"Let's Move!" She Said.

When I was a child I walked everywhere with my mum - to and from school, and then to and from the grocery store and everywhere else in between. I never complained about it, everybody did it. Physical exercise was part and parcel of everyday life. In fact, we never thought to use the remote control for the T.V.  And words like “weight loss” or “diet” just weren’t part of my vocabulary back then 40 odd years ago.

Today I experience a very different kind of life style.  I find myself irritated when I can’t park my car as close to the stores as I would like. Taking the stairs is something that I remind myself to do, not something that occurs naturally anymore.  I go to the gym specifically to exercise, forgetting that I can do this without a treadmill and a 20 lb dumbbell. Today, I read the fat and sugar nutritional content on the back packages and then return it to the shelf.

I know I’m not alone.

"The physical and emotional health of an entire generation and the economic health and security of our nation is at stake." - First Lady Michelle Obama at the Let’s Move! launch on February 9, 2010

According to the American Heart Association, childhood obesity rates in America have tripled over the past three decades. One in three children ages 2 to 19 are overweight, and one in six are obese. Overall, overweight and obese children are more likely enter in to adulthood in the same way.

Let’s Move! The initiative launched by the First Lady, is dedicated to solving the challenge of childhood obesity within a generation.  It provides parents with helpful information to foster an environment that supports healthy choices. The campaign involves changing the way children eat, awareness of dietary choices and of course, helping kids become more physically active.

Although we know that (childhood) obesity means more type II diabetes, more high blood pressure, more asthma and more heart disease at younger ages, we forget that overweight men and women are also more likely to have reproductive problems. And given the record low fertility rates in the US, falling below the replacement rate, one can’t help but wonder if obesity and lowered fertility rates are somehow linked.

In a recent report published in Frontiers in Endocrinology, researchers suggest that childhood obesity "may disrupt timing of puberty in girls” and can lead to poorer reproductive systems.

How? In part, the answer lies in the fat stored in our bodies. Fat produces a protein called Leptin. Leptin induces the production of another hormone called Kisspeptin, which triggers the production of reproductive hormones involved in menstruation.

A high fat diet causes the brain to become unresponsive to Leptin, which may then alter the normal secretion of Kisspeptin, resulting in imbalances in fertility hormones and irregular menstrual cycles.

In fact, irregular cycles and anovulation “is probably the most common side effect of obesity itself”. And “If the reproductive 'thermostat' is not set properly at the time of menarche,…… there’s a lifelong problem even with further weight loss” are the thoughts of  Robert Matteri M.D., the Medical Director of Oregon Medicine.

 Ultimately if this is true, it may complicate or add to some of the fertility problems we now see such as polycystic ovarian syndrome (PCOS).

PCOS is typically caused by hormonal imbalance exacerbated by insulin resistance-related obesity. It's a disorder that affects an estimated 5 - 10 percent of women.  Characterized by multiple abnormal cysts in the ovaries and higher than normal male hormone levels, it can cause fertility problems.

Although the relationship between PCOS and obesity needs to be clearly determined- not all women who have PCOS are obese, and not all obese women have PCOS, a good diet from an early age, together with regular exercise can go a long way.  Experts believe that even thin women with pcos benefit from a low-carbohydrate diet that helps to balance insulin resistance.

The Let’s Move campaign helps with this in two big ways; a healthy diet, one that’s low in refined carbohydrates (sugar, white bread, pasta, pastries, white rice, etc.) and processed foods can prevent insulin resistance. Regular exercise may help to prevent weight problems, insulin and blood sugar problems as well as any future diseases like diabetes.

So Let’s Move, move away very fast in the opposite direction.

Fenella Das Gupta is a licensed Marriage and Family Therapist ( #47275) working in Northern California,specializing in fertility counseling. She works with individuals and couples as they make their way through the fertility maze.