Category Archives: Nutrition

Your Health is Important When Trying to Conceive

Every aspect of your health – from the drinks you consume to the exercise you do (or don’t do) – can have an impact on your fertility and on the health of your pregnancy. By looking at your healthy (and unhealthy) habits now (before the bun is in the oven) you can start off on the right foot. Our expert OB/GYN team has shared some important steps to take to ensure your health is at its best for conception, which will hopefully make conception easier and your pregnancy safer.

Habits to Break

Smoking is never good for you, so just don’t do it. But if you need a little motivation not to light up, repeat this fact to yourself: smoking (cigarettes, e-cigarettes, hookahs, vape pens, and so on) causes my 30-year-old eggs to act more like 40-year-old eggs. This results in a more difficult path to conception and a greater risk of miscarriage. Heavy smoking damages the ovaries as well as the uterus, and secondhand smoke can harm your health and fertility, too, so just choose to stay away!

Along with smoking cigarettes, smoking marijuana isn’t good for conception either. Whether you smoke, vape, or consume edibles, you can inadvertently affect the ability of your partner’s sperm to fertilize an egg – even if he doesn’t smoke marijuana! The active ingredient in marijuana, THC, gets in your vaginal fluids and reproductive organs. So to be most fertile (not to mention safe), say goodbye to marijuana. (And you should obviously also not use any illicit drugs, including cocaine, crack, or heroin, etc.).

Some studies have linked too much caffeine consumption with lowered fertility and an increased risk of miscarriage. If a baby is in your immediate plans, it’s time to put a little less coffee in your cup. You don’t have to give it up completely but moderation is the key here. Limit your caffeine intake to no more than 200 mg per day. That’s equivalent to 12 ounces of brewed coffee per day.

Another beverage to limit (or eliminate completely) is alcohol. Drinking alcoholic beverages in excess can mess with your menstrual cycle, possibly interfering with ovulation. And because you won’t necessarily know the moment you conceive, there’s a chance you might be drinking in the first few weeks of your baby’s growth. Drinking alcohol while pregnant could harm your little one in the future. Choose to reduce your drinking to less than 7 drinks a week and never more than one on any occasion when trying to get pregnant. Only you and your bartender need to know you’re drinking a mocktail.

As far as medications go, most over-the-counter and many prescription meds are considered safe while you’re trying to conceive. But because some medications may compromise fertility, you should run any medications you take by your provider before you consume them. This includes the medications you take for your chronic condition and any vitamins or herbals you may take on a regular basis. The good news is there are almost always safer alternatives. Just ask your healthcare provider before making any changes to your medication routine.

Habits to Keep

There is a strong connection between weight and fertility. Reaching a healthy weight for your body type is an important step for conception. It’s not just the scale that determines this, though. The relationship between your weight and height are factored to determine your body mass index, or BMI. Being overweight can cause diminished egg quality, decreased ovarian function, or polycystic ovarian syndrome (PCOS), a fairly common cause of fertility issues. Alternatively, women with a low BMI can also experience conception woes. Being underweight can lower estrogen levels, which can lead to irregular ovulation or periods (or even no ovulation or periods). Women who are obese or underweight when they become pregnant also have a higher risk of miscarriage.

Though it may be different for everyone, a moderate exercise program is the key. Moderate exercise can boost fertility, and you only need 30 minutes of aerobic exercise to do this. It can be walking, stretching, strength training, or anything that increases your heart rate. Remember to keep an eye on your body fat though. Prolonged, strenuous exercise can disrupt the delicate balance of hormones needed for ovulation and conception, especially if your BMI is very low. An ideal BMI for conceiving is between 18.5 and 24.9.

Before you put yourself on a diet or start packing on the carbs, it’s important to talk to your healthcare provider. Come up with a simple plan that features a well-balanced diet. Fill your meals with lean protein, veggies and fruits, and low-fat dairy. Cut down on junk foods and sugary drinks. Try water instead. Add in that moderate workout routine discussed above and you’ll be ready to kick-off your healthy path to pregnancy!

