The EU fertility rates

France and Sweden have the highest fertility rates in Europe but births across the EU are less than needed to replenish the population naturally, the bloc’s statistics agency said on Wednesday.

Spain and Italy had the lowest birth rates, with countries in southern Europe, which has suffered most from economic problems in recent years, generally lower than those in the north.

Across the 28-nation European Union, 5.148 million babies were born in 2016, the last year for which figures were available, compared to 5.103 million in 2015, Eurostat announced.

Overall the total fertility rate was 1.60 births per woman, well short of the 2.1 live births per woman that Eurostat says is “considered to be the replacement level in developed countries”.

France led the way with a fertility rate of 1.92 births per woman, followed by Sweden (1.85), Ireland (1.81), Denmark and the United Kingdom (both on 1.79), the figures showed.

Spain and Italy were the lowest on 1.34 births per woman, followed by Portugal (1.36), Cyprus and Malta (both 1.37), Greece (1.38) and Poland (1.39).

Germany, where the rate is 1.59 births per woman, noted a record number of babies in 2016 at 792,131, boosted by an increase in births by non-German women following large numbers of migrant arrivals.

The federal statistics authority Destatis, who released the figures Wednesday, said while German women had some 3.0 percent more babies, non-German births increased 25 percent.

Declining birth rate

Women in the EU had their first child on average at 29 years old, with the youngest in Bulgaria (26 years) and the oldest in Italy (31 years), Eurostat said.

The highest shares of births to teenage mothers were in Romania, Bulgaria and Hungary.

Finland led the way for large families with one in ten mothers having their fourth or subsequent child.

Europeans have been having fewer children for decades, and a slight rebound since reaching a low of 5.0 million in 2002 has largely stalled since 2014.

Eurostat said in a statement last year that the 2.1 replenishment level was the “average number of live births per woman required to keep the population size constant in the absence of migration.”

Migration is a political hot potato in the European Union with right-wing parties making gains in elections in Italy and Germany recently on the back of anti-immigration platforms.

The issue has been sensitive since the 2015 migration crisis during which more than one million refugees and migrants came to Europe, many of them fleeing the war in Syria.

Here is an interactive map, with more detailed information, interactive world fertility and health statistics 2017:

https://esrimedia.maps.arcgis.com/apps/MapSeries/index.html?appid=15e767cd077443e3a7777f328d85f5f0

Folic Acid Is A Super Vitamin For Pregnancy. Here’s Why

Once a woman finds out she’s pregnant, the questions begin.”What should I eat?” “What should I remove from my diet?”—the list of answers can be long. So how do you cut through the noise to decide what’s best for your baby and for you?

All of the science and research points to following a healthy balanced diet that provides an abundance of vitamins and minerals from whole and minimally processed sources to best support the baby’s growth and development. Increasingly, there’s more of focus on what you “can’t have” as a pregnant woman. But as a registered dietitian, I tell my clients that what is consumed is as important as what is not consumed.

Often our diets don’t meet our bodies’ nutritional needs—pregnant women need more of certain vitamins and minerals to help support the growing baby. Prenatal vitamins and supplements enriched with vitamin D, calcium, DHA, and other pregnancy-specific nutrients can be immensely helpful in prepping the body to be ready to conceive and supporting it throughout the pregnancy. Finding a prenatal with sufficient folic acid or to supplement with folic acid separately before getting pregnant is particularly important.

What is folic acid (and folate)?

Folic acid is the synthetic form of the B vitamin folate, and folate naturally occurs in food. Folic acid can be found in fortified foods and supplements. For women older than 19, the recommended dietary allowance for folate is 400 mcg daily. During pregnancy, the recommendation increases to 600 mcg daily and during lactation decreases slightly to 500 mcg.

Folic acid and birth defect prevention.

In the first weeks of pregnancy, embryonic development is fast and furious. Nerves are configured, organs begin to grow, and the neural tube forms, laying the pathway for later development of the brain and spinal cord.

If the mother is unaware of her pregnancy, she may also not know about her own nutritional deficiencies. At this developmental stage, a folate deficiency could result in a defect in the neural tube, a structure that becomes the baby’s spine. Neural tube defects (NTDs) are birth defects that negatively affect the spinal cord, spine, and brain. When the neural tube isn’t properly formed, it can result in spina bifida or anencephaly, two of the more commonly known NTDs.

When to take folic acid supplements.

In an effort to mitigate the adverse effects of having insufficient amounts of folic acid, the U.S. government began to require the supplementation of folic acid in grain-based foods in 1998. This was a public health measure to increase the population-wide consumption of folic acid as a widespread tool for decreasing the risk of NTDs. When someone consumes folate in food, the body uses energy for absorption in the gut, and it passively diffuses across the cell membrane. So when it comes to women who are of childbearing age, recommendations focus on supplementation along with dietary intake.

