid it, but you can.

If you have exposure for men, it inhibits sperm motility by decreasing the level of energy in the sperm cells, what are called ATP. It binds to estrogen receptors. It affects gene expression and has epigenetic impact. And these impacts may be transgenerational. We know that these can kind of cross generations, as I mentioned. It also binds to other hormone regulators like sex hormone binding globulin. It may increase testosterone. That can affect fertility. It damages female reproductive organs. It causes follicle loss.

This is kind of a bummer, right? But it's out there. We have to deal with it. But BPA definitely affects follicle loss. It habits embryo implantation, impairs the reproductive cycle. So you got to watch out for it. Now, what's happening as we've sort of started reducing BPA and things, they've added a new chemical. So basically tweak it a

little bit, change it, and then throw it back in the system and then wait till we find out it's bad. And then people cry out about it and try to deal with it, but it's bad. I mean, it's just bad news. There's another chemical that we want to watch out for related. It's called bisphenol S or BPS. And it also is an issue that's found everywhere. People who had exposure to BPS because it was replacing BPA, it was even worse. And there was a 250 times higher risk of exposure because of the absorption for an equal dose. So the same dose of BPA and BPS, BPS levels get 250 times higher for an equal dose of BPA in animal studies. That's scary. So that means that replacing BPA with BPS will likely lead to an increased level of exposure.

So you really want to deal with this. What can you do? Don't store things in plastic. Don't buy things in plastic. These leach into the food, use containers that are glass or metal or whatever. A drink from glass cups, not plastic cups. Don't drink from plastic bottles. Don't heat food or drinks in plastic containers. Avoid BPA line coffee cups.

Take your mug to the, to the coffee shop instead of using their BPA line coffee cups, take your mug to the, to the, uh, uh, coffee shop instead of using their, uh, BPA line mugs, avoid plastic tea bags, which are everywhere. Uh, skip the receipt, right? And receipts from when you go shopping from credit card receipts, the tickets you get at a parking garage, all these things have, when you get your gas at the gas tank, all these things have BPA on them. Don't touch them. Phthalates also are everywhere. They're in children's toys and vinyl, personal care products, and they are banned in Europe. But when you have high levels of phthalates, and we can test this in people, there's impaired sperm, DNA damage, and lowered testosterone. Not good.

A new study from the University of Washington School of Medicine found that pregnant women who consumed ultra-processed food, which is 60 plus percent of our diet, run a higher risk of phthalate exposure from food packaging. So don't eat packaged food. I've been saying that forever. And in the thousand pregnant women in this study, about 10 to 60% of their diets came from ultra-processed food. And for every 10% of their diet that was ultra-processed food, there was a 13% higher concentration of phthalates,

which transfers into the bloodstream through the placenta into the fetal bloodstream and creates a cascade of inflammation and oxidative stress. So it's just bad news. There's also a link between phthalate exposure during pregnancy and increased risk of low birth weight, preterm labor, and even mental health issues like autism, ADHD. And this is just from phthalates, right? Where else do you get these things? Fragrances, candles, plug-in, you know, scent things that people put in their cars, in the bathroom. Don't do that. Perfume can sometimes have it, deodorizers, deodorant, lotions. You want to opt out of all these typical skincare and other products and use products that have low levels of toxins. And I'm on the board of the Environmental Working Group.

We'll put a link. It's ewg.org. They have a great database called Skin Deep. You can put your care products in there, see what's in there, find ones that are healthier. Other toxins to avoid are important like parabens or sunblock and creams, aluminum deodorant, triclosan and skincare products. These are all based. So just go to ewg.org, go to Skin Deep database and you can put in your products and see what's good, what's bad and find them. Okay, what else? Well, PFAS. These are forever chemicals, right? PFAS exposure may be associated with lower fertility in women. A case control population study found that there was a 5%, 10% reduction in fertility for every quartile, for every little increase in exposure for pregnancy.

So the higher the level is, the lower chance you have of getting pregnant. Now, where do you find these? PFASs, well, in tap water. So filter your water. Large fish, so don't eat them. Food packaging, air pollution, particularly matter that's 2.5, like mold, dust spores, allergens, pet dander, all of it's sort of in there. Indoor air pollution, burning candles with scents and stuff incense air

fresheners get rid of them all avoid also toxic household products that you can use there's a great again database on edwg on how to find the healthiest household cleaning products so you don't have to actually use crap there's ones you can use that are healthy uh all these things are linked to autism add so uh make sure you have an filter, get rid of all the toxic crap in your house, eat organic. It's pretty straightforward. Avoid heavy metals, lead, arsenic, mercury. All these impair female reproductive health. They create epigenetic changes.

