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Can Fibre Improve PCOS Parameters?

March 27, 2020
pcos fibre diet naturopathic doctor toronto

I’ve written many posts about PCOS, and today I want to explore the relationship between PCOS and dietary fibre.

To recap, polycystic ovary syndrome (PCOS) is the most common hormonal disorder in reproductive-aged women. Whenever I mention PCOS to my clients, many of them say that they don’t have cysts on their ovaries. Here’s the thing, you can be diagnosed with PCOS without having cysts.

To be diagnosed, you need at least 2 of the 3 following criteria:

  1. Delayed ovulation or irregular menstrual cycles (oligomenorrhea)
  2. High androgenic hormones like testosterone
  3. Polycystic ovaries on ultrasound

Whenever I’m suspecting PCOS, I like to run blood work to determine androgen levels. In addition, because insulin resistance is common with PCOS, it’s important to also assess those parameters.

Some of the tests I like to run:

  • Free testosterone
  • Total testosterone
  • DHEA-S
  • Sex Hormone Binding Globulin (SHBG)
  • Fasting insulin
  • Fasting glucose

A 2019 study looked at the relationship between fibre, insulin resistance and PCOS. It demonstrated that a low fibre intake in people with PCOS is a significant factor in insulin resistance, and people with PCOS consumed less fibre than those without PCOS.

Fibre is a complex carbohydrate that isn’t digestible. There are 2 types – soluble and insoluble. Soluble helps to lower things like blood glucose and cholesterol. While insoluble helps to bulk up stool, improve motility, and it can also increase insulin sensitivity.

However, many of us don’t eat nearly as much fibre as we should. A low-fibre diet is associated with many health problems including type 2 diabetes and metabolic syndrome (which is essentially a cluster of syndromes including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels).

Fibre can help regulate blood glucose by slowing it’s absorption in the blood, which then improves glucose tolerance. The 2019 study also showed that in people with PCOS who did not eat much fibre, they tended to have increased testosterone and DHEAS levels. Moreover, insulin resistance may actually worsen high androgens.

This means that including more fibre-rich foods in your diet may lower insulin resistance and manage high androgen levels and improve those PCOS parameters.

Foods that are rich in fibre include fruits, vegetables, beans and legumes, as well as grains. Some fibre-rich foods include:

  • Raspberries – 4g of fibre for 1/2 cup
  • Pear – 5.2g of fibre for 1 medium pear
  • Apple – 3.3g of fibre for 1 medium apple
  • Brussel sprouts (cooked) – 3.2g of fibre for 1/2 cup
  • Carrots – 3g of fibre for 1 large carrot
  • Lentils (cooked) – 10.4g for 2/3 cup
  • Black beans (cooked) – 7.5g for 1/2 cup
  • Peanut butter (chunky) – 2.6g for 2 tbsp
  • Brown rice (cooked) – 1.8g for 1/2 cup
  • Rolled oats (cooked) – 4.2g for 3/4 cup

Ideally people with PCOS should be aiming for 30-35g of fibre per day. As you increase your fibre intake, be sure to make sure you’re also increasing the amount of water you’re drinking per day (this is because fibre can bind water).

Reference

Cutler, D., Pride, S., & Cheung, A. (2019). Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Science & Nutrition7(4), 1426-1437. doi: 10.1002/fsn3.977

What should men eat for fertility?

December 24, 2018
male fertility diet, toronto naturopath, naturopathic doctor toronto, fertility naturopath

Spoiler alert: Men can contribute to infertility. 

It’s not just a woman’s issue. And what you’re eating (or not eating), can affect your fertility success. Let’s dive into a couple of things that can help improve sperm parameters in men. 

Fatty Acids and Fertility

The sperm cell membrane high in fatty acids, and these acids are necessary for sperm function. The membrane is pretty important when it comes to fertilization – it helps with cell maturation, penetrating and fusing with the egg. 

The fatty acids that you need to do these jobs can’t be made by your body, so you need to either eat fish, supplement with fish oil, or eat nuts and seeds. Studies have shown that male fertility patients who have a higher intake of omega-3, have more normal sperm. A study looking at walnuts (which are a great source of omega 3s) have been related to higher sperm parameters – vitality, motility (how sperm move), and morphology (how sperm look). Another study showed that men’s fish intake was related to shorter time to pregnancy and a lower risk of infertility. 

It is important to pay attention to mercury levels in fish, and consider avoiding fish with high mercury levels as it may impact fertility. 

Soy and Fertility

Women aren’t the only ones cautious about soy. From my experience, men are pretty fearful too. When we look at the research on dietary soy and men’s health it’s pretty conflicting. While one study mentions that dietary isoflavone intake is associated with higher sperm count and motility, another says that soy intake is associated with lower sperm concentration. 

Here’s the thing, if you’re vegan or vegetarian and soy makes up a large part of your diet, aim for non-GMO and organic sources. 

Dairy & Meat and Fertility

Research on diary and sperm parameters is pretty mixed. One study looking at young men and dairy consumption showed that intake of dairy products (like milk) have been related to lower testosterone, FSH and LH levels. 

