The Effects of Hormones in Milk on Infertility in Women

The Effects of Hormones in Milk on Infertility in Women
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Dairy consumption is associated with years of advanced ovarian aging, thought to be due to the steroid hormones or endocrine-disrupting chemicals in cow milk.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

When it comes to the amount of steroid hormones we are exposed to in the food supply, milk products, dairy products, supply about 60 to 80 percent of ingested female sex steroids. I’ve talked about the effects of these estrogens and progesterone in men and prepubescent children: how milk intake can spike estrogen levels within hours of consumption. But in terms of effects on women, I talked about the increased endometrial cancer risk in postmenopausal women, but what about reproductive-age women? Might dairy hormones affect reproduction?

We’ve known dairy food intake has sometimes been associated with infertility; however, little is known with regard to associations with reproductive hormones or anovulation, meaning how might dairy do it, by affecting how the uterus prepares, or affecting the ovary itself. The researchers found that women who ate yogurt or cream had about twice the risk of sporadic anovulation, meaning failure of ovulation, so some months there was no egg to fertilize at all. Now we know most yogurt these days is packed with sugar. Even plain Greek yogurt can have more sugar than a double chocolate glazed cake Dunkin’ donut. But they controlled for that, and the results remained after adjusting for the sugar content, which suggests that the risk of anovulation was independent of the sugar content included in many yogurts. Now we don’t know if this was just a fluke, or exactly what the mechanism might be, but if women skip ovulations here and there throughout their life, might they end up with a larger ovarian reserve of eggs?

Women are starting to have their first baby later and later; there’s been a rise in women having babies in their late 30s, and 40s. And we used to think that women’s ovarian reserve of eggs stayed relatively stable until a rapid decline at about age 37, but now we know it appears to be more of a gradual loss of eggs over time. Here’s what the graph looks like, where there’s a steady loss starting at peak fertility in one’s 20s. This is measuring “antral follicle count,” which is an ultrasound test where you can just count the number of like next-batter-up eggs in the ovaries. It’s probably the best reflection of true reproductive age. It’s a measure of ovarian reserve—how many eggs a woman has left.

Okay, so what does this have to do with diet? Researchers at Harvard looked at the association of various protein intakes with ovarian antral follicle counts among women having trouble getting pregnant. Even though diminished ovarian reserve is one of the major causes of female infertility, the process leading to reproductive deterioration with age is still poorly understood. In light of women delaying pregnancy until older age, the identification of reversible factors that may affect the individual rates of reproductive decline might be of significant clinical value.

They did ultrasounds on all the women and studied their diets, and concluded that higher dairy protein intake was associated with lower antral follicle counts, in other words: accelerated ovarian aging.

Here’s what the graph looked like in nonsmokers. Significantly lower ovarian reserve at the highest dairy intake, which would be like three ounces of cheese a day, compared to the lowest dairy intake. Okay, but what do these numbers mean in terms of biological age? Is 16.9 down to 12.7 really that much of a difference? If you look at women with really robust ovaries, a follicle count of 16.9 would be like what you might see in a 36- or 37-year-old. Whereas 12.7, what you can see in women eating the most dairy, is like what you might see in a really fertile 50-year-old. So, we’re talking years’ worth of ovarian aging, between the highest and lowest dairy consumers.

While it wasn’t possible for the researchers to identify the underlying mechanism linking higher dairy protein intake to lower antral follicle count, they had several educated guesses. One: it could be the steroid hormones and growth factors; two: the contamination of milk products by pesticides and endocrine-disrupting chemicals that may negatively affect the development of these ovarian follicles and egg competence.

Regarding the hormones, studies suggest that commercial milk (derived from both pregnant and non-pregnant animals) contains large amounts of estrogens, progesterone, and other placental hormones that are eventually released into the human food chain, with dairy intake accounting for 60-80 percent of the estrogens consumed, as I mentioned before. Dairy estrogens survive processing, appear both in raw and commercial milk products, are found in substantially higher concentrations with increasing amounts of milk fat, with no apparent difference between organic and conventional dairy products—that’s important to realize. It’s not just cows that have been injected with growth hormones. Their hormones are just in their bodies naturally. and once inside the human body, these bovine hormones get converted to estrone and estradiol, the main active human estrogens. And following absorption, bovine steroids may then affect reproductive outcomes.

It is imperative that further studies are designed to clarify the biology underlying the observed associations. This might be crucial, given that consumption of another species’ milk by humans is an evolutionary novel dietary behavior that has the potential to alter reproductive parameters and may have long-term adverse health effects.

Please consider volunteering to help out on the site.

Image credit: Debby Hudson via unsplash. Image has been modified.

Video production by Glass Entertainment.

Motion graphics by Avocado Video.

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

When it comes to the amount of steroid hormones we are exposed to in the food supply, milk products, dairy products, supply about 60 to 80 percent of ingested female sex steroids. I’ve talked about the effects of these estrogens and progesterone in men and prepubescent children: how milk intake can spike estrogen levels within hours of consumption. But in terms of effects on women, I talked about the increased endometrial cancer risk in postmenopausal women, but what about reproductive-age women? Might dairy hormones affect reproduction?

We’ve known dairy food intake has sometimes been associated with infertility; however, little is known with regard to associations with reproductive hormones or anovulation, meaning how might dairy do it, by affecting how the uterus prepares, or affecting the ovary itself. The researchers found that women who ate yogurt or cream had about twice the risk of sporadic anovulation, meaning failure of ovulation, so some months there was no egg to fertilize at all. Now we know most yogurt these days is packed with sugar. Even plain Greek yogurt can have more sugar than a double chocolate glazed cake Dunkin’ donut. But they controlled for that, and the results remained after adjusting for the sugar content, which suggests that the risk of anovulation was independent of the sugar content included in many yogurts. Now we don’t know if this was just a fluke, or exactly what the mechanism might be, but if women skip ovulations here and there throughout their life, might they end up with a larger ovarian reserve of eggs?

Women are starting to have their first baby later and later; there’s been a rise in women having babies in their late 30s, and 40s. And we used to think that women’s ovarian reserve of eggs stayed relatively stable until a rapid decline at about age 37, but now we know it appears to be more of a gradual loss of eggs over time. Here’s what the graph looks like, where there’s a steady loss starting at peak fertility in one’s 20s. This is measuring “antral follicle count,” which is an ultrasound test where you can just count the number of like next-batter-up eggs in the ovaries. It’s probably the best reflection of true reproductive age. It’s a measure of ovarian reserve—how many eggs a woman has left.

Okay, so what does this have to do with diet? Researchers at Harvard looked at the association of various protein intakes with ovarian antral follicle counts among women having trouble getting pregnant. Even though diminished ovarian reserve is one of the major causes of female infertility, the process leading to reproductive deterioration with age is still poorly understood. In light of women delaying pregnancy until older age, the identification of reversible factors that may affect the individual rates of reproductive decline might be of significant clinical value.

They did ultrasounds on all the women and studied their diets, and concluded that higher dairy protein intake was associated with lower antral follicle counts, in other words: accelerated ovarian aging.

Here’s what the graph looked like in nonsmokers. Significantly lower ovarian reserve at the highest dairy intake, which would be like three ounces of cheese a day, compared to the lowest dairy intake. Okay, but what do these numbers mean in terms of biological age? Is 16.9 down to 12.7 really that much of a difference? If you look at women with really robust ovaries, a follicle count of 16.9 would be like what you might see in a 36- or 37-year-old. Whereas 12.7, what you can see in women eating the most dairy, is like what you might see in a really fertile 50-year-old. So, we’re talking years’ worth of ovarian aging, between the highest and lowest dairy consumers.