They lead to autism, ADD. Where do you get these? Well, tap water, large fish. So get a water filter and avoid large mercury fish. And again, we'll put the links of how you can know which fish are high or low in mercury in the show notes. So I know it's a little depressing, but it's important to know because knowledge is power. And when you know these things, you can avoid these toxins. You can improve your diet. You can optimize the chance of having a healthy conception and a healthy baby. And that's

really important. What else? Glyphosate, we mentioned a little bit earlier, pesticides. In animal studies, this is kind of scary study I saw. It just kind of freaked me out a little bit, but it's true, which is glyphosate, which is everywhere, was shown to promote the epigenetic changes across generations. So it led to all sorts of diseases in not only the subsequent generation, right, but even the great grand offspring, three generations down in animal studies. This was in a paper in Epigenetics Journal. So eat organic whenever possible, at least the dirty dozen, which is the most contaminated fruits and vegetables.

Now, EMFs. What about EMFs? A lot of controversy about that, but there is data about this, and we'll link to this in this show notes. This is not something I'm making up or conspiracy theory, but radio frequency from EMFs, electromagnetic frequencies from microwaves, laptops, Wi-Fi, cell phones may have negative effects on testicles or testes and may affect sperm count, the shape of the sperm, motility, how fast it swims, and DNA damage. And this is from a journal called Reproductive Biology and Endocrinology. And it's kind of scary. You know, there's an

association between high frequency of smartphone use, for example, more than 20 times a day, and lower sperm concentrations and total sperm count. So, you know, keep your phone away from your body. Don't put it in your pocket. Put it in airplane mode when it's in your body and, you know, use speakerphone and just be careful. This is from the journal Fertility and Sterility. What about tobacco, marijuana? Well, research shows that a man's exposure to nicotine and THC can change in a bad way DNA methylation in sperm or even certain genes, seven genes, that play a role in neurodevelopment, which are associated with autism. So this is kind of weird. If you smoke pot or if you smoke cigarettes, you may have an increased risk of having a child with autism. And we're seeing, again,

all these things happening. If you stop all this stuff, you're okay, right? Sperm production increases and over two months you get back to normal. What about exercise? Obviously it's good for everything, including fertility. So it helps you balance your hormones. It helps blood sugar control, insulin, blood flow, lowers oxidative stress, all important for preparing yourself to have a healthy pregnancy. Sweating, really important. So saunas, not when you're pregnant, but before. Sauna, sweating from exercise helps reduce metals in your body like cadmium, lead, mercury, helps excrete BPA through saunas. Men, you want to avoid excess heat from saunas and a hot bath when trying to conceive because

hot temperatures can lower sperm count. So you got to be careful. Also being sedentary and renal active means you have a low fat-free lean mass, meaning low muscle, and you have higher fat mass, meaning more fat. And when that's true, you have trouble with fertility and trouble conceiving. So do a combo package, aerobic exercise, strength, high intensity interval training, start with what you can manage, work your way up, really important. Stress, what about stress? Well, stress can also disrupt reproductive hormones that are tied to fertility and to pregnancy. It activates something called the HPA axis, the hypothalamic pituitary adrenal axis, that leads to higher cortisol or the stress hormone.

And when you activate this stress response, it affects not only the HPA axis, but something called the HPG axis, which is the hypothalamic pituitary gonadal axis, which regulates sex hormones and reproductive hormones, both for men and women. When you have high levels of stress, it can inhibit the release of something called gonadotropin-releasing hormone or GNRH. And that signals the pituitary from your hypothalamus to produce FSH and LH, which are hormones that actually stimulate the ovaries and the testicles to produce FSH and LH, which are hormones that actually stimulate the ovaries and the testicles to do their thing, you know, to get eggs ready, to make more sperm and so forth. And when you have this inhibition of this signal from your

brain because of stress, it can delay or prevent ovulation and it can lead to irregular cycles and even loss of your menstrual cycle. So researchers actually did a study on this. They calculated mean stress levels during each phase of the menstrual cycle. And the woman who reported feeling more stressed than other women during the ovulatory window, meaning when they're ovulating, they were 45% less likely to conceive. Think about that. If you're stressed during the time you're likely to get pregnant, you're 45% less likely to conceive. This is from the Annals of Epidemiology. So here's what you can do also to offset the stress. We've talked about this a lot in many podcasts. We have a lot of podcasts on this. We'll link to this. Things like meditation, movement, yoga, walking, nature exposure, all increase endorphins and relaxation,

gratitude practices and journaling, breath work, avoiding long travel, which interrupts your dislocating rhythms and increases stress hormones. Get rid of sugary foods, all in spite cortisol. Prioritize self-care, which helps reduce stress on your nervous system. Massage, journaling, taking a bath, my favorite, taking a walk, playing with friends, hanging out, just being in a less stressed state. And it's something you have to work at. It's kind of weird to think about active relaxation, but you kind of actively have to relax. Maybe you need therapy, whatever it is, get it. Sleep, also important. If you don't sleep, it screws up your

