Whether you are just beginning to consider expanding your family, want to plan for the future through egg freezing, or have struggled with fertility issues for some time, it can be empowering to understand the impact that diet and healthy-weight can have on fertility outcomes.

Dietary patterns focused on plant-based and anti-inflammatory foods are associated with improved fertility [1]. For example, try filling at least half of your plate with fruits and vegetables, choose healthy monounsaturated fats instead of saturated and trans fats, and make at least half your grains whole. 

Along with healthy eating, it is important to achieve and maintain a healthy weight. For women who are considered overweight or obese based on a BMI greater than or equal to 25, weight-loss may improve fertility. In addition to a balanced diet, moderate-intensity physical activity for at least 150 minutes per week can aid in meeting this goal.

For more information on foods for fertility and creating a personalized eating plan, schedule a visit with our Registered Dietitian and lactation consultant, Holly Murphy, MS, RD, LDN, IBCLC.

[1] Panth, N. et al. The Influence of Diet on Fertility and the Implications for Public Health Nutrition in the United States. Front Public Health. 2018. doi: 10.3389/fpubh.2018.00211

The month of February brings us National Eating Disorders Awareness Week. For most of us, this is the first February that we will be spending in a pandemic.

If an eating disorder could choose its favorite environment, it could do no better than the stay-at-home orders issued in many states to combat the coronavirus. Fear over health? Check. Fear around food? Double-check. Social isolation? Triple-check. Combine all this with economic volatility and an international sense of dread, and eating disorder behaviors seem to have a big advantage over recovery. In short, coronavirus quarantine and eating disorders: it’s a perfect storm.

When life as we know it is suddenly upended, it is going to be difficult for most people. For those with eating disorders, who often tend toward greater rigidity rather than flexibility, it is especially challenging.

Food Availability: Both Too Little and Too Much

Empty Shelves and a Very Full Pantry

The current unpredictability of grocery store inventory can bring up the urge to both restrict and binge. When entire store shelves of pasta, eggs, and toilet paper are empty, it can trigger a deep sense of unease and a desire to hoard. Panic buying has been rampant, with many stores now limiting purchases of staple items. Scarce inventory leads to a scarcity mindset, which is not unlike the eating disorder voice or diet culture in general: “This food is hard to get, so get it all while you can!”

On the other hand, having a well-stocked kitchen can also ignite disordered eating thoughts. When food is the apparent enemy, being surrounded by it can feel threatening. It can set up a resolve to restrict eating in order to demonstrate control. It can create fears of bingeing and/or purging, due to easy access.

Foods Good for Sheltering in Place Are Often “Fear” Foods for Those with an Eating Disorder

When hunkering down at home for weeks at a time, shelf-stable foods like pasta, rice, peanut butter, and frozen entrees are standard. They are nutrient-dense and last in storage. However, these are often the types of foods that people with eating disorders may consider off-limits, or a “fear food.” While working with a therapist and dietitian helps broaden the list of tolerable foods, the process is usually done in an organized manner. Being suddenly faced with a pantry full of spaghetti and canned soups may be an unusual situation that can spike anxiety. However, it is important to remember that all foods fit into a nutritious diet. No food is “good” or “bad.”

Structure and Boundaries Help Break the Connection between Coronavirus Quarantine and Eating Disorders

Going from a busy schedule to long swaths of free time can open the door to eating disorder thoughts and behaviors. Working or completing school from home can provide structure for days that would otherwise blend into each other. Even if you have no current work or school responsibilities, there are some other ways to add structure to life under quarantine.

1. Eat regularly. Every single body deserves nourishment, even when less physically active than usual. You do not have to earn the right to eat. Also, for people with an eating disorder, hunger and fullness cues must be relearned. In times of stress, such as the current pandemic, those fledgling hunger and fullness cues may subside. Eating at regular intervals (like every 3 hours) helps ensure nutritional intake – as well as helps to regain awareness of body cues.
2. Sleep regularly. Regular rest helps us feel more energized, of course. Sleep also helps with emotion regulation, which is an important part of eating disorder recovery. Try to practice going to bed and waking up around the same time each day, and put away devices and bright screens about an hour before bedtime to help the mind prepare for sleep.
3. Carve out time for hobbies, reading, games, etc. But there’s no pressure to achieve here; it’s about relaxation and engagement. It is not necessary to learn a new language or find a new way to organize your closet during this time. Yes, there are many examples of people on social media baking 32 kinds of bread. You do not have to be one of them. If a nap sounds better one day than reading a chapter of Anna Karenina, go for it.
4. Set boundaries around media use. There is now 24/7 news coverage of the coronavirus. While keeping up on news is fine, it is easy to get pulled into hours of consumption. This is not good for our mental health! Skim the news or set a time limit. The same is true for social media. Even amidst this crisis, diet culture lurks, masquerading as health information. Be wary of supplements to “boost” the immune system, or people obsessing about potential weight gain while they are sheltering at home.

• Each day, write down something positive about yourself.
• Make a commitment to limiting negative self talk this summer.

• I am lovable in this body.
• Every body is a bathing suit body!
• I accept myself as a beautiful work in progress.