While it wasn’t possible for the researchers to identify the underlying mechanism linking higher dairy protein intake to lower antral follicle count, they had several educated guesses. One: it could be the steroid hormones and growth factors; two: the contamination of milk products by pesticides and endocrine-disrupting chemicals that may negatively affect the development of these ovarian follicles and egg competence.

Regarding the hormones, studies suggest that commercial milk (derived from both pregnant and non-pregnant animals) contains large amounts of estrogens, progesterone, and other placental hormones that are eventually released into the human food chain, with dairy intake accounting for 60-80 percent of the estrogens consumed, as I mentioned before. Dairy estrogens survive processing, appear both in raw and commercial milk products, are found in substantially higher concentrations with increasing amounts of milk fat, with no apparent difference between organic and conventional dairy products—that’s important to realize. It’s not just cows that have been injected with growth hormones. Their hormones are just in their bodies naturally. and once inside the human body, these bovine hormones get converted to estrone and estradiol, the main active human estrogens. And following absorption, bovine steroids may then affect reproductive outcomes.

It is imperative that further studies are designed to clarify the biology underlying the observed associations. This might be crucial, given that consumption of another species’ milk by humans is an evolutionary novel dietary behavior that has the potential to alter reproductive parameters and may have long-term adverse health effects.

Please consider volunteering to help out on the site.

Image credit: Debby Hudson via unsplash. Image has been modified.

Video production by Glass Entertainment.

Motion graphics by Avocado Video.

Doctor's Note

The video I mentioned about the effects of these estrogens and progesterone in men and prepubescent children is The Effects of Hormones in Dairy Milk on Cancer.

I talk about the effect of dairy estrogen on male fertility in Dairy Estrogen & Male Fertility.

How else might diet effect fertility? See:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

49 responses to “The Effects of Hormones in Milk on Infertility in Women

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  1. Fix this reference, Maruyama K, Oshima T, Ohyama K. Exposure to exogenous estrogen through intake of commercial milk produced from pregnant cows. Pediatrics International. 2010;52(1):33-38. doi:10.1111/j.1442-200X.2009.02890.x. https://www.ncbi.nlm.nih.gov/pubmed/19496976

    For this, Maruyama K, Oshima T, Ohyama K. Exposure to exogenous estrogen through intake of commercial milk produced from pregnant cows. Pediatrics International. 2010;52(1):33-38.

  2. From a highlighted piece of an article in the video: “the process leading to reproductive senescence is poorly understood”

    Is that to say that there are senescent reproductive cells causing less fertility or are they simply referring to the declined ability to reproduce and using the word as an expression for that? Just trying to better understand. I know senescent cells cause a lot of problems in the body so that would be alarming to think the decline of egg production is due to that, but if that were the case it would make me believe that staying more fertile has a lot to do with the body’s overall health and the health of the telomeres specifically, which really I already believe.

    This was a really good video with incredible information and also it was less distracting than the last one, I think because Dr. Greger was a bit calmer and there were less hand gestures. Not that I’m criticizing his persona at all, I actually really like his enthusiasm but in the videos it can be distracting when you’re trying to focus on the science.

    Back to the info… Who knew that forcefully impregnating a female animal and then stealing her baby away from her and stealing the milk from her body intended for her baby would have so many ill-effects on health….

    1. Who knew that forcefully impregnating a female animal and then stealing her baby away from her and stealing the milk from her body intended for her baby would have so many ill-effects on health….
      —————————————————————–
      Hah! S, the stealth Vegan Activist! Well played…

        1. Well if you learned about the dairy industry, you would, YR. really not sure why you would randomly bring up an epidemic completely unrelated to anything on this topic or in the comments. Very strange.

            1. Yes, an epidemic, what would be your confusion or issue with this word? Well I do know about human trafficking, certainly not all there is to, but if there’s some kind of connection between dairy and the epidemic of human trafficking you’d like to express, maybe just share it with the rest of the class instead of being condescending…

              1. Okay: All life is energy; some energy has formed what we call animals; there are human animals; there are also wild, domestic, and farm animals (or those that are raised for human food).

                Human animals are often treated in the abusive way farm animals are often treated. Some farm animals are actually treated a lot better than human animals. Female human animals too have their offspring taken from them.

                Cows are females; many human animals are also females. And there’s the connection.

                1. YR, go live as a “farm” animal… no, they are never treated better than any human animal and I know how horrifically awful many humans are treated and my statement stands because I have seen and I know. I’m not going to respond to any of the other nonsense in your post because this ridiculous branch-off conversation shouldn’t have happened in the first place. I made a very simple and truthful comment pertaining to the industry and product discussed in the video, apparently that upset for unjustifiable reasons, but at least for the sake of comments board can this “conversation” simply end now…

  3. I liked this one.

    If the internet statistic source is right, infertility affects 6.1 million American females.

    I think topics like this will change young people’s views about dairy more than health issues because bad health is often further down the road.

    I the concept of having the ovaries of a 50-year old speed up the ticking biological clock speed for many young women.

  4. To the preparers of Dr. Greger’s videos … please try to stop flipping the Dr. from the left side of the screen to the right as you insert text and charts. He looks like he’s dancing between frame edges and that distorts attention to his message. Let him be positioned on one side and present all images on the other. This is a teaching video not a broadway show. Thanks

  5. Considering that there is no shortage of humans whatsoever, I doubt humanity is in any danger of dying off within the next several hundred years due to infertility.

    1. Reality bites,

      True on a population level. But when it happens to you personally, it can be devastating.

      What you’re saying is like saying: Well, there are so many people, why does it matter that anyone dies early from a heart attack? Or diabetes? Or cancer? Etc etc.

      Yet I’m going to guess that you care, because here you are, looking at the videos, presumably for ideas on how to live a healthy lifestyle and avoid just those fates. So, I’m going to go further and suggest that you try to find a little empathy, somewhere, for what other people suffer.

      1. Dr. J – Thank you for your most appropriate and thoughtful comments. Cavalier and caustic comments about another’s deep emotional losses just drives the pain further into the wound. I appreciate that you chose to speak up.

  6. I know this comment does not relate to hormones in milk but I do not know where else to post it. I know Dr Gregor often reads these comments so just to say that I live in the UK and there is very little information in our press about WFPB way of eating so I was delighted to read today in my Daily Telegraph the whole page review of his book How Not to Diet. I will make sure that my library buys a copy. I really enjoy the discussions everyone posts on this site as well of course as watching the videos.

  7. Hello, it’s Bafoza again. Small misunderstanding from my side, if dairy results in anovulation then the AFC must be higher in dairy consumers compared to non dairy consumers. Please clear up my misunderstanding. Best Regards, Bafoza

    1. I am not a science or health-oriented person, but what I read was:

      When protein from different food sources was considered separately, we found a negative association between dairy protein intake and AFC. Total protein intake (% energy) was unrelated to AFC.

      Higher dairy protein intake (≥ 5.24% of energy) was associated with lower antral follicle counts among women presenting for infertility treatment.

      Women in the highest quintile of dairy protein intake (≥5.24% of energy, or ≥2.3 cups of milk/day) had 14.4% (3.9%–23.7%, p=0.009) lower AFC than women in the lowest quintile after adjusting for potential confounders (Table 2). In addition, we estimated the effect of substituting 2% energy of dairy protein (around 1 cup of milk) with vegetable protein, and calculated BJOG : an international journal of obstetrics and gynaecology
      Author Manuscript
      HHS Public Access
      The association of protein intake (amount and type) with ovarian antral follicle counts among infertile women: results from the EARTH prospective study cohort
      Irene SOUTER, Yu-Han CHIU, […], and Jorge E. CHAVARRO

      Additional article information

      Abstract
      Objective
      To evaluate the association between protein intake (amount and type) and antral follicle count (AFC).

