To couples who seek to start a family, infertility can be heartbreaking. Unfortunately, it is also common. The U.S. Centers for Disease Control estimates that about 10 percent of American women between the ages of 15 and 44 have difficulty getting pregnant or carrying pregnancies to term.
The good news is that an optimal diet, exercise regime, stress reduction program and other lifestyle changes can have a large, positive impact on fertility. Be Fruitful: The Essential Guide to Maximizing Fertility and Giving Birth to a Healthy Child by Victoria Maizes, M.D., executive director of the Arizona Center for Integrative Medicine, provides sensible, straightforward, and at times surprising advice on what couples who seek to become parents should, and should not, do. She spoke with Brad Lemley:
What led you to write Be Fruitful? What sets this book apart from other pregnancy books?
I felt that, given my experience in this field, I had an incredible opportunity to bring wisdom of integrative medicine to a younger demographic. And there is no time in life when caring for health is more important than when a couple is considering conceiving a child. Being as healthy as possible before and during conception is vital, as very early fetal development sets up a child for a lifetime of good or not-so-good health. I'm passionate about public health, and giving people good information to help them have successful pregnancies and healthy children is the best "early intervention" that we can possibly make to create a healthier society.
Can you summarize some of the challenges that are unique to modern women when it comes to becoming pregnant?
There is so much that is challenging now. There are over 80,000 industrial chemicals in use and many of them are proven to be hormone disruptors, increasing the risk of infertility and of health problems in children. Also, the world is awash in low-quality food. The standard American diet is perhaps the worst diet you could design when it comes to enhancing fertility. And there are more pressures now to put off childbirth. Newer research is making it clear that it is not just women who have "biological clock." Children of fathers who are over 40 have a higher risk of autism, schizophrenia and other mental and physical health conditions. One of my major points is that age matters when it comes to getting pregnant and giving birth to a healthy child. It's wishful thinking to believe otherwise.
You recommend the anti-inflammatory diet, with which our readers are quite familiar. Let's focus on a couple of recommendations that some people may find surprising. Many women are concerned about eating fish during pregnancy, due to concerns about mercury contamination - so why do you recommend consuming at least 12 ounces of fish per week?
It turns out that when the FDA and EPA warned pregnant women in 2004 to limit fish consumption to reduce exposure to mercury, the American population as a whole began eating far less fish. But the evidence is clear - women who eat little or no fish during pregnancy give birth to children with significantly lower I.Q.s. That's almost certainly because optimal fetal brain and nervous system development depend on a steady supply of omega 3 fatty acids, and these are most easily supplied in the diet via fish consumption. If you are pregnant or want to become so, choose your fish carefully, avoiding shark, swordfish, king mackerel, and tilefish because of their high mercury content. But don't go to the extreme of avoiding all fish. Eat fish with high amounts of omega 3 and lower mercury such as wild Alaskan salmon, sardines, and black cod.
And you recommend full-fat dairy products as well?
The Nurse's Health Study found that women who consume whole-fat dairy products have less ovulatory infertility. That may be because when processors centrifuge milk to make nonfat and low-fat versions, they are actually changing the hormonal balance of milk so that it contains more androgens (male hormones).
Let's talk about supplementation - do you think it is vital for a healthy pregnancy? Does supplementation for fertility and successful pregnancy differ from supplementation for adults in general?
This is one place where there is no controversy about multivitamins. The need for prenatal multivitamins that have optimal amounts of folic acid, iodine, and iron is absolutely clear. Supplementation leads to lower infertility rates, fewer miscarriages, fewer birth defects, less cancer and fewer cases of autism and severe learning disabilities.
The modern world contains many toxins - chemical, electromagnetic and more. How important is it to reduce exposures, and how can that best be done?
This is a big subject, and people can easily become overwhelmed and afraid to eat, or do, anything. One basic thing you can do is buy organic food if you can afford it and drink filtered water. I also recommend learning more about women's personal care products. Spend a couple of hours at Skin Deep, the Environmental Working Group's database, and check the ratings on the things you use every day - your sunscreen, for example. For men, don't wear your cellphone on your belt, or put your laptop actually on your lap - these alter the development of sperm in unhealthy ways.
How important is exercise to a successful fertility and pregnancy?
Exercise is important - especially for overweight women, as excess weight can compromise fertility, and exercise can help them achieve normal weight. But it's a complex question. Even women who are recreational athletes often have luteal phase dysfunction, which means the time immediately after ovulation becomes shorter than is optimal - this can make getting pregnant more difficult. So normal-weight women who are athletic and having trouble getting pregnant should probably slow down - in other words, walk rather than run.
You discuss the effects of stress on fertility - what can women do to reduce their stress?
If someone is chronically stressed, it can very much affect fertility. There are direct links from the hypothalamus and pituitary to the ovaries and testes. I talk about breathing exercises, yoga and meditation as options to explore.
In researching this book, what surprised you most?
More than surprised - I was outraged to learn that babies today are born with over 200 environmental chemicals in their bloodstreams at birth. The womb should be a pristine, welcoming environment. I'm very glad that there are groups like the Environmental Working Group, Cornucopia, TreeHugger and so forth that monitor and push for a cleaner world. Anyone who is interested in the health of our next generation - essentially all of us - should consider supporting those groups.
People often ask Dr. Weil for short lists - the three or four things that we must do to maintain our health. If you could offer only one, or a few, short pieces of advice to women who seek a healthy pregnancy, what would they be?
Number one, diet matters a great deal. If you've been casual about eating the past, take the time to learn about the best fats, proteins, carbs to eat and micronutrients to supplement before you try to get pregnant. Two, there are important environmental steps that everyone should consider - we live in a polluted world, and everyone can take steps to detox and be as clean as possible. Three, develop a relaxation practice that works for you, so that you can naturally return to it when times become stressful. And four, age is important. Don't let Hollywood stars, or a friend who had a great pregnancy after age 40, or anyone else convince you otherwise. It is indeed possible for older women to have successful pregnancies, but they odds are greatly in favor of women who have children before the age of 35. This requires young adults to make thoughtful and life-changing decisions.
- Dr. Maizes book is available through the DrWeil.com Marketplace.