A good night’s rest is also very important. Six to nine hours of sleep per night is best. Beating the stress of the day and letting your body recuperate will only encourage fertility.

Finally, take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day if you are planning a pregnancy or are currently pregnant. You can take a vitamin or eat a breakfast cereal containing your daily quota of folic acid. This will lower your risk of some birth defects of the brain and spine, including Spina bifida. Talk with your doctor about your folic acid needs. Some doctors prescribe prenatal vitamins that contain higher amounts of folic acid.


Whether it’s your first, second, or fifth baby, your body needs to be nurtured and cared for so that it can do the same for your future child. Both the female AND the male partner’s fertility can benefit from the advice listed above. And remember that no two bodies are exactly the same, so talk to your doctor before getting pregnant. They will discuss your medical history, any medical conditions you have, any medications you are currently taking, and any vaccinations you might need. This will help make a preconception health plan that is best for you.

For more information on preconception health, check out this conception plan template from the CDC.


The Obstetrics/Gynecology & Infertility Team at Medical Associates Clinic:
Joseph Berger, MD  |  Tara L. Holste, DO  |  Lisa A. Kramer, MD
Trupti S. Mehta, MD  |  Laura Neal, MD  |  Erika O’Donnell, MD

Call 563-584-4435 to schedule an appointment.


Living with Diabetes: What Can I Eat?

Grains and Starchy Vegetables

If you are going to eat grains, choose whole grains. Whole grains are high in fiber. Foods high in fiber take longer to digest and therefore affect your blood glucose more slowly (i.e. whole wheat bread, prunes and other vegetables). Reading food labels can help you with making the best choice.

What is a Whole Grain?

A whole grain is the entire grain—which includes the bran, germ and endosperm (starchy part). “Refined” flours like white and enriched wheat flour include only part of the grain. They are missing many of the nutrients found in whole wheat flour. Examples of whole grain wheat products include 100% whole wheat bread, pasta, tortillas, and crackers. For cereals, pick those with at least 3 grams of fiber per serving and less than 6 grams of sugar.

Best Choices of Starchy Vegetables

Starchy vegetables are great sources of vitamins, minerals and fiber. The best choices do not have added fats, sugar or sodium. Try a variety such as parsnip, plantain, potato, pumpkin, acorn squash, butternut squash, green peas, and corn.

Best Choices of Dried Beans, Legumes, Peas and Lentils

Try to include dried beans into several meals per week. They are a great source of protein and are loaded with fiber, vitamins and minerals. Examples include dried beans (such as black, lima, and pinto), lentils, dried peas (such as black-eyed and split), fat-free refried beans, and vegetarian baked beans.

What you need to know about Cholesterol

LDL (Bad) Cholesterol

LDL cholesterol is called “bad” cholesterol. Think of it as less desirable or even lousy cholesterol, because it contributes to fatty buildups in arteries (atherosclerosis). Plaque buildup narrows arteries and raise the risk for heart attack, stroke and peripheral artery disease.

HDL (Good) Cholesterol

HDL cholesterol is “good” cholesterol. Think of it as the “healthy” cholesterol, so higher levels are better. HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it can be broken down and passed from the body.

A healthy HDL cholesterol level may protect against heart attack and stroke. Low levels of HDL cholesterol increases the risk of heart disease. HDL cholesterol does not completely eliminate LDL cholesterol. Only 1/4 to 1/3 of blood cholesterol is carried by HDL.


Triglycerides are the most common type of fat in the body; they store excess energy from your diet. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is linked with fatty buildups in artery walls. This increases the risk of heart attack and stroke.



The Medical Associates Department of Internal Medicine provides a Fellowship-trained Endocrinologist, who specializes in diabetes, thyroid disease, and osteoporosis. The staff also includes two certified diabetes educators with board certifications in advanced diabetes management. They see patients for diabetes education appointments and medication. Call 563-584-3310 to schedule an appointment.


Building Healthy Habits

Make a commitment to yourself to improve your health with better nutrition and healthy habits. Following these simple tips can help you start to live healthier right now!