      Design
      Prospective cohort.

      Setting
      Academic fertility center.

      Population
      265 women undergoing fertility treatments at an academic fertility center and participating in an ongoing study on environment and reproductive health.

      Methods
      We measured AFC in ultrasonographic evaluation among women undergoing infertility treatments. Women completed a previously validated semi-quantitative food frequency questionnaire. We used Poisson regression to evaluate the relation between protein intake and AFC while adjusting for age, body mass index, race, smoking status, and total energy intake.

      Main Outcome Measures
      Antral follicle count.

      Results
      Among 265 women (mean age: 35.0±3.9 years, 85% Caucasian), total protein intake (% energy) was unrelated to AFC. When protein from different food sources was considered separately, we found a negative association between dairy protein intake and AFC. The mean AFC was 14.4% (3.9%–23.7%) lower for women in the highest quintile of dairy protein intake than for women in the bottom quintile after adjusting for potential confounders (p-trend=0.04). This association was stronger among women who had never smoked (p-trend=0.002) but was not observed among previous smokers (p-trend=0.36). There were no associations between protein intake from either non-dairy animal or vegetable sources and AFC.

      Conclusion
      Higher dairy protein intake (≥ 5.24% of energy) was associated with lower antral follicle counts among women presenting for infertility treatment. These findings should be further investigated in prospective studies designed to also clarify the biology underlying the observed associations.

      Keywords: antral follicle count, dairy intake, protein intake, ovarian reserve, ovary, female infertility
      INTRODUCTION
      Infertility affects 15.5% of couples seeking conception1 and bears significant financial and psychosocial repercussions for both the individuals involved and society in general.2–4 Despite a well-established notion that both nutrition and modifiable lifestyle factors impact female5–9 and male reproductive potential,10–12 research in this field is not extensive leaving couples planning pregnancy with few evidence-based resources to guide preconception diet advice.

      Even though diminished ovarian reserve is one of the major causes of female infertility, the process leading to reproductive senescence is currently poorly understood. In light of emerging population trends towards delayed pregnancy,13 the identification of reversible factors (including diet) that affect the individual rates of reproductive decline might be of significant clinical value. Diets restricting the use of certain types of protein are gaining popularity, mainly due to increasing health and environmental awareness and compassion for animals. However, their effects on reproductive health and ovarian aging remain unknown. Animal studies suggest a possible adverse effect of a low-protein diet on conception rates, ovarian follicular numbers and ovarian reserve in adulthood,14–18 effects potentially mediated by accelerated accumulation of oxidative stress, altered ovarian telomere length and mitochondrial DNA copy number. Human data are lacking.

      AFC and anti-mullerian hormone (AMH) are markers known to predict ovarian primordial follicle numbers better than basal follicle stimulating hormone (FSH) levels.19 AFC, in particular, appears to be even more sensitive than AMH in predicting both ovarian primordial follicle numbers19 and response to medication in in-vitro fertilization (IVF) cycles20 and has been found to be independently associated with age at natural menopause.21

      Study Objective
      The objective of the present analysis was to examine the relation between protein intake (both amount and source of dietary protein) and AFC (as a measure of ovarian reserve) in a group of women attending an infertility clinic.

      METHODS
      Study Population
      Participants were women enrolled in the EARTH (Environment and Reproductive Health) study, an ongoing prospective cohort started in 2004 aimed at evaluating the effects of various environmental factors on reproductive health.22–24 Couples presenting to the Massachusetts General Hospital (MGH) for infertility treatments were invited to participate. Women between 18 and 45 years using their own gametes for intrauterine insemination or IVF were eligible to enroll. At enrollment, all participants underwent an anthropometric evaluation and completed a nurse-administered general health questionnaire where data on demographics, lifestyle, medical and reproductive history was collected. In 2007, a previously validated25 semi-quantitative food frequency questionnaire (FFQ) was introduced to assess participant’s dietary habits. Of 326 women who prospectively completed diet questionnaires and underwent ultrasound assessment, we excluded women with a prior oophorectomy (n=4), incomplete or missing AFC data (n=25), as well as women whose ultrasound for AFC determination was performed more than one year after FFQ completion (n=32), leaving 265 women for the present analysis. Included participants did not differ significantly from those excluded in age, body mass index (BMI), smoking status or race/ethnicity but did so in the prevalence of female factor infertility (p<0.01).

      Diet assessment
      All study participants completed a previously validated FFQ, thus providing information on how often, on average, they consumed specified amounts of each food, beverage and supplement included in the questionnaire during the year preceding their enrollment in the study. For each food, the questionnaire offered nine possible responses, ranging from never or less than once a month to six or more times per day. Nutrient content of each item was obtained from the nutrient database of the US Department of Agriculture26 (USDA) and supplemented with data from food manufacturers. Nutrient intakes were estimated by summing the contribution of all relevant food items and were expressed as daily intakes. Total protein intake, as well as protein intake from different food sources (dairy foods, animal foods, vegetables) was estimated and expressed as the percentage of energy consumed. In a validation study, the correlation between FFQ-assessed protein intake and protein intake assessed with prospectively collected diet records representing one year of diet was 0.44.27 Among the major food sources of protein, recall was better for dairy foods (skim milk r=0.88) and worse for vegetables (beans r= 0.34).28

      Ultrasonographic Determination of Antral Follicle Counts
      All women participating in the study underwent a standard infertility work-up which included the ultrasonographic determination of the AFC for ovarian reserve evaluation, either on the 3rd day of an unstimulated menstrual cycle or on the 3rd day of a progesterone withdrawal bleed (at which time a serum FSH level was measured as well). All transvaginal ultrasounds were performed by one of the MGH reproductive endocrinology and infertility physicians. No fertility medications were used in the cycle preceding the ultrasonographic determination of the AFC.

      Statistical Analysis
      We divided women into quintiles of protein intake (total, vegetable, and animal (dairy and non-dairy)). We first summarized participant characteristics by quintiles of total protein intake and tested for differences across quintiles using Kruskal-Wallis test for continuous variables and Chi-square test for categorical variables. Poisson regression models were used to examine the relation between protein intake and log(AFC), while adjusting for potential confounders. We compared AFC of women in increasing quintiles of protein intake in relation to those of women in the lowest quintile (reference). Population marginal means were utilized to present marginal population averages adjusted for the covariates in the model, and results were exponentiated to express them in the original count scale. Tests for linear trend were performed using the median values of protein intake in each quintile as a continuous variable. Protein intake was adjusted for total energy intake using the nutrient density method. Specifically, terms for fat intake (% of calories) and total energy intake were added to the models to allow the protein intake parameters to represent the isocaloric substitution of carbohydrates with the same amount of energy from protein. In addition, we estimated the effect of substituting a type of protein for another by including energy contribution from all protein types as continuous variable in the same model. The effect of substituting one type of protein for another was estimated using linear combinations of the regression coefficients; the 95% confidence interval of a substitution was estimated based on the variance of each regression coefficient and their covariance. Multivariable-adjusted models included additional terms for age, BMI, race, and smoking status. We evaluated whether the association between protein intake and AFC was modified by BMI (≥ 25 kg/m2 and < 25 kg/m2), age (≥ 35 and < 35 years) and smoking (current/former and never smokers) by introducing cross-product terms to the final multivariate models. All statistical analyses were conducted using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA). Two-sided p values ≤0.05 were considered statistically significant.

