A Fresh Look at Old Statistics

I was intrigued and excited for my acupuncture and infertility patients when I read  Dr. Jean Twenge’s article, “How Long Can You Wait To Have a Baby?” in the July issue of the Atlantic Magazine.

Dr. Twenge, who is a Phd. in Psychology at San Diego State University who dealt with “baby panic” in her thirties, states that, “The widely cited statistic that one in three women ages 35 to 39 will not be pregnant after a year of trying….is based on an article published in 2004 in the journal of Human Reproduction. Rarely mentioned is the source of the data:French birth records from 1670 to 1830. The chance of remaining childless–30 percent–was also calculated on historical populations”. Twenge goes on to say that she could not get a citation (source) from the American Society of Reproductive Medicine’s for their published guidelines that state only 20 percent of 30 year old women and 5 percent of 40 year old women will get pregnant each cycle.

More optimistic research she highlights was done by Dr. David Dunson of Duke Uiversity and published in Obstetrics and Gynecology (2004). It showed tat in 770 European women who had sex at least twice per week, 82 percent of 35 to 39 year olds conceived within a year, compared with 86 percent of 27 to 24 year olds. In a recent Danish study published in Fertility and Sterility, “…among women having sex during their fertile time, 78 percent of 35 to 40 year olds became pregnant within a year, compared to 84 percent of 20 to 34 year olds”.  I did wonder if averaging 35 year olds with 40 year olds is misleading, but that gets back to what can be done with statistics. Dr. Twenge goes on to say that Dunson’s research reveals that if couples in their late thirties time intercourse more closely to ovulation, their chances of conception are the same as couples in their late 20’s who seem to have a longer window of fertility each month.

The statistics Twenge reports are very positive and helpful to me as I try to support couples who are trying to conceive naturally or through IVF.  However, the fact remains that fertility does decline with age, and the number of eggs a women can produce through IVF at a later age is often reduced. Fortunately , the biomedical options for women in this situation, such as egg and embryo preservation, continue to expand and improve.

Mayo Clinic Complementary and Alternative Medicine Conference

7/11/2013

Syllabus photo

Last weekend I attended the Mayo Clinic Complementary and Alternative Medicine Conference. Along with about 29 other major medical centers that include Harvard, Yale, Duke, Cleveland Clinic and Georgetown, Mayo has a department dedicated to Integrative Medicine. A broad range of topics were presented at the conference including Integrative Medicine for Women’s Health, chronic pain, headaches and weight loss. There were sessions on acupuncture, Taiji, Qigong, and Laughter, as well as updates on nutritional supplements and hormone replacement . Although I would like to share all of the conference information with you, I have put just a few facts in the “We already kind of knew that but it’s nice to be reminded category and a “Really? category. The goal of the Mayo physicians was to present e research based information.

“We already kind of knew that” category:

1. Acupuncture has been shown to decrease dysmenorrhoea.

2. Tai Chi improves balance and decreases falls in the elderly.

3. Flaxseed and fish oil lower triglycerides.

4. Probiotics can positively impact gut health

5. The Mediterranean Diet (olive oil, whole grains, fruits and vegetables) can result in a 75% less chance of death over the first 5 years after a myocardial infarction.

 “Really?” category:

1. Metformin (a type II diabetes drug) “results in vitamin B12 deficiency in 30% of patients.” This was of interest to me because many of my infertility patients with PCOS symptoms have been put on metformin by their physicians.

2. 90% of women have inadequate intake of folate and vitamin E from food. This has important implications for women in their reproductive years, as it has been well established that folate and its cousin folic acid are key players in healthy formation of the spinal cord in babies.

3. 73% of women do not eat more than three servings of vegetables per day. Five to seven servings of fruits and vegetables (combined) is considered essential to obtain needed nutrients. My opinion is that women struggling with infertility or who are already pregnant need even more.

4. 55% of people do not tell their physicians what supplements they are taking.

5. Patients electing to have “food allergy testing” should know that most of the companies doing expensive testing look at the blood “Igg” response which is not definitive. Measuring “Ige” response is more accurate. Dr. Larry Bergstrom from the Mayo Clinic said people should simple eat a food, “and see how it makes them feel”.

6. In a study done with Topirimate vs. Yoga for migraines, more patients improved with Yoga. Their anxiety and depression scores improved more also.

7. Laughter makes our bodies relax and the effects can last up to 45 minutes.

Although these “take aways” seem to cover many different topics, the conference was indeed broad in scope. As always, I will be discussing more information from the conference with each of my patients, as indicated.

