I’m thrilled to welcome Judy Simon and Dr. Angela Thyer back to the podcast to talk all about their brand new book, Getting to Baby. Dr. Angela is a board-certified reproductive endocrinologist and infertility specialist, and Judy is a registered dietitian nutritionist who specializes in reproductive health.
They’ve developed a practical, food-based fertility blueprint that helps fertility patients improve their odds of success and shorten their time to pregnancy. If you’ve heard me talk about assembling your fertility TEAM, you know that E stands for “exercise and nutrition.” What you fuel your body with during this journey makes a difference, and based on Dr. Angela and Judy’s work, that difference can be huge.
They’ve already helped thousands of women who were struggling with infertility thanks to this blueprint, and I know they’re going to help so many more with this book. Getting to Baby makes it easier to understand exactly what to eat and how to make those dietary changes in a simple, straightforward way with the science to back it up.
During our conversation, we talked about:
- How food supports fertility
- The research-based science behind their plan
- Using food to support specific fertility diagnoses, like PCOS and endometriosis
- Practical tips and ways to make this transition easier
- Their course, Food for Fertility
Resources:
Purchase “Getting to Baby: A Food First Fertility Plan To Improve Your Odds & Shorten Time to Pregnancy“
Visit Dr. Angela Thyer’s website
Transcript:
Dr. Aimee: The title of today’s show is Getting to Baby: A Food-First Fertility Plan to Improve Your Odds and Shorten Time to Pregnancy, with my special guests Dr. Angela Thyer and Judy Simon. Welcome.
Judy Simon: Thanks, Aimee. It’s great to be here.
Dr. Angela Thyer: Glad to be here.
Dr. Aimee: I’m so excited. I’d love for you to share with our listeners about your background and how you work together.
Dr. Angela Thyer: Just like you, I’m a reproductive endocrinologist and fertility specialist. Initially, in my training, I did my clinical research with women who have polycystic ovary syndrome. That area of working, understanding metabolism and the endocrine system, how everything functions together, and some of the impacts of diet really started when I was doing studies during my fellowship at the University Health Science Center in San Antonio.
From there, when I moved to the University of Washington, I was looking for somebody to continue this work and begin to collaborate with me. Judy and I found each other. We had a lot of patients in common and we both had this common understanding of how food and nutrition can impact the metabolic system, the endocrine system, patients with PCOS, patients with endometriosis, and other aspects of infertility. So, we started working together way back when at the University of Washington.
Judy Simon: Yes. In my journey, I had been a dietitian and had moved to Seattle. Prior to that, I had a long journey with my own fertility. It was about seven years until we conceived my daughter. Totally in that unexplained category and the frustration. With the help of a great OBGYN, we did finally conceive using IUI. When we moved to Seattle, due to the change in environment, perhaps, I conceived our son.
When I went back into working in nutrition, PCOS just popped in my face. I couldn’t believe all these young women that had been on birth control because of their irregular cycles, no diagnosis. I was seeing all these women come off the pill and they weren’t ovulating. They were trying to get pregnant. That’s when I had to go to the next building to meet Angela and her colleagues and say, “How do we help these women? Why are they gaining weight? Why can’t they get pregnant?” Really understanding the role of lifestyle.
As we went on, Angela and I went on to different venues, and we decided let’s bring these women together. Let’s go to this kitchen that we put together in the staff room at SRM, and let’s not just say eat healthy, let’s do it, let’s cook together, let’s learn together, let’s plan together. There was no template, we just did this. Angela is a medical director, I’m also a health educator, that’s my master’s degree.
The women loved it. That’s where these stories come from in our book, the women that we worked with over those 12 years that we did the class live, and then we did a few years virtually. Our plan was, we need to reach more people, they need more solid information to help them with getting to a healthy pregnancy and getting to their baby.
Dr. Aimee: For our audience who buy the book, and I really hope you will, you’ll read lovely stories from different patients, what they went through and how the book and their experience with both of you also helped them reach their goals. I love that about your book.
You also reference that the fastest, healthiest way to baby is through the kitchen. How does food support fertility?