      RESULTS
      The study population was primarily Caucasian (85%) with a mean (±SD) age of 35.0 (±3.9) years. The majority of women (65%) were of normal weight defined as a BMI <25 kg/m2 (median (25th, 75th): 23.3 (21.2, 26.2) kg/m2), while 25%, and 10% of them were either overweight or obese, respectively. Most of the women had never smoked (72%). Mean (±SD) alcohol and caffeine intake were 7.7 (±8.9) g/day and 120 (±115) mg/day, respectively. Median intakes of protein, fat and carbohydrates (% energy) were 17, 33, and 50% energy, respectively (US mean protein intake: 14.6% energy).29 The most common infertility diagnosis was idiopathic (46%), followed by male factor (28%), ovulatory dysfunction (9%) and diminished ovarian reserve (7%). 38% of participants reported at least one prior pregnancy. Overall, 37% of participants had an AFC ≥ 15 whereas 6.4% had an AFC ≤ 5 and were thus expected to be either high or poor responders, respectively.

      There were no appreciable differences in age, BMI, smoking status, reproductive history or intakes of caffeine, alcohol, total energy or total fat across quintiles of total protein intake (Table 1). As expected, carbohydrate intake decreased with increasing intake of protein (p-trend: <.0001).

      Table 1
      Table 1
      Demographic characteristics of 265 EARTH study women according to quintile of PI.
      Total protein intake was unrelated to AFC in age-adjusted and multivariable-adjusted analyses (Table 2). While AFC was significantly lower among women in the second and third quintile of total protein intake when compared to women in the bottom quintile, there was not a clear pattern across quintiles of intake. Similarly, when this relation was examined separately for protein coming either from vegetable or animal sources, we noted no association between vegetable protein intake and AFC (Table 2) and while AFC was significantly lower among women in the 2nd and 5th quintile compared to the 1st, no significant trend was noted across quintiles of animal protein intake (Table 2).

      Table 2
      Table 2
      Association between antral follicle counts (AFC) and protein intake in 265 women.

      We then further divided animal protein intake into protein coming from dairy and protein coming from other animal sources. Women in the highest quintile of dairy protein intake (≥5.24% of energy, or ≥2.3 cups of milk/day) had 14.4% (3.9%–23.7%, p=0.009) lower AFC than women in the lowest quintile after adjusting for potential confounders (Table 2). In addition, we estimated the effect of substituting 2% energy of dairy protein (around 1 cup of milk) with vegetable protein, and calculated that the AFC would be 5% higher

      They weren't sure what the mechanism was. They hypothesized that environmental contaminations in milk might have had an effect, but they also hypothesized that dairy increasing IGF-1 could have been a mechanism.

      It is possible that the higher circulating IGF-I levels (resulting either from the diet itself or from stimulation of endogenous production44) adversely impact the ovary and its reserve (IGF-I regulates granulosa cell steroidogenesis and apoptosis during follicular development thus playing an essential role in reproduction).51 IGF-I is also known to influence fertility at multiple other levels within the reproductive system, including effects on the hypothalamic–pituitary-gonadal axis52–55 and the gonads.56–60

      I am sorry if that didn't answer your question.

  8. I joined Twitter today. Just to respond to Alan Alda thinking he wants to lose 7 or 8 pounds so that he can gain them back again.

    I figured that he could use a Treating Parkinson’s with diet video.

  9. As much as I can respect the need to remove/reduce dairy, the image used to compare Chobani Greek Yogurt 0% with a double chocolate donut is very misleading. Whoever made/edited this video should realize that this yogurt has 4gr of sugar (not added) per 3/4 cup serving – Where can I find a donut with only 4gr of sugar???
    I understand the study was measuring for sugar in general, however, I find this graphic to be very misleading and creates an unneeded sense of bias. Many vegan plain yogurts have this much if not more sugar as well.

    1. Meaghan,

      The transcript read: “Even plain Greek yogurt can have more sugar than a double chocolate glazed cake Dunkin’ donut.” The brand wasn’t mentioned.

      But the image does show Chobani Greek Non Fat Yogurt, which lists sugar as 4 grams, total carbohydrates as 6 grams. That’s too bad. It would be better to show a plain Greek yogurt which does have a lot of sugar.

      I don’t eat dairy yogurt, so I’ve no idea what yogurt might have added sugar. But I do know that soy yogurt sold commercially has lots of additives, which is why I now make my own yogurt at home from commercial soy milk which itself has only two ingredients, water and soy beans. I often add a small amount of maple syrup to the soy milk along with the yogurt culture, because I love the resulting flavor.

      1. Christine, with great respect, your ‘team’ could have found more accurate content, let alone presentation. And I apologise for taking you out of your comfort zone. But its time for a genuine reality check at ‘nutrionfacts’.

        This video clip is Dr Greger at his cherry-pickin’ best. Delivering a highly selective, highly edited and completely misleading overview of the scientific consensus on female infertility. Once again he attempts to lay the blame on dairy. Quoting out-dated studies made redundant by more recent studies, conflating low-fat milk with full cream milk (at times they function differently, at other times they are complementary), and misinterpreting the role of milk hormones and environmental pollutants in female infertility. More contemporary studies demonstrate whole milk is protective of fertility, albeit this is considerably less certain with low-fat milk and yoghurt. Particularly the latter, inasmuch fermentation may eliminate the fertility-beneficial hormones in milk. Disingenuously, Dr Greger attempts to make a link between milk consumption and infertility via the action of environmental pollutants (Messerlian et al, 2018) . However, this study instead refers to the effects of phthalates, bisphenol A, intake of soy and folate and non-organic fruit and vegetables, shift work, and heavy lifting (particularly in older women) on fertility. The link to milk is tenuous or non-existent, and exists more for fruit and vegetables. ‘Eating fruit and vegetables with high pesticide residue was linked to lower fertility’.

        Itemising the known negatives, Chavarro et al (2007) found that low-fat dairy foods was associated with a higher risk of ovulatory infertility. Carwile et al (2013) found that pre-menopausal women consuming low-fat milk products were 14% more likely to have delayed menopause. Cramer et al (1994), found that milk consumption was associated with age-related decreases in fertility rates in a 31-countries ecologic study. However, a subsequent case–control study (Greenlee et al., 2003) found that women who consumed three or more glasses of milk per day had a 70% lower risk of infertility when compared with women who did not consume milk. A prospective cohort study found that intake of high-fat dairy foods was associated with a lower risk of ovulatory infertility, notwithstanding low-fat dairy foods were associated with a higher risk (Chavarro et al., 2007). Souter et al (2017) found higher dairy protein intake was associated with 14% lower antral follicle count. However, this appears to refer to low-fat milk, not full cream milk – and may also be confounded by a higher risk of PCOS (see Dr Purdue-Smithe, following).

        Whilst low-fat milk is implicated in regards infertility, particularly in earlier studies, Afeichi et al (2016) also found that low-fat milk was not the culprit. The contradictory outcomes suggest low-fat milk risk (if it does exist) is low. Meanwhile, many studies demonstrate full cream milk (ie saturated dairy fat) is protective against infertility. On the evidence, Dr Greger’s implied suggestion to cease whole milk consumption diminishes fertility potential in women.

        According to the 2018 PhD thesis from Purdue-Smithe, 1. both low and high fat milk lower the risk of early menopause, 2., low fat milk dairy (especially yoghurt) increases the risk of anovulatory infertility, whilst 3., high-fat dairy reduces the risk of anovulatory infertility.

        ‘Results of this study suggest that high versus low intakes of vitamin D and calcium from food sources, particularly dairy foods, are associated with 17% and 13% lower risk of early menopause, respectively’.