So women of childbearing age are recommended to supplement with 400 mcg of folic acid at least one month before conception and during the first four weeks of pregnancy, which can prevent up to 70 percent of NTDs. The risk for NTDs is highest during the first few weeks of the pregnancy. Once the neural tube is closed, the protective effects of folic acid supplementation wear off. Because the neural tubes close so early in pregnancy there are worldwide public health recommendations that strongly encourage all women in their childbearing years to supplement with 400 mcg folic acid daily to reduce the risk of NTDs. When it comes to folic acid, timing of supplementation is key to reaping its protective effects.

Some research suggests that vitamin C may boost folate absorption as a result of the protective antioxidant properties of vitamin C, so try taking it with your vitamin C or vitamin-C-rich foods.

Whole food sources of folate.

Any woman who is thinking about getting pregnant should know the CDC’s recommendations and begin taking a prenatal vitamin with 400 mcg of folic acid at least three months before trying to get pregnant. This preconception time is a wonderful moment to re-examine and to take a good look at what is being consumed on a regular basis while continuing to incorporate well-balanced whole and minimally processed foods that provide an array of vitamins and minerals. It’s a great way of showing your body and growing baby some love.

When thinking about obtaining folate from food sources, fresh is best. Because folate is a water-soluble vitamin, it can be subject to easy degradation. This means that supplemental folate may be easily broken down and/or become unstable as a result of extended storage and being exposed to heat such as in cooking, so keep that in mind when preparing your folate-rich foods. For the veggies, I would recommend shorter cooking times and methods that do not leach nutrients from the food. The most bioavailable plant-based food sources of folate are spinach, black-eyed peas, and fortified breakfast cereals. Liver provides more than 50 percent of your daily value for folate in one serving.

According to the USDA, here are some high-folate, whole food sources:

• 3 ounces of beef liver 215 mcg/serving
• ½ cup boiled spinach 131 mcg/serving
• ½ cup black-eyed peas 105 mcg/serving
• 1 serving fortified breakfast cereal 100 mcg/serving
• 4 spears of boiled asparagus 89 mcg/serving
• 1 cup romaine lettuce 64 mcg/serving
• ½ cup avocado 59 mcg/serving

 

by Maya Feller, R.D., M.S.

Asthma medication linked to infertility in women

Women with asthma who only use short-acting asthma relievers take longer to become pregnant than other women, according to international research led by the University of Adelaide.

However, the study of more than 5600 women in Australia, New Zealand, the United Kingdom and Ireland also shows that women with asthma who use long-acting asthma preventers conceive as quickly as other women.
Published in the European Respiratory Journal, the study was led by Dr Luke Grzeskowiak from the University of Adelaide’s Robinson Research Institute.
Dr Grzeskowiak says the results provide reassurance for asthmatic women that using inhaled corticosteroids to prevent symptoms does not appear to reduce fertility.
“Five to ten per cent of all women around the world have asthma and it is one of the most common chronic medical conditions in women of reproductive age. Several studies have identified a link between asthma and female infertility, but the impact of asthma treatments on fertility has been unclear,” Dr Grzeskowiak says.

“Studying the effect of asthma treatments in women who are pregnant or trying to get pregnant is important as women often express concerns about exposing their unborn babies to potentially harmful effects of medications.”

The researchers examined data from the international Screening for Pregnancy Endpoints (SCOPE) study, which recruited more than 5600 women expecting their first babies in the early stages of pregnancy.
Ten per cent of women in the study said they had asthma and, overall, these women took longer to get pregnant.
When researchers separated this group according to the types of asthma treatments they were using, they found no difference in fertility between women using long-acting asthma treatments and women without asthma.

Women using short-acting reliever medication (known as beta-agonists) took 20% longer to conceive on average. They were also 30% more likely to have taken more than a year to conceive, which the researchers defined as the threshold for infertility.
This difference remained even after researchers took other factors known to influence fertility, such as age and weight, into account.
Dr Grzeskowiak says: “This study shows that women using short-acting asthma relievers take longer to get pregnant. On the other hand, continued use of long-acting asthma preventers to control asthma seems to protect fertility and reduce the time it takes women with asthma to become pregnant. This could lead to a reduction in the need for fertility treatments.”

“There is plenty of evidence that maternal asthma has a negative impact on the health of pregnant mothers and their babies, and so our general advice is that women should take steps to get their asthma under control before trying to conceive,” he says.
“What we don’t yet know is exactly how asthma or asthma treatments lead to fertility problems. As well as affecting the lungs, asthma could cause inflammation elsewhere in the body, including the uterus. It could also affect the health of eggs in the ovaries.
“Inhaled corticosteroids suppress the immune system, whereas short-acting asthma treatments do not alter immune function. In women who are only using relievers it’s possible that, while their asthma symptoms may improve, inflammation may still be present in the lungs and other organs in the body.”
The researchers plan further studies involving women with asthma who are undergoing fertility treatments, to see whether improving asthma control could also improve fertility outcomes.

What’s Food Got to Do With Infertility? Turns Out, A Lot!