Changing your diet can sometimes seem very difficult. But making a few small changes can make a big difference. Here are a few ideas to help you get started!

  • Snack on fruits and vegetables: Fruits and vegetables are the original fast food, and are full of vitamins and nutrients to keep you full and energized in between meals. A great tip is to keep fruits in a bowl on your kitchen counter. Keeping healthy options in plain sight can make you less likely to grab a less healthy alternative.
  • Make your plate colorful: Use fruits and vegetables to create a bright and colorful plate.
  • Don’t skip breakfast: Breakfast truly is the most important meal of the day, but make sure you eat something with protein and fiber to keep you full and satisfied.
  • Use smaller plates: Trick your brain into thinking you are eating more by simply using a smaller plate. You’ll find you are just as satisfied with less food.
  • Water your body: We know that drinking water is important, but did you know that drinking water can actually help you eat less? Drink two glasses of water before you eat to help you feel fuller faster. And remember to always drink at least eight, eight-ounce glasses of water each and every day!
  • Recreate your favorite meals: A great way to help you stick to eating better is to find ways to cook your favorite meals in a healthier way. For example, if you love pizza, try this recipe for pizza with a cauliflower crust instead of real dough. When you don’t have to completely give up your favorite foods, you’ll be more likely to stick to your diet.

Whether you’re new to exercise or haven’t been active in a while, starting to exercise can feel like an intimidating undertaking.

  • Prepare: Make sure you’re well prepared with the items you need to succeed, like proper shoes and a BPA-free water bottle.
  • Make time: Finding the time to fit exercise into your schedule can be difficult with hectic schedules. Make it a part of your daily routine by scheduling it for the same time every day, and at a time that is convenient for you and your family.
  • Set goals and track your progress: Set reasonable goals for yourself and make a plan to work towards them. Track your progress, whether it’s on a mobile app or with a notebook, and celebrate your successes!
  • Have fun: Probably the most important part, is to find a type of exercise that you love to do. Keep yourself entertained during your workout by asking a friend to join you, or by listening to your favorite music.

Stopping Bad Habits
Many of us have habits we don’t like to admit to, like nail biting, smoking, or cracking our knuckles. Kick those bad habits to the curb with the help of our three tips: make it conscious, write it down and find a substitute.

  • Make it conscious: Identify the habit you want to stop and be conscious of when it happens and what causes it. If you want to stop cracking your knuckles or biting your nails for instance, take note of when you start doing these things.
  • Write it down: Keeping track of when you start biting your nails by writing it down in a log will help to create a baseline, and make you more aware of your habits. After tracking your habits, evaluate your log and look to see if you can determine a trigger for your habits. Are you biting your nails because you’re stressed? Or cracking your knuckles because you’re anxious?
  • Substitute: Find something that you can do in place of your bad habit. If your habit is knuckle-cracking, find a different way to keep your hands busy!


For more information on how you can start building healthy habits, visit our Treating You Well blog, or call your primary care provider at Medical Associates to schedule your annual checkup.

How to eat heart-healthy all day long

Diet is a big part of a heart-healthy lifestyle. Luckily, there are plenty of foods that provide the kind of nutrients essential to keeping your heart in good shape, and they’re varied enough to give you great options for breakfast, lunch, dinner and in between.


Use egg whites when making breakfast foods, and add flavor with spices like cinnamon and nutmeg. Plus, a side of oatmeal is a great way to add heart-healthy fiber to your morning routine and keep you feeling full enough to avoid snacking throughout the morning. Use the items in this list to create a delicious breakfast routine.