        ‘The positive association of low-fat dairy with anovulatory infertility appears to be driven, at least in part, by yogurt intake; according to their findings, for each additional serving/d, risk of anovulatory infertility increased by 34% (95% CI: 1.02-1.74; P-trend=0.03). Likewise, the inverse association observed for high-fat dairy appears to be driven by intake of whole milk (RR for each 1 serving/d increase: 0.46; 95% CI: 0.25-0.84; P-trend=0.01). Estimates for both high and low-fat dairy foods were stronger among women older than 32 years, and among women with clinical manifestations of PCOS’
        Dr Greger also fails to disclose the intake of total dairy foods is associated with a decreased risk of endometriosis (Harris et al, 2013). He also fails to disclose dairy food intake reduces the risk of uterine leiomyomata (Wise et al, 2010, 2013). He also fails to disclose ‘drinking 3 or more glasses of milk per day was protective of female fertility’ (Greenlee, et al, 2003). He also failed to disclose the ‘inverse association between high-fat dairy food intake and anovulatory infertility’, and the finding that ‘lactose (the main carbohydrate in milk and dairy products) does not affect fertility (Chavarro et al, 2007). He also fails to disclose that circulating levels of IGF-I as a consequence of milk consumption (Heaney et al., 1999; Giovannucci et al., 2003) has a probable positive effect on fetal growth and birthweight. For example, the Danish National Birth Cohort (Olsen et al., 2007) discovered that milk consumption during pregnancy was associated with higher placental size and offspring size at birth. Heppe et al (2011) discovered milk consumption during pregnancy increased birthweight resulting from higher fetal weight gain in the third trimester of pregnancy. The EARTH team also speculate that milk consumption improves IGF-1/IGFBP-3 ratio during ovarian stimulation, and this is ‘associated with higher likelihood of pregnancy and ongoing pregnancy (Schoyer et al., 2007).

        Dr Greger also fails to disclose that Nagel et al, found ‘no association of total dairy intake and age at menopause among 5,110 participants of the EPIC cohort.’ Dr Greger also fails to disclose ‘dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth.

        Affechi, Chavarro, and Souter are members of Harvard University’s EARTH team.

        ‘We hypothesized that intake of total and full-fat dairy foods would be associated with lower chances of live birth’ . ‘Given the inconsistency of the existing literature and suggested biological effects of dairy foods on reproductive function, we anticipated either an inverse relation or no association’…..

        ‘The positive association between dairy food intake and live birth in ART was unexpected’. ‘Our findings of a lack of association with pre-clinical end-points and a positive association with live births but not with other clinical end-points are consistent with an interpretation that dairy foods may have a positive influence on pregnancy maintenance’.

        ‘This prospective cohort of women undergoing infertility treatment with assisted reproductive technologies, intake of dairy foods was positively associated with live birth among women ≥35 years of age. This relation did not differ between full-fat and low-fat dairy foods and did not appear to be driven by one single dairy food item. Dairy food intake was not related to ovarian response to stimulation, embryological, implantation or clinical pregnancy outcomes’. ‘Dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth’.

        Afeiche et al, 2016 (https://academic.oup.com/humrep/article/31/3/563/2384937)

        References:

        ‘Results of this study suggest that high versus low intakes of vitamin D and calcium from food sources, particularly dairy foods, are associated with 17% and 13% lower risk of early menopause, respectively.

        ‘The positive association of low-fat dairy with anovulatory infertility appears to be driven, at least in part, by yogurt intake; according to their findings, for each additional serving/d, risk of anovulatory infertility increased by 34% (95% CI: 1.02-1.74; P-trend=0.03). Likewise, the inverse association observed for high-fat dairy appears to be driven by intake of whole milk (RR for each 1 serving/d increase: 0.46; 95% CI: 0.25-0.84; P-trend=0.01). Estimates for both high and low-fat dairy foods were stronger among women older than 32 years, and among women with clinical manifestations of PCOS’

        Purdue-Smith, 2018

        https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=2270&context=dissertations_2

        ‘Intakes of total and low-fat dairy foods were associated with a lower risk of endometriosis. Women consuming more than 3 servings of total dairy foods per day were 18% less likely to be diagnosed with endometriosis than those reporting 2 servings per day (rate ratio = 0.82, 95% confidence interval: 0.71, 0.95; P(trend) = 0.03). In addition, predicted plasma 25(OH)D level was inversely associated with endometriosis. Women in the highest quintile of predicted vitamin D level had a 24% lower risk of endometriosis than women in the lowest quintile (rate ratio = 0.76, 95% confidence interval: 0.60, 0.97; P(trend) = 0.004). Our findings suggest that greater predicted plasma 25(OH)D levels and higher intake of dairy foods are associated with a decreased risk of endometriosis’.

        Harris et al, 2013
        https://www.ncbi.nlm.nih.gov/pubmed/23380045

        Low-fat dairy food intake is associated with a decreased risk of delayed menopause

        Carwile et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/23946341

        Increasing dairy food intake reduces the risk of uterine leiomyomata

        Wise et al, 2010, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/19955473

        https://www.ncbi.nlm.nih.gov/pubmed/23825169

        ‘Drinking 3 or more glasses of milk per day was protective of female fertility’

        Greenlee, et al, 2003

        https://www.ncbi.nlm.nih.gov/pubmed/12843768

        A positive association between low-fat dairy food intake and an increased risk of anovulatory infertility, and conversely, an inverse association between high-fat dairy food intake and anovulatory infertility

        Chavarro et al, 2007

        https://www.ncbi.nlm.nih.gov/pubmed/17329264

        ‘High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk. Further, lactose (the main carbohydrate in milk and dairy products) may not affect fertility within the usual range of intake levels in humans’.

        Chavarro et al, 2007

        https://www.ncbi.nlm.nih.gov/pubmed/17329264

        A dietary score based on factors previously related to lower ovulatory disorder infertility (higher consumption of monounsaturated rather than trans fats, vegetable rather than animal protein sources, low glycemic carbohydrates, HIGH FAT DAIRY, multivitamins, and iron from plants and supplements) and other lifestyle information was prospectively related to the incidence of infertility’.

        Chavarro et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/17978119
        Women aged over 35 undergoing infertility treatment reported a positive association between dairy food intake and live birth.

        ‘Dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth’.

        Afeiche et al, 2016

        https://www.ncbi.nlm.nih.gov/pubmed/26787645

        ‘no association of total dairy intake and age at menopause among 5,110 participants of the EPIC cohort.’

        Nagel et al,

        https://www.ncbi.nlm.nih.gov/pubmed/16011884

        Dr Purdue-Smithe analysed the available data on this link for her PhD thesis (May 2018). According to Dr Purdue-Smithe there is ‘a plausible role for dairy in delaying ovarian aging’ Note, delaying, not advancing.
        ‘These results suggest a possible underlying cause of anovulation, such as a longer-term subclinical follicular, ovarian or hypothalamic/pituitary dysfunction, even among healthy, regularly menstruating women’.

        Hambridge et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/23589536

        Milk and Sex Steroids

        Dr Greger claims milk is responsible for 60-80% of ingested sex steroids, implying this is linked with infertility. Nutritionist Monica Reinagel (MS, LD/N, CNS) has investigated the link between milk hormones and fertility, and makes the following salient points:

        1. The amount of hormones in milk is tiny compared to what’s already in your body. Guys ….produce about 6,000 times as much estrogen every day as you’d get in a glass of whole milk. Ladies …are producing 28,000 times that much. Compared to what your own body pumps out, the amount of estrogen you’re exposed to from dairy products is far too little to have any physiological effect.
        If drinking milk could raise your estrogen levels, we could expect it to be useful in treating symptoms of menopause. Ironically, soymilk may be more effective than cow’s milk in beating hot flashes.