Dr. Angela Thyer: The other thing that evolved over time was just as we were talking to women and couples about what they were eating, a lot of people just weren’t really sure. They were maybe eating low carb, maybe cutting out gluten, maybe cutting out dairy. They weren’t sure why they were doing it. Maybe taking so many supplements and not really understanding what the role of those were. We really wanted to refocus the program on food first to understand how food actually provides most of what we need for our health and wellbeing, including our fertility.
Obviously, people can choose a range of different eating styles, which is why this book isn’t really prescriptive, it doesn’t say one thing for every person. It says, based on how you’re eating, how you can make sure you’re getting everything you need. Maybe you do need some supplements if you’re missing one particular micronutrient or mineral from a particular type of diet. We want people to know most of what people can get is going to be through the kitchen and through food. Usually, that means cooking, which is a little bit of a leap with people’s busy schedules. Time being such a short commodity for most people that learning to cook at home efficiently and understand how to put ingredients together and make them taste delicious was really key to having more nutrients in your diet and better fertility.
Dr. Aimee: In the book, you have this section that I love, the blueprint, your six-week guide. You can follow it step by step. It’s really easy even for me to follow. When I get home, the only button I know how to push is the microwave start button, but I was like I could totally do this and these recipes look delicious.
Judy Simon: I wanted to add that a lot of people are hearing more about nutrition and fertility. We have had some studies that have come out that have really supported this. I think what’s important is we want everyone to feel included, no matter what their budget is. I don’t want them to think that organic is the only thing they can eat. We want it to be really practical.
We tried to include all global cuisine. So, often people hear Mediterranean is the perfect thing. When you say that to a patient who is South Asian, which many of my patients are, they’re like, “We eat a lot of dals. Is that okay?” Yes. That’s lentils. An Indian diet is amazing, and we can work from that. So, we tried to be very global in the book.
We also put a lot of kitchen tips in, things that are just really easy, how you can cook without a recipe, how you can meal prep. With that six-week template, what we thought is for some people, that might be a 12-week. They might say they’re going to work on one of these a few weeks at a time. In fact, when the class went from live to virtual, we started doing it every other week, and we received really positive feedback from the patients. They said, “It gives us a little bit more time to work on that. I’m going to work on trying a whole grain or adding in a lentil dish. It gives me a little bit more time to do it.” We thought this could give the book a little bit of flexibility for folks to work on their own timeframe.
Dr. Aimee: I also want to point out that there’s nowhere in your book that says eliminate dairy, eliminate gluten, eliminate meat. You talk about lusty legumes and going fish. “Lusty legumes” sounds very sexy. The book is written in a fun way. Don’t get me wrong, it’s dense, but you can tell that it is written by two experts in the field, people that we should trust.
Dr. Angela Thyer: We spent so much time with people, mainly women, talking to them about their diets and their fertility, so we kind of know what works. One thing that we found works is that if you are trying to change anything in your diet or incorporate some foods that maybe you haven’t tried before, doing it more slowly is way more successful. We talk about setting small individual goals, like trying one new food or one new recipe every week, and that doesn’t overwhelm you. It also helps you feel in control, and you can have fun with it. It’s a fun part of just experimenting with new cuisines, new spices, new foods, all that. Then sharing that with friends or family, whoever you have.
It’s a diet that’s good forever. We talk about how nutrition lasts forever, into pregnancy and beyond, and when you have kids, and when you are getting older. These practical tips of a healthy diet with a lot of plants in it, because we need those antioxidants and it’s really good for the gut, but also you can eat meat, you can be vegetarian, you can do all sorts of things. We tell you how to make that best work for fertility.
Dr. Aimee: You also talk about alcohol and environmental toxins and give scientifically based advice on both of those things. I appreciate both of those sections a lot, and I think my patients should be reading them.
Judy Simon: The disruptors, right. This book was going to be twice as long, and then our publisher said, “No. People want a book this size that they can get through.” We shrank it down, but we have the disruptors so that people would have just short and sweet what we know about alcohol, caffeine, cannabis, BPA. Then we have boosters, how to deal with stress, get better sleep, incorporate movement. We thought we really took a lifestyle approach, and I think that’s important.
