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I’m talking about one of my all time favourite things…sleep. I’ll take you through a chronotype quiz to help you understand your ideal sleep and wake times, followed by a bunch of practical, science-backed strategies to boost your chances of falling and staying asleep.

Get ready to fuel your marathon! This episode is all about endurance event fuelling so tune in to nail your nutrition and hydration strategy and hit your PBs.

SHOW NOTES What impact does surgery have on the body? Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation.  Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions. Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines. These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing. But here’s where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress. So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It’s all about helping the body maintain balance during a time when it’s incredibly vulnerable Disruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.'   Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength.   Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications.   Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery. ERAS helps to mitigate these by  Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances. Key Components of ERAS: Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility. Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state. Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol. Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements. How can we use this info to optimize surgical outcomes? Patient education  Early nutrition pre and post surgery - Minimise fasting time  What is ERAS? How does it differ from traditional care/practice? Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition? Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even for patients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolonged hospital stays and higher healthcare costs.  What are the benefits of ERAS for the patient? It has been shown that the key physiological benefits include: -enhances the body’s anabolic processes -promotes wound healing, which is critical for patient recovery. -Reduces the risk of nutritional depletion -Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function. -Reduce protein catabolism -And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery. What are the benefits of ERAS from a healthcare perspective?  From a healthcare perspective, ERAS has been shown to -shorter length of hospital stay for patients, -Lower risk of ICU transfer rates -reduce readmission rates -And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain. Step 1: Screen & Strengthen If you’ve lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it’s really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it’s effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition  If you’re planned for major sur

SHOW NOTES Post-COVID questionnaire: https://chroniccare.snapforms.com.au/form/post-covid-questionnaire Post COVID Recovery steps       References https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 https://www.bmj.com/content/372/bmj.n136 https://www.bmj.com/content/372/bmj.n136/rapid-responses http://www.buckshealthcare.nhs.uk/pifs/nutrition-and-long-covid/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429479/ NICE (2020) “COVID-19 guideline scope: management of the long-term effects of COVID-19” https://www.nice.org.uk/guidance/ng188/documents/final-scope] Leon et al. (2021) ‘More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis”. [ https://pubmed.ncbi.nlm.nih.gov/33532785] Afrin et al. (2020) “Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome”. International journal of infectious diseases, 100: 327–332 https://pubmed.ncbi.nlm.nih.gov/17490952/] Casas et al. (2016) “The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases”. Endocr Metab Immune Disord Drug Targets. 14(4): 245–254. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443792/]  LaTrobe Research https://www.latrobe.edu.au/news/articles/2022/release/possible-cause-of-long-covid-brain-fog Souvenaid  https://nutricia.com.au/souvenaid/ https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-long-covid-recovery/ https://www.pomi-t.co.uk/national-trial/ https://pubmed.ncbi.nlm.nih.gov/35334962/   https://pubmed.ncbi.nlm.nih.gov/33933299/   https://www.bda.uk.com/resource/long-covid-and-diet.html   https://www.buckshealthcare.nhs.uk/wp-content/uploads/2021/10/Nutrition-and-Long-COVID.pdf     https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/     https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-expert-shares-5-early-care-tips-for-people-with-long-covid/     https://www.todaysdietitian.com/newarchives/ND21p40.shtml   https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/     https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/   https://www.healthspan.co.uk/advice/long-covid-diet-and-lifestyle-changes-that-can-help Smell training https://www.fifthsense.org.uk/smell-training/ https://abscent.org/learn-us/smell-training/how-smell-train https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364?login=false https://www.cidrap.umn.edu/news-perspective/2022/04/global-data-reveal-half-may-have-long-covid-4-months

We take a wander through fad diet history to explore the weird and not so wonderful, and how to spot a fad.

https://www.cdc.gov/obesity/adult/defining.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414803/ https://www.aihw.gov.au/getmedia/384eafec-fa90-412d-8c98-b279fddc7911/ah16-4-4-overweight-obesity.pdf.aspx https://www.nature.com/articles/s41366-020-0547-1 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386524/

SHOW NOTES    Mindful Eating Guide - free download Hunger Fullness Guide - free download Diet Cycle Guide - free download