‘Tis the season for lots of cookies, cakes, creamy drinks, hearty meals and overall indulgence!  This is the time of year when you are faced with more temptation than ever. Let’s take a few moments to think about how you can maintain your health while still enjoying the season:

1. Remember that balance is everything! 
Follow the 80/20 rule. This means that 80% of the time you will eat as healthily as usual and 20% of the time you will let yourself enjoy a treat without guilt. Here is some math: There are 40 days and 120 meals between Thanksgiving and New Years. If you follow the 80/20 rule you can have a treat at 24 of those meals. Choose wisely and consider tracking on your calendar. You may find that you can’t resist indulging at one event but you have no problem at another. Skip the donuts and leftover pies at work and save your 24 for a dinner or a party!

2. “Indulge” with these healthy but tasty treats:
A) Dip your vegetables in something creamy…. Make a savory dip with plain Greek yogurt!  For a thicker consistency, strain the yogurt overnight over a cheesecloth to remove liquid, then mix the thickened yogurt with your favorite savory seasoning and top with fresh chives or scallions. (Tip: you can use Greek yogurt as a substitute for many recipes that call for cream or sour cream).

B) Fill your house with the warm smell of baked apples and cinnamon: Slice apples in half or in to bite sized pieces. Coat with a small amount of coconut oil and cinnamon to taste. Optional: Sprinkle with almond slivers. Bake in the oven at 350F 20-30 minutes.

C) Try making “cookie dough” balls with chickpeas! Blend together chickpeas, nut butter and a small amount of honey. Your goal is a cookie dough consistency. Toss in some chocolate chips and roll the “dough” in to bite sized balls. You can eat this raw or you can bake it to get the melted chocolate effect!

3. Ask yourself, is this making me healthy? Is it making me happy?
If the answer is neither, why are you eating it? When was the last time somebody offered you a cookie and you took one bite and thought “this isn’t very good” but kept eating it anyway? This season challenge yourself to put the not-so-tasty cookie down! Save your 24 for something worthwhile!

4. Choose this not that:
A) Choose an apple crumble instead of an apple pie
B) Choose grilled, braised or roasted instead of stuffed, smothered, or rich
C) Instead of randomly grazing at a party, choose one item you can’t resist and then fill the rest of your plate with protein and produce

Summertime is party time. We often associate summertime with beach trips, cookouts, and, less than healthy food and beverage choices. The biggest cookout of all, Independence Day, is quickly approaching. Feel your best this 4th of July by using some of these tips to healthify your holiday:

1. Make burgers with grass fed beef –

Grass fed beef does not increase cholesterol in the same way as traditional grain fed beef. Eating grass fed beef can benefit your body by increasing circulating omega-3 fatty acids (aka good, anti-inflammatory fats), introducing vitamin A and E precursors, and providing cancer fighting antioxidants.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846864/)

2. Offer options for hydration –

Fruit, fruit and more fruit. Your body gets 20% of it’s hydration from food and fruit is a big source! In addition to sliced watermelon, make a fruit salad with berries and dress it up with lime and honey. Offer a third fruit option in the form of a Fourth of July themed infused water. Fill your punch bowl the day before the party with club soda, strawberries, blueberries and mint leaves and leave overnight to maximize flavor. Lastly, don’t forget to make water generally available, throw some bottles in to your beer and soda coolers.

3. Do the cafeteria trick and put the salad at the front of the buffet-

Food service organizations are good at influencing customer behavior. They put the salad at the front of buffets because they know that patrons will take the largest serving from the first food they encounter. These organizations want to trick you in to filling your plate with the cheapest food item so that they can save money. As a party host, you can use this concept to trick your guests (and yourself) in to eating more of the healthy stuff!

4. Create a space for physical activity –

If you want your guests to have a great time at your party, get them moving. Physical activity after eating can lift endorphins (more energy!) and can help stabilize blood sugar to avoid that ‘crash’ feeling. Set up lawn games or play some dance music to inspire guests to get their bodies in motion.

5. Attending a party as a guest? Be the person who brings the healthy thing-

Don’t worry, somebody else will show up with the chips and dessert. Party goers will thank you for your nutritious addition. Try making a mayo-free Russian style coleslaw with a vinegar base.

There is always an event around the corner that will challenge your healthy diet goals. Don’t wait to get started, just incorporate some healthiness in to the unhealthy fun and it won’t be so hard to get back on track after the party is over.

Many people choose to go vegan for one reason or another – perhaps it is concern for the treatment of animals, environmental factors or perhaps they are trying to become healthier.

A vegan diet is a type of vegetarian diet that excludes all meat, fish, poultry and dairy products as well as foods that are processed using animal products. While becoming vegan can reap some health benefits, it is not for everyone and there are some important factors to consider before making the decision to switch.

Vegan diets are typically higher in nutrients such as fiber (which can help lower cholesterol), magnesium, potassium, vitamins C& E, iron, antioxidants and overall tends to be lower calorie and lower in saturated fat; however, it involves more planning and discipline to ensure you are getting all the nutrients you need.