        2. There’s no clear link between intake of dairy products and early puberty. It’s true that kids are reaching puberty earlier these days but I don’t think dairy is the cause. For one thing, kids are drinking less milk than they used to. If the hormones in dairy caused early puberty, we’d expect to see the average age of puberty go up as dairy consumption went down, but the opposite is true. I think the increase in childhood obesity is a much more likely explanation for early puberty because circulating estrogen levels increase with body fat.

        3. There’s no clear link between intake of dairy products and increased risk of breast or ovarian cancer. Some people have pointed out that breast cancer rates are lower in cultures or countries where dairy is not commonly consumed. But there are so many other differences between these populations that it’s impossible to say that the difference in cancer risk—or any other difference, for that matter—is due to the difference in dairy intake.
        When we compare people from the same country and culture, those who drink the most milk don’t have a higher incidence of breast cancer than those who drink the least. In fact, several studies have found a modest protective effect.

        https://www.quickanddirtytips.com/health-fitness/womens-health/how-does-dairy-affect-your-hormone-levels?page=1

        Summary

        Female infertility is a very complex condition, and there are remaining unknowns. It involves genetics, obesity, reproductive lifespan, age at menopause, PCOS, endometriosis, protein intake, fat content of milk, vitamin D and folate intake, environmental pollutants, and longer-term subclinical follicular, ovarian or hypothalamic/pituitary dysfunction. The latter may cause anovulation.
        Milk (and vitamin D) may be hormonally active in humans but IGF-1 appears to enhance fertility. The sex-hormones appear inconsequential in terms of fertility (Reinagel). Full cream milk, especially vitamin D-enriched full cream milk, reduces the risk of early menopause, PCOS and endometriosis. Thereby enhancing fertility. In premenopausal women less than 51 years of age, low-fat milk extends reproductive lifespan (later menopause), and thereby fertility. Notwithstanding this, full cream dairy milk and yoghurt more consistently demonstrate an ability to enhance female fertility.

        .

  10. I would like to see information on:
    –Fake meat, fake milk, fake ice cream, fake cheese
    –If the majority of nutritional supplements, being unregulated, do not contain what is advertised, where can I get nutrional supplements that do contain what is advertised…. For instance – B12, plant-based omega 3?
    –Confused about yeast… Hearing it is not good for you, then hearing you should eat it every day.
    Thank you.
    I recently saw an old movie about Louis Pasteur. People did not believe his claims about microbes causing child bed fever and anthrax. They did not believe that something so small could cause illness and death. There is a parallel between the learning curve of the public then about Pasteur’s research, and the public now about plant-based diet research. I am reading “How Not to Diet” and it is just fascinating what healthy food does for you in so many ways. Thank you for this essential guidebook. It should be required reading for every physician.

    1. Hi, Wendy!
      Many of these products are too new to have been fully tested. When they are, I am sure the results will be reported here. Dr. Greger does not advocate eating these products, however. His approach is centered on whole plant foods. With regard to supplements, look for those that participate in independent testing programs. Yeast may be a problem for some people but not for others. More on that here: https://nutritionfacts.org/topics/yeast/ I hope that helps!

  11. First off, I love Dr. Greger, and I have always understood everything that was written by him. I certainly don’t need any more reasons to avoid dairy, but I did also read The Fertility Diet, (by Jorge E. Chavarro, Md, ScD and Walter C. Willett, Md DrPH, 2008), which is reporting on the findings from the Nurses Health Study. They say that the data on dairy and fertility is complex. Women who had 1 full fat dairy product a day had LESS anovulatory infertility than women who had none (or low fat dairy). I’d be interested in what you guys think of this study: https://academic.oup.com/humrep/article/22/5/1340/2914869 The entire study is free so you can all have access.
    I’m also hearing that dairy is “toxic to ovaries,” (from another leader in the WFPB world), and that it might be due to the galactose, because women with galactosemia have more ovulatory dysfunction and infertility. However, this research was using rodents and the amount of galactose that they were exposed to, is not something humans would see in a normal diet. Also, I’m hearing that some are making the leap from galactose being “toxic” to the ovaries to dairy causing ovarian cancer. However, most types of ovarian cancer start in the fallopian tubes (this is why we now recommend removing the tubes, when women desire permanent sterilization). Some cancers like Granulosa Cell, Germ Cell, and Teratomas, arise from ovarian tissue; but Serous and Mucinous Cystadenocarcinomas and Clear Cell Carcinomas are cancers that originate from cells in the fallopian tube.
    Lastly (back to this video), a really good test of ovarian reserve is the AMH (anti-mullerian hormone), which can be drawn (it’s a blood test) at any time during the cycle, too. OB/GYN’s consider anything over 5-7 antral follicles to be normal (according to my College, at least).
    Here is a relevant quote of their info for OBGYN’s on diminished ovarian reserve: “Ultrasonographic assessment of the antral follicle count is determined by the number of follicles that measure 2–10 mm in both ovaries. Low antral follicle count may be defined as fewer than 5–7 follicles and is associated with poor response to ovarian stimulation. However, antral follicle count is a relatively poor predictor of future ability to become pregnant. Antral follicle counts may be elevated in women with polycystic ovary syndrome (PCOS) or depressed in those women with hypothalamic amenorrhea or those using certain hormonal contraceptives.”
    I know this is a bit rambling, but perhaps someone can see that I’m having trouble making sense of what I’m expected to know and understand as an OBGYN, and what the plant based leaders are saying. I can envision a patient demanding an ultrasound for an AFC and becoming concerned if she doesn’t have 10 follicles, for example. Or even being happy that she has many follicles, when, in fact, that suggests PCOS.
    Again, I can think of no good reason to drink cows milk, and I am absolutely not trying to find some excuse to ingest it. (I’m also an ethical vegan with 8 years of WFPBD under my belt). Willett and Chavarro seem like smart guys, too, and perhaps we just don’t know exactly how dairy (full fat or low fat) affects the female reproductive system. The IGF-1 increase alone would be concerning.
    Are there any other OBGYN’s out there thinking about this?
    Thanks!

    1. Interesting. I would expect that full fat dairy would contain significant levels of bovine reproductive hormones, which may be a factor.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265695/.

      There’s also a possibility that there is a substitution effect in operation eg do people eating full fat dairy eat less (red) meat for example?

      ‘Preliminary data suggest that red meat may have an adverse effect on fertility. Results from an infertility cohort study showed that consumption of red meat was negatively associated (OR: 0.81; 95% CI, 0.65, 0.99) with likelihood of blastocyst formation during embryo development (12).’
      https://www.frontiersin.org/articles/10.3389/fpubh.2018.00211/full

      A single study also needs to be considered cautiously – for example, another later study reported

      ‘we did not detect any associations between dairy fat and sporadic anovulation in this analysis. Even after dairy consumption was stratified by low-fat and high-fat dairy, no significant associations were detected. Different results across studies may be due to differing study populations and outcomes of interest. In addition, each study used different types of dietary assessment methods (e.g., FFQ or 24-h diet recall) or adjusted for different covariates in the models.’
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265695/?report=classic

      Finally,

      ‘ It is important to consider that with self-reported dietary intake data, especially with “unhealthy” dietary components, large errors in self-reporting, specifically underreporting of data, may be confounding these studies’
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283234/?report=classic

      1. Tom,
        Hope this helps:

        This video clip is Dr Greger at his cherry-pickin’ best. Delivering a highly selective, highly edited and misleading overview of the scientific consensus on female infertility. Once again he attempts to lay the blame on dairy. Quoting out-dated studies made redundant by more recent studies, conflating low-fat milk with full cream milk (at times they function differently, at other times they are complementary), and misinterpreting the role of milk hormones and environmental pollutants in female infertility. More contemporary studies demonstrate whole milk is protective of fertility, albeit this is considerably less certain with low-fat milk and yoghurt. Particularly the latter, inasmuch fermentation may eliminate the fertility-beneficial hormones in milk. Disingenuously, Dr Greger attempts to make a link between milk consumption and infertility via the action of environmental pollutants (Messerlian et al, 2018) . However, this study instead refers to the effects of phthalates, bisphenol A, intake of soy and folate and non-organic fruit and vegetables, shift work, and heavy lifting (particularly in older women) on fertility. The link to milk is tenuous or non-existent, and exists more for fruit and vegetables. ‘Eating fruit and vegetables with high pesticide residue was linked to lower fertility’.

