The lay media suddenly discovered the ultimate cure for infertility: healthy food! A plethora of articles in newspapers and on the web discovered the value of healthy eating for women as well as men. Both sexes are alleged to be more fertile if they follow the Mediterranean diet, drink less alcohol and coffee, abstain from gluten, stay dairy-free, restrict sugar but eat, nevertheless, more fruits and less fast food. Even an article in the fertility literature recently suggested that less fruit intake and more fast food consumption were associated with “modest” prolongations of time to pregnancy (Grieger et al., Hum Reprod 2018; doi:10.1093/humrep/dey079).
Where is all of this coming from?
The answer is simple: Don’t believe everything you read! Fake news also exists when it comes to medical advice and medicine in general. Most fake news usually, however, has a crenel of truth, and what we are witnessing recently with the new obsession about nutrition in infertility is no exception. Having a healthy body, of course, is good for conception. Eating healthy and exercising is good for everybody, including those who are trying to conceive.
That obesity is associated with poor fertility in men and women has been known for decades. Of course, one should try to abstain from inflammatory foods, like gluten (wheat and other food sources), dairy, etc., if blood tests show inflammatory markers to be elevated or if certain foods cause GI-symptoms like cramping and bloating. But to put women on gluten-free diets when they have neither laboratory evidence of inflammation, nor any GI symptoms, just because they are trying to conceive, makes absolutely no sense.
To the best of our knowledge, there are no significant differences in female or male fertility levels between different races, ethnicities and countries. If food patterns significantly affected fertility, such differences could, however, be expected. For example, how come having a glass of wine a day is, if we were to follow the advice of many alleged experts, “verboten”? Yet, France, Italy and Spain have never been reported to suffer from sub-fertility, while regular modest wine consumption is deeply ingrained in their cultures? The same, of course, also applies to coffee; Are South American countries and, again, previously noted Mediterranean nations infertile because they have a habit of drinking espressos? We don’t think so; according to most recent news, they are still reproducing like everybody else.
It, in our opinion, also does not make sense to prescribe 20 different food supplements to every patient, as many fertility centers increasingly do. We recently discussed in these pages the use of fertility supplements in female infertility. While some supplementation may, indeed, make sense if prescribed for specific well delineated causes, large numbers of supplement never make sense. They, indeed, should be avoided, not only because of their unnecessary costs but also because of the very real risk that at least some may adversely interact with each other and, possibly, also with pharmaceuticals patients really must take. After all, nutraceuticals contain chemicals. Just because they come from natural sources does not mean that they may not be harmful.
Based on our understanding of the literature on the subject, CHR recommends patients who are planning to conceive and/or are in fertility treatments a well-balanced diet without restrictions. We, however, do recommend abstaining from smoking and social drug use. Once pregnant, we also recommend abstaining from alcohol.
This is a part of the June 2018 CHR VOICE.