As you know, probably the two most common reasons a woman goes to a fertility clinic is for PCOS and endometriosis. If we’re helping the health of their entire body, we’re helping them with glycemic control if they have insulin resistance, reducing inflammation, that’s going to help improve the quality of their gametes, their eggs and sperm. It’s going to help a better uterine environment. We’re going to not only help improve their fertility, but hopefully decrease risk for miscarriage and loss, especially as people are older. We’re seeing older women and we have to have everything on their side.
That’s what I tell them. If you can spend three months nourishing your body, that will add to your chances for increased success. Of course, I wish we could promise everyone. We’ve seen so many good results and there’s no bad side effects because people are going to be healthy, they’re going to improve their insulin resistance and their high blood pressure if they have any chronic diseases they need to manage.
Dr. Aimee: One of the most common questions I get asked is, “What should I eat? What should I stay away from?” I always say just get Judy and Angela’s book, it’s all there. Let’s talk about that a little bit more. What should people eat more of while trying to conceive?
Dr. Angela Thyer: There are lots, and we can cover them all. The number one thing is more fruits and vegetables. It’s really well recognized that our population in general tends not to eat enough fruits and vegetables. One thing is because they take a little bit more effort. Most people aren’t eating raw vegetables all the time, so they take a little work to make them pretty, prep them, make them beautiful and make them taste good. Spending time saying if half your plate can be fruits and vegetables, that’s going to give you the antioxidants you need, which are so important to help the cells and the mitochondria, the cellular processes, help free radical formation and reduce oxidative stress.
These antioxidants from fruits and vegetables for sure I would say are number one, which is why we start with that at the beginning of the book. Then leafy greens, cruciferous vegetables, and we go through all of the colors. We kind of color code it to say the purples and the blues, the anthocyanins, how important those are. We break it down by here’s a food group, here’s how they help your fertility, here are some great recipes incorporating these particular foods.
Dr. Aimee: What about what should they eat less of? Are there any foods someone who is trying to conceive should avoid?
Judy Simon: I would say probably less of the really ultra processed . What I mean is if people are always snacking, taking something out of the bag that probably has no fiber, very little plants, maybe a lot of added fat and salt, if you had those veggies ready or some roasted chickpeas, other snacks. You could eat popcorn and that would be a healthier crunchy snack. Popcorn is just salt, toil, and grains.
We do talk about trying to move away from ultra processed foods. We’re not saying no processed foods, because none of us are milling our grain and making our bread from scratch. You don’t have to. That’s okay. Really trying to eat more whole food.
I want to give you an example. In the grains, something we found out from classes is people eat a lot of rice, potatoes, and noodles because they’re fast and easy. When you introduce them to things like quinoa, farrow, these other whole grains that have so much more fiber and so many more nutrients, they’re like, “But the carbs,” what we can share with them is besides the benefits of the fiber, people live longer who eat more ancient grains and they have inositol. For the women that are trying to improve their insulin resistance, you make some inositol, but you get it from your whole grains, like soba noodles.
We try to show some of the switches, how you can go toward using more of the whole grains. The ultra processed would be one example of a thing to eat less of. I don’t want to knock eating out because we should enjoy dining out, but I think it’s the frequency and the choices people make. Often, it’s a burger place. Make sure you’re making up all the fruits and veggies that you didn’t get that meal. If it’s every day that they’re doing it versus occasionally we like to go out for a nice burger, that might be a little bit different. I would say the ultra processed are the ones we would like them to have less of, and go more with the whole grains. Of course, we are big promoters of the lusty legumes, the beans, and the lentils.
The thing is once you get someone to try something – I had a patient whose husband said, “I am never eating beans,” but he loves chili. I said, “Why don’t you puree the beans, put them in the sauce, make it spicy with the tomato?” She said he loved it. He said, “It was better than usual. What did you do?” She said, “I added beans.” He said, “I guess beans are okay.”
We want to help to be practical on how to emphasize the positive instead of the negative that people are hearing so much.
Dr. Aimee: You just brought up how you talk to people one-on-one, Judy. I just want to bring up how I refer my patients to you for fertility nutrition coaching and guidance. You do nutrition consults for me. Can you talk a little bit about that?
Judy Simon: Sure. When I see someone on a one-on-one basis, I try to find out as much information as I can. I have them fill out a questionnaire, tell me about their likes and dislikes. I have this special question, I ask them to rate their diet, what they think. No matter what number, if they tell me it’s a three or a seven, I’m like, “Why isn’t it one higher,” using some motivational interviewing and finding out, because they will share with me where they think they fall short.
I find out about their lifestyle, where they are in their reproductive journey. If they tell me, “I have a retrieval in one month,” okay, what changes are realistic that aren’t going to stress you out? I don’t want someone to feel like they’re going to be throwing everything out of the cupboards. What’s really easy? You have frozen veggies, you want to put those in the air fryer, great. You can pick up salads that have grains.
I try to be as practical as possible with people. Of course, sometimes they’ve told me they’ve read the book already, which is great because they’ll have a good background. I really try to be practical and nonjudgmental. When I follow up with them, I always ask them first, “How do you feel?” They’re like, “I’m pooping like a champ. I’m eating more fiber. My gut is feeling good. I have more energy.”
There’s a lot of women that are trying to intermittently fast, cut out gluten, all this stuff, and I’m like that’s restrictive. We’re talking about a time in your life that you’re preparing for pregnancy. You want to make sure to put the focus on, like how you go to get a massage, put the focus on like you’re preparing to buy a house, you have to prepare in a positive way for your fertility and pregnancy. Get your partner on board, even if you can get those guys to eat nuts and eat some of the foods that you’re eating, they’re going to get a benefit. They’re always building their sperm.
I try to be practical, meet them where they’re at. I spend a lot of time with recipes and culinary skills. Do you want to spend time in the kitchen? If not, what are some easy things you can put together from Trader Joe’s? Meet people where they’re at and they’re so much more likely to feel empowered and not overwhelmed. Your patients, when I see them, they’re deep into the IVF journey and they have a timeline, so it’s what’s practical.
Dr. Aimee: Let’s say you see someone who has PCOS or endometriosis. Do you have any special food tips for them?
Judy Simon: Yes. Everything we’ve been talking about, the fruits, veggies, fish. If they’ll eat fish, we want to go fishing with them. We try to up the omega-3s. Those will help with being anti-inflammatory. Plus, if you look at any studies that have been done on fertility, they look at the couples and they see that the couples that have been eating fish, two to three servings a week, have a shorter time to conception, better outcomes in IVF. We have a lot of fish data, if they eat it. If not, we go for seeds and nuts, and maybe a plant-based omega-3 if they’re not a fish eater.
I really try to help them include foods that are anti-inflammatory, and contain more fiber. I think it’s important for listeners to know that when you have a healthy gut biome and you’re getting enough fiber, that can help balance some of the excess estrogen and it can be beneficial. We have more nutrition studies done on PCOS and endometriosis. Unfortunately, endometriosis is the sad sister that needs more research. With PCOS, we have the diet research that eating tofu, eating vegetables actually improves the biomarkers. You don’t have to be vegetarian, but more plant-centered really makes a difference.
Protein is important in PCOS, and balancing meals. I don’t want my patients to just snack on carbs all day. I want them to have the apple and peanut butter, the hummus and veggies. We want to have that balance. We do want to have adequate protein. You can get a lot of it from plants. We’re big egg pushers, they’re great choices of choline for pregnancy. If women eat eggs, we try to encourage them to have three to seven eggs a week. Healthy fats. Really trying to be anti-inflammatory for both of those, less processed, more whole foods.
Sleep is important, too, with all of our patients.
Dr. Aimee: When you say seeds and nuts, what are your favorite go-to seeds and nuts that you recommend?
Judy Simon: First, I find out what they like. Almonds. I do tell them Brazil nuts, which are not always the most popular nut in the mix, you eat one and it’s all the selenium you need for the day. Super great for sperm.
