nutrition and fertility - gp cme north/sat_room10_1100... · avoid fad diets & unnecessary...
TRANSCRIPT
Rebecca BaskettRegistered Dietitian
Fertility Associates
11:00 - 11:55 WS #119: Eating Your Way to A Baby
12:05 - 13:00 WS #131: Eating Your Way to A Baby (Repeated)
Eating Your Way to a Baby
Rebecca Baskett
New Zealand Registered Dietitian
Nutrition and Fertility: WHY?
Diet leading up to IVF treatment is important
The closer to your most ‘healthy weight’ you can get the better :
Obese men have sperm counts on average 22% lower than their
slimmer counterparts
For women having a healthy BMI is associated with better fertility.
Further more pregnancy in overweight women is associated with
problems such as diabetes and high blood pressure.
Diet can effect egg and sperm production
Eggs and sperm take 3 months to mature
Eating Your Way to a Baby
NZ statistics 2014/15
Almost 1 in 3 adults were obese
A further 35% of adults were overweight
So that’s the general population….what about
people having fertility treatment….?
Eating Your Way to a Baby
Alice Reward (NZRD) Masters Theses 2012
Assessment of maternal nutrition during the periconceptional
period in women undergoing in vitro fertilisation (IVF) treatment
Women under going fertility treatment at Auckland and
Hamilton Fertility Associates clinics (n=250)
Nutrition of Women under-going Fertility
Treatment (NZ)
Diets were…..
High in Total and Saturated Fat & Na
Low in fibre, calcium and carbohydrate
Folic acid supplementation inadequate in 17% of women
No nutritional factors were clearly associated with IVF
success
Diet and Nutrition – what’s happening out there?
FAD diets
Supplements ++
Herbal remedies
Confusion +++
What should I be doing?
FAD Diets
Derived from 16th Century term “fiddle-faddle”.
(Nonsense)
Passing dietary craze, short term fix, little to no scientific
backing but with a strong media presence.
Generally restrictive, obsessive and unsustainable
FAD Diets
The Cabbage and Urine Diet (175 BC)
Arsenic Diet Pills (Late 1800s)
The Tapeworm Diet (Early1900s)
The Seeping Beauty Diet (1976)
Paleo
Eating foods that were available to our
hunter-gatherer ancestors.
High in protein - keeps you full
Less calories consumed after protein is
eaten compared to other nutrients.
Paleo
Eat: Fish, seafood, meat (from grass not grain fed
animals), eggs, oils (olive, flaxseed, avocado, coconut,
walnut, macadamia), fresh fruit and vegetables
Avoid: Dairy, cereals/grains, legumes (including
peanuts), refined sugar, potatoes, processed foods, salt
and refined vegetable oils
Paleo
Positives
An 85:15 rule can be followed on this diet where three
non- paleo meals can be eaten per week.
An association has been seen with the paleo diet and
weight loss.
Paleo
Negatives
Dairy products may be cut out
good source of calcium, essential for bone health.
Grains which are excluded have been seen to have an
array of health benefits.
Packaged paleo foods can be expensive.
No sugar diet
What: This diet is based on cutting out foods with fructose
and added sugar.
No sugar diet
Eat: Meat, eggs, nuts, seeds, cheese, fruit, vegetables,
legumes, yoghurt (no sugar added), rice, pasta and
coconut oil
Avoid: Baked or processed foods with added sugar
including bread and breakfast cereal, fruit juices, honey or
corn syrup.
Some versions suggest restricting or even cutting out fruit
compeletly
No sugar diet
Positives
Focused on eating whole unprocessed foods.
Weight loss seen with this diet is probably due to a decrease
in calories consumed.
Encourage the message “limit/reduce processed foods” (often
high in saturated/trans fats, sugar and salt)
No sugar diet
Negatives
Rice malt sugar is allowed as a sweetener but is broken
down just like other sugars.
Some versions even also cut out fruit as it contains
fructose.
Fruit contains many vitamins and minerals and there is no
need to remove fruit from the diet.
Lactose may restricted
No sugar diet
Negatives continued….
Promotes coconut oil (comprised mainly of saturated fat,
evidence of the negative effects of saturated fat on heart
disease.
Time consuming - cooking from scratch
FAD diets
There are loads!!
Lemon Detox, Aitkin's, Dukan diet, Cabbage soup diet, ‘Meat
and Milk diet’, Greenlane Heart diet......
Short term weight loss
Nutritionally incomplete
Side effects
Hard to maintain
Expensive
Eating Your Way to a Baby : HOW?