Rebecca Gawler [email protected]  Instagram handles: @reloadphysio Facebook page: https://www.facebook.com/ReloadPhysio   Are you exercising to  make you feel good or enhance your health or is it the opposite? Are you feeling compelled to exercise and if you're unable to meet your targets does this cause you concern or guilt?   HAES practitioners (to find personal trainers who promote intuitive movement): https://haesaustraliainc.wildapricot.org/find-a-provider   The Physiotherapy Eating Disorders Professional Network Group https://cpmh.csp.org.uk/content/physiotherapy-eating-disorders   A website Bec has put together to summarise the research/info on dysfunctional exercise, intuitive exercise and physio for eating disorders: https://eating-disorder-physiotherapy7.webnode.com/?fbclid=IwAR0Uz0wrMmvX2tdFnYPueCXagmotGGQwHhVmtC3yJ91RoDnPXziZZ1hqI   Virtual care https://chroniccare.com.au/ Speak to the team to arrange an appointment with the most appropriate professional.    Platinum Physio  Women’s Health Physio 

Find and Fuel Your Fire Thurs 24th Feb 6:30pm AEDT Details and Tickets here  

SHOW NOTES   OnCore Nutrition Ladies Lunch Series Ladies Lunch 1 - Understanding your cycle Wed 27th Oct 1-1:45pm Ladies Lunch 2 - Lifestyle strategies to harness your health, feel and perform at your best throughout each season of your cycle Wed 3rd Nov 1-1:45pm Tickets and info via Eventbrite       Study discussed Ovulatory Cycle Effects on Tip Earnings by Lap Dancers: Economic Evidence for Human Estrus?  https://www.researchgate.net/publication/228632689_Ovulatory_Cycle_Effects_on_Tip_Earnings_by_Lap_Dancers_Economic_Evidence_for_Human_Estrus

Episode SummaryCalling all nutrition students and new grads...talking through tips to finding and fueling your fire and an exciting workshop we have planned just for you. Episode NotesFind and Fuel Your Fire Workshop Tickets via Eventbrite   Getting a nutrition job is HARD!  The Dietetics Workforce Report 2018 There has been a 95% increase in dietetic grads over the last 7 years.Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees.Many grads are still seeking work up to 12 mths post graduation.In this time, grads are driven to volunteering - but not always meaningfulYou are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management careThe report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses.Despite working in a clinical role 30% of dietitians had no clinical supervisor.file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdf Potential career pathways  Clinical dietetics Popular!When we’ve advertised for grad jobs there have been >100 applicants.A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare!Hard to get grad jobsConsultancy and private practice Often don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision.Important for your own development but also for the reputation of the profession  Food service Media and marketing Don’t expect to get here straight away - need some experience behind youBe responsible with what you put out into the world, social media etc. Don’t know what you don’t know.  Public health and nutrition Eventually policy, health promotion, advocacy Often start as a public health dietitian, community dietitianFood industry ConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch  Nutrition research and education Generally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dietetics https://www.myhealthcareer.com.au/dietetics-career/ Our tips Volunteer meaningfullyUpskillGet a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviewsSeek feedback - and actually be prepared to take it  Our upcoming workshop https://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-159824540503  Wed 11th Aug 6pm    Topics to cover  How to land the job you want Job application preparationInterview (including phone/video interview) preparationSetting yourself apartWhat NOT to do!Volunteer / work experience opportunitiesProfessional developmentFinding your career niche / Progressing your career  SpecialisingQuality projects opportunities in nutritionEducation opportunities in nutritionResearch opportunities in nutritionConference / presentation opportunitiesSupervision and mentoring Finding the right supervisorInnovation in dietetics   Identifying gapsPitching your ideaIntroduction to grants and proposalsDelivery  Online2hr workshop2 sessions - one evening, one weekend‘Take home’ toolkit of resources