Common nutrient deficiencies with a vegan diet include calcium, Vitamin D, omega-3, B12 and folate. Because you are eliminating food groups as a vegan, you are eliminating food groups that have these important nutrients. It is important to replace these nutrients so that your body is able to function properly. All vegans need to take some form of B12 whether it is through a supplement or nutrient rich food such as nutritional yeast.

Because a vegan diet is “plant-based,” there is the benefit of reducing risk of cardiovascular disease and the complications associated with diabetes.

Ensuring a well balanced meal by incorporating all of the essential nutrients to nourish your body is important for your health and just like any diet – failure to plan successfully and safely can lead to poor outcomes.

One of the most common eating disorders in U.S. women is Binge Eating Disorder with a lifetime prevalence of 3.5%. Binge Eating Disorder is characterized by episodes of eating larger-than-normal amounts of food until uncomfortable or full, coupled with a feeling of lack of control. It may also include eating faster than usual, eating when not hungry, eating alone out of embarrassment, and/or feeling guilty after eating. Frequently, individuals will have patterns of restrictive eating in between episodes. Episodes occur at least once a week for a period of three months, can impair social functioning or potentially cause health problems.

For many people, overeating is an occasional or less dramatic occurrence, not meeting the above clinical criteria. It is not clear why some people develop binge eating disorder, but there is a high prevalence of comorbid psychiatric conditions in people with this disorder, including depression, anxiety, and phobias. About 50% of those with Binge Eating disorder are overweight, about the same as in the general population. For those who are trying to optimize their eating habits overall for better health, recognizing triggers and becoming more educated about food and nutrition is useful. Meeting with a nutritionist to discuss healthy food choices and appropriate portion size is a good start. Having a plan ahead of time for a holiday or special occasion meal, such as not having second helpings or focusing more on the healthier parts of the meal can also help. For anyone who feels their overeating is causing personal distress, or has evolved onto the spectrum of Binge Eating Disorder, the most successful treatment strategy is Cognitive-Behavioral therapy, either in a group or individual setting. Medications can be used as a second-line therapy, usually the SSRI antidepressants. The first step is to recognize if your eating behaviors have gotten out of your control, and to seek assistance from your provider to determine the best treatment option for you.

Not everyone may realize, but nutrition has everything to do with our mental health. In fact, all body functions are connected and intertwined in one way or another. The recognition of the brain-gut axis, or connection, has been on the rise and we are finally acknowledging the importance of a healthy gut. And by gut, we don’t mean the “stomach, belly or tummy”, we mean the GI tract- specifically the small and large intestines. To many, it’s a foreign concept that our overall health lies in the condition of our gut.

Alzheimer’s, which is just one form of dementia, has actually been termed Diabetes Type 3 due to the correlation of dramatic decline in cognitive function and chronic insulin resistance… Lot’s of big words. Let’s back up a minute. What causes insulin resistance in the first place? Well, we have three macronutrients that fuel our bodies- Carbs, Proteins, and Fats. Can you guess which one is related to diabetes?

You guessed it- Carbs.

All carbs eventually turn into glucose, which raises our blood sugar. Insulin then is released to allow the digested sugar into our cells. However, eventually our cells become insulin resistant and stop absorbing glucose, leaving sugar in the blood stream. Uncontrolled insulin resistance leads to type 2 diabetes.

So what about the previously mentioned “Type 3”? Well first off, increased sugar in the body causes chronic inflammation. This means that our gut, which has also been termed our “second brain”, is so inflamed that it cannot properly absorb any nutrients from the food that we’re eating- assuming that we are even eating nutrient dense foods.

Free flowing sugar also means sticky, or viscous, blood. Increased viscosity can impair blood flow to the brain which affects how much oxygen and nutrients the brain cells are receiving. When circulation in the brain is compromised, you are at an increased risk of stroke and the development of dementia. In addition, insulin resistance impairs signaling to the brain and prevents brain cells from properly utilizing glucose for energy. Overall brain functioning suffers as a result of this.¹  Ever have difficulty thinking straight due to low blood sugar? This is the same concept- except a bit more deep-rooted.

The gut-brain axis is complex yet fascinating. We have discounted the association for so long but recently are coming to terms with just how powerful the health of our gut is, (or lack thereof). “The gut–brain axis seems to influence a range of diseases, and researchers have begun to target communication pathways between the nervous system and the digestive system in an attempt to treat metabolic disorders specifically.” ²

Have you ever been nervous, felt nauseous or had butterflies in your stomach? This is because the GI tract is sensitive to emotions, which go hand in hand with the hormones that are regulated by the brain.³ The connection goes both ways since over 90% of serotonin (the happy hormone) is produced in the gut. Therefore, if your gut is inflamed from an unhealthy diet, say goodbye to serotonin and hello to mood swings, anxiety, and depression!

If you’re interested to find out if you have a healthy gut, before you spend the copay on a very uncomfortable endoscopy or colonoscopy, see a registered dietitian who can assess whether your daily intake is helping or hurting you.

¹ http://dlife.com/type-3-diabetes/
² https://www.scientificamerican.com/article/metabolism-in-mind-new-insights-into-the-gut-brain-axis-spur-commercial-efforts-to-target-it/
³ http://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection