Laura Londra MD
At the recent American Society of Reproductive Medicine meeting in San Antonio, I was fortunate to have the opportunity to join a roundtable discussion lead by Dr. Jorge Chavarro, Associate Professor Nutrition and Epidemiology at Harvard University. Dr. Chavarro’s work has just been published in the prestigious Journal of the American Medical Association (JAMA). The full article can be found here, but I have summarized the meeting discussion and research paper below.
Fruits and vegetables are supposed to be good for health and reproduction. People should definitely continuing getting the daily requirement of fruits and vegetables, but there is more to it, according to the new study. The researchers looked at the relationship between food and fertility. They classified fruits and vegetables based on their high or low content of pesticide residue and they evaluated the association of consumption of them with the reproductive outcomes. The results of this study apply to women with infertility who are undergoing in vitro fertilization, therefore, they might not necessarily apply to fertile couples from the general population.
Here are some findings from this provocative and important piece of research:
-Total fruit and vegetable intake was unrelated to the probability of implantation, clinical pregnancy, and live birth, which is initially surprising.
However, when fruits and vegetable consumption was classified as having high vs low pesticide residues, differences in clinical pregnancy and live birth rates were observed.
-Specifically, consumption of fruits and vegetables with high levels of pesticide residue was inversely associated with probability of clinical pregnancy and live birth per initiated cycle, in other words, when higher pesticide produce was ingested, the probability of clinical pregnancy and live birth per cycle was lower.
-Compared with women who had the lowest intake of high pesticide residue produce (<1 serving per day), women who had the highest intake of produce with high pesticide-residue (2.3 servings/day) had 18% lower probability of clinical pregnancy and 26% lower probability of live birth.
No associations were found between the intake of high or low pesticide residue fruits and vegetables with markers of response to ovarian stimulation, fertilization rate, or embryo quality.
Finally, the consumption of fruits and vegetables with high pesticide residue was associated with a higher probability of pregnancy loss (including biochemical pregnancy, ectopic pregnancy, miscarriage and stillbirth). Overall, these findings suggest that the effect of pesticide residues that comes with food could be acting on early embryo development, implantation and placentation after infertility treatment.
So here is the list, as transcribed directly from the research paper:
High pesticide fruits and vegetables: for these it is best to choose organic!
Kale, mustard, chard greens
Fresh apples or pears
Grape or raisins
Spinach, cooked or frozen
Peach or plums
Spinach, fresh or raw
Low pesticide fruits and vegetables: less risk if you eat these not organic
Peas or lima beans, Sweet peas
Dried plums or prunes
Beans or lentils
Cabbage or cole slaw
Orange juice, regular or calcium fortified
Apple juice or cider
Eggplant, summer squash, zucchini
Yam or sweet potatoes
Head lettuce, leaf lettuce