Google Trends   Health and disease risk https://pubmed.ncbi.nlm.nih.gov/29276945/ https://pubmed.ncbi.nlm.nih.gov/28853910/ https://pubmed.ncbi.nlm.nih.gov/16507475/ https://pubmed.ncbi.nlm.nih.gov/24671262/ https://pubmed.ncbi.nlm.nih.gov/25156996/ https://pubmed.ncbi.nlm.nih.gov/16685044/ https://pubmed.ncbi.nlm.nih.gov/22591295/   Diuretic effect  Despite the fact that caffeine is a mild diuretic, you don't lose more fluid than you take in by drinking coffee, so it cannot dehydrate you. While we don’t count coffee towards our fluid targets for the day, it doesn’t throw you into the negatives. It’s a net-neutral sort of scenario.    Coffee and exercise performance The impact of coffee on exercise performance is related to caffeine’s impact on the CNS. It’s a stimulant meaning it enhances alertness, and also  reduces our perception of fatigue and our perception of effort. So you feel like you’re not working as hard, and also feel less tired.  Those that are most likely to benefit from caffeine are those involved in team or intermittent sports so basketball, footy etc, endurance sports and high intensity, short duration sports. How much do you need?  While research initially focused on high doses of caffeine, more recent research indicates that lower doses can provide similar performance benefits with less negative side effects. Around 1-3 mg caffeine per kg body weight are sufficient to improve performance (so for a 60kg athlete this equates to roughly 1-2 cups of coffee). Timing is also important - coffee reaches peak concentrations 1hr post intake and will generally last for 3-4hrs. The ideal time to down your coffee is 30-45mins pre-training and often black is best if you’re likely to be sensitive to exercising on a tummy full of milk. https://www.sportsdietitians.com.au/factsheets/supplements/caffeine/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867441/   Coffee and sleep We all know the joys of caffeine in perking us up, but does it affect our sleep?  The stimulating effects of caffeine from coffee last 3–5 hours, and depending on individual differences, about half of the total caffeine you consume remains in your body after 5 hours. It’s no surprise that consuming coffee too close to bedtime can cause sleeping problems. Most studies suggest avoiding caffeine for 6 hours prior to bed.  The good news is that a switch to tea in these 6 hrs, including green tea which contains about a third of the caffeine as coffee, will be helpful due to the presence of amino acid L-theanine, which has relaxing and calming properties.    Coffee and waking!  Studies have shown that the ideal time to drink coffee is around 203hrs after waiting.  This is because of our hormones.  As we wake up, a hormone called cortisol is at its highest. Cortisol is responsible for balancing our energy levels, blood pressure and how we respond to stress or danger.  So, drinking coffee when cortisol is already at its highest may not be giving you any additional energy. In fact, it may be making you feel more tired and stressed or anxious later in the day.  Science suggests waiting 2-3 hours after waking when cortisol is slowly declining to have your morning coffee for the most bang for your buck. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684472/   Coffee naps Some research suggests that combining caffeine with naps is more energising than caffeine or sleep alone. Enter the coffee nap. The theory is that if you drink coffee (or anything caffeinated) before sleeping for a short period, you can boost your energy levels by increasing your brain’s capacity to receive caffeine.  This is related to caffeine competing with adenosine for receptors in your brain.  Adenosine is an organic compound whose derivatives are important for energy processes in the body amongst other things. Adenosine circulation increases when we feel tired and the act of sleep brings these levels down. But coffee might give us a double whammy by blocking some of the adenosine being registered in our brain. This can make us feel even less tired when we wake.  Most of the research suggests the best way to take a coffee nap is to have some caffeine right before taking a 15–20 minute nap (and no more than 30mins). https://pubmed.ncbi.nlm.nih.gov/9401427/ https://pubmed.ncbi.nlm.nih.gov/14652086/   Fun facts Coffee is the world’s most valuable traded commodity next to petroleum.Globally people consume about 2.25 billion cups of coffee every day.Coffee beans are fruit pips and not beans.A coffee bean is  the pip inside the bright red fruit often referred to as a the coffee cherry or coffee berry. Millennials spend an average of $2008 oer year on coffee https://www.ngpf.org/blog/budgeting/question-of-the-day-how-much-do-millennials-spend-every-year-on-coffee/Coffee grounds sprinkled on the ground around plants and the garden will stop snails and slugs from eating the plants.Studies have found an association between regular moderate coffee consumption (2-4 cups per day) and a reduced risk of suicide. Go for less the 8 cups per day.   https://pubmed.ncbi.nlm.nih.gov/23819683/ https://pubmed.ncbi.nlm.nih.gov/31254722/Scientists have successfully turned ground coffee into biodiesel, so one day coffee may be fuelling your carlaws of physics have proven that coffee with milk cools about 20% slower than black coffee - due to the colour. viscosity and rate of heat radiation. The Guinness World record holder for the "Oldest Cat Ever," a 38-year-old cat named Creme Puff - drank coffee every morning her whole life.