Acupuncture and Synchronizing Conception

Jane Gleeson Infertility Acupuncture Wisconsin, Milwaukee

Jane Gleeson Infertility Acupuncture Wisconsin, Milwaukee

I have written in the past about how I am continually amazed at all of the events in the human body that must occur in a definite sequence in a definite window of time for conception to take place. When a patient has done all of the appropriate tracking of fertile mucus, temperature, LH surges, etc. and combined that with the most important part–intercourse, I am at a loss to explain to them why another month will go by without a positive test. After seeing how a patients cycles have become regular and normal in every way  (including proper luteal phase) after coming to acupuncture,  I am often frustrated and disappointed right along with my patients.

Although the timing of intercourse does indeed need to be synchronized with ovulation, I am intrigued by some scientific evidence that men’s semen may indeed contain a hormone or chemical that encourages ovulation and helps regulate a woman’s cycles. So for women with irregular or anovulatory cycles, it may be good to have relations throughout the month, as opposed to waiting for fertility signs. This can also be a more relaxed approach to becoming pregnant, which could be good for a relationship.

 

Fruit for Thought

Fruit For Thought

Fruit For Thought

The benefits of eating organic are obvious: fewer toxic chemicals building up in our bodies. It is a fact that we all have pesticides and plastics in our bodies–babies are born with 232 chemicals in their umbilical cord blood. But the question is how many chemicals can we tolerate before they affect our health.

A recent study  showed that fruit flies who dined on organic bananas and  potatoes were much more fertile, and lived longer than their unlucky cousins who were given non-organic foods.

It’s not always easy to buy organic–it is often more expensive and your nearest grocery store may not stock a lot of items, and one study indicated that organic fruits and vegetable are not necessarily higher in nutrients. However,even though I would like any fruit flies in my kitchen to die young and have few offspring, this study inspires me to think about how vigilant I want to be about buying organic.

Recipe for Best Purple Food You Will Ever Eat!

Best Purple Food You Will Ever Eat !

Purple Glutinous Rice Pudding

(Khao Neow Dum Ptag)

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Similar to the Western Rice Pudding this is a Thai dessert that is very nourishing. In Traditional Chinese Medicine, rice congees are prepared for people when they are recovering from an illness. It is also used to nourish a new mother after she has given birth. Congees are basically overcooked, soupy rice that nourishes because the overcooking of the rice makes it easily digested. Although Thai in origin, this  pudding is similar to a congee.
1 cup purple glutinous rice (not black rice). Ingredients:

Can be found at Asian grocery stores and Larry’s Brown Deer Market.

6 cups water

1/2 cup palm sugar

2 cups coconut milk

 

Reduce heat to a slow simmer and cook for 45 minutes, until rice is very soft and soupy. Stir occasionally.

 

Topping:

1/2 cup coconut cream

1/2 tsp salt

1/4 cup palm sugar

(I sometimes skip making the topping and top with fresh mangoes)

 

Rinse and drain rice. Place rice in medium saucepan, add water, and heat to boiling.

Add the palm sugar and coconut milk. Stir well and simmer for another 10 minutes.

Combine topping ingredients and pour a small amount over each serving.

Serves 4

Note: Use of Palm Sugar is important. When I have substituted regular white sugar, it does not have the same flavor. An added advantage of palm sugar is tht it has a low glycemic index, meaning it will keep your blood sugar and insulin more even.

 

 

Berry Good News

photoA study published in the the American Heart Associations’s journal  Circulation, has revealed that women who consume at least three servings per week of blueberries or strawberries per week have a 30% reduced risk of a heart attack. While it is not new news that berries are good for us, it is good to hear it confirmed (especially at the cost of berries). I like this research for two reasons. One, the subjects were young women (in many studies the subjects were men) and two, the researchers “controlled” for variables such as weight, exercise, family history, blood pressure, caffeine and alcohol intake.

It is believed that the active ingredient in the berries is anthocyanin, the researchers caution that it is not possible to know for sure which of the many components of a blueberry is the one responsible for the good effects. It could be another component, or all of them. So eat whole foods, not dietary supplements !

Other good news: research has indicated that the nutrients in blueberries are fairly well preserved in the freezing process.

Click http://www.medpagetoday.com/Cardiology/MyocardialInfarction/36838 for the full story.

 

Endocrine Disruptors and Obesity

chem-1Here is one big, fat reason to finally ditch those plastic bottles and household chemicals.  Endocrine disrupting chemicals, which are found in everyday items such as food packaging, cleaning products, furniture and cosmetics may very well be contributing to the obesity epidemic.  These chemicals mimic the body’s hormones, causing the body to create more and larger fat cells.

Recent studies found that mice exposed to endocrine-disrupting chemicals at at birth were much more likely to be overweight than the mice mot exposed to the chemicals.  Both groups were fed the same diet and had equal opportunity to move and expend energy, leading researchers to conclude that even brief and small exposure to the chemicals had a significant impact on their weight gain.