Dr. Aimee: Just one?
Judy Simon: Just one. One Brazil nut. I tell women and men at least a quarter of a handful of nuts and seeds, whatever they like.
We have recipes. We love chia seeds to put in our homemade smoothies and in chia pudding. We also have one smoothie recipe, because we’re like you don’t have to use protein powders. You can use yogurt, plant-based milk, nut butters, and vegetables like kale to make amazing healthy smoothies that aren’t processed at all, just your favorite foods. Frozen berries, stuff like that. Oats, we put oats in our smoothies. Things like that.
Any nuts. Almonds, seeds, they all have a great profile. Angela, what’s your favorite?
Dr. Angela Thyer: I love walnuts. I eat walnuts almost every day. We talk about pistachios having all the essential amino acids. Pecans. Macadamia nuts. You name it. A variety and mixing it up is good to add different nuts. That’s a great snack, too. When people think about snacks, having some whole nuts is a great option.
Judy Simon: I try to get people who live on bars and protein drinks, I’m like how about that little container of nuts and a piece of fruit to replace one of your protein bars. You’re going to really get the real food and get the benefits, and they taste a lot better. We’re not against having emergency snacks, because that’s important, but nuts fit the bill there to keep in your drawer.
Dr. Aimee: You do have recipes in Getting to Baby. Do you have plans for a separate cookbook as well, is that coming soon?
Judy Simon: We have many recipes and cooking tips for quick recipes in Getting to Baby. We may write a cookbook in the future.
Dr. Angela Thyer: Maybe. We’re always working on recipes. We occasionally have pop-up classes and try out new recipes with folks. It is fun. I also have done a little bit of chef training to try to increase the deliciousness of the food, because I feel like that’s such a big part of it. Wanting to eat differently or experiment is having fun in the kitchen and knowing you might not like everything you make, but try some things. Especially if you’re trying to get some of these different food groups into your diet that you maybe haven’t thought of before, like lentils, beans, or certain vegetables, or the whole ancient grains that we talk about.
We definitely have talked about whether we do a full-on cookbook, if there’s interest.
Judy Simon: I do want your listeners to know that as we help folks build their families, they have children. What I tell them is you are setting the table for when you become parents. A lot of the patients I work with are working on their second child, so we talk about how their kids work into it.
This is kind of a fun little thing. One of the very first fertility clients I worked with, they just got in touch with me lately, their kids are 8, 9, and 10 years old. This is how long ago it was. We’re going to get together for a picnic next month.
For a while, for several years, I did food for moms. I worked with the moms and the little kids. It was up until COVID that we did that, we would meet in parks and things like that. They would talk about some of their food struggles growing up, and as parents they wanted to help their kids be healthier. We kind of feel like it’s for your fertility, your pregnancy, and for when you’re starting your family, building a foundation, and that’s going to make a difference in the health of those children.
Dr. Aimee: One hundred percent, absolutely. I just want to go back to a practical tip. In your book, you have a lot about grain bowls. Can you touch on that a little bit? You do have recipes in the book. You’ll get your recipe fix from the book. But I love grain bowls. There’s this one restaurant that I go to only for their grain bowls. I appreciate that you actually talk about that in the book and describe ways of making them at home.
Dr. Angela Thyer: Grain bowls are so versatile. They’re great because you can take whatever grain you have on hand. We love quinoa and farrow, but brown rice, barley, bulgar, millet, whatever you have for your grain. A green, your greens could be salad greens, whatever you have. You could go to a restaurant that has these, or you could just say, “What’s in my refrigerator today,” and just pull out a bunch of random things. Cut up some raw vegetables. Maybe you cook or blanche some greens if it’s more like a kale, a chard, or mustard greens, collard greens, or salad greens. Then something with some color, so adding some color, adding some crunch. Maybe some nuts. Just making it delicious.
For your protein, we use a lot of tofu, tempeh, and fish. You can use tinned fish like sardines if you want to, or tuna if you’re trying to get your fish up. You can use chicken if you have that leftover. Whatever you have, just make these components of this bowl and vary it. If you want to make a drizzle of a dressing, you can do a vinaigrette, you can do a miso lemon, miso garlic, tahini garlic. You can make these delicious different themed types of bowls. We love sweet potatoes in bowls, too, those are great.
