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Thinking Of Starting A Family? Read These Health Tips First

By Sally Shi-po POON (Registered Dietitian)

Infertility is defined as not being able to get pregnant after one year (or longer) of regular unprotected sex. It is said to affect 1 in every 6 couples. While couples cannot control all of the factors causing infertility, they can control their eating habits and lifestyle as these can have significant impacts on the ability to get pregnant. The following are important steps to help you get ready for the healthiest pregnancy possible.

 

1. Maintain a healthy weight

In women, being underweight, being overweight or exercising too much may lead to infertility, according to the American College of Obstetricians and Gynecologists. In men, obesity is also associated with infertility due to lowered sperm count and motility, according to the National Infertility Association. Therefore, couples should maintain an optimal body weight as well as waist circumference to increase the chance of getting pregnant.

Healthy Weight Ranges

Boyd Mass Index (BMI): 18.5-24.9 (Caucasian); 18.5-22.9 (Asian)
Waist Circumference: <94cm for men and <80cm for women (Caucasian); <90cm for men and <80cm for women (Asian)

Sadly, there is no magic solution to sustainable weight loss. To lose weight successfully, you need to make healthier food choices, eat a balanced diet with portion control, and be physically active. Furthermore, adherence to healthy diets favouring whole grains, fruits, vegetables, poultry, and seafood are associated with better fertility in women and better semen quality in men, according to a review published in the American Journal of Obstetrics and Gynecology in 2017.

Avoid going on a fad diet where you eat a very restrictive diet for a short period of time and often lose weight quickly. Most people on this style of diet get fed-up very soon, start over-eating, make poor food choices and regain the weight they lost. Fad diets can also deplete your body of the nutrients it needs for healthy pregnancy. Consult a dietitian who can help you lose weight in a way that suits your lifestyle.

 

2. Get plenty of iron from plants

A diet rich in plant-based iron may reduce the risk of infertility, according to results from The Nurses’ Health Study II. Plant foods that are rich in iron include lentils, kidney beans, chickpeas, tofu, black sesame, cashew nuts, spinach, fortified cereals, and whole grains. To absorb the most iron from the foods, avoid drinking coffee, tea or milk with meals and add vitamin C from guava, orange, kiwi, lemon, or bell peppers to your meals to enhance iron absorption.

 

3. Go low GI

Polycystic ovary syndrome (PCOS) is the most common cause of female infertility. PCOS affects between 6% and 12% of women overall, which appears to be more common among overweight women. Women with PCOS often don’t have menstrual periods, or they only have periods on occasion. Because the eggs are not released, most women with PCOS have trouble getting pregnant. Research shows that weight loss of 5% is associated with improvement in amenorrhoea (absence of menstruation) for overweight women with PCOS.

Healthy eating tips for women with PCOS:

  • choose high-fibre, low-glycaemia index (GI) carbohydrates – at least half of all the grains eaten should be whole grains such as whole-wheat flour, oatmeal, and brown rice;
  • limit added sugars and refined grains such as sugary beverages, cakes, white bread and white rice;
  • choose monounsaturated and polyunsaturated fats such as avocados, olive oil, flaxseeds, walnuts, salmon, and sardines; and
  • limit saturated and trans fats such as butter, lard, stick margarine, shortening, and partially hydrogenated oil.

 

4. Stop drinking and smoking

Alcohol and smoking can damage the eggs and sperm, and reduce the fertility of both males and females. Therefore, if you and your partner are serious about trying to start a family, you should consider avoiding alcoholic drinks and quitting smoking to increase the chance of pregnancy.

 

5. Increase your folic acid intake

Folic acid won’t boost your fertility, but taking folic acid regularly before becoming pregnant and during pregnancy helps prevent neural tube defects (malformations of the spine, skull, and brain) in babies. Therefore, all women who could become pregnant should take 400 micrograms of folic acid daily from supplements. In addition, choose foods that are rich in folic acid, including asparagus, Brussels sprouts, spinach, mustard greens, oranges, peanuts, black-eyed peas, kidney beans, liver, whole grains, and fortified breakfast cereals.

 

For more information about eating for fertility, consult a dietitian for personalized advice and diet plan.

 

Sally’s Nutrition Blog @ Hong Kong Tatler: https://hk.asiatatler.com/life/thinking-of-starting-a-family-health-tips

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Thinking Of Going Gluten-free? Read This First

Sally Shi-po POON (Registered Dietitian)

Gluten-free diet has gained considerable popularity in the general population over the past decade. Many celebrities and athletes have acclaimed it as an effective way to better health, weight control and athletic performance. There is, however, a lack of scientific evidence to support these claims. On the contrary, there are studies suggesting that gluten avoidance in diet may not be as “healthy” as it claims.