        Itemising the known negatives, Chavarro et al (2007) found that low-fat dairy foods was associated with a higher risk of ovulatory infertility. Carwile et al (2013) found that pre-menopausal women consuming low-fat milk products were 14% more likely to have delayed menopause. Cramer et al (1994), found that milk consumption was associated with age-related decreases in fertility rates in a 31-countries ecologic study. However, a subsequent case–control study (Greenlee et al., 2003) found that women who consumed three or more glasses of milk per day had a 70% lower risk of infertility when compared with women who did not consume milk. A prospective cohort study found that intake of high-fat dairy foods was associated with a lower risk of ovulatory infertility, notwithstanding low-fat dairy foods were associated with a higher risk (Chavarro et al., 2007). Souter et al (2017) found higher dairy protein intake was associated with 14% lower antral follicle count. However, this appears to refer to low-fat milk, not full cream milk – and may also be confounded by a higher risk of PCOS (see Dr Purdue-Smithe, following).

        Whilst low-fat milk is implicated in regards infertility, particularly in earlier studies, Afeichi et al (2016) also found that low-fat milk was not the culprit. The contradictory outcomes suggest low-fat milk risk (if it does exist) is low. Meanwhile, many studies demonstrate full cream milk (ie saturated dairy fat) is protective against infertility. On the evidence, Dr Greger’s implied suggestion to cease whole milk consumption diminishes fertility potential in women.

        According to the 2018 PhD thesis from Purdue-Smithe, 1. both low and high fat milk lower the risk of early menopause, 2., low fat milk dairy (especially yoghurt) increases the risk of anovulatory infertility, whilst 3., high-fat dairy reduces the risk of anovulatory infertility.

        ‘Results of this study suggest that high versus low intakes of vitamin D and calcium from food sources, particularly dairy foods, are associated with 17% and 13% lower risk of early menopause, respectively’.

        ‘The positive association of low-fat dairy with anovulatory infertility appears to be driven, at least in part, by yogurt intake; according to their findings, for each additional serving/d, risk of anovulatory infertility increased by 34% (95% CI: 1.02-1.74; P-trend=0.03). Likewise, the inverse association observed for high-fat dairy appears to be driven by intake of whole milk (RR for each 1 serving/d increase: 0.46; 95% CI: 0.25-0.84; P-trend=0.01). Estimates for both high and low-fat dairy foods were stronger among women older than 32 years, and among women with clinical manifestations of PCOS’
        Dr Greger also fails to disclose the intake of total dairy foods is associated with a decreased risk of endometriosis (Harris et al, 2013). He also fails to disclose dairy food intake reduces the risk of uterine leiomyomata (Wise et al, 2010, 2013). He also fails to disclose ‘drinking 3 or more glasses of milk per day was protective of female fertility’ (Greenlee, et al, 2003). He also failed to disclose the ‘inverse association between high-fat dairy food intake and anovulatory infertility’, and the finding that ‘lactose (the main carbohydrate in milk and dairy products) does not affect fertility (Chavarro et al, 2007). He also fails to disclose that circulating levels of IGF-I as a consequence of milk consumption (Heaney et al., 1999; Giovannucci et al., 2003) has a probable positive effect on fetal growth and birthweight. For example, the Danish National Birth Cohort (Olsen et al., 2007) discovered that milk consumption during pregnancy was associated with higher placental size and offspring size at birth. Heppe et al (2011) discovered milk consumption during pregnancy increased birthweight resulting from higher fetal weight gain in the third trimester of pregnancy. The EARTH team also speculate that milk consumption improves IGF-1/IGFBP-3 ratio during ovarian stimulation, and this is ‘associated with higher likelihood of pregnancy and ongoing pregnancy (Schoyer et al., 2007).

        Dr Greger also fails to disclose that Nagel et al, found ‘no association of total dairy intake and age at menopause among 5,110 participants of the EPIC cohort.’ Dr Greger also fails to disclose ‘dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth.

        Affechi, Chavarro, and Souter are members of Harvard University’s EARTH team.

        ‘We hypothesized that intake of total and full-fat dairy foods would be associated with lower chances of live birth’ . ‘Given the inconsistency of the existing literature and suggested biological effects of dairy foods on reproductive function, we anticipated either an inverse relation or no association’…..

        ‘The positive association between dairy food intake and live birth in ART was unexpected’. ‘Our findings of a lack of association with pre-clinical end-points and a positive association with live births but not with other clinical end-points are consistent with an interpretation that dairy foods may have a positive influence on pregnancy maintenance’.

        ‘This prospective cohort of women undergoing infertility treatment with assisted reproductive technologies, intake of dairy foods was positively associated with live birth among women ≥35 years of age. This relation did not differ between full-fat and low-fat dairy foods and did not appear to be driven by one single dairy food item. Dairy food intake was not related to ovarian response to stimulation, embryological, implantation or clinical pregnancy outcomes’. ‘Dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth’.

        Afeiche et al, 2016 (https://academic.oup.com/humrep/article/31/3/563/2384937)

        References:

        ‘Results of this study suggest that high versus low intakes of vitamin D and calcium from food sources, particularly dairy foods, are associated with 17% and 13% lower risk of early menopause, respectively.

        ‘The positive association of low-fat dairy with anovulatory infertility appears to be driven, at least in part, by yogurt intake; according to their findings, for each additional serving/d, risk of anovulatory infertility increased by 34% (95% CI: 1.02-1.74; P-trend=0.03). Likewise, the inverse association observed for high-fat dairy appears to be driven by intake of whole milk (RR for each 1 serving/d increase: 0.46; 95% CI: 0.25-0.84; P-trend=0.01). Estimates for both high and low-fat dairy foods were stronger among women older than 32 years, and among women with clinical manifestations of PCOS’

        Purdue-Smith, 2018

        https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=2270&context=dissertations_2

        ‘Intakes of total and low-fat dairy foods were associated with a lower risk of endometriosis. Women consuming more than 3 servings of total dairy foods per day were 18% less likely to be diagnosed with endometriosis than those reporting 2 servings per day (rate ratio = 0.82, 95% confidence interval: 0.71, 0.95; P(trend) = 0.03). In addition, predicted plasma 25(OH)D level was inversely associated with endometriosis. Women in the highest quintile of predicted vitamin D level had a 24% lower risk of endometriosis than women in the lowest quintile (rate ratio = 0.76, 95% confidence interval: 0.60, 0.97; P(trend) = 0.004). Our findings suggest that greater predicted plasma 25(OH)D levels and higher intake of dairy foods are associated with a decreased risk of endometriosis’.

