Evidence has accumulated for the role of Vitamin D in maintaining glucose homeostatsis –effectively, reducing the tendencies toward diabetes.  In a relatively recent study of women both deficient and repleted in Vitamin D, those women with lower circulating blood levels were 2-fold more likely to be diagnosed with Gestational Diabetes Mellitus (diabetes in pregnancy).

It also has been proposed that adequate Vitamin D levels during pregnancy may afford protection against the risk of Type I Diabetes in early childhood.  In a large population study performed in Norway representing over 29,000 women, it was reported that women deficient in Vitamin D in pregnancy had a higher tendency toward diabetes in their offspring.  Women with adequate Vitamin D were 2-fold less likely to have a child with diabetes then their Vitamin D-deficient counterparts. (Sorensen et. Al.  Diabetes 2012. Jan; 61(1):175-8.)

Maintaining adequate Vitamin D levels will not abolish childhood diabetes, but it may lower its frequency.

Simplistically, to maintain your weight, approximately 15 calories per pound are required if you lead a very active life style. In older women who are active, 13 calories per pound is all that is needed, and for those who are relatively inactive, only 10 calories per pound are necessary to maintain current weight.

To lose weight, you should subtract 500 calories from your maintenance caloric level, while to gain weight, you would need to add 500 calories.  Therefore, if your maintenance caloric needs are 2,000 calories per day, you should consume no more than 1500 calories each day to lose approximately one pound per week.  If you are very inactive, have a difficult time losing weight, or are obese (Obese=BMI > 30,  which for a 5 foot 5 inch tall women would be a weight over 180 pounds), then you should consume no more than 9 calories per pound which would be no more than 1680 calories for a 5 foot 5 inch tall woman who was 180 pounds.

No diet works for everyone. Each plan must be tailored to suit the individual. A diet should not be thought as short term but rather as a healthy lifestyle choice.  Select lower glycemic index carbohydrates like whole grains, fruits, vegetables and legumes instead of rice, potatoes, white bread, and sweets.

Prepare balanced meals.  Select healthy unsaturated fats and eliminate saturated and trans fats. Include omega 3 fats found in fatty fish like salmon, canola oil, leafy green vegetables, and walnuts.  Beware, however, of very low fat diets, as these may lead to food cravings. Don’t  go overboard on fats as one tablespoon of olive oil contains 120 calories.

Aerobic exercise is an important  component of maintaining a healthy life style. Three to four 20-30 minute brisk walks every week is sufficient especially if combined with resistance training using light weights and more repetition.

Make small changes one at a time. Get adequate sleep and practice stress management. Vitamin and mineral supplements are also worthwhile and should include a standard multivitamin with at least 400 mcg of Folic Acid. Additional daily supplements of Vitamin D, 2000 IU together with 1500 mg of Calcium (equivalent to 2 Extra Strength Tums tablets) has been shown to enhance egg and embryo quality especially in women with ovulation dysfunction and endometriosis. B complex should be taken if you have PCOS and are taking Metformin.  Approximately 1-2 grams of mega 3 fatty acids should be taken if you are not eating fatty fish at least 3 times per week.

Weight management can be frustrating.  However, you can empower yourself to be healthier and thereby improve your chances for a successful pregnancy. This can be done using common sense by making a few healthy lifestyle choices.

Toxins and other negative environmental aspects can interfere with reproduction. These negative effects may be ameliorated by adopting a healthy lifestyle including better nutrition. Many nutritional supplements have been promoted to enhance reproductive performance facilitating successful pregnancy.

Omega 6 fatty acids are pro-inflammatory which means your body senses injury, creating a wound response releasing free radicals that can be harmful. Antioxidants scavenge free radicals lessening their harmful effects. Antioxidants are in fruits and vegetables.  Omega 6 fatty acids are in many processed foods. So by simply supplementing processed foods with fruits and vegetables is a great start to enhancing fertility.