  • Egg whites: this low-calorie, high protein food gets you all the benefits of amino acids without the cholesterol
  • Flaxseed: lignans and omega-3s in this food help improve cardiovascular health
  • Oatmeal: this breakfast food not only helps lower cholesterol levels, the fiber also stops you from snacking by keeping you feeling full
  • Soy milk: soy is low in saturated fat and contains heart-healthy omega-3 acids, making it a great way to get protein without high fat intake
  • Papaya: antioxidants in this fruit like vitamin C and vitamin A help prevent the buildup of cholesterol that can cause heart attacks and strokes
  • Blueberries: this superfood helps more than your heart—anthocyanins help prevent the buildup of plaque in arteries while vitamin C, fiber and lack of saturated fat promote overall health
  • Oranges: the vitamins and minerals in oranges keep cholesterol from oxidizing and sticking to the walls of arteries, fight inflammation and promote healthy blood pressure
  • Cantaloupe: antioxidants like vitamin C and beta-carotene keep arteries clear and fight heart disease


There are plenty of heart-healthy foods that make great lunches. Whether it’s an almond-walnut-spinach salad, black bean soup or a tuna sandwich, get those omega-3s, E and B vitamins! Mix and match some of the items on this list for a fresh and healthy mid-day meal!

  • Spinach: this green is packed with B vitamins and other nutrients that pack a punch for your health—plus, it can be used in so many dishes!
  • Black and kidney beans: these contain B vitamins, folate, omega-3 fatty acids and other nutrients that do your heart good
  • Red bell peppers: these bright foods are full of vitamin C, carotenoids and other vitamins and minerals important to fighting oxidation and promoting cardiovascular health
  • Sweet potato: these are high in vitamin A, B vitamins, carotenoids and more—plus, they’re fat-free, low in sodium and low in calories
  • Brown rice: the fiber in this whole grain helps reduce risk of heart disease and keeps you feeling full so you don’t reach for the snacks
  • Tuna: the omega-3s in tuna make it a great heart-healthy addition to your meal by reducing inflammation and risk of heart disease
  • Tomatoes: this bright fruit is full of carotenoids, potassium and vitamin C—among other vitamins and minerals—which help reduce cholesterol through antioxidant properties
  • Avocado: avocados are rich in both dietary fiber, monounsaturated fat, B vitamins and potassium, which makes them a true superfood and heart health promoter


Chicken breast isn’t bad, but the omega-3 fatty acids in salmon are a home run for heart health. Try swapping your chicken for fish and making sides out of legumes and vegetables like those on our dinner mix-and-match list!

  • Salmon: like tuna, the omega-3s in salmon make it a perfect meat substitute on the dinner plate
  • Acorn squash: there’s a naturally anti-inflammatory ingredient in acorn squash called cucurbitacin—that plus B vitamins, folate, anti-oxidants
  • Asparagus: high in potassium and folate, asparagus is a well-balanced, nutrient-rich, anti-inflammatory food that is also low in calories and sodium and contains no fat
  • Lentils: lentils are high in fiber, thereby helping to reduce blood cholesterol levels, and they’re an excellent source of protein
  • Potatoes: potatoes are loaded with nutrients that help lower blood pressure, like flavonoids and kukoa-mines, making them heart-healthy in proper portions
  • Broccoli: this green food’s nutrients prevent inflammation,
  • Tofu: a product of soy, tofu is high in protein, contains all essential amino acids, lots of vitamins and minerals and helps lower bad cholesterol


Even the most health-conscious eater might crave a mid-day snack or after-dinner drink and dessert. Pack some nuts in your desk drawer at work and stay hydrated and awake with green tea instead of sugary drinks like soda. Even dark chocolate is good for your heart in moderation!

  • Nuts: besides lowering bad cholesterol in your blood, nuts also reduce your risk of blood clots by preventing plaque buildup and promoting flexibility of the artery wall
  • Berries: flavonoids called anthocyanins help reduce your risk of heart attack with anti-inflammatory properties and benefits to arterial walls
  • Dark chocolate: flavonoids and antioxidants in chocolate can lower bad cholesterol and lower blood pressure to improve vascular health—but enjoy in moderation!
  • Tea: black tea has the ability to lower cholesterol and reduce your risk of heart disease, and the antioxidants in green tea are a heart-healthy benefit as well


For further direction in building a healthy lifestyle diet that protects your heart, make an appointment with a registered dietitian at Medical Associates. Visit our website or call (563) 584-3000 to schedule an appointment with Medical Associates today.