 

A seemingly simple process of a healthy sperm meeting a healthy egg is followed by another seemingly simple process of the fertilized egg nestling itself in the specially prepared home that is the uterus, for the next 9 months.

While so much has been written about what role does diet play in the health of your heart, or on your chances of developing cancer, not much attention has been given to the effect diet has on the health of the sperm and the egg.

What’s Diet Got to Do With It?

In most cultures, the role diet plays on fertility has been a matter of fable and old wives tales of conventional wisdom and almost no science.

However, the largest and the longest running ‘Nurses Health Study’ conducted by Harvard School of Public Health, which has looked at the role of diet on various chronic health issues including fertility, has helped reduce the gap in our knowledge.

On comparing the diets, exercise, habits and other lifestyle choices of those who readily got pregnant and those who experienced ovulatory infertility, several key differences emerged.

Good Carbs vs Bad Carbs

Like all diet fads, the no carb craze which till recently had many takers, also faded away. The Nurses Health Study shows that eating lots of easily digestible carbohydrates like white sugar, white bread, soda pops etc. will increase the chances of infertility in women.

On the other hand, slowly digested carbohydrates which have fibre, such as whole grains and fresh fruit, improve fertility.

This has got something to do with what is called glycemic load, which is a measure that conveys information about how quickly carbohydrate is turned into blood sugar. Women in the highest glycemic load category were far more likely to have faced ovulatory infertility than those who had a low glycemic index. This is because the finely tuned balance of hormones needed for reproduction is disrupted by insulin levels, which become too high in response to the fast carbohydrates.

Say No to Trans Fats

There is enough evidence to show how trans fats work against ovulation. So eating artificial fat, found in your fast food, in your fried Indian food is not going to do any favours to your ability to ovulate. Instead, opt for good fat whenever possible to boost fertility.

Some recent studies have suggested that more fat in the diet and in some cases the saturated fat, for example butter and ghee, normalizes the menstrual cycle, affecting the ovulation in a positive manner. The good fats increase the insulin sensitivity and decrease inflammation – exactly the opposite of what trans fats do.

So, it is not the total quantity of carbs and fats, but the quality of these that matters when it comes to boosting your fertility.

Make Protein Your Friend

A very surprising finding that emerged from the Nurses Health Study was that adding animal protein, instead of carbohydrate, to your plate leads to a greater risk of ovulatory infertility.

So get more protein from vegetable source and less from animals.

Watch That Weight

Large deviation from the ideal body weight can disrupt normal menstrual cycles and throw ovulation completely out of gear. Women with BMI between 20 and 24 are least likely to have infertility. Same holds true for male fertility.

by Dr Ashwini Setya.

Can stress really stop you from conceiving?

It’s thought a stressful environment can impact fertility – but is there really any truth to it?

If you’ve arrived at the next stage of adulthood, and feel you’re finally ready to sacrifice Saturday morning lie-ins (or a full night’s sleep, for that matter) for baby cuddles and cooing over tiny toes, you’ll probably be reading up on how to improve your chances of conceiving.

Typical advice about how to boost your fertility might include a healthy diet, regular exercise, better sleep patterns and less stress. But sometimes it’s hard to eliminate stress – especially if the reason you’re stressed is that you’re struggling to conceive. So how much of a role does stress really play when it comes to your chances of getting pregnant?
According to Georgia Witkin, an Assistant Professor of Psychiatry and Ob/Gyn and Reproductive Sciences at Mount Sinai School of Medicine – not a lot. While research has of course demonstrated that fertility issues cause stress, there’s no evidence to say it works the other way round.

Writing for Psychology Today, Witkin rubbished “Aunt Fannie’s advice to, ‘just relax and then you’ll get pregnant’.” Labelling it a “myth”, the professor pointed out that “women can conceive under the most stressful circumstances if there is no physiological problem – even traumatised women and war prisoners often get pregnant.”

Of course, we know both physical and emotional stress can interfere with your menstrual cycle, but Witkin insists this doesn’t directly extend to fertility. “When there is a fertility problem that follows stress, the stress was most likely a trigger for a pre-existing medical condition or predisposition,” she explained.

While stress won’t physically damage the quality of an egg or sperm, what it can do is cause behaviours that might do so. “For example, women may leave fertility treatment, harm their fertility through drugs, smoking, or drinking, avoid sex, postpone child-bearing, or not follow instructions for fertility medication [when they’re stressed],” the expert said.

And backing up her point, she added: “If reproductive systems are as vulnerable to stress as many believe, the human species would have perished long ago.”

Very true.

So if you’re experiencing stress and are also struggling to get pregnant, Witkin’s fundamental advice is to look after yourself a bit more. “Be your own best friend. Stop blaming yourself and treat yourself to the same supportiveness, consideration and respect you give to others you love,” she said.

Eventually, you’ll start to relieve stress, and while this won’t boost your physical fertility, it’ll certainly make the whole process of trying to conceive a lot more enjoyable for you.

By Catriona Harvey-Jenner