Step 1: Fix your gut
“Let food be thy medicine and medicine be thy food.” Hippocrates
Eating healthily seems to be a moving target. A few years ago eggs were bad for you due to cholesterol scares, now they are a superfood we of which we can’t get enough. The food’s goodness or badness hasn’t changed, just the research and popular understanding. There are plenty of examples of foods that have gone from saint to villain and vice versa that it is hard to trust that what the research is telling us is healthy now will remain the case into the future.
My version of healthy used to consist of switching delicious white bread for the more worth wholegrain equivalent, saying no to puddings at the end of a meal (but really only when I was bursting at the seams) and making a homemade quinoa salad once a week.
But I was waking up early every morning to urgently attend the bathroom for an unpleasant ‘good morning’ from my tummy. In addition I also experienced a number of other symptoms of an irritated bowel, including cramps and wind that made the air so thick that you could almost chew it. My gut was poorly.
Impact of diet and nutrition on the menstrual cycle
Interestingly, the menstrual cycle also effects your diet with evidence showing that that women eat more food per day during the 10 days after they ovulate than during the 10 days before.
Control, Alt, Delete and reboot my nutrition
Some doctors and nutrition experts, such as Dr Natasha McBride Campbell (more on this crazy Russian doctor later) say that good gut health is essential for fertility and that once the gut it healed, your body will be in a position to allow you to become pregnant. Your immune system is intricately intertwined with your gut health and if you are not well then you are not going to be fertile.
So food was my first step. I pressed control-alt-delete on my nutrition and gave my diet a complete overhaul. This involved a great deal of research and exploration to find what is ‘healthy’. It is likely to differ significantly from person to person as people’s history of food, gut biome, intolerances and general health can vary hugely. So I trialled lots of food changes to find out what was right for me.
Key food principles for the next 12 months
There are wide ranging and passionately felt disputes between experts on what is good and bad for a person to eat. But of all the research that I have come across there appear to be some principles that the vast majority agree upon, and that will form the basis of my nutrition.
- Eat more fresh vegetables - especially dark, leafy greens. We can all feel pretty comfortable that the evidence points towards vegetables being a good thing (e.g. Harvard School of Public Health). I defy anyone to find a nutritionalist who doesn’t suggest that we eat more vegetables, in a wide variety of colours and types. There is more disagreement around whether we should be eating raw (full of nutrients but can be hard on the tummy) or cooked (which can reduce the nutrient value but can become more easily digestible and bioavailable) so every day I will eat a combination of both.
- Eat only the best quality organic, untreated, unprocessed, free range produce wherever possible. And I knew that it wouldn’t always be possible, so I cut myself a little slack. Whenever I have a choice, I choose free range organic.
- Do not eat processed, convenience foods. No ready meals or shop made sauces, cakes, biscuits. In fact, there will be whole aisles of the supermarket down which I am no longer required to walk. I once heard it explained that ‘if your granny wouldn’t recognise it, don’t put it in your mouth’.
What does a healthy gut look like?
“All disease begins in the gut” - Hippocrates
The Bristol Stool Scale
Doctor’s working at the University of Bristol created a scale to measure types of faeces (known as the Bristol Stool Form Scale or the Meyers Scale). I can get a good sense of the state of my digestive system from looking into the toilet bowel before a flush. When I am consistently hitting those 4s (sausage or snake like, smooth and soft) then it is a good sign that my gut is healing and I’m back on track. Anything else is likely to need work.
I would love to get a print out of the Bristol Stool Scale framed and hung in the bathroom. But I have been informed by my husband that this type of relevant and educational wall art is not appropriate for our bathroom look. Shame.
How often is normal?
How often someone visits the bathroom varies from person to person and anything from 3 times a week to 3 times a day is considered within the range of 'normal' (Mercola.com). For me (and I fear I am oversharing here) I am trying for a steady once or twice a day.
One of the reasons that I am obsessed by the frequency and size of my faeces is that my cycles indicate that I may be oestrogen dominant (see My Monthly Results). Although GP's test results show that I am producing sufficient oestrogen and progesterone, my long pre-ovulatory phases and short post ovulatory phases could be the result of my body being dominant in oestrogen. So how does my body rid itself of excess oestrogen? Yep, you guessed it - through excrement. There is an interesting video on the research available on the Nutritional Facts website.
Keeping a poo record
There’s an app for everything these days and as I like to take things (possibly) a step too far, I also keep track of my bowel movements via the My Symptoms app. You can keep a record of your poops using the Bristol scale and compare it against the food that you are eating, your energy levels. sleep and exercise. The My Symptoms app uses an algorithm to predict the most likely causes of digestive or other symptoms that you are experiencing, which could help in indicating the likely culprits for food intolerances. The app can be helpful if you remember to input the data everyday and and you have a few months worth of data.
It has made a few things clearer to me, including that the amount of water I drink has a huge impact on my energy levels and that cups of tea bring on the 'tea wees'.
How to make improvements
Eating organic food
I'm not going to rehash the arguments on if and how organic produce may be better for you, although I have read plenty of interesting articles on this topic, including one exploring this topic on WedMD entitled Is Organic Food Better for You? The conclusion of this article is that although there isn't loads of research on the additional nutritional value of organic food, there is conclusive evidence that you are less likely to be exposed to pesticides if you eat organic. It suggests that if you can afford to go organic, like the idea of eating less toxins (who doesn't?) and supporting environmentally friendly food production then going organic is the way forward. It also suggests that if you are not ready to go fully organic then you can always pick and chose, which leads me on to the 'dirty dozen' and the 'clean fifteen'.
