The Food Medic - S10 EP 8 Food for Fertility with Dietitian Ro

Episode Date: November 20, 2023

In this episode Dr Hazel is joined by Ro Huntriss - one of the UK’s leading fertility dietitians and is the Founder of Fertility Dietitian UK.She is also the author of the book Deliciously Health Fertility (available on amazon) This episode covers: The role does diet plays in male and female fertility How can we eat for fertility? Key nutrients associated with fertility Nutrition considerations for IVF and egg freezing. The role of supplements in fertility Should you give up alcohol and caffeine on your fertility journey? Exercise when trying to conceive - finding the balance The impact of environmental toxins and EDC’s on fertility Interested in more content like this? Check out www.thefoodmedic.co.uk Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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exclusions and terms apply. Instacart, groceries that over-deliver. Hello and a big welcome back to the podcast. I'm your host, as always, Dr. Hazel. Today, I'm joined by Ro Huntress, one of the UK's leading fertility dietitians and founder of Fertility Dietitian UK, which offers patient services for men, women and couples on their fertility journey and training for healthcare professionals on the topic of fertility nutrition. Ro is also author of the book Deliciously Healthy Fertility, as well as being a published academic author in the area and was titled Social Media Influencer 2022 by the British Dietetic Association for her work around fertility. In this episode, we're breaking down the role of nutrition and supplements for fertility. Of course,

nutrition is only just one piece to a very complex puzzle when it comes to fertility. But if you're planning to have children at some point, even if it's not right now, it's a good idea to be aware of some of the key nutrients that support fertility. So I know this episode is going to help many of you. So Ro, welcome to the Food Medic podcast. Thank you so much and what an amazing studio you have, may I say. It's so nice to have you here. We do some of them virtually, but it's much nicer to see people in person and have a chat. And I've not seen you in

a couple of months now since you released your book. Congratulations. Thank you so much. Yeah, that's it's my first book. And I'm really happy that it is in the field that I am so passionate in, which is fertility nutrition. And, you know, the publisher approached me to write the topic, which I think just goes to show like the importance of this topic and the fact that people are really starting to understand like the power of nutrition in somebody's fertility journey. So, yeah yeah it was released in um in March and things seem to be going pretty well with it so far it's got great feedback so far yeah it's a brilliant book I have it and I think it's amazing um I think you know in the field of nutrition we often focus on pregnancy and preconception and maybe breastfeeding but we don't really talk about fertility and we

don't talk about male fertility very often either and so I'm really excited to just dive in and chat all about nutrition and fertility and also some other lifestyle factors. So maybe we can just start there what do we know in terms of the role of nutrition in male and female fertility? Well it works in lots of different ways I guess you can think of it from role of nutrition in male and female fertility? Well it works in lots of different ways I guess you can think of it from kind of like a broad angle at first in that nutrition has been shown to or a fertility friendly diet should I say has been shown to increase the probability of pregnancy and it can also reduce the time that it takes to get there so we know that as a whole, but then

actually you can start to get quite intricate with fertility nutrition because nutrition can affect different parts of the fertility journey. So we know that it can support egg quality, it can help to promote egg quality, it can support sperm quality and sperm health. And then also we've got implantation. So some people, you know, they don't get to the point of being able to have the embryo actually implant. So nutrition can support that. And then also when we're at that stage, we then need to sustain that pregnancy. And nutrition and lifestyle can have an impact in reducing the risk of miscarriage and sustaining those pregnancies. And then, you know, you can get really quite intricate in terms of how it can work.

So say, you know, with regards to like sperm health, for example, you can then go and look into like the different parameters. So we've got, you know, sperm count, concentration, motility, morphology, DNA fragmentation. And nutrition can kind of like influence those but just like in slightly different ways it might be that certain nutrients helps one parameter but potentially you know not another and then i think like another thing to consider is uh the impact that nutrition can have on health conditions that are associated with fertility and infertility so say for example um pcos um even things like diabetes because like poorly controlled