Find and Fuel Your Fire Workshop Tickets via Eventbrite   Getting a nutrition job is HARD!  The Dietetics Workforce Report 2018 There has been a 95% increase in dietetic grads over the last 7 years.Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees. Many grads are still seeking work up to 12 mths post graduation.In this time, grads are driven to volunteering - but not always meaningful You are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management careThe report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses. Despite working in a clinical role 30% of dietitians had no clinical supervisor.file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdf Potential career pathways  Clinical dietetics Popular!When we’ve advertised for grad jobs there have been >100 applicants. A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare! Hard to get grad jobs Consultancy and private practice Often don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision. Important for your own development but also for the reputation of the profession   Food service Media and marketing Don’t expect to get here straight away - need some experience behind you Be responsible with what you put out into the world, social media etc. Don’t know what you don’t know.   Public health and nutrition Eventually policy, health promotion, advocacy Often start as a public health dietitian, community dietitianFood industry ConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch   Nutrition research and education Generally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dietetics https://www.myhealthcareer.com.au/dietetics-career/ Our tips Volunteer meaningfullyUpskill Get a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviews Seek feedback - and actually be prepared to take it Our upcoming workshops https://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-112762650122 Wed 26th Aug at 6pm  Sun 29th aug at 2pm Topics to cover  How to land the job you want Job application preparationInterview (including phone/video interview) preparation Setting yourself apart What NOT to do! Volunteer / work experience opportunitiesProfessional development Finding your career niche / Progressing your career  Specialising Quality projects opportunities in nutrition Education opportunities in nutrition Research opportunities in nutrition Conference / presentation opportunities Supervision and mentoring Finding the right supervisorInnovation in dietetics   Identifying gapsPitching your ideaIntroduction to grants and proposals Delivery  Online 2hr workshop 2 sessions - one evening, one weekend ‘Take home’ toolkit of resources 