Eat Breakfast, Lunch and Dinner every day
Regular meals can help you avoid snacking and over eating
Plan meal times and avoid relying on takeaways, fast foods
and/or snack foods (often high in fat, sugar and/or salt)
Eating Your Way to a Baby: HOW?
5 + a day !
≥2 handfuls of fruit
≥ 3 of vegetables
high in fibre
Rich in antioxidants : can protect sperm against damage from free radicals.
Eating Your Way to a Baby: HOW?
Protein Foods Red meat
richest source of iron
Chicken
Hormones are NOT permitted in NZ chicken
Fish
Oily fish (salmon, sardines, tuna) are rich in omega-3’s
Legumes (chickpeas, beans, lentils), tofu, nuts and seeds
In general NZer’s eat too much
1-2 serves daily (hand rule)
Eat with vitamin C rich foods (fruit and vegetables) to aid absorption of
iron
Eating Your Way to a Baby: HOW?
Dairy Products
Rich source of calcium, riboflavin (B1), vitamin B12
and protein!
Choose low fat varieties
2-3 serves each day (e.g. glass of milk, pottle of yoghurt,
slice of cheese)
Choose calcium fortified milk alternatives
soy milk is the most nutritionally balanced milk alternative
Eating Your way to a Baby: HOW?
What about Fat!? Yes you do need it BUT
In small amounts
Aim to have more ‘good’ than ‘bad’ fats
Limit you Saturated fat intake
Meat fat, chicken skin, takeaways, pastry-based items, butter, high fat
dairy products (cream, cheese), processed snack items (crisps,
chocolate, baked goods).
try to use mono- and poly-unsaturated fats instead
e.g. margarine, avocado, plant based oils (olive, canola, safflower, rice
bran)
Eating Your Way to a Baby
Eating Your Way to a Baby
Eating Your Way to a Baby: HOW
What to Drink? Alcohol – no safe upper limit known = AVOID
Caffeine – try to limit/avoid
Coffee, tea, green tea, cola, energy drinks
Soft drinks/cordials – contain sugar and often unnecessary calories.
Fruit juice – not a substitute for fruit!
contain a lot of sugar/calories. Contains vitamins but no fibre. Limit to a cup per day
Drink more Water!! Its safe and free
Choose low calorie/sugar free flavourings
Herbal teas, non-caffeinated coffee
Vitamins and Minerals
More is NOT necessarily better or safe!!
Aim to get the vitamins and minerals you need from
your food
Cheaper
Body can absorb them better
Additional benefits e.g. fibre, micronutrients not in pills,
foods rich in vits/mins are generally low in fat and energy
Multivitamins do not necessarily have everything you need
and/or at the right level
Vitamins and Minerals
Exceptions to the rule Folic acid
800mcg/day 4 weeks prior to conception and 12 weeks after
becoming pregnant
Apo- Folic Acid Tab: 800mcg ($19.80 per 1000)
Iodine
150mcg/day when pregnant and breastfeeding
Neurokare: 150mcg ($7.55 per 90)
Deficiency – if you are low in a particular nutrient then you should see your doctor and take a prescribed supplement.
Total approx. 10 cents/day
Vitamins and Minerals
Over the Counter (OTC) multivitamins
Blackmore's Pregnancy and Breastfeeding Gold Per capsule: Folic acid 500mcg, iodine 150mcg
Dose: 1 capsule daily
<800mcg folic acid
60 capsules $29.95; 120 capsules $52.95
Cost per day = $0.45 approx
Elevit with iodine Per capsule :Folic acid 800mcg, iodine 250mcg
Dose : 1 capsule daily
100 capsules = $74.30
Cost per day = $0.75
Vitamins and Minerals
Over the Counter products (OTC)
May not contain the correct amount of the vitamin or mineral (too
little or too much) e.g. seaweed, spirulina, kelp.
May not be in a form the body can absorb
No guarantee of content (not regulated)
Often are expensive
Prescribed supplement
They are regulated
The nutrient is in an absorbable form
Cheaper! (funded)
Eating Your Way to a Baby : Summary
Start NOW!
Aim for a healthy weight
Avoid FAD diets & unnecessary supplements
Eat for a healthy body and mind – get the basics right:
regular meals, 5 + a day, low fat dairy, quality
protein, low fat diet.
Females - start folic acid: 800mcg/day and iodine
150mcg/day.
Check adequacy of OTC supplements before you buy
Eating Your Way to a Baby
Questions?
Thank you!