diabetes can have an impact on fertility and things like celiac disease as well so undiagnosed or unmanaged celiac disease in women can increase the the risk of infertility and miscarriage as well yeah it's so fascinating and I mean to, it's quite interesting that it's not something that is widely known. Yeah. I mean, you can do a quick Google search and you'll find the best fertility diets or eat these, you know, five foods for fertility. But it's not really that straightforward as it were black and white. If you were to say, you know, what kind of typical dietary pattern is the best for both male and female fertility what would you advise yeah i think the research suggests that the mediterranean diet is a really really good place to start so you know we're thinking plenty of colorful fruits and

vegetables nuts seeds legumes olive oil oily fish and a diet that's kind of lower in sugar and red meat. And that dietary pattern, first of all, it's kind of like, it's not too an overwhelming place to start. And it can support women, it can support men, but it can also support better outcomes in terms of IVF and other fertility treatments as well. So that is a that's a really good place for people to start and you know obviously like a lot of people think about fertility really when they're thinking about getting pregnant um but how soon should we be thinking about nutrition for fertility even if we're not ready right now to get pregnant i mean I think it's always good to have at the back of your mind. And I think, you know, we're maybe all guilty of it as humans. If I feel fine, I won't change

anything kind of thing. But I think it is always good to have that at the at the back of your mind and just, you know, not just for fertility, but for just for just for general health, to try and have, you know, a healthy diet for the most part to try and leave live a healthy lifestyle. Even doing that is going to put you in a good position. But when we look at when we look at fertility, and really kind of like the acute impact that that nutrition and lifestyle can have, we tend to say roughly around about the three months before trying to before trying to conceive. The reason why this period is quite important is that for women, it takes approximately 90 to 100 days for the egg to mature and develop before ovulation.

So that means it's a window of opportunity in that, you know, the foods that we're eating, the nutrients that we're consuming, the lifestyle that we have can influence the quality of the egg that then puts us in a good position for the rest of that fertility journey. And similarly, for men, it takes approximately two and a half months for the sperm to develop. So it means that we've got that window of opportunity to influence the sperm then. So certainly, yeah, that three months and it kind of like it's it's a useful thing for people who think oh god you know my diet hasn't been that great for the past however long and you know what I say to people is like well one thing that we can't control is the past but we can control what's going on now in the present and we can control you know our actions

and behaviors in the future so don't don't worry about what we can't control and let's focus on what we can yeah i think that's a really helpful message because sometimes we talk about kind of risk factors in our previous life but it's really helpful to know that there is that window of opportunity where maybe we can nourish ourselves a little bit better um and like we've been talking about pregnancy and getting pregnant naturally but does this apply to those who are using IVF for example to get pregnant and is the research there when it comes to nutrition yeah and to be honest the foundation is very very similar um there's you know there's some studies that have obviously they're they're generally done in kind of like either population

so those who are trying to um get pregnant naturally or those who are going through IVF. So there's been some studies that have looked at specific things for IVF, so such as whole grains. So women who had a higher intake of whole grains, they they have been associated with with greater and better IVF outcomes. And even things like the inclusion of soy has been linked to improved outcomes in women who are undergoing IVF. Oh, wow. Yeah, which is quite interesting. And then even just like from a supplement point of view,

so for example, like a higher supplemental dose of folate has been associated with improved IVF outcomes and even like looking at specific supplements such as like the role of myo-inositol that's proven to have some benefits for for women who are going through who are going through IVF and that myo-inositol may not necessarily support we don't have the evidence to say that it will support everybody who is like you know who is conceiving naturally so there are some kind of there are some differences but with with IVF and with with women and couples who are who are going through this it allows you to really be quite targeted because people know at what point things are happening so it's like in the run-up we're

like okay we know we're going to be focusing on egg quality sperm quality right now you know let's really really optimize um optimize the health of the egg and sperm right now and then you know then we can focus when it's like the embryo transfer we will focus on um implantation and then you know we work with people just to ensure uh that everything is you know in terms of diet, lifestyle supplements is optimized to to help to sustain that pregnancy. But, you know, some people may have a frozen embryo transfer, for example. So if they've got their frozen embryos, then they don't need to do the stuff that's targeted to egg and sperm quality because we've already got the embryo. Yeah. So you can kind of. Yeah. So so in that way you can make it quite targeted but you know from the patients that i've worked

with they actually find it really empowering to be working on something that they know and you know we must say that we we can't say that like nutrition will solve and cure all problems but it's something that we know that's got you know good evidence behind it and it and it really could help and it's really empowering for people to be able to focus on nutrition supplements lifestyle because these are things that they can control and there are so many things in one's fertility journey that they are unable to control so it can actually yeah it could be quite an empowering journey for them yeah i can imagine it is because a lot of it is kind of you're just waiting and hoping and having something that you can practically do and have control over I can imagine is really empowering yeah for women who are undergoing egg freezing and not planning to get pregnant in the

immediate future is it something that you advise that they start to think about as well prior to harvesting oh definitely because it's exactly what I was saying before they still have that window of opportunity to really optimize the quality and the health of their eggs so and and one of the one of the reasons why egg quality can be lower is due to like oxidative stress so you know like a key thing to focus on um can be like antioxidants in the diet um as well and you know many women take a prenatal supplement when they're trying to get pregnant but actually taking a prenatal supplement for the few months before egg freezing can actually be a really good way to increase the likelihood of having good quality eggs yeah i think i think i mean i've gone through egg freezing i think it's

really helpful to hear that information but when i was going through the process you'd be surprised with how many different um kind of fertility clinics i spoke to or was researching about were just blankets saying you don't need to consider your diet or change anything because you're not getting pregnant and so they were like you can eat what you want you can continue drinking like and it was really interesting like a really interesting narrative because regardless of what procedure you're undergoing when you're putting your body through so much stress like you would think you'd need to be considering all of those things and so that was one thing that I felt from my personal experience is not really communicated very well yes for couples undergoing IVF and pregnancy but not women egg freezing yeah like you saying that just put like my body into like slight state of

stress I was like no yeah but but this is the thing that there are so many people who don't who don't understand you know like the power and the influence that like nutrition can have and like quite simply that that's the wrong advice to give because there are things that we can do but I think yeah it's it's they're kind of like thinking about it just in terms of kind of you know the the outcome and things like and carrying a pregnancy and things like that but egg quality plays a part yeah yeah 100% we mentioned the dietary pattern and kind of briefly touched on supplements but what would be like key nutrients that people might have to look out for in their diet especially if they're kind of maybe having a bit more of

a restrictive diet or exclude certain food groups for whatever reason what are the kind of key nutrients you would like ensure that someone has in their diet and in good amounts yeah i think like when i started to work in fertility i know, really started to understand the importance of micronutrients. Like we all know that there are essential nutrients, but it's like when you when you deep dive into into this area, you understand like the individual responsibilities of each of these key nutrients. So really, like all nutrients are going to be really important, which is why it's important that we try to have a nutritionally complete diet. But just taking some of the kind of like more important ones with regards to the role in fertility. So take take vitamin D, for example, people who are deficient or who have low levels of vitamin D. They can have a lower probability of pregnancy if trying to conceive naturally and then also

there are poorer IVF outcomes associated with those who have low vitamin D levels and sometimes correcting a nutrient deficiency can be the answer to somebody's infertility problems which is just crazy you know like people don't think about it, but, you know, I've had clients, and literally they're low vitamin D level. As soon as that, you know, we can't necessarily claim cause or effect, but as soon as that was treated, you know, they became pregnant.

So it's like, it is really, really important to look at these kinds of levels. But yeah, you know, vitamin D is one. Folate, so we all hear about like folate and folic acid. So everybody knows of it in terms of its role in the prevention of neural tube defects but actually it does much more than that it plays a role in sperm health it plays a role in egg health and also you know low levels of folate are associated with higher rates of miscarriage um and taking like vitamin b12 as

well low levels are associated with infertility, and low levels are associated with increased risk of miscarriage. And then you can look at nutrients such as like vitamin E, for example, you know, it's one of the key antioxidants, so it can support egg and sperm health, but also it's been linked to a thick endometrium, and we want to have a nice, healthy, thick endometrium for the embryo to be able to implant so those are just kind of like a few examples but there are actually so many more that play in and that's you know my role as a fertility dietitian to ensure that there aren't any gaps and there aren't any deficiencies

and we make sure that somebody is as nutritionally optimized as possible you did touch on already but the role of supplementation when it comes to fertility and how that might differ for men and women because i know there's kind of yeah some stronger evidence for maybe antioxidant supplements and in male fertility um what would be kind of like your i guess top supplements if someone's thinking about conceiving and wants to optimize in that way yeah well you know like when we're when we're taught at um you know nutrition dietetics at university etc you know it's always food first food first um moving into the field of and that has always been my approach and always will be, you know,

food first, we optimise the diet first. But, you know, there is so much evidence around the usefulness of supplements on somebody's fertility journey. And, you know, even like prenatal supplements that I mentioned before, there are associations with several positive things. You know, there's been studies that have specifically looked at the role of prenatal supplements and they can increase chance of pregnancy reduce time to pregnancy restore micronutrient status um decrease oxidative stress there's been links to kind of like improved increased improved amh levels so like for me for women i feel and bearing in mind that the people

coming to me are those who are struggling um i think there is sufficient evidence for uh for women to be taking a prenatal supplement when trying to conceive and that will have um you know the important nutrients that we'd be looking for including um including folate including vitamin d vitamin b12 as we mentioned before you know the key antioxidants vitamin c vitamin e zinc selenium um and i think it's a really really good baseline but you will find uh there'll be in some in some prenatal supplements you may find things like uh coenzyme q10 or myo-inositol that we know can be useful um but they tend to be not in therapeutic doses when found in prenatal supplements so it's like you know don't just necessarily look at oh it's got myo-inositol in it great that's me covered

it probably won't be the dose that you would require to actually have the benefits that you would want from from myo-inositol um so so yeah there are other supplements like that and and then yeah with with men um i mean how we tend to look at it so obviously it's like looking at somebody's like how complete is is somebody's diet in terms of nutrients you know could could they benefit from a um you know like a multi-nutrient supplement in that respect but generally it tends to be like more targeted so i mentioned like sperm parameters before so like if we're looking at sperm count for example then you know we'd be looking at things like omega-3 vitamin b12 lycopene coenzyme q10 because there's evidence for those nutrients to support sperm count so it's similar in terms of the diet in that you

can look at things in kind of like a general way but you can take each individual and then assess what additional supplements may they need to optimize their status and their chances of conception and for some people there might not be anything additional um but yeah we always have to take people on an individual basis yeah and i think like the reason i keep bringing men into it is because i feel like we're always focusing on the woman and like what her role should be when it comes to trying to conceive but it's fascinating when we kind of look at both partners because it does take two to make a baby and both their health parameters are important

caffeine and alcohol are two substances that we talk about in pregnancy and recommend avoiding for alcohol and limiting for caffeine. For those trying to conceive, is that something that you advise also to limit? Because the advice is always very variable. And I'm the type of person who would err on the side of caution when it comes to these things, especially from the research that I've looked at. But I'd be keen to hear your advice on that. Yeah. So, I mean, in terms of alcohol for women, the advice is to abstain.

And, you know, the key reason for that is that so if you do fall pregnant, it does not do damage to your unborn baby. And we know that there is a strong relationship as well between alcohol consumption and miscarriage as well and that can be even at kind of like at lower levels so so that that is the advice when it becomes tricky is when somebody's been trying to conceive for four years yeah so what do they do um so again you know thing the advice is the advice but we need to kind of like take it into consideration of that of that individual person. And with with men, the advice is generally to avoid a high alcohol intake. So it seems that generally, you know, like a low a low intake of alcohol is probably unlikely to do too much too much damage but yeah i'm with

you on this in that i do tend to kind of like err on the side of caution um and with with caffeine because so in in pregnancy the advice is to limit caffeine to 200 milligrams for women and that advice remains for women who are trying to conceive and generally the reason behind that is that association with miscarriage there is a strong link between caffeine and um and miscarriage so you know if we want to have it minimized kind of like in the case of somebody falling pregnant because there's actually less evidence There's not really that much evidence to say like caffeine causes infertility. It doesn't really seem to prevent people from getting pregnant. It's more the fact of them staying pregnant.

And with with men, again, it's more like erring on the side of caution and kind of like the advice of men is like maybe stick to around two to three hundred milligrams of caffeine per day you know don't overdo it but it's just more for like for the for the unknown and the potential possibilities yeah yeah absolutely I think it's just really important to clarify that because from speaking to a lot of people I think some of that information is not like widely available so that it's only until someone gets pregnant then they're like oh I better you know stop drinking alcohol I better you know think about my caffeine um but as you said some people are going through this for years and years and it's about kind of finding a way to reduce that risk but also continue living as well yeah exactly that it's a tricky balance it is we've like covered nutrition quite

like thoroughly but there are also other lifestyle factors that are implicated in fertility and we're not going into the other like obviously there's so many other medical reasons why someone might yeah struggle with fertility but we're just going to focus on kind of lifestyle and nutrition on the podcast today like exercise and sleep and stress what are kind of lifestyle and nutrition on the podcast today like exercise and sleep and stress what are kind of the main things that you would work through with your client to focus on in addition to nutrition yeah and i think it's a really important discussion to have because nutrition is one piece of the puzzle when it comes to when it comes to fertility management and in an ideal world we want to make the management of things as holistic as possible

and all those things that you mentioned there in an assessment with, we want to make the management of things as holistic as possible. And all those things that you mentioned there in an assessment with a client, we would go through all of those with sleep, with stress, with physical activity. So there is a known association between poor sleep and poor outcomes. With stress, it's difficult because we don't really quite know like what came first you know it's kind of like chicken and the egg situation is it stress that causes infertility or is it actually the infertility infertility that's causing the stress so we don't really know but what we know is that we want to we want to reduce and manage stress because i mean it's it's likely that it well it could have a potential positive implication on somebody if we were to to manage their stress but stress but equally you know it will just help

someone's mental health it will help if their stress levels are lower it helps them to be able to deal with what can be quite a challenging journey yeah um so stress management is always something that we look at um and yeah with with physical activity here, again, it's kind of like striking the balance. We don't want people to be inactive. We know that kind of like moderate activity levels and even higher activity levels as well can be protective of fertility. But equally, we don't want to go too high and there's researchers say that you know above like 60 minutes of vigorous activity per day can increase the risk of an ovulation so a woman not ovulating so it's it's important to be

really aware of that and I think for for women as well it can be very useful to like track one cycle yeah and people within the fertility sphere as well it can be very useful to like track one cycle yeah um and people within the fertility sphere as well may also track ovulation um so again it kind of like needs to be individualized because if somebody is you know like i know like you like to run all over the place and run really long distances so you know you have a very high activity level so it might just be that the that what you aim for with somebody you, advice for one person might be slightly different because people are going to have different baselines. Yeah. But we don't want to go to the extremes at either level.

We want to find a happy point. But what we know is that, you know, activity is a good thing. Yeah, I agree with you. I think it's finding that balance. And I think women are so individual and one woman can do a marathon a week and have you know very regular cycles and ovulate every month and then another woman can do two pit classes a week and lose her cycle yes and I think you know from a menstrual cycle point of view,

you need to like consider how much food you're taking on board as well. Other stresses in your life, your BMI, and also previous weight loss history. So there's like loads of factors. So I do think it's super individual. I don't agree with the advice that some doctors have which is to not exercise when you're trying to conceive and I think that's probably coming from a place of caution for people who are maybe going like yeah like you know hard and trying to do everything

and kind of increasing their stress levels so it's something that you need to kind of sit back and probably look at and try to be as honest with yourself like am I striking the balance here or am I pushing it a little bit too hard that's it and I think that like a lot of us we do know our bodies and you know even like cycle tracking is becoming you know freely available like even on our on the iPhone now you know you can like you know so many people have access to be able to do that. And I think it is, it's a really useful thing for a woman to be in tune with, with her cycles, what's and what's going on, because it can help you to make decisions like that. And you mentioned also tracking ovulation. It'd be great to actually speak about that really

quickly, like some signs that women can look out for and they use like the utility of maybe testing at home um is that something that you use in practice so generally like some people some people will will add that into their kind of like fertility management kit yeah if you like because there is uh we have we have a fertile window which is basically it's kind of um roughly roughly the five days leading up to ovulation and then the kind of like the 24 hours afterwards. So this is the time at which, you know, we encourage people to have intercourse so that, you know, chances are chances are kind of optimized. So, yeah, there are there are different things that people can do. So you know, even just like the example of what I said before, just even on like, the app on your iPhone, you can tell them when you have your periods, and then they can predict when your fertile window