Dirty Dozen and the Clean Fifteen
The Environmental Working Group ranks the fruits and vegetables with the most and least pesticide residue, based on the USDA's Pesticides Data Program. This data is then used to compile the EWG's Shopper's Guide to Pesticides in Produce™. EWG singles out produce with the highest pesticide loads for its Dirty Dozen™ list, which in 2016 consists of:
- Sweet bell peppers
- Cherry tomatoes
Plus 2 additions - Hot peppers and kale/collard greens
EWG's Clean Fifteen™ list the produce least likely to hold pesticides, and therefore if you are going to pick and chose your organic products, the ones that you may feel more comfortable buying non-organic varieties:
- Sweet corn
- Sweat peas frozen
- Honeydew melon
A UK version of the best and worst foods for pesticide residue is available on the Pesticide Action Network UK website.
Buying organic produce
Most supermarkets stock an organic range making it a very real choice whether to buy organic or not. Under EU law, producers of packaged organic food are required to use the EU organic logo. For food to be labelled as "organic" in the UK, 95% of the farm grown ingredients making up the product must be organic. If the food comes in packaging then I also like to check the packet for a Soil Association or other certification, as there are a number of other certification bodies in the UK .
For meats to be classed as "organic" in the UK they must, amongst other things, be given space to graze, not be given hormones to improve growth or routine antibiotics. Food labelling can be confusing, for example the difference between organic, free range and outdoor bred, and so Farms Not Factories has produced a helpful guide to help decipher the labels to make an informed choice.
Organic veg boxes
An additional way to pack in organic veggies is to order an organic veg box, direct from the farm. There are a number of options across the the UK, although I have chosen to use Riverford. For the past year my organic veg box, along with organic non-hormonganised whole milk and cheese, arrives on my doorstep every Friday. Of course, you can chose to purchase organic vegetables from most supermarkets now but the amount of fresh veggies that I eat has dramatically increased since joining the scheme. The pressure to get through the whole box each week encourages me to blend, chop, make soups and take raw veg snacks to work. The only downside for me is that every week comes with a variant of potatoes, which are one of the few vegetables not allowed on the GAPS diet that I am currently following. Our friends live a few streets away and every week I leave the bag on their doorstep, like a slightly creepy potato fairy.
Cookbooks and diet plans
There are a number of cookbooks and diet plans that I have used to help me overcome my constant 'disaster pants' situation.
GAPs (Gut and Psychology Syndrome) diet
The GAPs diet is one that I have followed (with ranging levels of strictness) over the past few months. It is focused on how easy or hard foods are to digest and aims to give your digestive system a break whilst it fixes itself. It is good for enforcing the general principles of everything being homemade and eating lots of fresh produce, but it is restrictive in what it allows and so is definitely only for the truly committed. I have followed (nearly all of) it for a few months and my digestion is better by a country mile, with regular 4s on the Bristol Scale and dramatically reduced emergency (loo) stops. The one negative, other than it being impossible to buy an acceptable shop bought lunch, is that it made my husband and I both very tired. Could this be due to the lack of grains or starches in the diet? Not sure, but we have reintroduced some gluten free carbs back in, such as a little rice or buckwheat porridge. Many of the recipes from Hemsley and Hemsley (see below) are GAPs appropriate or buying a GAPs cookbook would have helped wth staying on track.
The Bulletproof diet/The Better Baby diet
The Bulletproof diet was designed by Dave Asprey, Silicon Valley zillionaire and ex-fatty, and focuses on reducing inflammation and toxins within the body. The diet in the Better Baby Book, written by Dave and his doctor wife Lana, is based on the same principles with some fertility specific additions.
Weston A Price Foundation
A non-for profit organisation that encourages the eating of nutrient-dense foods. The website has plenty of free information and guidance on nutrition and disseminates the findings of nutrition pioneer, Dr Weston Price. The food principles focus on traditional food preparation, farming and consumption. There is a very useful article on the differences between a paleo diet and the Weston A Price diet, which also handily sets out the main principles.
My favourite cook books with many recipes suitable for the three diets above:
Free recipes online
Hemsley and Hemsley, cruelly referred to in our household as the 'smug sisters' due to their too 'worthy' appearances on their cooking show, have an excellent website with many recipes that can be made when following the GAPS diet. Every single dish that I have made from their site and their cook books has been delicious, which is no mean feat given the restrictiveness of some of the diets and my questionable ability in the kitchen. Their cakes, bakes and puddings are particularly delicious but I have had to cut back for the sake of my honey intake.
In order to help with the rebalancing of my gut bacteria I started taking probiotics. I (and anyone who has ever been in a room with me when I've farted) can tell you that my gut bacteria was 'off'. Not being able to afford tests to check which bacteria was winning the fuedal dispute in my stomach, I opted for taking an everyday probiotic consisting of the most common good bacteria. Probiotics are especially important if you have been on antibiotics, which is everyone who has undergone the dreaded HSG fertility test.
I use Optibac because they undertake their own scientific research and compose their probiotics based on the findings.
An alternative, and more natural way to get bacteria into your system is by eating fermented foods such as sauerkraut, kimchi, kombucha, kaffir etc. The bacterial strains entering your system are not controlled to the same degree as taking a probiotic capsule, but it is a traditional way of introducing more good bacteria into the diet.
Make your own bone broth to sooth and health your gut. You can throw any vegetables or bones into a broth according to your tastes, but a recipe that i regularly use is available here.