Fertility Nutrition Important to highlight that conception is a miracle! And for many couples this is not an easy journey. 1 in 6 Australian couples are unable to become pregnant after a year of unprotected sex.Nutrition and lifestyle can play a role and have a positive effect on fertility, in fact, it may improve fertility by up to 69%! https://pubmed.ncbi.nlm.nih.gov/17978119/Female Fertility A balanced diet is important, including a wide variety of fresh produce dailyMediterranean-style diets have been associated with improved fertility Which foods and nutrients are important to include? Folic acid has been shown to be important in female fertility, even with assisted reproduction. It is recommended to include a daily prenatal multivitamin supplement with folic acid (400-500 µg/day) from 12 weeks pre-conception and for the first 12 weeks of pregnancy to decrease the risk of neural tube defects. This supplementation is particularly important in early stages of pregnancy when many women may not yet know they are pregnant, so if you have the opportunity to forward plan it’s always a good idea. Vitamin B12 - animal products, vegans should consider supplementation under guidance from their doctor or dietitian Omega-3 fatty acids - EPA and DHA are important for fertility, conception and foetal development Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).Opt for complex, low GI, high fibre carbohydrates from whole grains, vegetables, nuts and seeds. Include plant-based proteins, reducing your reliance on animal proteins. Get creative with legumes and pulses, whole grains, nuts and seeds.Seafood may have a positive association with fertility. Couples eating more seafood were pregnant sooner than those rarely eating seafood.Choose full fat instead of low fat dairyIodine may be important - get this from seafood, seaweed (nori), potatoes, cranberries, strawberries iodised salt and our bread supply which is fortified. This is a good one to start with folate in the lead up to conception, and is included in most prenatal vitamin blends. Your eating window may be important. Some studies suggest that shifting towards an earlier eating pattern, with a larger breakfast and lunch and a smaller evening meal with reduced late-night eating, may improve fertility. Which foods and nutrients are worth eating less of?Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. Energy drinks - it’s no surprise that they don’t do us any fertility favours. Reduce alcohol intake Don’t overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. Recommend tailored advice from a dietitian in the case of any medical conditions  including PCOS, diabetes or GDM, if you’re in a small or larger body and have any concerns, and if taking any complementary or alternative therapies. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30311-8/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)90458-6/fulltext https://www.thelancet.com/series/preconception-health https://www.health.harvard.edu/blog/fertility-and-diet-is-there-a-connection-2018053113949 https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foods https://www.healthline.com/nutrition/17-fertility-tips-to-get-pregnant#1.-Eat-Foods-That-Are-Rich-in-Antioxidants https://pubmed.ncbi.nlm.nih.gov/22425198/ https://pubmed.ncbi.nlm.nih.gov/11880759/ https://pubmed.ncbi.nlm.nih.gov/11594714/ https://www.pennutrition.com/KnowledgePathway.aspx?kpid=1323&pqcatid=146&pqid=1313 - sweeteners  Male fertility  A balanced diet is important, including a wide variety of fresh produce dailyMediterranean-style diets have been associated with improved fertility and semen quality in menWhich foods and nutrients are important to include? Omega-3 fatty acids - EPA and DHA are important for fertilityAntioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).Which foods and nutrients are worth eating less of?Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. Energy drinks - it’s no surprise that they don’t do us any fertility favours. Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. Caffeine for fertility You certainly don’t need to forego your daily coffee! If you’re trying to conceive it is a good idea to not overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/ Decaf -3mg caffeine per tsp 1 Tsp of instant coffee - 60mg per tsp Espresso shot (30-35ml) - 90-200mg  Percolated - 100mg per cup Energy drinks - up to 110mg per serve Cola - 40mg per serve Black Tea - 50mg  Green tea - 30mg Chocolate - 60g of milk or dark Choc has about 30-40mg Pregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte  Pesticides fertility Some studies suggest that higher consumption of produce prone to harbour higher pesticide residues may be associated with lower probabilities of pregnancy. Those looking to conceive may wish to consider where they source fruits and vegetables that may be more likely to hold residual pesticides, such as strawberries, spinach, capsicum, apples, pears, nectarines, peaches, cherries and grapes.  While this is important to be aware of, washing fresh produce well will help to reduce exposure. And it’s important to keep eating PLENTY of fresh produce as the nutritional benefits of this is very important to consider (as well as any possible pesticide risks). For many, this may be easy to achieve with non-organic produce that’s easier on the purse strings.  https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659557     During Pregnancy Things to be aware of / avoid Vit A - Beta carotene safe, avoid retinol/retinyl esters - upper limit for preformed vitamin A (retinyl esters and retinol from food and supplements) during pregnancy of 3000 µg /day (~10,000 IU). Be cautious of liver (≤1 serving/week), particularly in 1st trimester. Avoid any topical creams, ointments, serums which contain vitamin A or vitamin A derivatives. Mercury in high doses may harm a developing baby's brain. Limit large loads of mercury by:Limit orange roughy (sea perch) or catfish to 150 g/week and to have no other fish that week or Limit shark (flake) or billfish (swordfish/broadbill and marlin) to 150 g/two weeks and to have no other fish during those two weeksExamples of low mercury fish that are high in omega-3 fats include sardines, mackerel, silver warehou, Atlantic salmon, canned salmon and tuna in oil and herrings. Pregnant women are advised to consume 300-450 g/week of lower mercury fish and seafood.  Food safety is important to minimise the risk of food-borne illness. Elevated progesterone levels in pregnancy suppressed the immune system, making women more prone to infection and illness. In particular, we want to reduce the risk of foodborne illnesses listeriosis, toxoplasmosis, campylobacteriosis and salmonellosis. The consequences of foodborne illness can be particularly devastating during pregnancy because both the woman and her foetus are