may be and when your ovulation is. But there are other ways to look at things as well in terms of like basal body temperature, for example. So the basal body temperature will increase around the time of ovulation. Also, there are changes in cervical mucus that people can look out for. And then people can do like hormone-related tests to identify when their ovulation may have taken place yeah so there's there's various things and i'd say i don't think that everybody needs to do it some people

who are like right you know let's let's go in and let's kind of like do do everything that we can and it can it can be very very useful for people but also i think you can get an idea of things by kind of like by by doing doing less as well. And just kind of the simple cycle tracking just so that you've got an idea. And I mean, you know, people who may tend to go into the more kind of like in-depth look at ovulation tracking, they may be people who have irregular cycles. So it's like it's less easy for them to be able to determine when their ovulation is so that that you know it makes it makes sense for that group yeah i would i would agree with you there i think perhaps if you're someone who really likes to get kind of nerdy and

and figure out exactly when you might be ovulating it's really helpful um but it's just like useful for people to know that that's another tool they could use if they wanted yes i think most people know the implications of smoking on fertility do we have any like emerging evidence on the role of vaping and how that might affect not good in short i could have predicted that but yeah what do we know so far? Because the thing is, it's like people see that, you know, people see like cigarettes as like the devil and then like the vapes is like, oh, like the angel to solve a problem. But like, yes, sadly, the data does not look good. It does look to decrease people's fertility so yeah general kind of like across the board we do recommend to try to reduce abstain and again it's working with that individual client

and just seeing what improvements can we make yeah yeah absolutely is there anything we haven't covered in kind of lifestyle environment that is something important that someone should be considering? I'd say we've probably covered the key pillars. So obviously, you know, diet is the foundation. Looking at supplements to optimize physical activity, stress management, sleep, potentially assessing environmental toxins, things like that. And I think, you know, as we've discussed just kind of like having an understanding of your of your body and and what's going on so I think we've probably covered I think before you go I've got three roundup questions for you which are just a bit

of fun and these have been sent in from listeners so you can blame them okay if you had an extra hour in the day how would you spend it well I think in all honesty that we're probably like very dependent on what day so if it was one day I may have an extra hour out at dinner another day I might have an extra hour in bed. Another day I may divulge into the latest fertility nutrition research. I think, or, you know, like just watching like trashy TV is something that I do like to watch. So even just like an extra hour of that. So I think I'm very much up for having 25 hours in the day to spend that extra hour, however feels most appropriate on that day. I would love that too if you're going to a desert island what three things are you bringing with you this is a really hard one everyone goes down the people route but we've decided you cannot

bring people with you you're a lone ranger okay my first one is definitely a random one. So I would bring a football. I love that. Yes. I became, this was like when I was at university, I became like a little bit obsessed with kick-ups. I got really good at kick-ups. Like my record was like 140 or something like that. And then, yeah, I know I could do tricks and everything.

And then now, you know, now I'm 36. Kick-ups don't really like play much of a part in my life but I feel like if I had all the time in the world I think I could beat my record so I would yeah I would football would be one of them uh isn't really geeky to say something like a solar-powered laptop because like I think that's a great idea because you can you could like work research learn better yourself but also watch Netflix, I'm sure. Exactly. So yes, that would be great if that was allowed. I would also, and I know this answer isn't allowed, but I would just take one of my friends.

So we could just entertain each other. Yeah, keep each other busy. And the last question is, what's one thing that you're grateful for today? I'm going to deliver you some cheese on toast right now ready I'm grateful for you oh thank you so thank you so much for inviting me here and I think that you're an amazing person in the industry because you're very very supportive of people such as myself with great missions but smaller platforms and yeah it's really really appreciated well i really appreciate your work and i'm just grateful to

have you on the podcast sharing your words of wisdom and for people who are listening and want more where can we direct them where can we get your book I am on Instagram so I'm at fertility.dietitian.uk I have my book deliciously healthy fertility so it's kind of available everywhere really but Amazon is probably the easiest place to to go and also I've got my website which is www.fertilitydietitian.co.uk thank you so much for your time and we'll see you very soon hopefully thank you thank you to everyone at home who's listening on the go or wherever you're listening to the podcast before we leave each other i would love if you could take just two minutes to rate the podcast leave a review and share it with someone you know will love it too that's all

from me see you again next time