Metabolism, Fertility, & Extinction

93% of American adults have metabolic dysfunction. NINETY-THREE.

Metabolism is how we convert food energy to cellular energy. All the reactions require cellular energy. Our bodies in the western world are broken right now. If we have problems with making energy, we will have problems with successful pregnancies both on the male and female side of things.

Research suggests infertility rates are up 15% since 1900 (.37% per year of infertility rates increasing). In one year, this may seem like a small amount, but when you look at the future and the trajectory of this...it starts to become concerning. We are NOT at risk of overpopulation, that much I can tell you.

The body is being so overpowered that it is shutting its ability to procreate down. What does this say about our modern lifestyle?

For women, a big factor of why this is happening is infertility due to PCOS - one of the leading causes of infertility in the US (and globally).

At least 12% of women (some stats show 26% globally) are affected by this and we now know that PCOS is fundamentally interlinked with metabolism.

So much so that the NIH tried to change the name of PCOS to Metabolic Reproductive Syndrome in 2012. They failed, but I encourage you to keep this new name in mind because that is exactly what it is.

One very prominent characteristic of PCOS is Hyperinsulinemia (high insulin levels) this high insulin will then stimulate the theca cells of ovaries to produce more testosterone. This creates a problem with the delicate balance of sex hormones that have to be in perfect harmony for ovulation and fertility to occur.

This doesn't even touch on the comorbidities of PCOS. 80% of women with PCOS are dealing with obesity. 50% of women by the age of 40 (if they have PCOS) will develop Type II Diabetes. Why do we wait this long for intervention? Not to mention women with PCOS are 5X more like to experience an eating disorder and are at higher risk for anxiety and depression. Did you know that it takes almost 2-2.5 years on average for a woman to receive this diagnosis?

For males, sperm quality and count are decreasing. Sperm count is down 50% over the past 100 years....is this not a public health emergency?!

Research out of Harvard shows that men who are dealing with obesity have a 42% higher chance of having lower sperm count than those of normal weight. There's also an 81% chance of having zero sperm in their semen (azoospermia) compared to people of normal weight.

One thing to be hyper aware of is that fat tissue is an endocrine organ. The visceral metabolically unhealthy fat around men's mid-section can act like a giant ovary. It converts testosterone into estrogen. This impairs spermatogenesis (ability for sperm to be produced).

High blood sugar levels alone increase free radicals and excess estrogen. Oxidative damage in sperm (metabolic dysfunction and high blood sugar levels) can also result in miscarriages.

Pregnancy outcomes with metabolic dysfunction and blood sugar are even worse.

The health at every size hypothesis is exacerbating the problem. We're trying to glorify a disease state that is leading to the decline of our species. You can love yourself and recognize that you're in a disease state and strive to be healthier. Two things can be true at once.

There seems to be a large genetic (And epigenetic) component part to PCOS. But there is so much research to show the dietary and lifestyle interventions that impact the insulin resistance pathway are extremely affective for women with PCOS. Regardless of genetics, the behavioral side of things can be profoundly effective.

A 2021 study took a group of women with PCOS and very prominent hormonal and metabolic biomarkers and put them on a very strategic dietary intervention which was focused on high quality Mediterranean whole foods (low glycemic) but not entirely restrictive. They were allowed unlimited leafy greens, low glycemic plant foods, moderate amounts of high-quality fish and poultry, no grains and then added a polyphenol supplement. In 12 weeks, the group of women lost an average of 20 pounds and had very statistically significant positive changes in hormonal, metabolic, & insulin sensitivity markers. There are many of these studies to support lifestyle changes to manage insulin sensitivity.

Diet should be first line for all doctors to discuss. CGM's (continuous glucose monitors) should be available at an affordable cost for everyone.

& for those women who don't care to have children (to each their own!) please know that there are alternative options to avoid reproducing. Driving your metabolic health into the ground is not the answer because this will affect your long-term quality of life.

All this to be said, I find joy in educating people on the facts about metabolic health. I am a health coach in my free time because it's a passion of mine. I have helped hundreds of people with their fitness & health journey and it truly brings a smile to my face. As a woman who manages her PCOS through lifestyle interventions, dietary approaches, & peptide therapy, I know what these metabolic issues feel like.

We shouldn't let that be an excuse.

We (both men and women) should question, dig, research, and adjust our habits accordingly.

Strive for excellence in every area of your life.

**Selin Steinacher is not a physician. Selin Steinacher is not a physician. The contents of this article should not be taken as medical advice. It is not intended to diagnose, treat, cure, or prevent disease. This is not intended to replace the advice of a physician. Always consult your physician or qualified health professional on any matters regarding your health and before physical activity or diet changes.