When it comes to meat, the same results exist. Some studies show that meat is unrelated to sperm parameters, some show that processed meat affects sperm counts. 

Something to consider though is your cardiovascular health. While that Double Big Mac might not do anything to your sperm, it might affect your heart health! Keep in mind that your body 

Fruits & Vegetables and Fertility

Unsurprisingly, fruits and vegetables are cornerstone of good health. But, many of them are sprayed with pesticides. One study showed that consumption of high-pesticide-residue fruits and vegetable was associated with poor sperm quality in men attending a fertility clinic. 

So what does this mean? Choose organic when eating foods off the Dirty Dozen list. 

Next Steps

Overall, the review that I read didn’t go into as much detail as the female version. However, it did mention that if you’re going to abide by a diet, then the Mediterranean Diet is a good bet. It’s high in seafood, vegetables and fruits, whole grains, etc. Basically you’re not eating processed and packaged foods.  

Changing a diet can be pretty difficult. I’m of the mind of taking it a week at a time, so if you’re introducing a new food or avoiding an old (but problematic) favourite, do it in weekly increments. 

When I was giving up gluten, cow dairy and eggs, I picked one and committed to that for a week, then gave up another, etc. When introducing new foods like salmon, commit to eating it once a week, find different ways to prepare it, etc. Changing your habits around food don’t need to be difficult. But like all things, it does take some work. 

For more information on how you can boost your fertility and improve your sperm parameters, consider working with a naturopathic doctor. If you have any questions, feel free to get in touch!

Reference

Nassan, F., Chavarro, J. and Tanrikut, C. (2018). Diet and men’s fertility: does diet affect sperm quality?. Fertility and Sterility, 110(4), pp.570-577.

What should women eat for fertility?

December 17, 2018
female fertility diet, toronto naturopath, naturopathic doctor toronto, fertility naturopath

It might come as a surprise that few people think about preconception health. And to be honest, when they do, it’s usually because of fertility struggles. Diet plays a huge role in how we feel and function, and provides the necessary building blocks to support conception.

Carbs and Fertility

Carbs might make up a significant part of your diet. When it comes to nutritional science, there’s a lot of learn about carbs, but I want to focus on 2 things: the glycemic index and glycemic load. 

The glycemic index is a value assigned to a particular food on how fast or slow it causes an increase in your blood glucose level.

The glycemic load combined quality and quantity of carbohydrates. It’s calculated by the amount of food you eat and the glycemic index of the particular food.The glycemic load is also associated with higher risks of ovulatory infertility.

In PCOS, it’s been found that women will often consume foods with a higher glycemic index. When women reduce their carb intake (or perhaps choose carbs with a lower index and load), their insulin sensitivity will improve, testosterone will decrease, and ovulation will occur (this is important, because anovulation is a key symptom in PCOS).

Fats and Fertility

Let’s clear something up. Fat isn’t bad. Yes, some are better than others and there are some you should avoid completely. But you need fat to make hormones, help your eggs mature and to get that tiny blastocyst to implant! 

Unsurprisingly, you should be avoiding trans fats. They increase insulin resistance, may prevent ovulation from happening, and decrease your chance of getting pregnant.

To get into specifics, omega 3 fatty acids are associated with progesterone production in the luteal phase (this is important!) and a reduced risk of anovulation. In women undergoing IVF, omega 3 fatty acid intake was associated with better embryo morphology. 

Protein and Fertility

You should be eating at least 1g of protein per kg of body weight (more if you’re active). Protein comes in different forms: animal and vegetable. One study showed that ovulation was negatively affected by increased animal protein. While another study showed that although fish, eggs, and processed meats didn’t have an effect on ovulation, vegetable protein intake decreased anovulation. Blastocyst formation in assisted reproductive technology decreased in patients consuming more red meat. But it was positively affected by fish consumption.

Now before you head on off to the local fish monger, you want to pay attention to fish and mercury content (as it may interfere with hormones and fertility). Fish to avoid would be bigeye tuna, king mackerel and swordfish.

Soy protein often gets a bad rap, but can actually be beneficial in women seeking fertility treatments. Soy isoflavone supplements were associated with improvement in reproductive outcomes, increased live birth after clomiphene administration, and higher endometrial thickness and ongoing pregnancy rates after IVF and ICSI. 

A couple things to consider before ordering your soy latte – choose organic, non-GMO soy. And if you have a thyroid condition, it’s best to avoid dietary soy altogether.

Next Steps

It might be obvious that a diet that leans towards fast food/processed foods and few fruits and vegetables is probably not the best. And when it comes to a diet in particular, adopting a Mediterranean diet (which basically has a foundation of vegetable and fruit, whole grains and fish) has shown to be effective in a few studies. 

Pesticides and other chemicals in our foods may also affect reproductive success, so if possible, choose organic when you can. Basically, if any of the fruits and vegetables that you eat appear on the Dirty Dozen, eat the organic version instead. 

When choosing meats, aim to get your meats from local farms if possible. And grass-fed and antibiotic-free are great options too. 

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References

Chiu, Y., Chavarro, J. and Souter, I. (2018). Diet and female fertility: doctor, what should I eat?. Fertility and Sterility, 110(4), pp.560-569.