hormones, your whole circadian rhythms and stresses your body. So make sure you have a set bedtime, how to get bed before 11. Um, and, uh, when you, when you have more of these stress responses from lack of sleep, you have higher cortisol, insulin resistance, and a lot of things you can do to optimize your sleep. We have a sleep masterclass we'll link to it, but you can keep your room dark, uh, light blocking curtains, or just keep a sleep mask. I travel with that all the time. Uh, don't use your screens before bed an hour or two. They overstimulate your pineal gland and change your circadian rhythms and sleep. Also don't eat two hours before bed, two or three. Give your body time to digest. Avoid snacks high in sugar, carbs, or caffeine because that'll increase cortisol, prevent your sleeping. Try to

get about seven, eight, nine hours a night. When you have long-term sleep disruption, it actually affects things directly in terms of reproductive cycles, something called luteinizing hormone. This is the hormone that triggers ovulation. So it's going to screw up ovulation if you don't sleep, basically. Gets sunlight first thing in the morning, helps reset your circadian rhythms. Okay, so you've done all these things. You've eaten better, you're exercising, reducing stress, you're sleeping, you're improving your diet, you're avoiding toxins. You've done all these stuff. What else do you need to do? Well, supplements. You need supplements because we're all deficient and it's really important not to start them when you find out you're pregnant,

but to start them before you're pregnant, at least three to six months before conception. Now I'm going to reference a prenatal vitamin I love called WeNatal. It's for men and women. There's two different versions, one for men, one for women. It's a great company. I'm advised by that company and it's a really clean product with all the right nutrients, but you want the right form of folate, methylfolate, not folic acid. And by the way, about 35 to 40% of the population has a mutation in this particular gene called MTHFR that regulates the abilities processing of folate and folic acid. So it's really important. You need to have the right form. You also need other B vitamins that are methylated like B12, high quality omega-3s, probiotics,

really important, can prevent a lot of allergic and inflammatory issues of the kid, vitamin D3, iron, and acetal. All these things are in the right prenatal vitamins. Weenatal has all these essential vitamins for women and men. As I mentioned, I'm an advisor to the company. If you want to know about my conflicts of interest, but I only endorse companies that I think are really doing good stuff out there and providing good products. Although support may be helpful, but I would check with your practitioner. Various herbs can be helpful. You can also

track your cycle, right? Remember important is that various tracking apps, natural cycles is a good one. That's FDA cleared. You can track your cycle by taking your temperature every morning. It syncs with your aura ring if you have one. And there are other apps like Flow and Clue, you can check them out. What about men? Do men need something? Yes, they do. They need full spectrum multivitamin and mineral and vitamin D and fish oil and folate, B12, antioxidants, zinc, CoQ10, particularly for men, and acetylcysteine, which helps detoxify things and increases glutathione. And when you do all this, what happens? For men, it increases sperm quality, reduces oxidative stress, which damages sperm. It helps sperm volume, reduces oxidative stress, which damages sperm,

and helps sperm volume, so more sperm, motility, better swimmers, and also viscosity in infertile men, which basically helps the sperm swim. Also things that can help are carnitine and maca, which improves sperm function and health. Now, Weenadl has all these and lots more. We're going to put a link in the show notes for more information about We Needle for women and men. And so we just covered a lot. I know there's a lot of information, but this is a topic that doesn't get covered very often. It's a topic that affects the future health of our children and our society. It's massively consequential, something that doesn't get talked about much. And this is really why we do these podcasts, to help you understand the science behind some of the practices that can really up-level your health and optimize your wellbeing and even protect your children. And this is all

through the lens of functional medicine. How do we think about not only preventing disease, not only treating disease, but optimizing the environment that your body has. And this is obviously not just going to help the baby. This is going to help you improve your health. So as we conclude today's episode, Ms. Health Byte, it's really important to point out that infertility and child health problems are exploding. Now, many of these issues and problems can be prevented by good preconception practices. So reproductive health is a vital aspect of our overall health, and it's got to be a shared journey. It's not just all on the woman. So embracing a functional medicine approach allows us to explore the root causes and work towards holistic solutions that are not just

good for conception, but also having a healthy pregnancy and a healthy baby. So I encourage everyone to approach this preconception window proactively. And also I encourage you to consult with healthcare professionals who understand these issues and also check out Function Health because you can get these lab tests and find out what's going on with your body. Again, everything for this podcast is in the show notes. A lot of information I downloaded. You can read the transcript. You can look at the show notes. You can see the links. You can get the references. All the things I've talked about are there. And I hope you enjoyed this podcast. Thanks for listening today.

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