NERD ALERT: Are these two major culprits behind infertility and developmental issues in babies?
Oxidative stress and inflammation. Two terms you may have heard of. Did you know they are both increasingly linked to a lot of modern chronic and even psychiatric diseases (more to come on this!) which are seemingly on the rise these days?
They are NOT things you want too much of, especially if you’re trying to conceive and grow a healthy new person. In fact, research is increasingly linking these two to infertility (unexplained/PCOS and endometriosis), pregnancy issues (preterm labor/preeclampsia etc) and developmental issues in babies (autism/Cerebral Palsy/autoimmune conditions).
Here’s what you need to know:
I dont know about you, but sometimes when I hear terms I sort of understand (but dont really) it goes in one ear and then out the other. Not particularly likely to lead to any change in my behaviour. So, when it comes to an important issue like this, it's well worth taking a quick couple of minutes to really understand what these are and how and why there can have such an impact.
So, what are they? (Dont worry - in brief!)
OXIDATIVE STRESS (OS): What is it? So, every part of cell life produces oxidation. It is a normal part of a cell living/part of metabolism. Think of it like a waste product of cell life. In fact, when we get pregnant, we actually have more oxidation as we have an entirely new person being built. Makes sense really: more cells/more metabolism. They key however is ensuring that there isn't too much for too long, and that it is balanced out on the other side by antioxidants.
When we have more oxidation than antioxidants that = oxidative stress (OS) and potential problems.
You’ve probably heard all about Antioxidants. These are there on the other side to balance out normal cell oxidation. The trouble comes when we produce more oxidation (which happens more when the body is defending itself from infections/pollutants and toxins etc) and not enough antioxidants to balance that. That causes free radicals (bad), oxidative stress and ultimately cell damage/proteins and DNA. Not what you want. Especially not if you are trying to conceive and have a healthy baby.
INFLAMMATION: this is the body’s reaction in part to attack - it is like a marker that something isn't right in the body or its ‘under attack’. Of course this is good in small doses when you are injured for example. The trouble comes (as we are seeing more and more) when this is chronic ie. persistent/low levels and lasting. This is a sign that we have a problem in the body and that the body is under attack. Click here for MUCH more, but in a nutshell it is also now widely appreciated to be a fundamental root cause for many chronic modern day health issues including cancer.
How are they linked?
Oxidative Stress and Inflammation have a complicated but often interlinked relationship. One way to think about it (in simplistic terms) is when you have oxidative stress and cell damage in the body, it brings about inflammation - the signal that something is wrong. It doesn't stop there though, some research has shown that inflammation can even increase the sensitivity of the body to reactive oxidative stress, resulting in tissue injury (1).
However, we could get lost for days down this route, the truth is it's a seriously complex and not fully understood relationship. The important thing to know is that ‘The mechanism by which oxidative stress induces inflammation and vice versa is unclear but is of great importance’ (3). Particularly for conceiving and having a healthy baby and preventing disease.
We also know that this has been on a steady increase over the last few decades:
‘An increase in inflammation among individuals living in Western societies is evidenced by the alarming rise of allergy and autoimmune disease in the United States and other Westernized countries over the past century and can be attributed to five major causes that result directly from social and cultural changes: (a) an “inflammatory diet” high in fat and simple sugars and low in fiber and nutrients, (b) lack of physical exercise, (c) chronic and unrequited psychological stress, (d) vitamin D deficiency, and (e) biome depletion. The recent rise in autism could be attributable, at least in part, to this rise in inflammation.’ (3)
So how could this be impacting our chances of having a healthy baby/small person?
‘OS [Oxidative Stress] plays a large role in infertility….OS induces local inflammation, resulting in elevated levels of cytokines’ (2)
First and foremost, research is increasingly suggesting the role of oxidative stress’ on male fertility. We have recently discovered that sperm counts in the western world have halved in only 40 years. One big culprit being blamed is oxidative stress. Click here for much more on this plus some things that have been shown to counteract this.
Female fertility (or lack of) has been a more complex issue:
Here is a quick snap-shot/summary of the process by which it can cause problems:
Oxidative stress (OS) can impair the reproductive organs including placenta
The inflammatory environment caused by OS causes a series of signal activations in the uterus
The connection between OS and progesterone causes the reproductive process to be blocked
Continued exposure to OS in postnatal and later life periods can further exacerbate the loss of antioxidant defenses established in utero and enhance susceptibility to disease in a baby. (2)
The common point between these is that they are activated during inflammatory processes which are brought on by oxidative stress.
In a nutshell: together they can cause many issues for conceiving, carrying and having a healthy baby in to the future. These issues include PCOS/Endometriosis, Preeclampsia, Preterm birth and labor and low success with assisted reproductive processes like IVF. Not to mention susceptibility to disease for the child in later life.
So are taking antioxidants the answer? Ahh if only it was that simple. For men, the research is more constructive on the role for antioxidant supplementation - click here for more. Unfortunately for women, even though there is clearly a role being played by inflammation and OS, supplementation with antioxidants alone does not appear to be a fix-all.