Judy Simon: We’ve done it all in bowls. I’d say in our virtual classes the last few years, we would always have them make four bowls because then if they had a partner they could eat. Literally, people will start eating them in class, which is great. Then we go now you have two for tomorrow. When you make a bowl, make more than one bowl while you’re setting them up.
I think probably the most popular dressing, and I think we have one in here, was tahini dressing. It’s really quick: tahini, olive oil, and lemon. You’re like wow, this is what you pay $20 for in a restaurant and I just made three of these at home, and they’re delicious. You can put the seeds and nuts in. They’re really fun to have. Put them in a mason jar.
We’re really big on grain bowls. We’re big on sheet pan meals with sweet potatoes or fish or chicken and broccoli. Things that people can get the whole meal idea together, because it does take time. I’ve done other cooking classes where I’m like that was two hours to make dinner. Our patients don’t have two hours. We have to make it easier for most of them, and they really appreciate that.
Dr. Aimee: Yes. I appreciate these practical tips as well, because you’re sharing with us how to make this transition easy and supporting them on their fertility journey as well. What are some key takeaways that you hope readers will gain from your book?
Judy Simon: We have ten of them. What are our keys, Angela?
Dr. Angela Thyer: Eat the rainbow. Protein and fiber. We talk about how protein and fiber actually can come together if you eat beans or lentils. A lot of people think protein is only meat and fiber is only vegetables, but the legume category actually has both. That’s great, you can get both in one package. We talk about soy because a lot of people are afraid to eat soy. Most of the studies that have been reported, people who incorporate soy, which might be edamame, or tofu, actually show higher fertility rates. That’s another thing that if people haven’t tried it, it’s easy to experiment with that as a novel protein source. Fish and nuts. Spices.
Judy Simon: Discover your ancient grains. Cook with extra virgin olive oil, it’s mono and saturated fat, it tastes delicious. Angela, you had a good one in here, the “boost it.” This isn’t food, but walk for ten minutes at least three times a day, lowering the glycemic effects of inflammation, too.
Dr. Angela Thyer: Right. Exercise and movement is another thing we encourage people to do because it really lowers inflammation, it lowers a glucose spike. A lot of people are aware that after a meal, especially a meal that contains some carbohydrates, you might have an increase in your glucose and then insulin. If you do something simple like walking for ten minutes after a meal, you can blunt that response and blunt the highs, so you blunt the spike. It helps your mitochondria. That’s simple. If you don’t have time to workout in a block, ten minutes after every meal is great. It’s an easy thing to do and it really helps your metabolism.
Dr. Aimee: Where can people find your book and find you both?
Judy Simon: They can find our book at any major bookseller like Amazon, Barnes and Noble, all the major sites, and a lot of the libraries. We wrote this book to make it accessible to everyone. I got on my library site last night and I saw there were holds on it, I was so excited. People are taking our book out. That made me feel really good.
Angela and I are both on Instagram. I’m @FertileNutrition. Angela?
Dr. Angela Thyer: I’m @AngelaThyerMD on Instagram, or my website. Those are good places.
Judy Simon: We’re happy to answer questions. On Instagram it’s great because when you send questions, more people are able to take advantage of that.
Dr. Aimee: Is there anything else that you’d like to add before we go?
Dr. Angela Thyer: I would just say we want people to have fun in the kitchen, have fun with food, know that it’s a wonderful part of our lives to broaden and expand current traditions that you have around food and eating, and know that what you do is going to enhance your health and your fertility.
Judy Simon: Ditto. Part of your journey. We all need to eat. Let’s love what we eat, let’s enjoy it, let’s have fun, let’s get our partners and our families and our friends involved. Never feel bad or negative about a choice that you make. It’s all a big picture.
Dr. Aimee: Thank you so much, both of you, for joining me. You’ve been on my show many times, and I’m so glad that we can do this again today. Thank you so much.