        Harris et al, 2013
        https://www.ncbi.nlm.nih.gov/pubmed/23380045

        Low-fat dairy food intake is associated with a decreased risk of delayed menopause

        Carwile et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/23946341

        Increasing dairy food intake reduces the risk of uterine leiomyomata

        Wise et al, 2010, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/19955473

        https://www.ncbi.nlm.nih.gov/pubmed/23825169

        ‘Drinking 3 or more glasses of milk per day was protective of female fertility’

        Greenlee, et al, 2003

        https://www.ncbi.nlm.nih.gov/pubmed/12843768

        A positive association between low-fat dairy food intake and an increased risk of anovulatory infertility, and conversely, an inverse association between high-fat dairy food intake and anovulatory infertility

        Chavarro et al, 2007

        https://www.ncbi.nlm.nih.gov/pubmed/17329264

        ‘High intake of low-fat dairy foods may increase the risk of anovulatory infertility whereas intake of high-fat dairy foods may decrease this risk. Further, lactose (the main carbohydrate in milk and dairy products) may not affect fertility within the usual range of intake levels in humans’.

        Chavarro et al, 2007

        https://www.ncbi.nlm.nih.gov/pubmed/17329264

        A dietary score based on factors previously related to lower ovulatory disorder infertility (higher consumption of monounsaturated rather than trans fats, vegetable rather than animal protein sources, low glycemic carbohydrates, HIGH FAT DAIRY, multivitamins, and iron from plants and supplements) and other lifestyle information was prospectively related to the incidence of infertility’.

        Chavarro et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/17978119
        Women aged over 35 undergoing infertility treatment reported a positive association between dairy food intake and live birth.

        ‘Dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth’.

        Afeiche et al, 2016

        https://www.ncbi.nlm.nih.gov/pubmed/26787645

        ‘no association of total dairy intake and age at menopause among 5,110 participants of the EPIC cohort.’

        Nagel et al,

        https://www.ncbi.nlm.nih.gov/pubmed/16011884

        Dr Purdue-Smithe analysed the available data on this link for her PhD thesis (May 2018). According to Dr Purdue-Smithe there is ‘a plausible role for dairy in delaying ovarian aging’ Note, delaying, not advancing.
        ‘These results suggest a possible underlying cause of anovulation, such as a longer-term subclinical follicular, ovarian or hypothalamic/pituitary dysfunction, even among healthy, regularly menstruating women’.

        Hambridge et al, 2013

        https://www.ncbi.nlm.nih.gov/pubmed/23589536

        Milk and Sex Steroids

        Dr Greger claims milk is responsible for 60-80% of ingested sex steroids, implying this is linked with infertility. Nutritionist Monica Reinagel (MS, LD/N, CNS) has investigated the link between milk hormones and fertility, and makes the following salient points:

        1. The amount of hormones in milk is tiny compared to what’s already in your body. Guys ….produce about 6,000 times as much estrogen every day as you’d get in a glass of whole milk. Ladies …are producing 28,000 times that much. Compared to what your own body pumps out, the amount of estrogen you’re exposed to from dairy products is far too little to have any physiological effect.
        If drinking milk could raise your estrogen levels, we could expect it to be useful in treating symptoms of menopause. Ironically, soymilk may be more effective than cow’s milk in beating hot flashes.

        2. There’s no clear link between intake of dairy products and early puberty. It’s true that kids are reaching puberty earlier these days but I don’t think dairy is the cause. For one thing, kids are drinking less milk than they used to. If the hormones in dairy caused early puberty, we’d expect to see the average age of puberty go up as dairy consumption went down, but the opposite is true. I think the increase in childhood obesity is a much more likely explanation for early puberty because circulating estrogen levels increase with body fat.

        3. There’s no clear link between intake of dairy products and increased risk of breast or ovarian cancer. Some people have pointed out that breast cancer rates are lower in cultures or countries where dairy is not commonly consumed. But there are so many other differences between these populations that it’s impossible to say that the difference in cancer risk—or any other difference, for that matter—is due to the difference in dairy intake.
        When we compare people from the same country and culture, those who drink the most milk don’t have a higher incidence of breast cancer than those who drink the least. In fact, several studies have found a modest protective effect.

        https://www.quickanddirtytips.com/health-fitness/womens-health/how-does-dairy-affect-your-hormone-levels?page=1

        Summary

        Female infertility is a very complex condition, and there are remaining unknowns. It involves genetics, obesity, reproductive lifespan, age at menopause, PCOS, endometriosis, protein intake, fat content of milk, vitamin D and folate intake, environmental pollutants, and longer-term subclinical follicular, ovarian or hypothalamic/pituitary dysfunction. The latter may cause anovulation.
        Milk (and vitamin D) may be hormonally active in humans but IGF-1 appears to enhance fertility. The sex-hormones appear inconsequential in terms of fertility (Reinagel). Full cream milk, especially vitamin D-enriched full cream milk, reduces the risk of early menopause, PCOS and endometriosis. Thereby enhancing fertility. In premenopausal women less than 51 years of age, low-fat milk extends reproductive lifespan (later menopause), and thereby fertility. Notwithstanding this, full cream dairy milk and yoghurt more consistently demonstrate an ability to enhance female fertility.

      2. Hi Tom,

        Just so you know. 24 hours ago I wrote a long reply to you on this subject – which has been completely deleted by ‘Nutritionfacts’. Not technical glitches, but instead wholesale censoring. Perhaps you can use your influence to have them in high-places publish it, and have the courage to scientifically debate the issue. Pete

        1. Just so you know. 24 hours ago I wrote a long reply to you on this subject – which has been completely deleted by ‘Nutritionfacts’. Not technical glitches, but instead wholesale censoring. Perhaps you can use your influence to have them in high-places publish it, and have the courage to scientifically debate the issue. Pete
          ———————————————————————————————————————————————–
          Heh, Pete… asking Tom to “influence” the “Neo-Sturmabteilung” to stop burning books (digital posts) suggests he may be their leader. ‘-)

          And while I am neutral in re: the efficacy of consuming milk products (other than goat milk products of which I am definitely pro) I realize I am putting my own posts at risk, standing up for the right to be heard (when done in an intellectual manner which I’m sure yours qualified as. ‘-)

          1. Hi Lonie,

            The ad-hoc censorship corresponds with the relentless propagation of false or misleading information when it comes to dairy nutrition. ‘Dairy-bashing’ !
            The evidence for low fat dairy (especially low-fat yoghurt) and female fertility is contradictory. Probably best avoided until there is more evidence. However, the evidence for full-fat dairy (saturated fats) is unequivocal:

            1. It reduces the risk of anovoluatory fertility.
            2. It significantly reduces the risk of early menopause (especially when vitamin D enriched), and otherwise does not alter age of menopause.
            3. It decreases the risk of endometriosis 4. It decreases the risk of uterine leiomyomata 5. It increases the odds of live birth in IVF patients 6. It delivers a higher placental size and birthweight 7. It decreases the risk of PCOS

            Moreover: 1. Sex hormones in milk are a non-event as their levels are so low.
            2. Growth hormones in milk such as IGF-1 improve female fertility/birth weight (causing a higher weight gain in the third trimester)

            I expect goats milk would do much the same.

            Happy to debate the science with ‘nutritionfacts’ anytime.

          1. Thankyou Steven. Appreciate your reply, and withdraw my imputation.
            Spam is a curse, and not sure how one resolves this issue. Sometimes, a long reply with links is the only way to comprehensively rebut a sweeping allegation allegation such as ‘milk causes female infertility’. On the evidence, the opposite appears the case – except perhaps for low-fat milk.
            Especially yoghurt.
            I wonder if the system can automatically challenge the poster for confirmation if it assumes it is a spam?

  12. Hi!

    Is there a connection between elevated DHEA-S (without any other hormones being in imbalance)?

    My friend is suffering from hirsutism and alopecia, she is only 24. Not plant-based though. Her hormonal profile showed only elevated DHEA-S, everything else is ok, including cholesterol.

    Can it be on the cellular level? Endocrinologists said there is no problem to treat.

    Could any specific plant-based thing help? Or any antioxidant?

    Please help.

    THANK YOU!

    LENKA

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