There are a couple of exceptions however where this could be a helpful tactic:
Recurrent miscarriage: Half the time there is a diagnosable cause. For the other half, studies have pointed to increased Oxidative Stress. A couple of studies have in fact found that boosting one particular antioxidant NAC (N-acetyl cysteine) which has been shown to replenish Glutathione in the body click here for more on why that is important to be potentially beneficial. Interestingly, it is also used when people have an overdose of Paracetamol (click here for why you want to avoid medicines for children that contain it) and research has demonstrated that a combination of NAC plus folic acid has had some positive results in terms of pregnancy outcome.
Preeclampsia: this is the leading cause of maternal and fetal morbidity worldwide and there are links to lower antioxidants as well as an association with inadequate levels of Vitamin C and higher risk. Results are not slam dunk, however there is some evidence of supplement benefit here.
Preterm labor: there is a strong link to inflammation in particular here. The main culprits usually being intrauterine infection and/or inflammation (alongside some genetic factors). However, research has shown that some women who suffer preterm labor have diminished antioxidant abilities to defend against Oxidative Stress. Once again NAC has been shown to have some positive effects here (less the case for Vitamins C&E).
IVF outcomes: research has shown that oral supplementation with vitamin and mineral supplements can increase serum concentrations of Glutathione (a key antioxidant) - click here for more and has been suggested to play a significant role in IVF outcomes. Free radical impact (when we get an imbalance with too much oxidation to not enough antioxidants) on oocytes/sperm and embryos have been linked to poor outcomes. (1)
For children: one paper in particular strongly sounds the warning bell for children experiencing oxidative stress and inflammation and linking this to the development of Autism. Particularly when you combine depleting antioxidants on the other side by administering Paracetamol (which unfortuhatly is in some common medicines for children). It is well worth a more in depth look at his report click here. For the cliff notes version (!) check out my article here.
So what to do??
A number of health complications for women when it comes to fertility, pregnancy etc are apparently linked to inflammation and oxidative stress. However (particularly for issues like PCOS and Endometriosis) there are a number factors at play making it a bit less clear cut. However, whichever way you look at it, making sure you avoid unnecessary oxidation (pollutants/stress/toxins etc) and have adequate levels of antioxidants which are the body’s defence is no bad thing. If anything it is a time you really don't want to add more Oxidative stress and inflammation to the body.
So what are the big risk factors for oxidative stress and inflammation that we can control?
Click here for the top ten ways to avoid in more detail, but in a brief nutshell:
Weight: most people know that being overweight is a no-no for a healthy conception and pregnancy. ‘Oxidative stress from excessive ROS generation has been implicated in pathogenesis of obesity’ and has been linked to all kinds of issues from trouble conceiving to increased risks of preeclampsia, gestational diabetes, delivery complications and health conditions for the baby.
‘Multiple studies link obesity to chronic, low-grade inflammation and the subsequent secretion of pro-inflammatory cytokines and infiltration of immune cells’. (3)
So how much weight should you put on during pregnancy? Ideally, women with a normal pre-pregnancy BMI (19.8-24.9) should gain between 25 and 35 pounds during pregnancy. Overweight women (BMI 25-29.9) should aim to gain between 15 and 25 pounds, and obese women (BMI >30) should gain no more than 15 pounds. (1)
Pesticides: not only are these known endocrine disruptors but they have been linked to issues with fertility. ‘Oxidative stress has been implicated in undesirable reproductive outcomes induced by organophosphate compounds’. (1) How? Research has shown that they can reduce the body’s own antioxidant stores (Glutathione in particular). Click here to learn much more about how and why on every level you should avoid these.
Exercise: All about getting it ‘just right’. Exercise causes an oxidative state, particularly when done in the extreme. However, physical activity on a prolonged basis (away from the extremes) has in fact been shown to heighten antioxidant response. In fact ‘overproduction of OS after acute exercise in certain diseased individuals may serve as a trigger for improved antioxidant defense when compared with their healthy counterparts. (1) It is a similar case for inflammation - exercise at the extremes (too much or too little) have been linked to chronic inflammation. Click here for more.
Diet: the “inflammatory diet” high in fat and simple sugars and low in fiber and nutrients is a major culprit of our modern times. Refined, processed foods. Against this, eating food high in antioxidants is also a no-brainer.
Stress and lack of sleep: the enemy of most things when it is chronic and persistent. Has been linked to increased inflammatory markers in the body (amongst many other things). Click here for much more and what to do about it.
Gut health: a poor gut microbiome has similarly been seen as the root of many issues but is also highly associated with inflammation when there are imbalances and lack of diversity. Click here for much more on this.
Vitamin D deficiency: the perennial problem of the office dwelling modern person. Make sure you go for D3 ideally in soluble form if you’re going to supplement.
Bottom line: if you needed any more reason to avoid unnecessary toxins, stress, bad food and pollutants here it is. It’s not rocket science, but modern life sometimes makes it hard to do. Hopefully being armed with this knowledge will be a little push in the direction of making a change.
1) AGARWAL A, APONTE-MELLADO A, GUPTA S: The effects of oxidative stress on female reproduction: a review. Reproductive Biology and Endocrinology: RB&E. 2012: 10: 49
2) LU J, WANG Z, DONG Y: A novel and compact review on the role of oxidative stress in female reproduction. Reproductive Biology and Endocrinology: RB&E: 2018: 16: 80
3) PARKER W, HORNIK CD, NEVISON CD: The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism. Journal of International Medical Research. 2017 Apr: 45(2): 407-438
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