Several studies have concluded that the chemicals, which are largely unregulated, have the most impact when the exposure occurs in utero.

For more information, please see the following article from the New York Times:

http://www.nytimes.com/2013/01/20/opinion/sunday/kristof-warnings-from-a-flabby-mouse.html?ref=todayspaper&_r=0

YUK

gatoradeMy patients have heard me say that it is OK to count all liquids when assessing whether they have reached a good intake for the day. HOWEVER, if they walk in with a brightly colored “Power Drink”, they will have points deducted and will  get a mini-lecture.

Drinks such as Powerade and some citrus drinks made by the Dr. Pepper Snapple Group contain brominated vegetable oil, which is used to keep the fruit flavor evenly distributed in the drink.  Known as “BVO”, it is also used as a flame retardant, in upholstery fabric, and in children’s products. BVO builds up in our tissues and some human studies have linked high levels to neurological impairment, reduced fertility, thyroid changes, and early puberty.

Approximately 10,000 chemicals are used in prepared foods, and only about 3,000 of them have FDA approval. This is because there is a law allowing the FDA to allow use of a chemical based on data from a company’s own “expert”. Brominated vegetable oil is one of the chemicals that lacks adequate testing and is not approved by the FDA. Europe and Japan have banned it already banned its use. So be your own FDA (Fertility Drug Assessor !) and read the labels of your drinks. And since they also contain artificial coloring and often come in plastic bottles, you should pass on them anyway !

Green Tea What?

I just returned from ten days in Japan where I enjoyed REALLY GOOD green tea, properly brewed from high quality tea leaves. Previous to my visit, I was not aware of how green tea has morphed into so many products—green tea cookies, green tea bread, green tea ice cream, green tea fondue, etc.

Most people are familiar with the fact that green tea can be good for our health because it contains anti-oxidants . These anti-oxidants scoop up the waste products of cells that are  harmful to health. These waste products include dead cells, extra cholesterol,etc.

This is a good thing of course, but there are some facts that consumers should know.

Green tea is relatively high in caffeine, and can therefore raise blood pressure, keep us awake at night, and can stimulate the nervous system causing tremors or headaches. It can also cause stomach upset in sensitive people as caffeine stimulates stomach acid.

While the anti-oxidants  effects are good for people struggling with infertility, the vaso-constriction action of caffeine could be detrimental to an early pregnancy. That is, in theory, as the capillaries constrict in response to the caffeine, the blood supply to a baby embryo could be compromised.

So if you are trending up in your blood pressure, have problems getting to sleep, or are actively trying to conceive, brew your tea on the weak side, and limit yourself to just a couple of cups per day.

To Bean or not to Bean…..

I recently returned from Japan where I consumed a lot of soy, which made me think about how many of my patients have asked me about whether soy is good or bad for health. Some of my patients have heard or read that soy is “good” and so consume a lot of it.

The fact is, whether eating soy and soy products is good or bad for our health depends on which research studies you read. However there are some facts you can ponder.

Soy plants contain “phytoestrogens”, or plant based estrogens, which in theory can affect our bodies the way that our own endogenous estrogens, or synthetic estrogens can.

Some studies seemed to show that intake of soy could block the effect of our own estrogen by attaching to estrogen receptor cells in the breast, thereby reducing the growth of estrogen sensitive breast cancers. However a recent study in the Journal of Cancer Prevention Research casts doubt on this theory. Some studies have shown that menopausal hot flashes are reduced for some, but not all people taking soy supplements.  A POSSIBLE link between soy and increased cognitive impairment in older people has also been observed, but other research has come to the opposite conclusion.

So what is a person to do ? So much that I advise patients about always comes back to what I call the “Goldi Locks Principle”.  Not too much, not too little. Everything in moderation.

I always have new patients keep a food journal for a week. One of my patients who came for help with irregular periods recorded that she had soy milk on her cereal for breakfast every morning, followed by soy yogurt for a mid morning snack, and frequently ate soy cheese as an evening appetizer.  She liked cheese and thought soy would be better than dairy based cheese.

I would say this is probably too much to have everyday, especially since the above products may contain a lot of “processed soy” which contains large amounts of soy “isoflavones” that may be a culprit in some of the possible negative effects of soy.

There may be something about whole soy beans and fermented soy that is healthier for us than soy supplements or soy isoflavones. So unless your physician advises you to avoid all types of soy for a specific reason, you should enjoy edamame (whole soy beans), tofu (preferably pickled or fermented), tempeh (a form of fermented soy), and miso (fermented rice, barley, and soy combined).  Maybe just not three servings per day, seven days per week.