What is gluten-free diet?

Gluten-free diet is a diet that doesn’t contain any gluten. Gluten is a protein that is found in wheat, barley, rye, malt, and oats (unless they are labelled gluten-free). These ingredients are commonly found in bread products, pasta, breakfast cereals, cakes, cookies, batter-fried foods, beer and ale. There are a number of gluten-free grains and plant foods that are suitable for those on gluten-free diet. They include amaranth, arrowroot, buckwheat, cassava, corn, flax, legumes, millet, nuts, oats labelled gluten-free, potato, quinoa, rice, sago, seeds, sorghum, soy, tapioca, and teff.

Who should follow gluten-free diet?

People who have coeliac disease should follow gluten-free diet strictly. Coeliac disease is a serious, genetic, autoimmune illness where the consumption of gluten induces damage to the small intestine and causes nutrient malabsorption. Symptoms include bloating, diarrhoea, nausea, gas, constipation, fatigue, mouth ulcers, unexpected weight loss, hair loss and anaemia. The only treatment for celiac disease is strict avoidance of gluten for life. If you think you have coeliac disease, do not remove gluten from your diet until your doctor makes a diagnosis. If you remove gluten from your diet too early, it will cause an inaccurate result for both blood test and gut biopsy.

Non-coeliac gluten sensitivity

Some people have gut symptoms when eating gluten, even if they don’t have coeliac disease. This is called non-coeliac gluten sensitivity. Symptoms are similar to coeliac disease, such as abdominal pain, bloating, and diarrhoea. Most people with non-coeliac gluten sensitivity agree that there is an improvement of symptoms after following gluten-free diet. The exact trigger for the non-coeliac gluten sensitivity remains controversial thus far. There are reports suggesting that fermentable oligo-di-mono-saccharides and polyols (FODMAP) in wheat, rather than gluten, induce the gut symptoms. The exact cause is, however, yet to be identified.

Is gluten-free diet healthy for the general population?

Not really! Although some celebrities adopt gluten-free diet for weight loss, there is no data to support similar effectiveness among people without coeliac disease. It is important to note that gluten-free does not necessarily mean low-energy. In 2017, experts from the European Society for Paediatric Gastroenterology Hepatology and Nutrition warned that gluten-free products should not be considered a healthy substitute to regular foods because they usually contain higher levels of saturated fat and lower levels of protein.

In 2017, a study published in British Medical Journal found that gluten-free diet may increase cardiovascular risk as a result of reduced consumption of hearty wholegrains. Gluten-free cakes, cookies, muffins, crackers, bread and pizza are usually made with refined carbohydrates, which are high in glycaemic index, and low in B vitamins, iron, and dietary fibre.

In addition, people on gluten-free diet were found to have significantly higher levels of heavy metals such as arsenic, mercury, lead, and cadmium than those not avoiding gluten. More research is needed to determine whether this diet poses a significant health risk in the long run. In case if gluten-free diet is needed, the best way to avoid excessive exposure to these metals is to diversify the food menu.

Does gluten-free diet improve athletic performance?

Implementation of gluten-free diet among non-coeliac athletes has become increasingly popular because of perceived ergogenic and health benefits. In 2015, a carefully designed study published in Medicine & Science in Sports & Exercise concluded that a short-term gluten-free diet had no overall effect on exercise performance, gut symptoms, perceived well-being, intestinal injury, and inflammatory responses in non-coeliac athletes. Whether avoiding gluten for a longer period of time would lead to improvements in sports performance or well-being is yet to be identified. Nevertheless, current study suggests that gluten-free diet is not a panacea. Athletes should always remember that proper nutrient intake and timing are critical components of athletic success.

Before adopting gluten-free diet…

The significance of gluten-free diet in the general population remains controversial and more research is warranted. Before adopting gluten-free diet, you should consult a dietitian to ensure that you will get all the essential nutrients from a variety of foods, including gluten-free grains, fruits, vegetables, legumes, fish, lean meat, nuts, seeds, and dairy.

If you are suffering from any gut symptoms, such as abdominal pain, bloating, or diarrhoea, you should consult a doctor for medical advice. Self-treatment or delay in treatment is undesirable.

Sally’s Nutrition Blog @ Hong Kong Tatler: https://hk.asiatatler.com/life/everything-you-need-to-know-about-going-gluten-free

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