before ovulation is the susceptible time-frame.
The future reproductive potential of the developing fetus can also be affected by your nutrition, and exposure to harmful chemicals before and during pregnancy. So avoid exposure to anything harmful; perfumes, bactericides, pesticides, petroleum, phthalates, household cleaning materials, paint strippers and some food additives – these could affect the health of your children and grandchildren. These chemicals may have a detrimental effect on the immune system. Use more eco-friendly products or non-biological versions of these products.
The Dietary and Nutritional Survey of British Adults in 1990 used a category of persons – eating affected by being unwell, which involved 9.5 per cent of women in the survey, aged from 16 to 64 years. Calorie intake in this category was some 18 per cent below average, with nutrient intake similarly reduced. The survey concluded: ‘Ten per cent of women may not be eating well enough to sustain a pregnancy’.41
When recovering from amenorrhoea (cessation of periods due to poor nutrient intake), there are menstrual cycles that are too long and luteal phases that are too short. Research at the University of Sydney suggested ‘a recovery period of at least six months from amenorrhoea before attempting a conception’.42 This allows all the body systems to recover sufficiently from the lack of nutrients. It takes the individual cells some time to regain their full capacity and be able to work at what is known as ‘enzyme saturation level’, when all the enzymes are working at their optimum rate.
Research into restricted calorie intake has been done on monkeys at the University of Pittsburgh, and it was discovered that ‘fasting for one day alone can change the hormone profile the following night’; moreover, ‘missing a single meal could override the suppression of luteinizing hormone (LH)’ … ‘The implication for slimmers is that even short-term deficiency can have a profound effect on endocrine function.’43 Other studies offer similar conclusions, suggesting that ‘restrained eating may be a marker for metabolic and emotional disturbances, and may also be associated with biological consequences, as the LH should take a message from the pituitary to the ovary. If suppressed, no message would be sent. Women with abnormal menstrual cycles experienced ovulatory disturbances including low progesterone and short luteal cycles’.44, 45, 46 If you are restricting nutrient intake in order to lose weight, you may be damaging your chances of becoming pregnant.
BODY MASS INDEX
A body mass index (BMI) measure shows that women’s weight:height ratio is a rough indicator of nutritional status. The body mass index chart has been designed as a result of feasibility testing. Low pre-pregnancy weight is a risk factor, with the risk increasing as the BMI falls below 24kg/m2. American data shows that 50 per cent of infertile women are below 20.7kg m2. In a Hackney hospital study the mothers of the healthy weight babies had a BMI, on average, of 23.7kg/m2. A tool for determining BMI is based upon:
| • Low BMI or underweight is | < 19.8kg/m2 |
| • Normal BMI is | 19.8–26.0kg/m2 |
| • High BMI or overweight is | 26.1–29.0kg/m2 |
| • Obese is | > 29.0kg/m2 |
The BMI is a good general guide to fertility. Indeed, nearly 80 per cent of infertile women have been judged to be underweight.47
To work out your BMI:
BMI = weight in kilogrammes ÷ height in metres squared
So if you weigh 52.5kg and are 1.52m tall, your BMI will be 22.7kg/m2 which is just below the optimum range.
BMI = 52.5 ÷ (1.52 × 1.52) = 22.7
In animal husbandry, it is well known that animals conceive on a rising body weight, not when weight is falling. All animals have a fertility threshold and in farming there still exists the practice called ‘flushing’: ‘The practice of giving ewes which are in fairly poor condition an improved diet for a few weeks before mating so that they are in a rapidly rising condition when they meet the ram. Flushing is not fattening up; it means supplying all the essential nutrients to make the hypothalamus and pituitary gland (and ovaries) provide an excellent hormone profile’.48 Dieting is a common cause of infertility. If the BMI is above 30, then fertility may be compromised. However, you need to lose weight first and then try to become pregnant when the BMI is around 23 to 28.
• CASE STUDY •
Claire C of London
In early 1996 I experienced dreadful pain on the left side of my stomach, which got worse midcycle and premenstrually, and I experienced some discomfort on intercourse. In March of that year, I was diagnosed as having pelvic inflammatory disease and was treated with antibiotics. The pain continued, but my husband and I were delighted to discover in September 1996 that I was pregnant. I suffered a miscarriage at 14 weeks in December that year, and after I had got over the immediate pain of that, Peter and I resolved to try to conceive again as quickly as possible.
In the spring of 1997, I was referred to a consultant gynaecologist because I was still suffering the same pain on the left side of my stomach, which a further course of antibiotics had not cleared up. I underwent a diagnostic laparoscopy and hysteroscopy in June 1997, which revealed extensive endometriosis and secondary adhesions, which were divided and ablated by laser. I underwent further laser treatment in August and October of 1997 because I was still in pain, and was told that I had extremely aggressive endometriosis, and was advised to conceive as soon as I could, because ‘a pregnancy would be ideal to settle things down’.
Easier said than done, I thought! However, to our great delight, I conceived again in November 1997, but once again miscarried, this time at 10 weeks, in January 1998. After this second miscarriage, I resolved to try to do something about my endometriosis because conventional medicine was obviously not working for me. I read everything I could on the subject, visited every website I could find, went to a naturopath, had acupuncture and even visited a lady who claimed to be able to heal me and get me pregnant by hypnosis! By sheer chance, I came across Dian Mills’ name one weekend in The Sunday Times, and managed to get an appointment with her at the Institute for Optimum Nutrition in Putney – she seemed to me like the light at the end of a very long and dark tunnel.
Dian spent an hour with me going over my history and my eating habits, and then devised a healthy eating plan for me and a regime of supplements, which I was to take for one month and then review. We agreed that my endometriosis did not seem to be affected by wheat or dairy products, as many people are, so luckily I was not advised to cut them out, but simply to increase other foods. I increased my intake of fresh vegetables, fish, live yoghurt, eggs, berries, nuts and seeds, and cut out citrus fruits, chocolate (as much as I could!) and caffeinated drinks; and reduced my alcohol consumption to less than five units a week. For breakfast I would eat (and still do) a chopped-up banana and pear, covered in live yoghurt and sprinkled with nutty and seedy muesli – yum! Lunch was salad with tuna or chicken, and dinner in the evenings was grilled fish or chicken with spinach, lots of garlic and herbs.
Dian prescribed vitamins C and E to work with the immune system and aid ovarian function; B6, magnesium and zinc to support the pituitary and ovaries; and evening primrose and fish oils (Efamarine) to aid hormone production and have an anti-inflammatory effect.
At the time I was working long, unsociable hours as a finance lawyer for a large US law firm, so had very little time to think about preparing food and making sure I had just the right ingredients. I’m certainly no Jamie Oliver in the kitchen, but there are so many interesting things you can do with food nowadays, and preparing a tasty nutritious meal does not have to take forever – just remember to always use the freshest ingredients, and get organized enough to plan what you’re going to eat so that you’re not snacking on things that are bad for you.
To our absolute joy, I became