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Transcript
Rebecca Baskett Registered 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 Plan meals can help you avoid snacking and over eating 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 Red meat Hormones are NOT permitted in NZ chicken Fish richest source of iron Chicken Foods 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 Folic acid to the rule 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 Dose: 1 capsule daily 500mcg, iodine 150mcg <800mcg folic acid 60 capsules $29.95; 120 capsules Cost per day = $0.45 approx $52.95 Elevit with iodine Per capsule :Folic acid Dose : 1 capsule daily 800mcg, iodine 250mcg 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!