Omega 3 fatty acids do many beneficial things including decreasing inflammation, decreasing the pain response associated with endometriosis, and promoting progesterone response and receptivity which supports normal pregnancy. Since humans cannot synthesize omega 3 fatty acids, we must get them from our diet, primarily from the fish we eat (from the algae they eat). Although fish oil can be supplemented, it is always best to get your vitamins and minerals from their natural source. Omega 3 fatty acids should outweigh our intake of Omega 6 fatty acids. Currently, the typical American diet consists of omega 6 fatty acids outweighing omega 3 fatty acids by 15 fold.

Other vitamins that can fight inflammation are: vitamin C which has a positive effect on percent of “normal” sperm and can increase sperm motility, Vitamin E which has been linked to reducing age related ovarian decline, Vitamin D which may enhance egg quality and whose deficiency is related to pain, and vitamin K. B vitamins are of special interest due to their role in flushing out estrogen. Your liver depends on B vitamins to filter estrogen from the bloodstream via the bile duct into the intestinal tract. If estrogen is not eliminated from the body it will re-circulate which can lead to estrogen dominance. An unhealthy weight and exposure to xenoestrogens which accumulate from ingesting pesticides disrupt endocrine function.

Oral contraceptives can deplete certain vitamins and minerals including vitamin C, B12, B6, B2, folic acid, magnesium and zinc. Therefore women using oral contraceptives should also be taking multivitamins.

Although, the thought of toxins and unknown chemicals in your body is scary to think about, there is something you can do about it. You have the power to improve your own fertility as well as your overall health though nutrition by cutting out processed foods, eating more fruits and vegetables, and incorporating more Omega 3 fatty acids into your diet. Remember, optimal nutrition before pregnancy is extremely important in helping you have a healthy baby.

Vitamin D is known to promote bone and heart health. It may provide benefit in boosting the immune system and lowering risks of certain cancers. Until recently, there have been few studies examining the effects of Vitamin D on reproductive health. Most of what is known regarding its precise activity has been studied primarily in laboratory mice and its potential role in human fertility has been inferred from these animal studies which show that Vitamin D-deficient animals demonstrate altered mating behaviors, decreased fertility rates and a lower litter size. These data suggest that although not critical for successful reproduction, Vitamin D levels and most importantly, its deficiency may affect reproductive efficiency. Furthermore, when these Vitamin D-deficient rodents are fed Vitamin D-rich diets, their reproductive capacity can be restored.

It is only natural to take the next step and to begin to question whether Vitamin D would have similar effects in human reproduction; could the lessons from mice and rats be applied to humans? Only recently, has science begun to explore associations between Vitamin D levels and reproductive capacity. In fact there have been associations between Vitamin-D deficiency and women who have irregular menstrual cycles due to Polycystic Ovarian Syndrome (PCOS). When supplemented with Vitamin D, some of these women experience a return of monthly menstrual cycles and can demonstrate fertility rates comparable to women who have regular menstrual cycles.

Most recently, the effects of Vitamin D have been associated with reproductive outcomes in IVF. In a one study, women who demonstrated adequate Vitamin D levels faired better during IVF cycles and were more likely to become pregnant than their Vitamin D-insufficient counterparts. Although these initial studies are small, the results are promising.

Vitamin D is not the smoking gun; low levels will not inhibit pregnancy and adequate supplementation will not insure a resultant pregnancy. Currently neither of our governing bodies, the American College of Gynecologists (ACOG) nor the American Society of Reproductive Medicine (ASRM), formally recommends Vitamin D supplementation; they call for adequate folic acid intake and promote a healthful and well-balanced diet. However, if these initial studies are confirmed and the adequate presence of Vitamin D promotes a favorable IVF cycle outcome, it behooves us to take note. The measurement of Vitamin D blood-levels prior to beginning an IVF cycle is not the standard of care. Thus, women must supplement these levels empirically. Daily intake of 2000 IU of Vitamin D may provide sufficient stores to promote reproductive capacity. In the absence of kidney disease, Vitamin D supplementation is safe and hopefully will continue to demonstrate a favorable outcome in larger clinical studies. It would not be surprising to find that Vitamin D supplementation will become a welcome addition to current treatment courses that promote fertility and bring a little sunshine into our lives.